RESUMEN

PURPOSE: To evaluate the efficacy and safety of first-line therapy with palbociclib in a Spanish cohort treated after palbociclib approval. METHODS: PALBOSPAIN is an observational, retrospective, multicenter study evaluating real-world patterns and outcomes with 1 L palbociclib in men and women (any menopausal status) with advanced HR+/HER2- BC diagnosed between November 2017 and November 2019. The primary endpoint was real-world progression-free survival (rw-PFS). Secondary endpoints included overall survival (OS), the real-world response rate (rw-RR), the clinical benefit rate, palbociclib dose reduction, and safety. RESULTS: A total of 762 patients were included. The median rw-PFS and OS were 24 months (95% CI 21-27) and 42 months (40-not estimable [NE]) in the whole population, respectively. By cohort, the median rw-PFS and OS were as follows: 28 (95% CI 23-39) and 44 (95% CI 38-NE) months in patients with de novo metastatic disease, 13 (95% CI 11-17) and 36 months (95% CI 31-41) in patients who experienced relapse < 12 months after the end of ET, and 31 months (95% CI 26-37) and not reached (NR) in patients who experienced relapse > 12 months after the end of ET. rw-PFS and OS were longer in patients with oligometastasis and only one metastatic site and those with non-visceral disease. The most frequent hematologic toxicity was neutropenia (72%; grade ≥ 3: 52.5%), and the most common non-hematologic adverse event was asthenia (38%). CONCLUSION: These findings, consistent with those from clinical trials, support use of palbociclib plus ET as 1 L for advanced BC in the real-world setting, including pre-menopausal women and men. TRIAL REGISTRATION NUMBER: NCT04874025 (PALBOSPAIN). Date of registration: 04/30/2021 retrospectively registered.

Asunto(s)

Neoplasias de la Mama , Piperazinas , Piridinas , Receptor ErbB-2 , Humanos , Piridinas/uso terapéutico , Piridinas/efectos adversos , Piridinas/administración & dosificación , Femenino , Piperazinas/uso terapéutico , Piperazinas/administración & dosificación , Piperazinas/efectos adversos , Persona de Mediana Edad , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/metabolismo , Anciano , Adulto , Masculino , Estudios Retrospectivos , Receptor ErbB-2/metabolismo , Anciano de 80 o más Años , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Inhibidores de Proteínas Quinasas/uso terapéutico , Inhibidores de Proteínas Quinasas/efectos adversos , Inhibidores de Proteínas Quinasas/administración & dosificación , Supervivencia sin Progresión

RESUMEN

La insuficiencia ovárica primaria es una condición en la que las mujeres menores de 40años experimentan oligomenorrea o amenorrea durante 4meses o más; esta pérdida temprana de la función ovárica puede estar relacionada con una serie de etiologías, incluidos trastornos genéticos, autoinmunes, infecciones o causas iatrogénicas; no obstante, del 74 al 90% son idiopáticas. A pesar de ser una alteración poco prevalente, es de gran importancia clínica, ya que afecta en múltiples aspectos de la vida a todas las mujeres. En la actualidad se están desarrollando diferentes estudios con el fin de encontrar nuevos blancos moleculares para establecer nuevas terapias para el tratamiento de esta patología.(AU)

---

Primary ovarian failure is a condition in which women under 40 experience oligomenorrhea or amenorrhea for 4months or longer; this early ovarian function loss may be related to a series of etiologies, including genetic disorders, autoimmune diseases, infections or iatrogenic causes; however 74%-90% are idiopathic. Despite being a less prevalent disorder, it is of great clinical importance since it affects all women in multiple aspects of life. At present, different studies are being developed in order to find new molecular targets to establish new therapies for the treatment of this pathology.(AU)

Asunto(s)

Humanos , Femenino , Oligomenorrea , Amenorrea , Insuficiencia Ovárica Primaria/epidemiología , Insuficiencia Ovárica Primaria/prevención & control , Ginecología , Enfermedades del Ovario , Calidad de Vida , Insuficiencia Ovárica Primaria/diagnóstico , Insuficiencia Ovárica Primaria/fisiopatología , Insuficiencia Ovárica Primaria/terapia

RESUMEN

Spatial cognition research requires behavioral paradigms that can distinguish between different navigational elements, such as allocentric (map-like) navigation and egocentric (e.g., body centered) navigation. To fill this need, we developed a flexible experimental platform that can be quickly modified without the need for significant changes to software and hardware. In this paper, we present this inexpensive and flexible behavioral platform paired with software which we are making freely available. Our behavioral platform serves as the foundation for a range of experiments, and though developed for assessing spatial cognition, it also has applications in the non-spatial domain of behavioral testing. There are two components of the software platform, 'Maze' and 'Stim Trigger'. Both programs can work in conjunction with electrophysiology acquisition systems, allowing for precise time stamping of neural events with behavior. The Maze program includes functionality for automatic reward delivery based on user defined zones. 'Stim Trigger' permits control of brain stimulation via any equipment that can be paired with an Arduino board. We seek to share our software and leverage the potential by expanding functionality in the future to meet the needs of a larger community of researchers.

