RESUMO
AIM: To establish the utility of baseline 18F-Fluorocholine (FCH) PET/CT and bone scintigraphy (BS) in the outcome prediction of patients with castration-resistant prostate cancer and bone metastases (CRPC-BM) treated with 223Ra. METHODS: Prospective, multicenter and non-randomized study (ChoPET-Rad study). FCH PET/CT and BS were performed before the initiation of 223Ra (basal FCH PET/CT and BS). Bone disease was classified attending the number of lesions in baseline BS and PET/CT. FCH PET/CT was semiquantitatively evaluated. Gleason score, baseline levels of prostate-specific antigen (PSA), alkaline phosphatase and lactate dehydrogenase were determined. Progression-free survival (PFS) and overall survival (OS) since the onset of 223Ra treatment was calculated. PFS was defined by PSA rising. Relations between clinical and imaging variables with PFS and OS were evaluated by Pearson, Mann-Whitney tests and Kapplan-Meier analysis. Univariate and multivariate Cox regression analysis was performed. RESULTS: Forty patients were evaluated. The median PFS and OS were of 3.0 ± 2.3 and 23.0 ± 4.2 months, respectively. 33 patients progressed and 13 died during the follow-up. The extension of the bone disease by FCH PET/CT (p = 0.011, χ2 = 10.63), BS (p = 0.044, χ2 = 8.04), SUVmax (p = 0.012) and average SUVmax (p = 0.014) were related to OS. No significant association was found for the PFS. ROC analysis revealed significant association of SUVmax, average SUVmax and basal PSA with OS. Only therapeutic failure was associated with OS in the multivariate analysis (HR = 3.6, p = 0.04). CONCLUSION: FCH PET/CT and BS had prognostic aim in the prediction of OS. None clinical or imaging variable was able to predict the PFS, probably due to the high rate of progressive disease.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/radioterapia , Neoplasias de Próstata Resistentes à Castração/diagnóstico por imagem , Neoplasias de Próstata Resistentes à Castração/radioterapia , Rádio (Elemento)/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/secundário , Colina/análogos & derivados , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Neoplasias de Próstata Resistentes à Castração/secundário , Radioisótopos/uso terapêutico , CintilografiaRESUMO
INTRODUCTION: Hip fracture is considered the most serious consequence of falls and osteoporosis. 18% of women will suffer one and 25% die in the first year. Only 73% of survivors will walk as they did previously. We know little about the assistance and evolution of it in Mexico. Our goal was to review the current state of Mexican literature on hip fracture, compare Mexican studies with each other and with quality indicators. METHODS: We conducted a search of Mexican articles published between 2000-2017 with the key words: hip fracture, elderly, Mexico and hip fracture (in English) in the databases PubMed, EBSCO and Bibliomed. RESULTS: Twenty-one articles were included. No clinical trials, multidisciplinary unit reports, records, or meta-analyses were found. The average age was 76.9 years and 67.2% were women. No papers were found to report quality indicators. Comorbidity is reported little. The most common complications of hip fractures were delirium, pneumonia and pressure ulcers. Mortality in the acute phase was 0.97 to 12.5%. Special units were not reported. The cost of care oscillated between 1,261 and 13,641 USD. CONCLUSIONS: The scientific information on hip fractures in Mexico is sparse, heterogeneous and does not allow for conclusive results. Increasing the amount and quality of research in hip fractures in Mexico is required. It would also be advisable to disseminate the usefulness of multidisciplinary teams and registry of hip fractures, which would help to improve attention.
