NKX2­1 copy number alterations are associated with oncogenic, immunological and prognostic remodeling in non­small cell lung cancer.

NK2 homeobox 1 (NKX2-1) copy number alterations (CNAs) are frequently observed in lung cancer. However, little is known about the complete landscape of focal alterations in NKX2-1 copy number (CN), their clinical significance and their therapeutic implications in non-small cell lung cancer (NSCLC). The correlations between NKX2-1 expression and EGFR driver mutations and programmed death ligand 1 (PD-L1) co-expression were studied using immunohistochemistry and PCR from the tumors of recruited Filipino patients (n=45). Clinical features of NSCLC with NKX2-1 CNAs were resolved at the tumor and clonal levels using the molecular profiles of patients with lung adenocarcinoma and lung squamous cell carcinoma from The Cancer Genome Atlas (n=1,130), and deconvoluted single-cell RNA-seq data from the Bivona project (n=1,654), respectively. Despite a significant and positive correlation between expression and CN (r=0.264; P<0.001), NKX2-1 CNAs exerted a stronger influence on the combined EGFR and PD-L1 status of NSCLC tumors than expression. NKX2-1 CN gain was prognostic of favorable survival (P=0.018) and a better response to targeted therapy. NKX2-1 CN loss predicted a worse survival (P=0.041). Mutational architecture in the Y-chromosome differentiated the two prognostic groups. There were 19,941 synonymous mutations and 1,408 genome-wide CN perturbations associated with NKX2-1 CNAs. Tumors with NKX2-1 CN gain expressed lymphocyte markers more heterogeneously than those with CN loss. Higher expression of tumor-infiltrating lymphocyte gene signatures in CN gain was prognostic of longer disease-free survival (P=0.005). Tumors with NKX2-1 CN gain had higher B-cell (P<0.001) and total T-cell estimates (P=0.003). NKX2-1 CN loss was associated with immunologically colder tumors due to higher M2 macrophage infiltrates (P=0.011) and higher expression of immune checkpoint proteins, CD274 (P=0.025), VTCN1 (P<0.001) and LGALS9 (P=0.002). In conclusion, NKX2-1 CNAs are associated with tumors that exhibit clinically diverse characteristics, and with unique oncogenic, immunological and prognostic signatures.

The differential prognostic implications of PD-L1 expression in the outcomes of Filipinos with EGFR-mutant NSCLC treated with tyrosine kinase inhibitors.

Background: The tumor immune microenvironment influences tumor evolution in non-small cell lung cancer (NSCLC). Yet, the prognostic value of programmed death-ligand 1 (PD-L1) in epidermal growth factor receptor (EGFR)-mutant NSCLC remains controversial. Additionally, prognostic studies in Filipinos with EGFR-mutant NSCLC remain unexplored to this day. Methods: We prospectively studied the outcomes of EGFR-mutant NSCLC in Filipino cohort, and retrospectively verified the survival trend using The Cancer Genome Atlas (TCGA) cohort. Kaplan-Meier method and generalized linear regression were used to assess survival. Expression and DNA methylation of cluster of differentiation 274 (CD274, gene that codes for PD-L1) were examined from TCGA tumor profiles. Pearson's correlation was used to correlate PD-L1 expression with outcomes associated with occurrence of EGFR mutations, tyrosine kinase inhibitor (TKI) types, and programmed cell death protein 1 (PD-1) expression. Proteome network analysis was used to examine the correlation between drug resistance and PD-L1. Results: PD-L1 positivity was associated with significantly longer progression-free survival (PFS; P=0.0096) but had a significantly contrasting influence in the overall survival (OS; P=0.0011). PD-L1 positivity (in both protein and RNA) was associated with longer median OS (mOS) in exon21 L858R, whereas, negativity was associated with longer mOS in exon19 deletion (exon19del). Stratification (high, low, negative) of PD-L1 expression lacked significant prognostic value (all P>0.05). PD-L1/CD274 expression (P<0.05) and DNA methylation (P<0.001) vary significantly among NSCLC subtypes and in different disease stages. Erlotinib treatment produced the longest median progression-free survival (mPFS; 874 days) relative to other EGFR-TKIs (137-311 days). PD-L1 lacked a significant correlation with EGFR-TKIs. Consistent with the immune-regulation activities of PD-1, higher expression leads to relatively shorter mOS. PD-1 correlated positively with PD-L1 expression and occurrence of exon21 L858R. Conclusions: PD-L1 differentially influenced the outcomes of Filipinos with EGFR-mutant NSCLC. NSCLC subtypes, disease stage, and PD-1 expression may impact the collective outcomes associated with PD-L1 and EGFR-sensitizing mutations.

Expression landscapes in non-small cell lung cancer shaped by the thyroid transcription factor 1.