RESUMEN

Introducción: La enfermedad de Pompe es una miopatía metabólica rara con espectro clínico heterogéneo, especialmente la de inicio tardío, cuya sintomatología es de progresión más lenta y representa un gran reto diagnóstico. Objetivo: Describir el genotipo y las características clínicas de pacientes mexicanos con Pompe de inicio tardío (LOPD). Material y métodos. Se incluyó a 19 pacientes mexicanos con LOPD confirmada mediante actividad enzimática y estudio molecular del gen GAA. Se evaluaron datos clínicos y se revisaron las mutaciones en bases de datos genómicas. Resultados: La mediana de edad de inicio de los síntomas fue de 19 años (rango: 2-43 años), y la edad de diagnóstico, de 36 años (rango: 9-52 años). Los síntomas más frecuentes fueron debilidad axial y proximal (n = 17; 89,5%), marcha basculante (n = 17; 89,5%) e hiperlordosis (n = 7; 36,8%). A 16 pacientes (84,2%) se les realizó electromiografía; 11 (57,8%) describieron patrón miopático y sólo en cinco pacientes (26%) se incluyó la valoración de los músculos paraespinales. Las variantes patogénicas más frecuentes en nuestra casuística fueron c.-32-13T>G, c.1799G>A y c.1082C>T. Conclusiones: Parecido a lo comunicado en publicaciones internacionales, la LOPD en México es clínicamente heterogénea; los pacientes pueden tardar años en llegar al diagnóstico. La debilidad muscular axial y proximal es el dato clínico más frecuente, por lo que la electromiografía debe incluir valoración de los músculos paraespinales. A excepción de una, las mutaciones encontradas en nuestra serie de casos se encuentran previamente descritas en las bases de datos de enfermedad de Pompe.(AU)

---

Introduction: Pompe disease (PD) is a rare metabolic myopathy with an ample and heterogeneous clinical spectrum, particularly late onset PD (LOPD), which is characterized by appearance at older age and slower disease progression, leading to diagnostic confirmation difficulty and delay. Aim: To describe the genotype and clinical characteristics of Mexican patients with LOPD. Material and methods: Clinical information from 19 Mexican patients with LOPD confirmed with enzyme activity and GAA gene analysis was reviewed. Genetic information of our population was crossed with international genetic databases. Results: Median age between onset of symptoms and diagnosis was 19 years (range 2-43) and diagnostic confirmation 36 years (range 9-52). Most frequently referred symptoms were proximal axial weakness (n = 17; 89.5%), waddling gait (n = 17; 89.5%) and hyperlordosis (n = 7; 36.8%). Sixteen patients (84.2%) were evaluated with electromyography; a myopathic pattern was reported in 11 (57.8%), but only in 5 patients (26%) paraspinal muscle evaluation was included. The most pathogenic mutations in our group were c.-32-13T>G, c.1799G>A and c.1082C>T. Conclusions: Similar to other international publications, LOPD in Mexico is clinically heterogeneous; patients may delay years before diagnosis is established. Axial and proximal weakness is the most frequent clinical feature; thus, electromyography with paraspinal muscle evaluation is essential. Except for one, the mutations found in our patients have been previously reported in PD genetic databases.(AU)

Asunto(s)

Humanos , Masculino , Femenino , Enfermedad del Almacenamiento de Glucógeno Tipo II , Grupos Diagnósticos Relacionados , Debilidad Muscular , Miopía , México , Neurología , Electromiografía

RESUMEN

INTRODUCTION: Pompe disease (PD) is a rare metabolic myopathy with an ample and heterogeneous clinical spectrum, particularly late onset PD (LOPD), which is characterized by appearance at older age and slower disease progression, leading to diagnostic confirmation difficulty and delay. AIM: To describe the genotype and clinical characteristics of Mexican patients with LOPD. MATERIAL AND METHODS: Clinical information from 19 Mexican patients with LOPD confirmed with enzyme activity and GAA gene analysis was reviewed. Genetic information of our population was crossed with international genetic databases. RESULTS: Median age between onset of symptoms and diagnosis was 19 years (range 2-43) and diagnostic confirmation 36 years (range 9-52). Most frequently referred symptoms were proximal axial weakness (n = 17; 89.5%), waddling gait (n = 17; 89.5%) and hyperlordosis (n = 7; 36.8%). Sixteen patients (84.2%) were evaluated with electromyography; a myopathic pattern was reported in 11 (57.8%), but only in 5 patients (26%) paraspinal muscle evaluation was included. The most pathogenic mutations in our group were c.-32-13T>G, c.1799G>A and c.1082C>T. CONCLUSIONS: Similar to other international publications, LOPD in Mexico is clinically heterogeneous; patients may delay years before diagnosis is established. Axial and proximal weakness is the most frequent clinical feature; thus, electromyography with paraspinal muscle evaluation is essential. Except for one, the mutations found in our patients have been previously reported in PD genetic databases.

