RESUMEN

BACKGROUND: HPV self-sampling has been widely supported by the scientific community following a strong body of literature on the subject. Self-sampling is important in cervical cancer screening as it has been shown to improve participation. It is well documented that HPV-testing has proven superior to cytology with regards to sensitivity in detection of CIN and cancer. The value of self-collected samples is reliant on the quality of the molecular testing performed, as well as the patients' preference in sampling procedure and compliance to follow up on positive test results. Due to the incompatibility of self-samples and cytology, triage of HPV-DNA positives by testing for molecular biomarkers is highly warranted. METHODS: Our objective was to compare the detection rate of genital Human Papillomavirus (HPV) infection in self- and clinician-collected samples by a 14-type HPV-DNA test and a 7-type mRNA E6/E7 test. RESULTS: Five hundred five women were recruited. Each study participant had two sample collection procedures performed upon the same visit, alternating order in execution of the self-collection or the clinician-taken procedure first or second, 1010 samples in total. HPV-DNA prevalence was 22.8% in self-collected versus 19.2% in clinician-collected samples (P = 0.19). Overexpression of mRNA E6/E7 from 7 HPV types was 7.1 and 6.3%, respectively (P = 0.71). The difference between HPV-DNA and HPV-mRNA positivity rates were statistically significant in both self-collected (22.8% versus 7.1%, P < 0.001) and clinician-collected samples (19.2% versus 6.3%, P < 0.001). Overall agreement between the two collection methods was fair, with a concordance rate of 78.2% (390/505), k = 0.34 (95% CI: 0.25-0.44), P < 0.001, for the HPV-DNA test and 92.5% (467/505), k = 0.40 (95% CI, 0.25-0.56), P < 0.001, for the mRNA test, respectively. 96.8% of the participants reported they felt confident carrying out the self-collection themselves, and 88.8% reported no discomfort at all performing the procedure. CONCLUSIONS: This comparative study of two sampling methods reports fair agreement of HPV positivity rates between the self-collected and clinician-collected specimens using Abbott hrHPV and PreTect HPV-Proofer'7 tests. Only one third of HPV-DNA positive women had overexpression of mRNA E6/E7. TRIAL REGISTRATION: ISRCTN77337300 .

Asunto(s)

Técnicas de Diagnóstico Molecular/métodos , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Manejo de Especímenes/métodos , Adulto , ADN Viral/genética , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae/genética , ARN Mensajero/genética , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología

RESUMEN

In this work, pH-sensitive hydrogel nanoparticles based on N-isopropyl acrylamide (NIPAM) and methacrylic acid (MAA) at various molar ratios, were synthesized and characterized in terms of physicochemical and biological properties. FTIR and 1HNMR spectra confirmed the successful synthesis of the copolymer that formed nanoparticles. AFM images and FE-SEM micrographs showed that nanoparticles were spherical, but their round-shape was slightly compromised with MAA content; besides, the size of particles tends to decrease as MAA content increased. The hydrogels nanoparticles also exhibited an interesting pH-sensitivity, displaying changes in its particle size when changes in pH media occurred. Biological characterization results indicate that all the synthesized particles are non-cytotoxic to endothelial cells and hemocompatible, although an increase of MAA content leads to a slight increase in the hemolysis percentage. Therefore, the pH-sensitivity hydrogels may serve as a versatile platform as self-regulated drug delivery systems in response to environmental pH changes.

Asunto(s)

Acrilamidas/síntesis química , Hidrogeles/síntesis química , Ácidos Polimetacrílicos/síntesis química , Acrilamidas/química , Acrilamidas/farmacología , Animales , Células Sanguíneas/efectos de los fármacos , Células Sanguíneas/fisiología , Bovinos , Células Cultivadas , Liofilización , Hemólisis/efectos de los fármacos , Humanos , Hidrogeles/química , Hidrogeles/farmacología , Concentración de Iones de Hidrógeno , Ensayo de Materiales , Metacrilatos/síntesis química , Metacrilatos/química , Nanopartículas/química , Tamaño de la Partícula , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/farmacología , Pruebas de Toxicidad

RESUMEN

Astrocytes express gap junction proteins and multiple types of P2Y receptors (P2YRs) that contribute to the propagation of intercellular Ca(2+) waves (ICW). To gain access to the role played by gap junctional communication in ICW propagation generated by P2YR activation, we selectively expressed P2Y(1,2,4)R subtypes and Cx43 in the human 1321N1 astrocytoma cell line, which lacks endogenous P2 receptors. Fluorescence recovery after photobleaching revealed that 1321N1 cells are poorly dye-coupled and do not propagate ICW. Forced expression of Cx43 in 1321N1 cells (which did not show functional hemichannels) increased dye coupling and allowed short-range ICW transmission that was mainly mediated by intercellular diffusion of Ca(2+) generated in the stimulated cells. Astrocytoma clones expressing each of the P2YR subtypes were also able to propagate ICWs that were likely dependent on IP(3) generation. These waves exhibited properties particular to each P2YR subtype. Co-expression of eGFP-hCx43 and P2Y(1)R modified the properties of P2Y(1)R-generated ICW to those characteristics of P2Y(2)R. Increased coupling in P2Y(4)R clones induced by expression of eGFP-hCx43 abolished the ICWs observed in uncoupled P2Y(4)R clones. No changes in the behavior of ICWs generated in P2Y(2)R clones were observed after forced expression of Cx43. These data indicate that in 1321N1 cells gap junctional communication provides intercellular integration of Ca(2+) signals generated by P2YR activation, thus coordinating the propagation of intercellular calcium waves.

