Evolution of mammographic image quality in the state of Rio de Janeiro / A evolução da qualidade da imagem em mamografia no Estado do Rio de Janeiro

Objective: To evaluate the evolution of mammographic image quality in the state of Rio de Janeiro on the basis of parameters measured and analyzed during health surveillance inspections in the period from 2006 to 2011. Materials and Methods: Descriptive study analyzing parameters connected with imaging quality of 52 mammography apparatuses inspected at least twice with a one-year interval. Results: Amongst the 16 analyzed parameters, 7 presented more than 70% of conformity, namely: compression paddle pressure intensity (85.1%), films development (72.7%), film response (72.7%), low contrast fine detail (92.2%), tumor mass visualization (76.5%), absence of image artifacts (94.1%), mammography-specific developers availability (88.2%). On the other hand, relevant parameters were below 50% conformity, namely: monthly image quality control testing (28.8%) and high contrast details with respect to microcalcifications visualization (47.1%). Conclusion: The analysis revealed critical situations in terms of compliance with the health surveillance standards. Priority should be given to those mammography apparatuses that remained non-compliant at the second inspection performed within the one-year interval. .

Objetivo: Avaliar a evolução da qualidade da imagem de mamógrafos localizados no Estado do Rio de Janeiro, de 2006 a 2011, com base em parâmetros medidos e observados durante inspeções sanitárias. Materiais e Métodos: Estudo descritivo sobre a evolução de parâmetros que condicionam a qualidade da imagem focalizou 52 mamógrafos, inspecionados no mínimo duas vezes, com intervalo de um ano. Resultados: Dos 16 parâmetros avaliados, 7 apresentaram mais de 70% de conformidade: força do dispositivo de compressão (85,1%), processamento dos filmes (72,7%), resposta do filme do serviço (72,7%), detalhes lineares de baixo contraste (92,2%), visualização de massas tumorais (76,5%), ausência de artefatos de imagem (94,1%), existência de processadoras específicas para mamografia (88,2%). Importantes parâmetros apresentaram-se abaixo de 50% de conformidade: realização de testes mensais da qualidade de imagem pelo estabelecimento (28,8%) e detalhes de alto contraste, que dizem respeito à visualização de microcalcificações (47,1%). Conclusão: A análise revelou situações críticas da atuação da vigilância sanitária, cuja prioridade deveria ser dirigida aos estacionários, ou seja, os mamógrafos que permaneceram na situação de não conformidade nas inspeções realizadas com intervalo de um ano. .

Maltrato institucional hacia el adulto mayor: percepciones del prestador de servicios de salud y de los ancianos / Institutional abuse toward the elderly: Perceptions of health care providers and older adults

Objetivo. Analizar la percepción que el prestador de servicios de salud y el adulto mayor (AM) tienen sobre el maltrato al AM en los servicios públicos de salud, en ciudades seleccionadas de México. Material y métodos. De 2009 a 2012 se realizó un estudio con diseño cualitativo y estrategia de triangulación de fuentes de datos; se efectuaron entrevistas semiestructuradas a 13 prestadores y a 12 ancianos para recuperar su experiencia en el tema. El análisis utilizó procedimientos de la Teoría Fundamentada. Resultados. El maltrato contra el AM es una práctica naturalizada por el personal y por el anciano, la cual se manifiesta de formas diversas. Conclusiones. La institucionalización, profesionalización histórica y falta de conciencia sobre las necesidades de los AM demandan cambios de planeación, organización y supervisión del Sistema de Salud. El personal requiere intervenciones de formación, capacitación y cambio de actitudes/comportamiento, para otorgar atención integral, digna, humana y de respeto a los Derechos Humanos de los AM.

Objective. To analyze the health care providers (HCP) and elderly patients' perceptions about abuse of the elderly by health personnel of public health services, in selected cities in Mexico. Materials and methods. A qualitative study and a strategy of data triangulation were performed during 2009 and 2012; 13 HCPs and 12 elders were interviewed, in order to obtain their experience regarding elder abuse. Grounded Theory proceedings were used for the analysis. Results. Elder abuse is a naturalized practice, from HCP and elderly people's point of view; these perceptions are showed in different ways. Conclusion. Institutionalization, historical professionalization and lack of consciousness about needs of the elderly (sociocultural and economic), require changes in planning, organization and monitoring process in the Health System; training and educational interventions on staff and exchange attitudes and behavior are necessary in order to offer a health care that is comprehensive, decent, human and with respect for the human rights.