---

TITLE: Enfermedad de Pompe de inicio tardío: análisis de una casuística de 19 pacientes mexicanos.Introducción. La enfermedad de Pompe es una miopatía metabólica rara con espectro clínico heterogéneo, especialmente la de inicio tardío, cuya sintomatología es de progresión más lenta y representa un gran reto diagnóstico. Objetivo. Describir el genotipo y las características clínicas de pacientes mexicanos con Pompe de inicio tardío (LOPD). Material y métodos. Se incluyó a 19 pacientes mexicanos con LOPD confirmada mediante actividad enzimática y estudio molecular del gen GAA. Se evaluaron datos clínicos y se revisaron las mutaciones en bases de datos genómicas. Resultados. La mediana de edad de inicio de los síntomas fue de 19 años (rango: 2-43 años), y la edad de diagnóstico, de 36 años (rango: 9-52 años). Los síntomas más frecuentes fueron debilidad axial y proximal (n = 17; 89,5%), marcha basculante (n = 17; 89,5%) e hiperlordosis (n = 7; 36,8%). A 16 pacientes (84,2%) se les realizó electromiografía; 11 (57,8%) describieron patrón miopático y sólo en cinco pacientes (26%) se incluyó la valoración de los músculos paraespinales. Las variantes patogénicas más frecuentes en nuestra casuística fueron c.-32-13T>G, c.1799G>A y c.1082C>T. Conclusiones. Parecido a lo comunicado en publicaciones internacionales, la LOPD en México es clínicamente heterogénea; los pacientes pueden tardar años en llegar al diagnóstico. La debilidad muscular axial y proximal es el dato clínico más frecuente, por lo que la electromiografía debe incluir valoración de los músculos paraespinales. A excepción de una, las mutaciones encontradas en nuestra serie de casos se encuentran previamente descritas en las bases de datos de enfermedad de Pompe.

Asunto(s)

Enfermedad del Almacenamiento de Glucógeno Tipo II , Enfermedades Musculares , Adolescente , Adulto , Edad de Inicio , Niño , Preescolar , Enfermedad del Almacenamiento de Glucógeno Tipo II/diagnóstico , Enfermedad del Almacenamiento de Glucógeno Tipo II/epidemiología , Enfermedad del Almacenamiento de Glucógeno Tipo II/genética , Humanos , México/epidemiología , Mutación , Adulto Joven , alfa-Glucosidasas/genética

RESUMEN

La preeclampsia es una patología con una importante incidencia a nivel mundial que se encuentra asociada directamente con el 15% de las muertes maternas. Esta se caracteriza usualmente por la presencia de hipertensión y proteinuria, que se manifiestan desde la mitad de la gestación. Los microARN son moléculas de ARN monocatenario que actúan principalmente degradando el ARN mensajero transcrito o inhibiendo la traducción de microARN. Los microARN placentarios ejercen un papel en el crecimiento y función de la placenta, se considera factible su uso potencial como biomarcadores de diagnóstico debido a la capacidad de entrar en la circulación materna y ser detectables en el plasma materno.

---

Preeclampsia is a disease with a significant incidence worldwide that is directly associated with 15% of maternal deaths. This is usually characterized by the presence of hypertension and proteinuria, which manifests itself from the middle of pregnancy. MicroRNAs are single-stranded RNA molecules that act primarily by degrading transcribed messenger RNA or inhibiting microRNA translation. Placental microRNAs play a role in the growth and function of the placenta, their potential use as diagnostic biomarkers is considered feasible due to the ability to enter the maternal circulation and be detectable in maternal plasma.

