RESUMO
Neurodegeneration is a pathological condition that is associated with the loss of neuronal function and structure. In neurodegenerative diseases, mounting evidence indicates that neuroinflammation is a common factor that contributes to neuronal damage and neurodegeneration. Neuroinflammation is characterized by the activation of microglia, the neuroimmune cells of the central nervous system (CNS), which have been implicated as active contributors to neuronal damage. Glycan structure modification is defining the outcome of neuroinflammation and neuronal regeneration; moreover, the expression of galectins, a group of lectins that specifically recognize ß-galactosides, has been proposed as a key factor in neuronal regeneration and modulation of the inflammatory response. Of the different galectins identified, galectin-1 stimulates the secretion of neurotrophic factors in astrocytes and promotes neuronal regeneration, whereas galectin-3 induces the proliferation of microglial cells and modulates cell apoptosis. Galectin-8 emerged as a neuroprotective factor, which, in addition to its immunosuppressive function, could generate a neuroprotective environment in the brain. This review describes the role of galectins in the activation and modulation of astrocytes and microglia and their anti- and proinflammatory functions within the context of neuroinflammation. Furthermore, it discusses the potential use of galectins as a therapeutic target for the inflammatory response and remodeling in damaged tissues in the central nervous system.
Assuntos
Doenças Neurodegenerativas , Astrócitos/metabolismo , Astrócitos/patologia , Galectinas/metabolismo , Humanos , Microglia/metabolismo , Microglia/patologia , Doenças Neurodegenerativas/patologia , Doenças NeuroinflamatóriasRESUMO
RESUMEN INTRODUCCIÓN : El cáncer cervicouterino (CC) es la cuarta causa de muerte por cáncer en mujeres. Las demoras en el tratamiento se asocian a un peor control de la enfermedad. Los objetivos de este estudio fueron describir las características de mujeres con diagnóstico de CC en la red pública de Jujuy y evaluar el grado de cumplimiento del tratamiento oncológico. MÉTODOS : Se realizó un estudio observacional de cohorte retrospectiva de mujeres con diagnóstico de CC en 2015 y 2016 en el Hospital Pablo Soria (centro de derivación provincial). Se registraron las fechas de las principales modalidades terapéuticas: cirugía, quimioterapia, radioterapia y braquiterapia. Se definió la duración recomendada de tratamiento según la literatura, considerando las diferentes combinaciones de terapéuticas (60, 90 o 120 días). RESULTADOS : Se incluyó a 78 mujeres con diagnóstico de CC. Entre quienes presentaban indicación de tratamiento oncológico, el 64% (n=48) no cumplió con el tratamiento indicado, por no haberlo iniciado (n=17) o por concluirlo en un intervalo mayor al recomendado (n=31). Entre las mujeres que iniciaron tratamiento, 48% (n=28) lo finalizó a tiempo. Tener más de 5 hijos se asoció a incumplimiento de tratamiento con quimio-radioterapia. La modalidad de inicio más tardío fue la braquiterapia, que debía realizarse en otra provincia por falta de disponibilidad local. DISCUSIÓN : El cumplimiento subóptimo del tratamiento de CC continúa siendo un problema de salud pública.
ABSTRACT INTRODUCTION : Cervical cáncer (CC) is the fourth cause of cancer-related death among women worldwide. Delays in treatment are associated with worse disease control. The objectives of this study were to describe the characteristics of women with newly-diagnosed CC in the Argentine province of Jujuy, and to evaluate the degree of treatment compliance. METHODS : An observational retrospective cohort study was conducted on women with CC diagnosed at Hospital Pablo Soria (state-wide referral center in Jujuy) in 2015-2016. Dates of the main treatment modalities were registered (surgery, chemotherapy, radiotherapy and brachytherapy). Recommended treatment duration was extracted from the literature, considering the different treatment combinations (60, 90 or 120 days). RESULTS : A total of 78 women with CC were included. Of all women who were prescribed oncological treatment, 64% (n=48) showed inappropriate compliance, either due to not having started treatment (n=17) or due to delays in completion of treatment (n=31). Among women who initiated treatment, 48% (n=28) completed it on time. For women receiving chemotherapy and radiotherapy, having more than 5 children was associated with treatment delays. Brachytherapy showed longer delays than other treatment modalities, due to lack of local availability and the need to travel to a different province for treatment. DISCUSSION : Suboptimal compliance with CC treatment remains a public health issue.