Death-associated protein kinase is underexpressed in high-grade oral squamous cell carcinoma / La expresión de la proteína quinasa asociada a muerte celular (DAP quinasa) está reducida en carcinoma de células escamosas oral de alto grado

An immunohistochemical analysis of 40 cases of oral squamous cell carcinoma was performed to evaluate the relationship between the expression pattern of death-associated protein kinase (DAPk) positive cells with the histological malignancy grading of these lesions. According to our results, eleven cases (27.5 percent) were high-grade malignancy tumours and 29 (72.5 percent) were low-grade ones. We found that 92.86 percent of the low-grade tumours were positive to anti-DAP kinase antibody whereas only 7.14 percent of the high-grade tumours presented positivity, and this difference was statistically significant (p<0.01). Sixteen (55.2 percent) of the low-grade carcinomas exhibited moderate immunoreactivity whereas ten cases (34.5 percent) showed weak staining and three cases (10.3 percent) were negative tumours. Immunostaining was lacking in nine (81.8 percent) of the high-grade carcinomas and "weak" in the two (18.2 percent) remaining cases. Thus, DAPk expression is significantly decreased in high-grade oral carcinomas, and evidences indicate that it might be related to the severity of cytological atypia.

Fue realizado un análisis inmunohistoquímico de 40 casos de carcinoma oral de células escamosas para evaluar la relación entre el patrón de expresión de la proteína quinasa (DAPK) asociada a la muerte celular y la clasificación histológica de malignidad de estas lesiones. Según nuestros resultados, 11 casos (27,5 por ciento) eran tumores de alto grado de malignidad y 29 (72,5 por ciento) de bajo grado. Se encontró que 92,86 por ciento de los tumores de bajo grado de malignidad fueron eran positivos para anticuerpos anti-DAP-quinasa, mientras que sólo 7,14 por ciento de los tumores de alto grado presentaron positividad, esta diferencia fue estadísticamente significativa (p <0,01). En 16 casos (55,2 por ciento) los carcinomas de bajo grado de malignidad mostraron inmunorreactividad moderada mientras que 10 casos (34,5 por ciento) mostraron una tinción débil y 3 casos (10,3 por ciento) fueron negativos. La inmunotinción estuvo ausente en 9 (81,8 por ciento) de los carcinomas de alto grado y "débil" grado de malignidad en los 2 (18,2 por ciento) casos restantes. Así, la expresión DAPK se redujo significativamente en los carcinomas orales de alto grado y las evidencias indican que podría estar relacionado con la severidad de la atipia citológica.

CaMKIIdelta overexpression in hypertrophy and heart failure: cellular consequences for excitation-contraction coupling

Ca/calmodulin-dependent protein kinase IIdelta (CaMKIIdelta) is the predominant isoform in the heart. During excitation-contraction coupling (ECC) CaMKII phosphorylates several Ca-handling proteins including ryanodine receptors (RyR), phospholamban, and L-type Ca channels. CaMKII expression and activity have been shown to correlate positively with impaired ejection fraction in the myocardium of patients with heart failure and CaMKII has been proposed to be a possible compensatory mechanism to keep hearts from complete failure. However, in addition to these acute effects on ECC, CaMKII was shown to be involved in hypertrophic signaling, termed excitation-transcription coupling (ETC). Thus, animal models have shown that overexpression of nuclear isoform CaMKIIdeltaB can induce myocyte hypertrophy. Recent study from our laboratory has suggested that transgenic overexpression of the cytosolic isoform CaMKIIdeltaC in mice causes severe heart failure with altered intracellular Ca handling and protein expression leading to reduced sarcoplasmic reticulum (SR) Ca content. Interestingly, the frequency of diastolic spontaneous SR Ca release events (or opening of RyR) was greatly enhanced, demonstrating increased diastolic SR Ca leak. This was attributed to increased CaMKII-dependent RyR phosphorylation, resulting in increased and prolonged openings of RyR since Ca spark frequency could be reduced back to normal levels by CaMKII inhibition. This review focuses on acute and chronic effects of CaMKII in ECC and ETC. In summary, CaMKII overexpression can lead to heart failure and CaMKII-dependent RyR hyperphosphorylation seems to be a novel and important mechanism in ECC due to SR Ca leak which may be important in the pathogenesis of heart failure.