Asunto(s)

Humanos , Femenino , Embarazo , Ciencias de la Salud , MicroARNs , Preeclampsia , Biología Molecular , Mantenimiento del Embarazo , Embarazo de Alto Riesgo , Obstetricia , Hipertensión Inducida en el Embarazo

RESUMEN

Introduction: Cancer patients in terminal stages present symptoms related to anemia, other cytopenias, and coagulopathies that deteriorate the quality of life. These symptoms can be multicausal and do not improve in most cases. Objective: Describe the use of blood transfusions in the six months before death as an alternative palliative treatment in patients with an oncological diagnosis in the city of Medellin during the period 2013-2018. Methods: Retrospective cohort, in patients with a cancer diagnosis who received transfusions in the last six months of life, a non-probabilistic sampling of consecutive cases was executed. The analysis was carried out in SPSS, estimating absolute and relative frequencies and median with interquartile ranges. Results: Out of 3,254 medical records of cancer pa­tients, 151 were included. The time to oncological diagnosis had a median of 2 years (IQR 1 and 3). The symptoms observed in patients before and after the first transfusion were pain, present in 32.1 % (46) and 16.9 % (25) respectively, besides drowsiness was distinguished in 25 % (36) before transfusion and 14.3 % (21) after. Finally, the clinical outcomes before and after the last transfusion prior to death, were a decrease in pain, asthenia/adynamia, drowsiness, among others. Conclusions: The findings of this research allow us to appreciate the current panorama in the institutions in which palliative care medical services are being provided and consider when to offer the blood products to a patient at the end of life as a therapeutic measure in the context of a human being cared by physicians.(AU)

---

Introducción: Los pacientes con cáncer en fase terminal presentan síntomas relacionados con la anemia, otras citopenias y coagulopatías que deterioran la calidad de vida. Estos síntomas pueden ser multicausales y no mejoran en la mayoría de los casos. Objetivo: Describir el uso de transfusiones sanguíneas en los seis meses previos a la muerte como alternativa de tratamiento paliativo en pacientes con diagnóstico oncológico en la ciudad de Medellín durante el periodo 2013-2018. Métodos: Cohorte retrospectiva, en pacientes con diagnóstico de cáncer que recibieron transfusiones en los últimos seis meses de vida, se ejecutó un muestreo no probabilístico de casos consecutivos. El análisis se realizó en SPSS, estimando frecuencias absolutas y relativas y mediana con rangos intercuartílicos.Resultados: De 3254 historias clínicas de pacientes con cáncer, 151 fueron incluidas. El tiempo hasta el diagnóstico oncológico tuvo una mediana de 2 años (IQR 1 y 3). Los síntomas observados en los pacientes antes y después de la primera transfusión fueron el dolor, presente en el 32,1 % (46) y el 16,9 % (25) respectivamente, además de la somnolencia que se distinguió en el 25 % (36) antes de la transfusión y el 14,3 % (21) después. Finalmente, los resultados clínicos antes y después de la última transfusión antes de la muerte, fueron una disminución del dolor, astenia/adinamia, somnolencia, entre otros. Conclusiones: Los hallazgos de esta investigación permiten apreciar el panorama actual en las instituciones en las que se prestan servicios médicos de cuidados paliativos y considerar cuándo ofrecer los hemoderivados a un paciente al final de la vida como medida terapéutica en el contexto de un ser humano atendido por los médicos.(AU)

Asunto(s)

Humanos , Masculino , Femenino , Transfusión Sanguínea , Dolor en Cáncer/tratamiento farmacológico , Calidad de Vida , Manejo del Dolor , Cuidados Paliativos/métodos , Neoplasias/tratamiento farmacológico , Oncología Médica , Colombia , Dolor/tratamiento farmacológico , Estudios de Cohortes , Estudios Retrospectivos

RESUMEN

INTRODUCTION: Knee dislocation is a rare injury but considered serious clinically since it can be accompanied by vascular and neurological injuries that if they do not have a timely diagnosis and treatment can lead to the loss of the limb. Regarding vascular injury, the optimal diagnostic method for the identification of this type of lesion is of the utmost importance. OBJECTIVE: To present the literature review on the epidemiology, classification and diagnostic approach of knee dislocation with or without associated vascular injury. METHODS: Report of the literature found in databases and analyses based on clinical experience and synthesis of these documents. CONCLUSION: Vascular injury is not an uncommon finding in the context of knee dislocation, with a high risk of complications and even amputation if an early diagnosis is not made, the authors recommend angio-CT to confirm the suspected diagnosis and not delay treatment.

---

INTRODUCCIÓN: La luxación de rodilla es una lesión poco común, pero considerada grave clínicamente, ya que puede acompañarse de lesiones vasculares y neurológicas que si no tienen un diagnóstico y tratamiento oportuno pueden llegar a la pérdida de la extremidad. Respecto a la lesión vascular es de suma importancia el método diagnóstico óptimo para la identificación de este tipo de lesiones. OBJETIVO: Presentar la revisión bibliográfica sobre la epidemiología, clasificación y aproximación diagnóstica de la luxación de rodilla con o sin lesión vascular asociada. MÉTODOS: Reporte de la literatura encontrada en bases de datos y análisis basados en experiencia clínica y síntesis de estos documentos. CONCLUSIÓN: La lesión vascular no es un hallazgo infrecuente en el contexto de una luxación de rodilla, tiene un riesgo elevado de complicaciones e incluso de amputación si no se realiza un diagnóstico temprano, los autores recomiendan la angio-TAC para confirmar la sospecha diagnóstica y no retrasar el tratamiento.