RESUMO
INTRODUCCIÓN: El cáncer cervicouterino (CC) es la cuarta causa de muerte por cáncer en mujeres. Las demoras en el tratamiento se asocian a un peor control de la enfermedad. Los objetivos de este estudio fueron describir las características de mujeres con diagnóstico de CC en la red pública de Jujuy y evaluar el grado de cumplimiento del tratamiento oncológico. MÉTODOS: Se realizó un estudio observacional de cohorte retrospectiva de mujeres con diagnóstico de CC en 2015 y 2016 en el Hospital Pablo Soria (centro de derivación provincial). Se registraron las fechas de las principales modalidades terapéuticas: cirugía, quimioterapia, radioterapia y braquiterapia. Se definió la duración recomendada de tratamiento según la literatura, considerando las diferentes combinaciones de terapéuticas (60, 90 o 120 días). RESULTADOS: Se incluyó a 78 mujeres con diagnóstico de CC. Entre quienes presentaban indicación de tratamiento oncológico, el 64% (n=48) no cumplió con el tratamiento indicado, por no haberlo iniciado (n=17) o por concluirlo en un intervalo mayor al recomendado (n=31). Entre las mujeres que iniciaron tratamiento, 48% (n=28) lo finalizó a tiempo. Tener más de 5 hijos se asoció a incumplimiento de tratamiento con quimio-radioterapia. La modalidad de inicio más tardío fue la braquiterapia, que debía realizarse en otra provincia por falta de disponibilidad local. DISCUSIÓN: El cumplimiento subóptimo del tratamiento de CC continúa siendo un problema de salud pública
Assuntos
Neoplasias do Colo do Útero , Oncologia , Cooperação e Adesão ao TratamentoRESUMO
BACKGROUND: Human papillomavirus (HPV) testing for cervical cancer prevention was introduced in Argentina through the Jujuy Demonstration Project (2011-14). The programme tested women aged 30 years and older attending the public health system with clinician-collected HPV tests. HPV self-collection was introduced as a programmatic strategy in 2014. We aimed to evaluate the effectiveness of programmatic HPV testing to detect cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+) in comparison with cytology-based screening. METHODS: We did a population-based, before-and-after retrospective cohort study using data from the National Cervical Cancer Prevention Program for the Jujuy province in northwest Argentina. We obtained data for the cytology-based screening period from Jan 1, 2010, until Dec 31, 2011, and for the HPV-based screening period from Jan 1, 2012, until Dec 31, 2014. The primary outcome was detection of histologically diagnosed CIN2+ among women aged 30 years and older. To assess the outcomes in all individuals included in the study, we used multivariable logistic regression and propensity score matching. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was used for the before-and-after analysis of programmatic dimensions. FINDINGS: Of the 29â631 women who underwent cytology-based screening in 2010-11, CIN2+ was detected in 236 (0·8%) individuals. Of the 49â565 women HPV tested in 2012-14 (clinician-collected tests, n=44â700; self-collection tests, n=4865), 693 (1·4%; 658 clinician-collected tests; 35 self-collection tests) were found to have CIN2+ after the first round of screening. Compared with cytology-based screening, the odds ratio of being diagnosed with a CIN2+ lesion was 2·34 (95% CI 2·01-2·73; p<0·0010) with clinician-collected tests, and 1·08 (0·74-1·52; p=0·68) when screened with self-collection tests, after controlling for age and health insurance status. Screening coverage was similar in both periods (52·7% vs 53·2%); improvements of programmatic indicators were observed in the HPV testing period in relation to laboratory centralisation, lower overscreening (6·6% vs 0·0%), higher adherance to age recommendations (79·3% vs 98·8%), and a decrease of inadequate samples (3·6% vs 0·2%). INTERPRETATION: HPV testing in middle-income settings increases detection of CIN2+ lesions and allows for improvement of programmatic indicators. Evidence suggests that the introduction of HPV testing will accelerate the reduction of cervical cancer burden. FUNDING: Argentinian National Cancer Institute and National Council of Scientific and Technologic Research.