Phosphorylation of ryanodine receptors

Both cardiac and skeletal muscle ryanodine receptors (RyRs) are parts of large complexes that include a number of kinases and phosphatases. These RyRs have several potential phosphorylation sites in their cytoplasmic domains, but the functional consequences of phosphorylation and the identity of the enzymes responsible have been subjects of considerable controversy. Hyperphosphorylation of Ser-2809 in RyR2 (cardiac isoform) and Ser-2843 in RyR1 (skeletal isoform) has been suggested to cause the dissociation of the FK506-binding protein (FKBP) from RyRs, producing "leaky channels," but some laboratories find no relationship between phosphorylation and FKBP binding. Also debated is the identity of the kinases that phosphorylate these serines: cAMP-dependent protein kinase (PKA) versus calmodulin kinase II (CaMKII). Phosphorylation of other targets of these kinases could also alter calcium homeostasis. For example, PKA also phosphorylates phospholamban (PLB), altering the Sarco-endoplasmic reticulum Ca2+ ATPase (SERCA) activity. This review summarizes the major findings and controversies associated with phosphorylation of RyRs.

Evidence for a modulation of neutral trehalase activity by Ca2+ and cAMP signaling pathways in Saccharomyces cerevisiae

Saccharomyces cerevisiae neutral trehalase (encoded by NTH1) is regulated by cAMP-dependent protein kinase (PKA) and by an endogenous modulator protein. A yeast strain with knockouts of CMK1 and CMK2 genes (cmk1cmk2) and its isogenic control (CMK1CMK2) were used to investigate the role of CaM kinase II in the in vitro activation of neutral trehalase during growth on glucose. In the exponential growth phase, cmk1cmk2 cells exhibited basal trehalase activity and an activation ratio by PKA very similar to that found in CMK1CMK2 cells. At diauxie, even though both cells presented comparable basal trehalase activities, cmk1cmk2 cells showed reduced activation by PKA and lower total trehalase activity when compared to CMK1CMK2 cells. To determine if CaM kinase II regulates NTH1 expression or is involved in post-translational modulation of neutral trehalase activity, NTH1 promoter activity was evaluated using an NTH1-lacZ reporter gene. Similar ß-galactosidase activities were found for CMK1CMK2 and cmk1cmk2 cells, ruling out the role of CaM kinase II in NTH1 expression. Thus, CaM kinase II should act in concert with PKA on the activation of the cryptic form of neutral trehalase. A model for trehalase regulation by CaM kinase II is proposed whereby the target protein for Ca2+/CaM-dependent kinase II phosphorylation is not the neutral trehalase itself. The possible identity of this target protein with the recently identified trehalase-associated protein YLR270Wp is discussed

Mecanismos de acción de los estabilizadores del ánimo / Mechanisms of action of mood stabilizers

Objetivo: analizar los progresos en el conocimiento de los mecanismos de acción de los estabilizadores del ánimo y sus potenciales implicancias para la clínica. Método: revisión de la literatura reciente, con énfasis en los artículos de revisión y de aplicación clínica y análisis crítico de la información. Resultados: los mecanismos iniciales de acción de los estabilizadores del ánimo son variados. No obstante, las acciones más importantes se producen en el largo plazo. Tanto el litio como el valproato producirían inhibición de la glicogen-sintetasa-kinasa 3-beta (GSK-3-beta) y disminución de proteinkinasa C. El litio disminuiría la proteinkinasa C a través de la depleción de inositol. Además el litio y el valproato ejercerían efectos no precisados sobre las proteínas G. Estas acciones afectarían la inducción de factores de transcripción génicos, la expresión de genes tempranos y la producción de factores neurotróficos en el sistema nervioso central. El resultado sería una serie de cambios plásticos en poblaciones neuronales específicas. Conclusión: se ha progresado mucho en el conocimiento acerca de los mecanismos de acción de los estabilizadores del ánimo, en especial sobre sus efectos celulares, genéticos y moleculares. Este conocimiento puede permitir el desarrollo de nuevos fármacos para el tratamiento de los trastornos del estado de ánimo