INTRODUCCIÓN: La fractura de cadera (FC) se considera la consecuencia más grave de las caídas y la osteoporosis. Dieciocho por ciento de las mujeres sufrirán una FC y 25% muere en el primer año. Sólo 73% de los supervivientes caminará como lo hacía previamente. Conocemos poco de la asistencia y evolución de la FC en México. OBJETIVO: Revisar el estado actual de la literatura mexicana sobre FC, comparar estudios mexicanos entre sí y con los indicadores de calidad. METODOLOGÍA: Se realizó una búsqueda de artículos mexicanos publicados entre 2000 y 2017 con las palabras clave: fractura de cadera, ancianos, México y hip fracture en las bases de datos PubMed, EBSCO y Bibliomed. RESULTADOS: Se incluyeron 22 artículos. No se encontraron ensayos clínicos, informes de unidades multidisciplinarias, registros, ni metaanálisis. La media de edad fue de 76.9 años y 67.2% fueron mujeres. No se encontraron trabajos que reportaran indicadores de calidad. La comorbilidad se describe poco. Las complicaciones más frecuentes de la FC fueron delirium, neumonía y úlceras por presión. La mortalidad en la fase aguda fue de 0.97 a 12.5%. No se reportaron unidades ortogeriátricas. El costo de atención osciló entre 1,261 y 13,641 dólares estadounidenses (USD). CONCLUSIONES: La información científica sobre FC en México es escasa, heterogénea y no permite obtener resultados concluyentes. Se requiere aumentar la cantidad y la calidad de la investigación en FC en México. Sería también conveniente difundir la utilidad de los equipos multidisciplinarios y registros de FC, lo que contribuiría a mejorar la atención.
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Fraturas do Quadril , Idoso , Feminino , Fraturas do Quadril/terapia , Humanos , México , Indicadores de Qualidade em Assistência à SaúdeRESUMO
The histomorphometric features of umbilical cord constituents in seven foetuses of alpaca (Vicugna pacos) from Cerro de Pasco, Department, Peru, were determined. Sections of 2-5 cm of umbilical cord were fixed in 10% neutral buffered formalin and processed for light microscopy. Standard histological slides stained with haematoxylin and eosin, Masson's trichrome and Van Gieson's trichrome were obtained. Histologically, common features of umbilical artery and vein were observed as well as mucous connective tissue, some cell features that compound this tissue constituted by cells presented features of myofibroblasts. Among most important findings that were observed, the lumen of umbilical vein was obliterated into star-shaped form with the thinner umbilical artery wall; the smooth muscles and fibroblast were comparatively more in number in umbilical artery than that of umbilical vein, and the tunica media was larger in dimension than the tunica adventitia in umbilical vein. Conclusively, this histological study features an observation of the umbilical cord of alpaca foetuses and shows the similarity between them and those of other mammal species, including dromedaries and South American camelids.
Assuntos
Camelídeos Americanos/anatomia & histologia , Cordão Umbilical/anatomia & histologia , Túnica Adventícia/anatomia & histologia , Alantoide/anatomia & histologia , Animais , Compostos Azo , Camelídeos Americanos/embriologia , Corantes , Tecido Elástico/anatomia & histologia , Amarelo de Eosina-(YS) , Feminino , Fibroblastos/citologia , Hematoxilina , Verde de Metila , Músculo Liso/anatomia & histologia , Gravidez , Túnica Média/anatomia & histologia , Artérias Umbilicais/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Veias Umbilicais/anatomia & histologiaRESUMO
No Abstract available.
