Metabolic changes that facilitate tumor growth are one of the hallmarks of cancer. The triggers of these metabolic changes are located in the tumor parenchymal cells, where oncogenic mutations induce an imperative need to proliferate and cause tumor initiation and progression. Cancer cells undergo significant metabolic reorganization during disease progression that is tailored to their energy demands and fluctuating environmental conditions. Oxidative stress plays an essential role as a trigger under such conditions. These metabolic changes are the consequence of the interaction between tumor cells and stromal myofibroblasts. The metabolic changes in tumor cells include protein anabolism and the synthesis of cell membranes and nucleic acids, which all facilitate cell proliferation. They are linked to catabolism and autophagy in stromal myofibroblasts, causing the release of nutrients for the cells of the tumor parenchyma. Metabolic changes lead to an interstitium deficient in nutrients, such as glucose and amino acids, and acidification by lactic acid. Together with hypoxia, they produce functional changes in other cells of the tumor stroma, such as many immune subpopulations and endothelial cells, which lead to tumor growth. Thus, immune cells favor tissue growth through changes in immunosuppression. This review considers some of the metabolic changes described in breast cancer.

GRB2-associated binder 1 (GAB1) is the inaugural member of the GAB/DOS family of pleckstrin homology (PH) domain-containing proteins. Upon receiving various stimuli, GAB1 transitions from the cytoplasm to the membrane where it is phosphorylated by a range of kinases. This event recruits SH2 domain-containing proteins like SHP2, PI3K’s p85 subunit, CRK, and others, thereby activating distinct signaling pathways, including MAPK, PI3K/AKT, and JNK. GAB1-deficient embryos succumb in utero, presenting with developmental abnormalities in the heart, placenta, liver, skin, limb, and diaphragm myocytes. Oncogenic mutations have been identified in the context of cancer. GAB1 expression levels are disrupted in various tumors, and elevated levels in patients often portend a worse prognosis in multiple cancer types. This review focuses on GAB1’s influence on cellular transformation particularly in proliferation, evasion of apoptosis, metastasis, and angiogenesis—each of these processes being a cancer hallmark. GAB1 also modulates the resistance/sensitivity to antitumor therapies, making it a promising target for future anticancer strategies.

Introduction: Nurses play a crucial role in global health promotion, and innovative teaching strategies are vital to addressing modern educational challenges. Service-learning, a credit-based approach, integrates community service with academic learning, enhancing students' understanding of course content while fostering civic values. Although established in the United States of America and growing in Europe, most studies on service-learning focus on student learning outcomes, often overlooking its impact on the communities served. Aims: The purpose of this study is to test whether the service-learning practice of nursing students teaching a pharmacology curriculum topic to school children promotes knowledge of the topic in both the nursing students and the school children. Design: This research involves two pretest-posttest quantitative analyses and two satisfaction surveys. Participants: Seventy-six nursing students participated during the 2022-2023 academic year, and 69 primary school pupils received the service-learning intervention. Results: Post-test scores of nursing students were significantly higher than pre-test scores (p = 0.0009). The percentage of correct answers post-intervention was significantly higher than pre-intervention (p < 0.0001). Additionally, 98.7 % of nursing students found the service-learning experience beneficial for learning, and 94.7 % reported increased social awareness. For the school children, the percentage of correct responses after the service-learning experience was statistically significantly higher than before the activity (p < 0.0001). The percentage of correct answers from pupils in each primary grade (fourth, fifth, and sixth) was statistically significantly higher after the application of the learning experience compared to before (p < 0.0001, p < 0.0001, and p < 0.001, respectively). The satisfaction survey indicated high acceptance of the methodology among both nursing students and school pupils. Conclusions: Service-learning enhances knowledge of the pharmacology topic in both nursing students and school children.

Effective pain management is central to anesthesia, critical care, and perioperative medicine, and opioids remain essential agents for moderate-to-severe pain despite ongoing concerns regarding their safety and misuse. This narrative review synthesizes the current knowledge on opioid mechanisms, clinical indications, safety considerations, and evolving strategies aimed at optimizing their use. Opioids exert their analgesic effects primarily through μ-, δ-, and κ-opioid receptors, which modulate central and peripheral nociceptive pathways. They maintain a well-established role in acute postoperative and cancer-related pain, whereas their use in chronic non-cancer pain remains controversial. Contemporary evidence suggests that physiological dependence and addiction are less frequent in appropriately selected and monitored patients, although the risk increases in the presence of psychological comorbidity, prior substance use, or adverse social determinants of health. Unequal access, prescribing variability, and persistent disparities further complicate global opioid management strategies. Recent advances, including partial agonists such as buprenorphine, dual-mechanism agents such as tapentadol, individualized titration, opioid rotation, and the integration of multimodal analgesia, support safer and more tailored prescribing. Non-pharmacological interventions, including behavioral and physical therapies, increasingly complement pharmacological strategies to minimize opioid exposure and improve functional outcomes. Clinicians must balance analgesic efficacy with adverse effects, such as tolerance, opioid-induced hyperalgesia, sedation, and respiratory depression, particularly in perioperative and critically ill populations. Opioids remain indispensable for selected indications but should be incorporated into a comprehensive, patient-centered, multimodal analgesic approach that prioritizes safety, ongoing reassessment, and individualized risk mitigation.

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.

Antimicrobial resistance is currently a global health threat. Numerous efforts have been made to prevent or mitigate this phenomenon, but all have been insufficient. Although numerous studies have postulated nursing as a potential mediator to address this problem, no research has been conducted to put it into practice. This study aims to contextualize the problem of inappropriate antibiotic use and antimicrobial resistance, as well as to develop and implement a nurse-led educational intervention aimed at mitigating it, emphasizing the role of nurses in health education. Two different groups of participants were recruited using convenience sampling. Nurses administered a survey to 782 citizens in a population from Spain to assess their knowledge of the correct use of antibiotics and antimicrobial resistance. After completing the survey, nurses explained to the participants how to use antibiotics correctly and the problem of antimicrobial resistance. Furthermore, an educational intervention led by nurses was carried out with 104 adolescents, consisting of an oral presentation to raise awareness about the issue. The effectiveness of this intervention was evaluated through a comparative analysis before and after the activity (pre-test and post-test). Our results indicated that the level of knowledge about the correct use of antibiotics and antimicrobial resistance is not statistically significant related to sex in the general population (p > 0.05). However, it is statistically significant related to age (p < 0.05), educational level (p < 0.0001) and study area (p < 0.0001). In addition, the nurse-led educational intervention increased significantly the level of knowledge on the topic among adolescents (p < 0.0001). These findings highlight the low level of knowledge in the population about the correct use of antibiotics and antimicrobial resistance. It also demonstrates how nurses, through their role in health education, can actively contribute to addressing the issue, providing a rationale for the inclusion of nursing in the design and implementation of strategies to prevent or mitigate antimicrobial resistance.