Pharmacological differences between memory consolidation of habituation to an open field and inhibitory avoidance learning

Rats implanted bilaterally with cannulae in the CA1 region of the dorsal hippocampus or the entorhinal cortex were submitted to either a one-trial inhibitory avoidance task, or to 5 min of habituation to an open field. Immediately after training, they received intrahippocampal or intraentorhinal 0.5-æl infusions of saline, of a vehicle (2 percent dimethylsulfoxide in saline), of the glutamatergic N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-5-phosphono pentanoic acid (AP5), of the protein kinase A inhibitor Rp-cAMPs (0.5 æg/side), of the calcium-calmodulin protein kinase II inhibitor KN-62, of the dopaminergic D1 antagonist SCH23390, or of the mitogen-activated protein kinase kinase inhibitor PD098059. Animals were tested in each task 24 h after training. Intrahippocampal KN-62 was amnestic for habituation; none of the other treatments had any effect on the retention of this task. In contrast, all of them strongly affected memory of the avoidance task. Intrahippocampal Rp-cAMPs, KN-62 and AP5, and intraentorhinal Rp-cAMPs, KN-62, PD098059 and SCH23390 caused retrograde amnesia. In view of the known actions of the treatments used, the present findings point to important biochemical differences in memory consolidation processes of the two tasks

Perturbation of EGF-induced MAP kinase activation by TGF-ß1

TGF-ß1 regulates both cellular growth and phenotypic plasticity important for maintaining a growth advantage and increased invasiveness in progressively malignant cells. Recent studies indicate that TGF-ß-1 stimulates the conversion of epitheliod to fibroblastoid phenotype which presumably leads to the inactivation of growth-inhibitory effects by TGF-ß1 (Portella et al. (1998) Cell Growth and Differentiation, 9: 393-404). Therefore, the investigation of TGF-ß1 signaling that leads to altered growth and migration may provide novel targets for the prevention of increased cell growth and invasion. Although much attention has been paid to TGF-ß1 responses in epithelial cells, the above studies suggest that examination of signal transduction pathways in fibroblasts are important as well. Data from our laboratory are consistent with the concept that TGF-ß1 can act as a regulatory switch in density-dependent C3H 10T1/2 fibroblasts capable of either promoting or delaying G1 traverse. The regulation of this switch is proposed to occur prior to pRb phosphorylation, namely prior to activation of cyclin-dependent kinases. The current study is concerned with the evaluation of a key cyclin (cyclin D1) which activates cdk4 and p27KIP1 which in turn inhibit cdk2 in the proliferative responses of epidermal growth factor (EGF) and platelet-derived growth factor (PDGF) and their modulation by TGF-ß1. Although the molecular events that lead to elevation of cyclin D1 are not completely understood, it appears likely that activation of p42/p44MAPK kinases is involved in its transcriptional regulation. TGF-ß1 delayed EGF- or PDGF-induced cyclin D1 expression and blocked the induction of active p42/p44MAPK. The mechanism by which TGF-ß1 induces a block in p42/p44MAPK activation is being examined and the possibility that TGF-ß1 regulates phosphatase activity is being tested

Inhibidores del sistema calcio-Calmodulina y diferenciación sexual hipotalámica en la rata. Parámetros bioquímicos / Inhibitors of calcium-calmoduline system and hypothalamic sexual diferentiation: Biochemical parameters