Asunto(s)

Luxación de la Rodilla , Lesiones del Sistema Vascular , Amputación Quirúrgica , Humanos , Luxación de la Rodilla/diagnóstico por imagen , Luxación de la Rodilla/cirugía , Lesiones del Sistema Vascular/diagnóstico por imagen

RESUMEN

La trasfusión de hemoderivados se utiliza con más frecuencia en pacientes con neoplasias hematológicas que en pacientes con tumores sólidos, y de forma variable en el caso de pacientes terminales con otro tipo de patologías. La anemia y trombocitopenia son frecuentes en este grupo diverso de pacientes, que reciben tratamientos hasta el final de la vida, siendo la transfusión de componentes sanguíneos, como los glóbulos rojos o las plaquetas, una intervención necesaria para el alivio de síntomas y mejoras en el estado clínico. Sin embargo, en pacientes con enfermedad terminal, los síntomas son de origen multifactorial y los valores hematológicos no necesariamente se convierte en un criterio para transfundir. No obstante, la evidencia científica que apoya que las transfusiones mejoren significativamente los síntomas de los pacientes paliativos aún no es concluyente.A pesar de que la literatura define algunas indicaciones para transfundir las dificultades, empiezan en el contexto de la selección del tipo de transfusión, la cantidad de las mismas y el fin de vida. En la literatura científica se encuentran diferentes comunicaciones que relacionan las últimas unidades de hemoderivados administrados, previo a la muerte del paciente; sin embargo, poco se encuentra con relación a criterios uniformes que apoyen la decisión al final de la vida y la relación riesgo beneficio no es clara.Las trasfusiones sanguíneas, además de ser procedimientos comunes en la práctica clínica, son terapias que generan riesgos y costes considerables para el sistema, por lo que la búsqueda de opciones alternas se hace imperativo a la hora de evitar terapias innecesarias.(AU)

---

Transfusion of blood products is used more frequently in patients with hematological malignancies than in patients with solid tumors, and variably in the case of terminally ill patients with other types of pathologies. Anemia and thrombocytopenia are frequent in this diverse group of patients, who receive treatments until the end of life, the transfusion of blood components, such as red blood cells or platelets, being a necessary intervention for the relief of symptoms and improvements in condition. clinical. However, in terminally ill patients, symptoms are multifactorial in origin and hematological values do not necessarily become a criterion for transfusing, however, the scientific evidence supporting that transfusions significantly improve the symptoms of palliative patients has not yet is conclusive.Although the literature defines some indications for transfusing difficulties, they begin in the context of the selection of the type of transfusion, the amount of the transfusion, and the end of life. In the scientific literature there are different reports that list the last units of blood products administered, prior to the death of the patient; however, little is found in relation to uniform criteria that support the decision at the end of life and the risk benefit ratio is not clear.Blood transfusions, in addition to being common procedures in clinical practice, are therapies that generate considerable risks and costs for the system, so the search for alternative options becomes imperative when it comes to avoiding unnecessary therapies.Patients with end-of-life transfusion needs generally have a history of known chronic disease; It is for this reason that the mobilization of individual and family resources becomes the challenge for healthcare personnel, since this will largely depend on the way in which the situation is dealt with and the links that are generated, so the approach must be carried out in an interdisciplinary way.(AU)

Asunto(s)

Humanos , Masculino , Femenino , Cuidados Paliativos , Manejo del Dolor , Transfusión Sanguínea/tendencias , Calidad de Vida , Anemia/terapia , Muerte , Dolor , Transfusión Sanguínea/estadística & datos numéricos , Transfusión Sanguínea , Prevalencia

RESUMEN

INTRODUCTION: Integrated care is a top priority for most of the National Health Services. In this study, an evaluation is made on the professional's beliefs and expectations regarding integration. MATERIAL AND METHODS: Between March and June 2017, Health Professionals from El Bierzo, León, Spain, were invited to complete 2 questionnaires on health integration process, including an online questionnaire on patient care integration (405 and 211 participants, respectively out of the total 1854 professionals). RESULTS: Three out of four professionals pointed at communication as the most important factor to achieve integration. Medical records, Health Care Education and medication reconciliation were the other prioritised factors. Care pathways (98%), nurse navigator (93%) or shared care protocols (92%) were highly recommended. The entire Hospital Service (55%) was the preferred link, with Primary Care versus a single consultant for every Primary Care Centre (29%), or for all the whole area (16%).There were no differences between primary and hospital services in most of the tools assessed. CONCLUSIONS: Communication tools are the cornerstone to achieve a successful integration of the care services according to Health Professionals.