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The Sall2 transcription factor is deregulated in several cancers; however, little is known about its cellular functions, including its target genes. Recently, we demonstrated that p53 directly regulates Sall2 expression under genotoxic stress. Here, we investigated the role of Sall2 in the context of cellular response to genotoxic stress. In addition, we further examined the Sall2-p53 relationship during genotoxic stress in primary mouse embryo fibroblasts (MEFs), which are derived from Sall2 knockout mice separately, or in combination with the p53ERTAM knock-in mice. We found that the levels of Sall2 mRNA and protein are dynamically modulated in response to doxorubicin. At early times of stress, Sall2 is downregulated, but increases under extension of the stress in a p53-independent manner. Based on caspase-3/7 activities, expression of cleaved poly (ADP-ribose) polymerase, expression of cleaved caspase-3 and induction of proapoptotic proteins, Sall2 expression was correlated with cellular apoptosis. Consequently, Sall2-/- MEFs have decreased apoptosis, which relates with increased cell viability in response to doxorubicin. Importantly, Sall2 was required for apoptosis even in the presence of fully activated p53. Searching for putative Sall2 targets that could mediate its role in apoptosis, we identified proapoptotic NOXA/PMAIP1 (phorbol-12-myristate-13-acetate-induced protein 1). We demonstrated that Sall2 positively regulates Noxa promoter activity. Conserved putative Sall2-binding sites at the NOXA promoter were validated in vitro by electrophoretic mobility shift assay and in vivo by ChIP experiments, identifying NOXA as a novel Sall2 target. In agreement, induction of Noxa protein and mRNA in response to doxorubicin was significantly decreased in Sall2-/- MEFs. In addition, studies in leukemia Jurkat T cells support the existence of the Sall2/Noxa axis, and the significance of this axis on the apoptotic response to doxorubicin in cancer cells. Our study highlights the relevance of Sall2 in the apoptotic response to extended genotoxic stress, which is important for understanding its role in normal physiology and disease.
Assuntos
Dano ao DNA , Peptídeos e Proteínas de Sinalização Intracelular/genética , Leucemia/genética , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteína Supressora de Tumor p53/genética , Animais , Apoptose/efeitos dos fármacos , Proteínas de Ligação a DNA , Doxorrubicina/administração & dosagem , Fibroblastos/patologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Células Jurkat , Leucemia/patologia , Camundongos , Camundongos Knockout , Ligação Proteica , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Fatores de Transcrição , Proteína Supressora de Tumor p53/metabolismoRESUMO
AIM: To assess the psychometric attributes of the stroke-adapted 30-item version of the Sickness Impact Profile, Spanish version (SA-SIP30), in stroke survivors. PATIENTS AND METHODS: 79 patients were evaluated (mean age: 68.1 years) by means of the modified Rankin Scale (m-RS), Scandinavian Stroke Scale (SSS), Barthel Index (BI), and the modified 23-item Beck-Hamilton's Depression Rating Scale (HDRS). Health-related quality of life was evaluated using the MOS-Short Form 36 (SF-36) and the SA-SIP30. RESULTS: SA-SIP30 mean score was 36.8. SA-SIP30 floor and ceiling effects were 3.8% and 0%. Regarding SA-SIP30 categories, floor effect ranged from 15.2% (social interaction) to 49.4% (alertness behavior), whereas ceiling effect ranged from 2.5% (social interaction) to 26.6% (household management). A floor effect was observed in seven SA-SIP30 categories. The internal consistency of SA-SIP30 (Cronbach's alpha = 0.87), physical (Cronbach's alpha = 0.89) and psychosocial (Cronbach's alpha = 0.75) dimensions were satisfactory. Standard error of measurement (SEM) values for each SA-SIP30 category ranged from 15.9 (household management) to 26.3 (ambulation). SEM values for overall SA-SIP30, physical and psychosocial dimensions were 8, 10 and 17.3, respectively. Corrected item-category correlations ranged from 0.17 (item 28) to 0.83 (item 23). A significant correlation (Spearman's correlation coefficient; p < 0.0001) between SA-SIP30 scores and BI (-0.71), m-RS (0.68), SSS (-0.67), HDRS (0.52), SF-36 physical (-0.67) and mental components (-0.51) was found. SA-SIP30 mean score significantly increased as m-RS increased (discriminative validity; Kruskal-Wallis, p < 0.0001). CONCLUSION: The Spanish-version of the SA-SIP30 has satisfactory internal consistency, convergent validity and discriminative validity in stroke patients.
