Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos / Preservation of the fertility and the ovaries in women with benign adnexal tumors

OBJETIVO: Avaliar a preservação da fertilidade e dos ovários em mulheres submetidas à cirurgia por tumor anexial benigno. MÉTODOS: Para este estudo observacional com coleta prospectiva foram incluídas 206 mulheres operadas no CAISM-Unicamp de fevereiro de 2010 a janeiro de 2014. A preservação da fertilidade foi definida como tumorectomia ou anexectomia unilateral sem histerectomia em mulheres na pré-menopausa. A preservação ovariana foi considerada quando pelo menos um ovário ou parte dele foi preservado. RESULTADOS: Das 206 mulheres com tumores anexiais benignos, 120 (58%) estavam na pré-menopausa e 86 (42%) na pós-menopausa. Na pré-menopausa, foram encontrados 36 (30%) tumores de células germinativas, 31 (26%) neoplasias epiteliais e 11 (9%) do cordão sexual e estroma. Na pós-menopausa foram identificados 35 (41%) neoplasias epiteliais, 27 (31%) do cordão sexual e estroma e 8 (9%) de células germinativas. Entre as 36 mulheres com tumores ovarianos não neoplásicos, 21 (58%) apresentavam endometriomas e 8 (22%) cistos funcionais. Das 22 mulheres com tumores extra ovarianos, o leiomioma uterino foi o achado mais frequente (50%). Entre as pacientes com ≤35 anos, 26 (57%) foram submetidas à tumorectomia e 18 (39%) a anexectomia unilateral com preservação do útero e anexo contralateral. Mulheres com ≤35 anos foram mais frequentemente operadas por laparoscopia que esteve associada a maior taxa de preservação de fertilidade quando comparada com a laparotomia (p<0,01). Observou-se que 26 das pacientes submetidas à histerectomia com anexectomia (28%) bilateral estavam na pré-menopausa. CONCLUSÕES: Embora se observe uma tendência em realizar apenas tumorectomia em mulheres com ≤35 anos, uma proporção significativa de mulheres jovens ainda é ...

PURPOSE: To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors. METHODS: Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained. RESULTS: Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal. CONCLUSION: Although there is a trend to perform only tumorectomy in women who are ≤35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. ...

Dieta y cáncer gástrico en México y en el mundo / Diet and gastric cancer in Mexico and in the world

El cáncer gástrico (CG) es la cuarta causa de muerte por cáncer a nivel global. La dieta y el consumo de alcohol y tabaco, además de la infección por Helicobacter pylori determinan un gran número de casos de esta neoplasia. Algunos alimentos contienen sustancias que podrían influir en el proceso de carcinogénesis gástrica, aunque los mecanismos subyacentes no están completamente dilucidados. En México y el mundo, la disminución en el consumo de frutas, vegetales no feculentos y allium, leguminosas y alimentos fuente de selenio, así como el aumento en el consumo de sal, alimentos salados, salmuera y ahumados, chile, carnes procesadas y asadas o a la parrilla se han asociado respectivamente con un aumento de riesgo de CG. Con la evidencia disponible, se podrían desarrollar y evaluar programas para la prevención y control del CG.

Gastric cancer (GC) is the fourt leading cause of cancer death at global level. Diet, alcohol and tobacco, in addition to Helicobacter pylori infection, account for a large number of cases. Some substances contained in foods may influence GC carcinogenesis process; however, the underlying mechanisms have not been fully elucidated. In Mexico and worldwide, a low intake of fruits, non-starchy and allium vegetables, pulses, and foods containing selenium, as well as high intake of salt, salty, salted and smoked foods, chili pepper, processed and grilled/barbecued meats, have been respectively associated with an increased risk of GC. Based on the available evidence, programs for GC prevention and control could be developed and evaluated.

Mecanismos celulares e moleculares de ação dos glicocorticóides endógenos sobre a mobilização de neutrófilos / Cellular and molecular mechanisms of action of endogenous glucocorticoids on the neutrophil mobilization