Asunto(s)

Actitud del Personal de Salud , Prestación Integrada de Atención de Salud/organización & administración , Personal de Salud/organización & administración , Atención al Paciente/métodos , Adulto , Comunicación , Femenino , Encuestas de Atención de la Salud , Personal de Salud/psicología , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud/organización & administración , España

RESUMEN

In this work, an alternative to deactivate noxious green tide Tetraselmis suecica in the short-term is proposed by employing Perovskite-like cube-shaped, crystalline CaTiO3 semiconductors functionalized with atomic silver nanoparticles. CaTiO3 was prepared by a microwave-assisted hydrothermal method and then Ag(0)NPs (1 wt% of CaTiO3), were added by the photoreduction method. The XRD results show that crystalline CaTiO3 has an orthorhombic unit cell with a Perovskite-like structure. Images obtained by FESEM and HRTEM microscopies show well-faceted CaTiO3 rectangular prismatic morphology functionalizated with silver nanoparticles ≈ 13.5 nm. XPS and EDS-FESEM has confirmed the composition of CaTiO3 and silver occurring mainly as reduced metal. The UV inactivation of noxious T. suecica with Ag/CaTiO3 nanocomposites formed on bare materials results in complete deactivation of the algae in 12 min. The direct contact between harmful algae and Ag/CaTiO3 nanocomposite is necessary to deactivate the algae and inhibits algae viability.

Asunto(s)

Antiinfecciosos/farmacología , Compuestos de Calcio/efectos de la radiación , Chlorophyta/efectos de los fármacos , Chlorophyta/efectos de la radiación , Nanocompuestos , Óxidos/efectos de la radiación , Plata/farmacología , Titanio/efectos de la radiación , Antiinfecciosos/química , Antiinfecciosos/efectos de la radiación , Compuestos de Calcio/química , Nanocompuestos/química , Nanocompuestos/efectos de la radiación , Óxidos/química , Plata/química , Plata/efectos de la radiación , Titanio/química , Rayos Ultravioleta

RESUMEN

CONTEXT: Desmopressin is a synthetic agonist of vasopressin receptors (AVPRs). The desmopressin stimulation test is used in the diagnosis and postsurgery prognosis of Cushing disease (CD). However, the cellular and molecular mechanisms underlying the desmopressin-induced ACTH increase in patients with CD are poorly understood. OBJECTIVE: The objectives of this study were to determine, for the first time, whether desmopressin acts directly and exclusively on pituitary corticotropinoma cells to stimulate ACTH expression/release and to elucidate the cellular and molecular mechanisms involved in desmopressin-induced ACTH increase in CD. DESIGN: A total of 8 normal pituitaries (NPs), 23 corticotropinomas, 14 nonfunctioning pituitary adenomas, 17 somatotropinomas, and 3 prolactinomas were analyzed for AVPR expression by quantitative real-time RT-PCR. Primary cultures derived from corticotropinomas, nonfunctioning pituitary adenomas, somatotropinomas, prolactinomas, and NPs were treated with desmopressin, and ACTH secretion/expression, [Ca(2+)]i kinetics, and AVPR expression and/or proliferative response were evaluated. The relationship between AVPR expression and plasma adrenocorticotropin/cortisol levels obtained from desmopressin tests was assessed. RESULTS: Desmopressin affects all functional parameters evaluated in corticotropinoma cells but not in NPs or other pituitary adenomas cells. These effects might be due to the dramatic elevation of AVPR1b expression levels found in corticotropinomas. In line with this notion, the use of an AVPR1b antagonist completely blocked desmopressin stimulatory effects. Remarkably, only AVPR1b expression was positively correlated with elevated plasma adrenocorticotropin levels in corticotropinomas. CONCLUSIONS: The present results provide a cellular and molecular basis to support the desmopressin stimulation test as a reliable, specific test for the diagnosis and postsurgery prognosis of CD. Furthermore, our data indicate that AVPR1b is responsible for the direct/exclusive desmopressin stimulatory pituitary effects observed in CD, thus opening the possibility of exploring AVPR1b antagonists as potential therapeutic tools for CD treatment.