Assuntos
Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , Argentina , Estudos Controlados Antes e Depois , Feminino , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Manejo de Espécimes/métodos , Neoplasias do Colo do Útero/virologia , Displasia do Colo do Útero/diagnósticoRESUMO
El objetivo fue determinar la sobreexpresión de c-MET en pacientes con cáncer biliar y analizar asociaciones con parámetros clínicos. Este es un estudio descriptivo, longitudinal, retrospectivo y prospectivo. Se determinó la sobreexpresión por inmunohistoquímica en 58 pacientes con resultados: positivo fuerte, positivo débil y negativo. Se construyeron curvas de supervivencia global con el método de KaplanMeier en todos los pacientes y en subgrupos según estadío, género, origen tumoral y grado de diferenciación histológica. La diferencia en supervivencia global entre subgrupos se analizó por el método log-rank. La asociación entre sobreexpresión y grado de diferenciación se estudió por el método chi cuadrado. Las pruebas estadísticas se realizaron a dos colas con un valor de p 0.05. Veintinueve muestras (50%) fueron negativas, 24 (41%) positivas débiles y 5 (9%) positivas fuertes. La mediana de supervivencia fue 18.2, 11.3 y 11.7 meses en pacientes con sobreexpresión negativa, positiva débil y positiva fuerte, respectivamente. Sin embargo, la diferencia en supervivencia global entre pacientes c-MET negativos y positivos (fuerte y débil) no alcanzó significancia estadística (p 0.068). En los subgrupos los resultados fueron similares. La sobreexpresión se asoció al grado de diferenciación (p 0.015), mostrando una relación inversa; y no se correlacionó con tasa de respuesta a la quimioterapia y tiempo a la progresión. La sobreexpresión de c-MET es frecuente en cáncer biliar, se asocia al grado de diferenciación tumoral y podría tener valor pronóstico. Si la vía c-MET es importante, los fármacos inhibidores tendrían impacto en la supervivencia global (AU)
The objective was to determine the overexpression of c-MET in patients with biliary cancer and to analyze associations with clinical parameters. This is a descriptive, longitudinal, retrospective and prospective study. Overexpression was obtained by immunohistochemistry in 58 patients, with the following results: strong positive, weak positive and negative. Overall survival curves were constructed using the Kaplan-Meier method in all patients and in subgroups according to stage, gender, tumor origin and grade of histological differentiation. The difference in overall survival between groups was analyzed by the log-rank test. The association between overexpression and grade of differentiation was studied using the chisquare method. Statistical tests were two-tailed with a p value 0.05. Twenty nine samples (50%) were negative, 24 (41%) weak positive and 5 (9%) strong positive. Median survival was 18.2, 11.3 and 11.7 months in patients with negative, weak positive and strong positive overexpression, respectively. However, the difference in overall survival between negative and positive (strong and weak together) c-MET patients did not reach statistical significance (p 0.068). In the subgroup analyses the results were similar. Overexpression correlated with tumor grade (p 0.015), showing an inverse association; and was not associated neither with chemotherapy response rate nor with time to progression. Overexpression of c-MET is common in biliary cancer, is associated with grade of tumor differentiation and could have prognostic value. If the c-MET pathway is important, the inhibitory drugs would have an impact on overall survival (AU)
Assuntos
Humanos , Neoplasias do Sistema Biliar , Proteínas Proto-Oncogênicas c-met , Imuno-HistoquímicaRESUMO
The aim of this article is to present results of programmatic introduction of HPV testing with cytologic triage among women 30 years and older in the province of Jujuy, Argentina, including description of the planning phase and results of program performance during the first year. We describe the project implementation process, and calculate key performance indicators using SITAM, the national screening information system. We also compare disease detection rates of HPV testing in 2012 with cytology as performed during the previous year. HPV testing with cytology triage was introduced through a consensus-building process. Key activities included establishment of algorithms and guidelines, creating the HPV laboratory, training of health professionals, information campaigns for women and designing the referral network. By the end of 2012, 100% (n = 270) of public health care centers were offering HPV testing and 22,834 women had been HPV tested, 98.5% (n = 22,515) were 30+. HPV positivity among women over 30 was 12.7%, 807 women were HPV+ and had abnormal cytology, and 281 CIN2+ were identified. CIN2+ detection rates was 1.25 in 2012 and 0.62 in 2011 when the program was cytology based (p = 0.0002). This project showed that effective introduction of HPV testing in programmatic contexts of low-middle income settings is feasible and detects more disease than cytology.