Temos mostrado que os glicocorticóides endógenos (GE) modulam o rolling e a aderência de neutrófilos in vivo, mediando a expressão de moléculas de adesão no leucócito e no endotélio. Adicionalmente, os GE controlam a maturação neutrofílica na medula e a sua mobilização para o sangue periférico. O presente trabalho visou investigar os mecanismos moleculares e celulares envolvidos na modulação exercida pelos GE neste processo. Utilizando ratos Wistar submetidos à adrenalectomia bilateral, tratados com RU 38486 ou controles (falso-operados, tratados com veículo ou não manipulados), foi demonstrado que: 1) os GE controlam, negativamente, a expressão de L-selectina em neutrófilos circulantes e ICAM-1, VCAM-1, PECAM-1, VAP-1 na célula endotelial e, positivamente, a expressão de L-selectina em granulócitos da medula óssea via seu receptor citosólico (GCR); 2) o mecanismo envolvido no controle dos GE sobre a expressão de L-selectina é independente de ação sobre sua expressão gênica ou da atividade de NFkB, mas dependente da expressão de anexina-A1, como verificado em camundongos knockouts (KO) para esta proteína 3) o controle da expressão de moléculas de adesão endotelial é dependente de ações sobre a expressão gênica, via translocação nuclear do NFkB; 4) a neutrofilia detectada em animais adrenalectomizados (ADR) é mediada pelo GCR, e dependente de anexina- A1; 5) a neutrofilia parece ser dependente da ação da anexina-A1 sobre a secreção de SDF-1 na medula óssea e expressão de CXCR-4 em neutrófilos circulantes e da medula; 6) concentrações circulantes elevadas de GE induzidas pela administração de ACTH confirmaram o controle dos GE, via anexina A-1, sobre o tráfego de neutrófilos da medula óssea para o sangue, mas sugerem um controle diferencial dos GE e anexina A-1 sobre a expressão de L-selectina em células da medula e do sangue circulante. Estes dados mostram mecanismos inéditos do controle dos GE sobre o tráfego de neutrófilos, que diferem em cada microambiente...

We have shown that endogenous glucocorticoids (GE) modulate the rolling and adhesion of neutrophils in vivo, mediating the expression of adhesion molecules on leukocytes and the endothelium. Additionally, the GE control neutrophil maturation in bone marrow and mobilization to peripheral blood. This work aimed to investigate the molecular and cellular mechanisms involved in the modulation exerted by GE in this process. Using male Wistar rats, submitted to bilateral adrenalectomy, treatment with RU 38 486 or controls (sham operated, vehicle or non manipulated), it was shown that: 1) GE control, negatively, L-selectin expression on circulating neutrophils and ICAM-1, VCAM-1, PECAM-1, VAP-1 on endothelial cell and, positively, L-selectin expression on bone marrow granulocytes via their cytosolic receptor (GCR); 2) the mechanism involved in the control of GE on the L-selectin expression is independent of its action on gene expression or NFkB activity, but dependent on the expression of anexina-A1, as observed in mice knockouts for this protein; 3) the control of endothelial adhesion molecules is dependent on gene expression, via NFkB translocation; 4) the neutrophilia detected in adrenalectomized animals (ADR) is mediated by GCR, and dependent on anexina-A1; 5) the neutrophilia seems to be dependent on the action of annexin A-1 on SDF-1á secretion in bone marrow and expression of CXCR-4 in peripheral blood and bone marrow; 6) high circulating concentrations of GE induced by administration of ACTH confirmed the control of GE, via the annexin-1, on the traffic of neutrophils from the bone marrow to the blood, but suggest a differential control of GE and annexin A-1 on the L-selectin expression in the bone marrow and circulating blood. These data indicate unpublished mechanisms of control of GE on the traffic of neutrophils, which differ in each microenvironment and cell type involved in this complex phenomenon.

Colchicine binding to tubulin from brain homogenates in the presence of the sugars, glycols and metal ions: effect of nickel ions on the tubulin solubility

The fact that glycerol preserves microtubules from depolymerizing in vitro, and that some ions such as Ca(II) and Mg(II), regulate the assembly-disassembly process of these structures, induced us to study the effect of several sugars, glycols and metal ions on solubility and colchicine affinity of tubulin in rat brain homogenates, and of purified microtubular protein. Inhibition of colchicine binding was significant with glycerol, polyethylene glycol 1000 (PEG-2) and the ions A1(III), Co(II), Ni(II), while compounds structurally related to glycero (glucose and sucrose) did not inhibition it. Mannitol, instead, increased the activity a 47% over control. Apparently the presence of some compounds in brain homogenates [PEG-2 (1000) and NI (II)] favored tubulin sedimentation when these latterwere centrifuged at 100,000 x g for 150 min at 20 degrees C, but the form in which tubulin becomes aggregated in the pellet is unknown. Nickel ion madeinsoluble microtubular protein of homogenates and the purified one by more than 90% without causing significant inhibition of the colchicine binding. The sediment containing nickel-treated two cycles purified microtubular protein observed with the electron microscope did not present microtubules, but it revealed the presence of irregular, wavy and streteched structures, but it revealed the presence of irregular, wavy and stretched structures bearing highly dense dotted material. The sediments became soluble in phosphate-glutamate buffer (pH 6.8) and, when incubated in polymerizing conditions, gave rise to microtubules undistinguishable from those prepared with untreated purified protein