Asunto(s)

Hormona Adrenocorticotrópica/sangre , Desamino Arginina Vasopresina , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/diagnóstico , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/metabolismo , Receptores de Vasopresinas/metabolismo , Adenoma/sangre , Adenoma/diagnóstico , Adenoma/cirugía , Anciano , Humanos , Masculino , Persona de Mediana Edad , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/cirugía , Pruebas de Función Hipofisaria , Hipófisis/efectos de los fármacos , Hipófisis/metabolismo , Neoplasias Hipofisarias/sangre , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/cirugía , Pronóstico

Asunto(s)

Carcinoma Hepatocelular/etiología , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/etiología , Neoplasias Hepáticas/patología , Hígado/patología , Animales , Muerte Celular , Humanos , Hepatopatías/patología

RESUMEN

No disponible

Asunto(s)

Humanos , Carcinoma Hepatocelular/patología , Muerte Celular , Hepatopatías/fisiopatología , Daño por Reperfusión/fisiopatología , Hígado Graso/fisiopatología , Colestasis/fisiopatología , Hepatitis Viral Humana/fisiopatología

RESUMEN

OBJECTIVE: Effective dengue prevention and Aedes aegypti control is a priority for the Cuban health authorities. To enhance effectiveness, strategies oriented towards a more active involvement of communities in control activities are being tested. This paper presents a sociological perspective on a pilot project conducted in the health area ''26 de Julio'' (La Havana) in 1999-2004. METHODS: Instrumental case study based on an exhaustive content analysis of project documents and on observations of a sociologist. RESULTS: The context and the pilot project are systematically described and an analysis of the evolution of the underlying concept of community participation is provided. The pilot experience was a dynamic process influenced by self-reflection of the research team, feedback from research partners and changes in the epidemiological context (provoked by two dengue outbreaks during the study period). Community participation evolved from being just one component in Aedes aegypti control directed by the health staff into a learning and empowering process for the people. This change in the concept of participation was reflected in different aspects of the pilot project such as the learning and evaluation processes. CONCLUSION: Empirical evidence from 5 years of research in the particular context of Cuba showed that moves towards community-based Aedes aegypti control are feasible. However, in order to be successful, community-based dengue prevention should be a social learning process, implying a transfer of power and responsibilities to local people. Actions undertaken must be oriented towards creating local capabilities, strengthening existing structures and organizations and promoting group work for learning participation from participation itself.

Asunto(s)

Aedes , Participación de la Comunidad/métodos , Dengue/prevención & control , Insectos Vectores , Animales , Control de Enfermedades Transmisibles/métodos , Conducta Cooperativa , Cuba/epidemiología , Toma de Decisiones en la Organización , Dengue/epidemiología , Brotes de Enfermedades , Programas de Gobierno/métodos , Educación en Salud/métodos , Humanos , Control de Mosquitos/métodos , Proyectos Piloto , Proyectos de Investigación

RESUMEN

The bark of Rhizophora mangle, the red mangrove, has been used traditionally in folk medicine of Caribbean countries due to its antiseptic, astringent, haemostatic and antifungal properties. Aqueous extracts are rich in tannins and have been proven experimentally to possess antibacterial, wound healing and antiulcerogenic effects. This work was designed to determine the gastroprotective effect of Rhizophora mangle in a model of diclofenac-induced ulcers in rats and to study the mechanisms involved, using the proton pump inhibitor omeprazole as a comparison. The lyophilized extract was given by oral gavage (125 and 62.5mg/kg) three times at 12h intervals before administering diclofenac 100mg/kg. Pretreatment with the extract resulted in a significant decrease of the ulcerated area (P<0.01). Rhizophora mangle induced a recovery of PGE(2) levels, which had been depleted by diclofenac. No anti-inflammatory effect was observed ex vivo or in vitro. The highest dose of the extract provoked a marked increase in glutathione peroxidase and superoxide dismutase activity, which was comparable to omeprazole. Furthermore, lipid peroxidation levels were inhibited in a dose-dependent manner. These results suggest that the gastroprotective effect of Rhizophora mangle in this experimental model appears through an antioxidant and prostaglandin-dependent way.

Asunto(s)

Antiinflamatorios no Esteroideos/toxicidad , Antiulcerosos/uso terapéutico , Antioxidantes/uso terapéutico , Fitoterapia , Corteza de la Planta , Extractos Vegetales/uso terapéutico , Úlcera Gástrica/prevención & control , Animales , Antiinflamatorios no Esteroideos/antagonistas & inhibidores , Antiulcerosos/aislamiento & purificación , Antioxidantes/aislamiento & purificación , Diclofenaco/antagonistas & inhibidores , Diclofenaco/toxicidad , Femenino , Peroxidación de Lípido/efectos de los fármacos , Masculino , Extractos Vegetales/aislamiento & purificación , Ratas , Ratas Wistar , Rhizophoraceae , Úlcera Gástrica/inducido químicamente , Úlcera Gástrica/patología