Se estudió el efecto de la administración perinatal de algunos fármacos psicotrópicos (haloperidol, penfluridol, trifluoperazina, pimocida y verapamil) sobre algunos parámetros morfológicos y bioquímicos del hipotálamo, en ratas machos y en hembras androgenizadas por la administración de propionato de testosterona a las 72 horas de vida extrauterina. El verapamil indujo el crecimiento hipotalámico tanto en machos como en hembras androgenizadas. Todos los fármacos disminuyeron el peso testicular, siendo más eficaces el haloperidol (1.50 ñ 0.49 g) y la pimocida (2.00 ñ 0.11 g). En las hembras neonatas, la testosterona disminuyó el desarrollo ovárico (46.3 ñ 4.5 vs 23.1 ñ 2.7 mg). El haloperidol y la pimocida revirtieron parcialmente dicho efecto mientras que el verapamil fue ineficaz. Las concentraciones de proteínas, DNA y RNA fueron mayores en el hipotálamo de la hembra adulta, tanto normal como tratada, que en el macho (fig. 1). La testosterona disminuyó las concentraciones de las tres macromoléculas al nivel encontrado en los machos; todos los fármacos utilizados revirtieron este efecto. En los machos, todos los tratamientos mostraron tendencia a elevar la concentración de proteínas, DNA y RNA a los niveles encontrados en la hembra adulta; la trifluoperazina, el verapamil y el penfluridol fueron los más eficaces, la pimocida sólo elevó las protéinas y el haloperidol únicamente elevó el DNA

Control of the phosphorylation of the astrocyte marker glial fibrillary acidic protein (GFP) in the immature rat hippocampus by glutamate and calcium ions: possible key factor in astrocytic plasticity

The present review describes recent research on the regulation by glutamate and Ca2+ of the phosphorylation state of the intermediate filament protein of the astrocytic cytoskeleton, glial fibrillary acidic protein (GFAP), in immature hippocampal slices. The results of this research are discussed against a background of modern knowledge of the functional importance of astrocytes in the brain and of the structure and dynamic properties of intermediate filament proteins. Astrocytes are now recognized as partners with neurons in many aspects of brain function with important roles in neural plasticity. Site-specific phosphorylation of intermediate filament proteins, including GFAP, has been shown to regulate the dynamic equilibrium between the polymerized and depolymerized state of the filaments and to play a fundamental role in mitosis. Glutamate was found to increase the phosphorylation state of GFAP in hippocampal slices from rats in the post-natal age range of 12-16 days in a reaction that was dependent on external Ca2+. The lack of external Ca2+ in the absence of glutamate also increased GFAP phosphorylation to the same extent. These effects of glutamate and Ca2+ were absent in adult hippocampal slices, where the phosphorylation of GFAP was completely Ca2+ -dependent. Studies using specific agonists of glutamate receptors showed that the glutamate response was mediated by a G protein-linked group II metabotropic glutamate receptor (mGluR). Since group II mGluRs do not act by liberating Ca2+ from internal stores, it is proposed that activation of thereceptor by glutamate inhibits Ca2+ entry into the astrocytes andconsequently down-regulates a Ca2+-dependent dephosphorylationcascade regulating the phosphorylation state of GFAP. The functional significance of these results may be related to the narrow developmental window when the glutamate response is present. In the rat brain this window corresponds to the period of massive synaptogenesis during which astrocytes are known to proliferate. Possibly, glutamate liberated from developing synapses during this period may signal an increase in the phosphorylation state of GFAP and a consequent increase in the number of mitotic astrocytes.

Memory of inhibitory avoidance in the rat is regulated by glutamate metabotropic receptors and by calcium/calmodulin kinase II in the hippocampus

We studied the effect on memory of the bilateral intrahippocampal posttraining infusion of the glutamate metabotropic receptor (mGLUR) agonist, 1S,2R-aminocyclopentane dicarboxylate (ACPD), of the mGLUR antagonist, [RS]-alpha-methyl-4-carboxyphenyl glycine (MCPG), and of the inhibitor of calcium/calmodulin protein kinase II (CaM II), 1-[N,O-Bis (5-isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenyl piperazine (KN62). Male Wistar rats were implanted with cannulae in the CA1 region of the dorsal hippocampus. After recovery from surgery they were trained in a step-down inhibitory avoidance task and tested for retention 24 h later. Immediately or 180 min after training they received an intrahippocampal infusion of saline (0.5 mul), KN62 (100 mumoles), ACPD (20 nmoles), MCPG (13 nmoles) or of ACPD plus MCPG in 0.5 mul of saline. When given immediately after training, KN62 and MCPG were amnestic and ACPD caused memory facilitation and antagonized the effect od MCPG. When given 180 min after training, the drugs had no effect on memory. The results indicate that the early phase of memory is regulated by mGLURs in the hippocampus and requires CaM II activity. The data support the suggestion that memory involves long-term potentiation in the hippocampus.