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Perfil de Impacto da Doença , Acidente Vascular Cerebral/psicologia , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Estudos de Coortes , Humanos , Relações Interpessoais , Idioma , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/epidemiologia , Transtornos dos Movimentos/etiologia , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Espanha , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/epidemiologiaRESUMO
Este estudio tiene el dignificado de demonstrar las peculiaridades y perfil clinico de los trastornos bipolares en los ancianos en los ancianos. Los puntos de mayor interés son abordados de manera como: heterogeneidad, aspestos evolutivos y etiopatogenia
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Humanos , Masculino , Idoso , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Transtorno Bipolar/genética , Transtorno Bipolar/patologia , Heterogeneidade GenéticaRESUMO
Hemos revisado la literatura sobre la relación entre el trastorno de ansiedad de separación en la infancia y el trastorno de pánico en la edad adulta. La mayoría de los estudios apoyan esta relación al encontrar una mayor frecuencia de antecedentes de ansiedad de separación en los adultos con trastornos de ansiedad especialmente con trastorno de pánico. La ansiedad de separación parece estar implicada como un factor de riesgo precoz en el trastorno emocional del adulto. Además hemos presentado los datos de un estudio en el que se utilizó el sistema HLA para evaluar la distribución de los diferentes antígenos en los miembros de una familia con alta morbilidad de trastorno de pánico y de trastorno de ansiedad de separación. El objetivo era comprobar la existencia de los mismos haplotipos en los miembros afectados. Los resultados sugieren un componente genético común para el trastorno de pánico y el trastorno de ansiedad de separación ya que se encontró el mismo haplotipo en los seis miembros adultos de la familia con trastorno de pánico y en dos niños con trastorno de ansiedad de separación frente a la ausência en los miembros de la familia libres de estos trastornos.
Assuntos
Humanos , Criança , Adulto , Ansiedade de Separação , Transtorno de Pânico , Agorafobia , Ansiedade de Separação/genética , Ansiedade de Separação/psicologia , Transtorno de Pânico/genética , Transtorno de Pânico/psicologiaRESUMO
Considerable interest has been paid to the biological basis of the aggressive behavior, in the last two decades. The 5-HT function has been the most studied function in animal models, and studies carried out with either psychiatric patients, antisocial subjects, or normal people. An overwhelming evidence favors the importance of the 5-HT function in the modulation of aggressive behavior, particularly when 5-HT function is associated to loss of impulse control. Data from literature are reviewed. Results of a challenge serotonin test with fluoxetine in normal subjects are presented. The therapeutic implications of such studies are also discussed.
Assuntos
Agressão/fisiologia , Serotonina/fisiologia , Adolescente , Adulto , Agressão/efeitos dos fármacos , Animais , Fluoxetina/farmacologia , Humanos , Ácido Hidroxi-Indolacético/líquido cefalorraquidiano , Macaca mulatta , Masculino , Prolactina/sangue , Prolactina/efeitos dos fármacos , Serotonina/sangueRESUMO
Considerable interest has been paid to the biological basis of the aggressive behavior, in the last two decades. The 5-HT function has been the most studied function in animal models, and studies carried out with either psychiatric patients, antisocial subjects, or normal people. An overwhelming evidence favors the importance of the 5-HT function in the modulation of aggressive behavior, particularly when 5-HT function is associated to loss of impulse control. Data from literature are reviewed. Results of a challenge serotonin test with fluoxetine in normal subjects are presented. The therapeutic implications of such studies are also discussed.
RESUMO
El Test de Supresion con Dexametasona (TSD) se ha propuesto como un marcador de estado de la melancolia, aunque existen resultados discrepantes seguin los autores. En nuestro trabajo, realizado con 117 pacientes hospitalizados diagnosticados de transtorno afectivo mayor y subclasificados seguin los criterios de Newcastle en endogenos (67) y no endogenos (50), encontramos una mayor frecuencia de respuestas anormales al TSD, en el grupo endogeno, aunque estos resultados no nos permitem afirmar que esta prueba pueda considerarse especifica de la depresion endogena.
Assuntos
Depressão , Transtorno Depressivo , Transtorno DepressivoRESUMO
A comparative study of 26 delusional depressive patients versus 47 non-delusional depressed controls is presented. In addition to the clinical evaluation, the dexamethasone suppression test was performed. The results show higher severity and increased retardation in the delusional sample. The breakdown of delusions demonstrates that the most common delusions were of reference and guilt. Multiple delusions were found more frequently than one type of delusions. The D.S.T. results show no significant differences between the rates of abnormal responses in both groups. However in the delusional depressive sample with mood-incongruency there was a higher percentage of normal responses.