RESUMEN

Proteolytic enzymes play an essential role in different physiological processes, including development, reproduction and host defence, as well as in numerous pathologies, like inflammatory diseases, neurological disorders or cancer. The completion of the human genome sequence allowed us to determine that more than 2% of all human genes are proteases or protease inhibitors, reflecting the importance of proteolysis in human biology. To understand better the complexity of proteases in human and other model organisms, we have used the available genome sequences of different mammalian organisms, including mouse, rat and chimpanzee, to identify and compare their degradomes, the complete set of protease genes in these species. Surprisingly, the rodent protease complement is more complex when compared with that of primates, mainly due to the expansion of protease families implicated in reproduction and host defence. Similarly, most differences between human and chimpanzee proteases are found in genes implicated in the immune system, which might explain some of the differences between both organisms. We have also found several genes implicated in reproduction, nutrition and the immune system, which are functional in rat, mouse or chimpanzee, but have been inactivated by mutations in the human lineage. These findings suggest that pseudogenization of specific protease genes has been a mechanism contributing to the evolution of the human genome. Finally, we found that proteases implicated in human hereditary diseases, and especially in neurodegenerative disorders, are highly conserved among mammals.

Asunto(s)

Endopeptidasas/genética , Endopeptidasas/metabolismo , Genómica , Animales , Humanos , Enfermedades Neurodegenerativas/enzimología , Enfermedades Neurodegenerativas/genética , Inhibidores de Proteasas/farmacología

RESUMEN

Biliary atresia is the most common indication for liver transplantation in the pediatric age group. The Kasai portoenterostomy has become established as the primary treatment for biliary atresia. If portoenterostomy fails, death before 2 years of age is likely without liver transplantation. The most common multiple malformation syndrome associated with biliary atresia is polysplenia syndrome, which forms a constellation of defects of body symmetry, splenic development and vascular anomalies, including situs inversus, polysplenia and others. The situs inversus was formerly considered an absolute contraindication for liver transplantation. Recently however, several case reports have been published suggesting that neither situs inversus nor this particular subset of vascular abnormalities should be considered contraindications to liver transplantation. We present one case of liver transplantation performed in patient with biliary atresia, situs inversus and polysplenia. This is the first report described in Spain for a liver transplant in a child with biliary atresia plus situs inversus.

Asunto(s)

Anomalías Múltiples/cirugía , Atresia Biliar/cirugía , Trasplante de Hígado/métodos , Situs Inversus/cirugía , Bazo/anomalías , Atresia Biliar/complicaciones , Humanos , Lactante , Masculino , Situs Inversus/complicaciones , España , Síndrome , Resultado del Tratamiento

RESUMEN

La atresia de vías biliares es la indicación más frecuente para trasplante hepático en la edad pediátrica. La portoenterostomía de Kasai es el tratamiento primario para la atresia de vías biliares. Si la portoenterostomía falla, el fallecimiento suele ocurrir antes de los 2años de edad sin el trasplante hepático. El síndrome de múltiples malformaciones más comunmente asociado con la atresia de vías biliares es el síndrome de poliesplenia, formado por una constelación de defectos en la simetría corporal, desarrollo del bazo y anomalías vasculares, incluyendo situs inversus, poliesplenia y otros. El situs inversus era considerado como una contraindicación absoluta para el trasplante hepático. Sin embargo recientemente han sido publicados varios casos, sugiriendo que ni el situs inversus ni la presencia de dichas alteraciones vasculares deben ser consideradas como contraindicaciones para el trasplante hepático. Presentamos un caso de trasplante hepático realizado a un paciente con atresia de vías biliares, situs inversus y poliesplenia. Es el primer caso descrito en España (AU)

Asunto(s)

Humanos , Masculino , Lactante , Atresia Biliar/cirugía , Situs Inversus/cirugía , Trasplante de Hígado , Enfermedades del Bazo/complicaciones , Complicaciones Posoperatorias/epidemiología

RESUMEN

Este trabalho teve por objetivo avaliar o efeito dos níveis 40, 55 e 70 por cento de concentrado associados a um volumoso de baixa qualidade sobre o consumo e ganho de peso de 16 novilhos mestiços, castrados, com 10 meses de idade e peso vivo inicial médio de 312kg, em delineamento inteiramente ao acaso, com três repetiçöes, durante 63 dias. O volumoso usado foi a aveia (Avena strigosa), tratada com uréia e o concentrado era constituído de milho, farelo de arroz, farelo de soja e minerais. Todas as dietas foram ajustadas para conter 12 por cento de proteína bruta. Houve resposta positiva e linear à proporçäo de concentrado na dieta, para as variáveis ganho de peso diário e consumo de matéria seca expresso em kg/animal/dia, em percentagem do peso vivo e em g por kg de peso metabólico em funçäo da proporçäo de concentrado na dieta. Houve resposta linear negativa para conversäo alimentar. O consumo de matéria seca e o ganho de peso diário aumentaram na medida em que se elevou a proporçäo de concentrado na dieta. O volumoso de baixa qualidade empregado possivelmente limitou o consumo e conseqüentemente o aporte de nutrientes

Asunto(s)

Animales , Alimentación Animal , Avena , Bovinos