Asunto(s)

Astrocitos/metabolismo , Señalización del Calcio/genética , Membrana Celular/metabolismo , Uniones Comunicantes/metabolismo , Receptores Purinérgicos P2/metabolismo , Animales , Astrocitoma , Calcio/metabolismo , Comunicación Celular/genética , Línea Celular Tumoral , Células Clonales/metabolismo , Conexina 43/genética , Conexina 43/metabolismo , Difusión , Recuperación de Fluorescencia tras Fotoblanqueo , Colorantes Fluorescentes , Uniones Comunicantes/efectos de los fármacos , Humanos , Inositol 1,4,5-Trifosfato/metabolismo , Líquido Intracelular/metabolismo , Ratones , Ratas , Receptores Purinérgicos P2/genética , Receptores Purinérgicos P2Y1 , Receptores Purinérgicos P2Y2

RESUMEN

The objective of this communication is to present a patient case with ovarian borderline tumor. The conservative management for laparoscopy, and we performed an analysis of the mundial literature in which respect to the conservative and laparoscopy management, in spite of the laparoscopy management are of controversy.

Asunto(s)

Cistoadenoma , Laparoscopía , Neoplasias Ováricas , Adulto , Cesárea , Cistoadenoma/diagnóstico , Cistoadenoma/patología , Cistoadenoma/cirugía , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Ovariectomía , Ovario/patología , Embarazo , Complicaciones Neoplásicas del Embarazo , Factores de Tiempo

RESUMEN

The clinical investigations with three types of a three days regimen of amocarzine permitted to adjust the fixed dosing to the body weight related dosing and subsequently the administration of amocarzine from fasting state to drug intake after food. The main objective to reach a dose with predictable and sustained absorption was achieved, and this in turn proved to be onchocercacidal and safe. A combined clinicopharmacokinetic study showed enhancement and consistency of amocarzine absorption after food. Quantitative assessment of the urinary excretion confirmed the presence of the N-oxide metabolite, which qualitatively was visible by a urine colorimetry. This assay proved useful for drug monitoring. Ultrasonography of onchocercal skin nodules detected changes within the nodules following amocarzine therapy. Histology after nodul-ectomy at four months post-therapy showed that 57% of the female worms were dead, 24% necrobiotic, and 19% alive; male worms were more necrobiotic. Skin microfilariae were reduced within one week to about 10% of the initial level and after one year they remained at about 20%. Skin punch biopsies on day 5 showed that most microfilariae were dead or moribund. Ocular reduction of microfilariae was also observed, although it was slower than in the skin. The visual acuity improved within the one year's observation time. Ocular and clinical tolerability was good, with one exception of neurological disturbance, which was fully reversible. Sequential testing of the liver function showed average values within the normal range. In conclusion, a repeat low dose regimen of amocarzine (3 mg/kg twice daily post-prandially for three consecutive days) was well absorbed with predictable plasma levels, macro- and microfilaricidal with good local and systemic tolerability in patients with moderate to heavy onchocerciasis. Amorcarzine is recommended for further clinical investigations, particularly in females and juveniles. Urine colorimetry and nodular ultrasonography are recommended for optional monitoring of amocarzine.

Asunto(s)

Filaricidas/uso terapéutico , Onchocerca/efectos de los fármacos , Oncocercosis/tratamiento farmacológico , Piperazinas/uso terapéutico , Administración Oral , Adulto , Animales , Disponibilidad Biológica , Esquema de Medicación , Tolerancia a Medicamentos , Ojo/parasitología , Femenino , Filaricidas/administración & dosificación , Filaricidas/farmacocinética , Filaricidas/farmacología , Guatemala , Humanos , Masculino , Microfilarias/efectos de los fármacos , Oncocercosis/diagnóstico por imagen , Oncocercosis/parasitología , Oncocercosis Ocular/diagnóstico por imagen , Oncocercosis Ocular/tratamiento farmacológico , Oncocercosis Ocular/parasitología , Piperazinas/administración & dosificación , Piperazinas/farmacocinética , Piperazinas/farmacología , Piel/parasitología , Ultrasonografía

RESUMEN

Three out of four cases of snake bite by Lachesis muta stenophrys (Bushmaster) in Costa Rica were fatal and one recovered after a long period of hospitalization. Initial symptoms were similar to those of bothropic envenomation: intense pain, nausea, vomiting, sweating, and excitability, but differing in the magnitude of a tremendous edema and in the absence of intensive bleeding and phlyctenae. We found important alterations in arterial blood pressure and in the activity and concentration of coagulation factors. All patients showed infections, and necrosis was found in at least three of them.

Asunto(s)

Mordeduras de Serpientes , Antivenenos/administración & dosificación , Trastornos de la Coagulación Sanguínea/etiología , Pruebas de Coagulación Sanguínea , Costa Rica , Venenos de Crotálidos , Humanos , Músculos/patología , Necrosis , Mordeduras de Serpientes/terapia

RESUMEN

De cuatro casos comprobados de accidente ofidico por Lachesis muta stenophrys (Cascabela Muda o Mata Buey), tres fueron fatales y uno se curo luego de un largo periodo de hospitalizacion. Ademas de una sintomatologia inicial similar a la del envenenamiento bothropico, consistente en dolor intenso, sudoracion, vomito, excitabilidad, mareos, etc., pudimos notar diferencias fundamentales como son un edema impresionante, la ausencia de un sangrado profuso y de flictenas. Hubo descensos importantes en la presion arterial y en la actividad y concentracion de factores de coagulacion. Todos los pacientes mostraron infeccion bacteriana importante y al menos tres de ellos necrosis muscular en el miembro afectado

Asunto(s)

Humanos , Trastornos de la Coagulación Sanguínea , Mordeduras de Serpientes , Venenos de Serpiente