Assuntos
Infecções por Papillomavirus/diagnóstico , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Adulto , Idoso , Argentina/epidemiologia , Feminino , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem , Displasia do Colo do Útero/epidemiologiaRESUMO
Acercarse al concepto de farmacodependencia sin antes asumir una postura clara y aceptada por una comunidad académica o científica, puede derivar en la generalización de terminologías o explicaciones buenamente intencionadas por cada autor, grupo o institución, sin que se exprese con precisión un concepto de drogadicción. Por ello, conviene citar en este caso a la Organización Mundial de la Salud que considera droga (sinónimo de fármaco) a toda sustancia que introducida en un organismo vivo, pueda modificar una o varias de sus funciones. (OMS1969).
Approaching the concept of drug dependence without first assuming a clear and accepted position by an academic or scientific community can lead to the generalization of terminologies or well-intentioned explanations by each author, group or institution, without a concept of drug addiction being precisely expressed. For this reason, it is convenient to cite in this case the World Health Organization, which considers a drug (synonymous with drug) to any substance that, when introduced into a living organism, can modify one or more of its functions. (WHO1969).
Assuntos
Humanos , Transtornos Relacionados ao Uso de Substâncias , Psicanálise/história , Teoria Psicológica , Psicologia/métodosRESUMO
El inicio de la pedagogía reeducativa se produce en España a finales del siglo XIX, a partir de la fundación de la Congregación de Religiosos Terciarios Capuchino, quienes durante el siglo XX realizan una intervención de carácter más científico, apoyados en la Psicología Experimental. Luego de extenderse por varios continentes hasta llegar a Colombia, donde los Terciarios inician su labor profesional con la Escuela de Trabajo San José, antiguamente Casa de Menores del departamento de Antioquia. En esta imparten unos cursos especializados de Psicopedagogía, como producto de su intervención científica en España. Estos cursos van tomando forma hasta servir como capacitación de los educadores de reeducación y docentes de las instituciones educativas oficiales y posteriormente evolucionan hasta proponer una formación de educación superior, dando paso, a la creación de la FUNLAM con la Licenciatura en Pedagogía Reeducativa como programa fundante.
The beginning of reeducational pedagogy occurs in Spain at the end of the 19th century, from the foundation of the Congregation of Capuchin Tertiary Religious, who during the 20th century made a more scientific intervention, supported by Experimental Psychology. After extending over several continents until arriving in Colombia, where the Tertiary begin their professional work with the San José School of Labor, formerly House of Minors of the department of Antioquia. In this they teach specialized courses in Psychopedagogy, as a product of their scientific intervention in Spain. These courses are taking shape to serve as training for reeducation educators and teachers of official educational institutions and subsequently evolve to propose a higher education training, giving way, to the creation of FUNLAM with the Bachelor of Reeducational Pedagogy as a founding program .
Assuntos
Humanos , Ensino de Recuperação , Psicologia Social , Psicoterapia/métodos , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/prevenção & controleRESUMO
El suicidio en la población escolar no es un tema que sea reflexionado por la educación como campo disciplinar, tradicionalmente la educación se ha dedicado a la formación científica básica, la formación para el trabajo y la formación ética, que tienen como finalidad propender por el desarrollo del pensamiento científico en los educandos, para que más tarde puedan tomar decisiones acertadas y se puedan desempeñar como buenos ciudadanos.