Assuntos
Delusões/diagnóstico , Depressão/diagnóstico , Dexametasona , Escalas de Graduação Psiquiátrica , Feminino , Humanos , Hidrocortisona/sangue , MasculinoRESUMO
Se describen los datos obtenidos en un analisis comparativo de 26 pacientes con depresion delirante y 47 controles con depresion simple. Ademas de la evaluacion clinica se procedio a la aplicacion del test de supresion de la dexametasona. Los resultados del estudio en la muestra delirante muestran una edad media mas avanzada asi como una mayor gravedad de la sintomatologia y un predominio de la inhibicion. El analisis del contenido delirante indica que los delirios mas comunes son los de culpa y paranoide, constatandose en la mayoria de los casos mas de un tipo de delirio. Los resultados del test de supresion de la dexametasona no arrojan diferencias significativas entre los porcentajes de respuestas anormales correspondientes a ambas muestras. Sin embargo, en el subgrupo de depresiones delirantes con incongruencia del animo se ha encontrado un mayor porcentaje de respuestas normales
Assuntos
Humanos , Masculino , Feminino , Delírio , Depressão , Dexametasona , Escalas de Graduação PsiquiátricaRESUMO
Se describen los datos obtenidos en un analisis comparativo de 26 pacientes con depresion delirante y 47 controles con depresion simple. Ademas de la evaluacion clinica se procedio a la aplicacion del test de supresion de la dexametasona. Los resultados del estudio en la muestra delirante muestran una edad media mas avanzada asi como una mayor gravedad de la sintomatologia y un predominio de la inhibicion. El analisis del contenido delirante indica que los delirios mas comunes son los de culpa y paranoide, constatandose en la mayoria de los casos mas de un tipo de delirio. Los resultados del test de supresion de la dexametasona no arrojan diferencias significativas entre los porcentajes de respuestas anormales correspondientes a ambas muestras. Sin embargo, en el subgrupo de depresiones delirantes con incongruencia del animo se ha encontrado un mayor porcentaje de respuestas normales
Assuntos
Humanos , Masculino , Feminino , Estudo Comparativo , Delírio , Depressão , Dexametasona , Escalas de Graduação PsiquiátricaRESUMO
A comparative study of 26 delusional depressive patients versus 47 non-delusional depressed controls is presented. In addition to the clinical evaluation, the dexamethasone suppression test was performed. The results show higher severity and increased retardation in the delusional sample. The breakdown of delusions demonstrates that the most common delusions were of reference and guilt. Multiple delusions were found more frequently than one type of delusions. The D.S.T. results show no significant differences between the rates of abnormal responses in both groups. However in the delusional depressive sample with mood-incongruency there was a higher percentage of normal responses.
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PIP: Health planning in Latin America became an organized activity with the Charter of Punta del Este in 1961. The charter's 10-Year Public Health Program set forth a series of objectives that stressed international cooperation, the link of public health with economic development, and assistance from the Pan American Health Organization (PAHO) and the U.N. through Economic Commission for Latin America. The basis for most planning efforts in the region has been the PAHO/Center for Development Studies (CENDES) method, a joint venture of WHO and the Central University of Venezuela. This methodology suggests health programs that are organized from the bottom up beginning with "program areas" for populations that lie not more than 2 hours from a health clinic. The program areas comprise a regional area, which in turn is serviced by specialized clinics not affordable in program areas. The regional areas serve as the building blocks for the national programs. Beginning in 1963, several countries undertook planning activities using the PAHO/CENDES procedures. In many countries, however, the evolution of the planning process did not measure up to the expectations of 1961; only a few countries actually completed the program cycle. The problems confronted by these programs demonstrated that health planning has to be more than the intermittent exercise of preparing plans and documents.^ieng