Suicide in the school population is not an issue that is reflected by education as a disciplinary field, traditionally education has been dedicated to basic scientific training, job training and ethical training, which are intended to promote development. of scientific thinking in the students, so that later they can make sound decisions and be able to perform as good citizens.
Assuntos
Humanos , Suicídio , Ensino de Recuperação , Tentativa de Suicídio/prevenção & controle , Psicologia do AdolescenteRESUMO
Human T-cell leukemia virus type 1 (HTLV-1) infection is prevalent in native Americans living in the Andes. Some of their malignant lymphomas (ML) show a peculiar histology suggestive of adult T-cell leukemia/lymphoma (ATLL). To determine whether ML resembling ATLL are indeed ATLL, re-analysis of 34 cases occurring in Jujuy, a province of Argentina, was conducted, concentrating on immunological phenotype, integration of HTLV-1 proviral DNA, expression of HTLV-1 p40Tax and p27Rex, and infection of Epstein-Barr virus (EBV). The ML were 22 cases of mature peripheral T-cell and natural killer (NK)-cell neoplasm (mT/NKN), 11 B-cell malignant neoplasms and one Hodgkin's lymphoma. Polymerase chain reaction against the HTLV-1 proviral DNA, using DNA extracted from paraffin sections, indicated integration of the HTLV-1 proviral DNA in three cases of eight mT/NKN. Two other cases of mT/NKN were positive for anti-HTLV-1 antibodies. Expression of p40Tax and p27Rex was detected in all five of these mT/NKN cases associated with HTLV-1. As such, these five mT/NKN were rediagnosed as ATLL. In situ hybridization signals for EBV-encoded small nuclear early region-1 were detected in nine cases of mT/NKN, of which five cases of NK-cell lymphoma were found to have cytoplasmic CD3 expression, a CD56 phenotype and positivity of TIA1. According to the new World Health Organization classification, the mT/NKN class includes five cases of ATLL and five cases of NK-cell lymphomas. The five cases of ATLL were of native American extraction from an HTLV-1-endemic area around Jujuy, north-west Argentina.
Assuntos
DNA Viral/análise , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Leucemia-Linfoma de Células T do Adulto/virologia , Linfoma/virologia , Adulto , Idoso , Argentina/epidemiologia , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por Vírus Epstein-Barr/genética , Infecções por Vírus Epstein-Barr/virologia , Feminino , Produtos do Gene tax/análise , Genes pX , Herpesvirus Humano 4/isolamento & purificação , Humanos , Imuno-Histoquímica , Hibridização In Situ , Leucemia-Linfoma de Células T do Adulto/epidemiologia , Leucemia-Linfoma de Células T do Adulto/genética , Leucemia-Linfoma de Células T do Adulto/metabolismo , Leucemia-Linfoma de Células T do Adulto/patologia , Linfoma/epidemiologia , Linfoma/genética , Linfoma/metabolismo , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/análise , Estudos RetrospectivosRESUMO
The organization of the cholinergic system in the brain of anuran and urodele amphibians was recently studied, and significant differences were noted between both amphibian orders. However, comparable data are not available for the third order of amphibians, the limbless gymnophionans (caecilians). To further assess general and derived features of the cholinergic system in amphibians, we have investigated the distribution of choline acetyltransferase immunoreactive (ChAT-ir) cell bodies and fibers in the brain of the gymnophionan Dermophis mexicanus. This distribution showed particular features of gymnophionans such as the existence of a particularly large cholinergic population in the striatum, the presence of ChAT-ir cells in the mesencephalic tectum, and the organization of the cranial nerve motor nuclei. These peculiarities probably reflect major adaptations of gymnophionans to a fossorial habit. Comparison of our results with those in other vertebrates, including a segmental approach to correlate cell populations across species, shows that the general pattern of organization of cholinergic systems in vertebrates can be modified in certain species in response to adaptative processes that lead to morphological and behavioral modifications of members of a given class of vertebrates, as shown for gymnophionans.