TTF-1-expressing non-small cell lung cancer (NSCLC) is one of the most prevalent lung cancer types worldwide. However, theparadoxical activity of TTF-1 in both lung carcinogenesis and tumor suppression is believed to be context-dependentwhich calls for a deeper understanding about the pathological expression of TTF-1. In addition, the expression circuitry of TTF-1-target genes in NSCLC has not been well examined which necessitates to revisit the involvement of TTF-1- in a multitude of oncologic pathways. We used RNA-seq and clinical data of patients from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx), including ChIP-seq data from different NSCLC cell lines, and mapped the proteome of NSCLC tumor. Our analysis showed significant variability in TTF-1 expression among NSCLC,and further clarified that this variability is orchestrated at the transcriptional level. We also found that high TTF-1 expression could negatively influence the survival outcomes of stage 1 LUAD which may be attributed to growth factor receptor-driven activation of mitogenic and angiogenic pathways. Mechanistically, TTF-1 may also control the genes associated with pathways involved in acquired TKI drug resistance or response to immune checkpoint inhibitors. Lastly, proteome-based biomarker discovery in stage 1 LUAD showed that TTF-1 positivity is potentially associated with the upregulation of several oncogenes which includes interferon proteins, MUC1, STAT3, and EIF2AK2. Collectively, this study highlights the potential involvement of TTF-1 in cell proliferation, immune evasion, and angiogenesis in early-stage NSCLC.

High-dose vitamin D versus placebo to prevent complications in COVID-19 patients: Multicentre randomized controlled clinical trial.

BACKGROUND: The role of oral vitamin D3 supplementation for hospitalized patients with COVID-19 remains to be determined. The study was aimed to evaluate whether vitamin D3 supplementation could prevent respiratory worsening among hospitalized patients with COVID-19. METHODS AND FINDINGS: We designed a multicentre, randomized, double-blind, sequential, placebo-controlled clinical trial. The study was conducted in 17 second and third level hospitals, located in four provinces of Argentina, from 14 August 2020 to 22 June 2021. We enrolled 218 adult patients, hospitalized in general wards with SARS-CoV-2 confirmed infection, mild-to-moderate COVID-19 and risk factors for disease progression. Participants were randomized to a single oral dose of 500 000 IU of vitamin D3 or matching placebo. Randomization ratio was 1:1, with permuted blocks and stratified for study site, diabetes and age (≤60 vs >60 years). The primary outcome was the change in the respiratory Sepsis related Organ Failure Assessment score between baseline and the highest value recorded up to day 7. Secondary outcomes included the length of hospital stay; intensive care unit admission; and in-hospital mortality. Overall, 115 participants were assigned to vitamin D3 and 105 to placebo (mean [SD] age, 59.1 [10.7] years; 103 [47.2%] women). There were no significant differences in the primary outcome between groups (median [IQR] 0.0 [0.0-1.0] vs 0.0 [0.0-1.0], for vitamin D3 and placebo, respectively; p = 0.925). Median [IQR] length of hospital stay was not significantly different between vitamin D3 group (6.0 [4.0-9.0] days) and placebo group (6.0 [4.0-10.0] days; p = 0.632). There were no significant differences for intensive care unit admissions (7.8% vs 10.7%; RR 0.73; 95% CI 0.32 to 1.70; p = 0.622), or in-hospital mortality (4.3% vs 1.9%; RR 2.24; 95% CI 0.44 to 11.29; p = 0.451). There were no significant differences in serious adverse events (vitamin D3 = 14.8%, placebo = 11.7%). CONCLUSIONS: Among hospitalized patients with mild-to-moderate COVID-19 and risk factors, a single high oral dose of vitamin D3 as compared with placebo, did not prevent the respiratory worsening. TRIAL REGISTRATION: ClincicalTrials.gov Identifier: NCT04411446.

Avaliação dos conhecimentos para o tratamento não farmacológico da dor / Evaluación de conocimientos para el manejo no farmacológico del dolor / Evaluation of knowledge for the non-pharmacological management of pain

Las intervenciones para el alivio del dolor se clasifican en farmacológicas y no farmacológicas; las primeras incluyen la administración de fármacos analgésicos y las segundas utilizan terapias complementarias. El objetivo de este estudio fue diseñar y validar un instrumento de medición denominado "Conocimiento sobre intervenciones no farmacológicas para el alivio del dolor" para evaluar el nivel de conocimientos sobre intervenciones no farmacológicas para el manejo del dolor en un grupo de enfermeras profesionales y auxiliares de enfermería de una institución de salud de Bucaramanga, Colombia. Métodos: El instrumento se desarrolló en dos fases; la primera fase consistió en la búsqueda bibliográfica para el diseño, la validación facial y de contenido por expertos. En la segunda fase se evalúo la confiabilidad prueba- reprueba de la versión final del cuestionario. Resultados: La versión final del cuestionario contempla seis dimensiones propuestas por el Instituto Nacional de Medicina Alternativa de Estados Unidos con un total de 30 ítems. La confiabilidad de este instrumento fue baja (Índice Kappa-Cohen <0.60) en el 80% de los ítems. Conclusión: Este es el primer instrumento diseñado para medir los conocimientos sobre intervenciones no farmacológicas para el alivio del dolor en enfermeras y auxiliares de enfermería en nuestro país, sin embargo, se requiere continuar con procesos que permitan mejorar su confiabilidad y evaluar su validez.

As intervenções para o alivio da dor classificam-se em farmacológicas e não farmacológicas; as primeiras, consideram a administração de analgésicos, as segundas, empregam-se terapias complementarias. Objetivo: desenvolver e validar um questionário para à avaliação do nível de conhecimentos sob intervenções não farmacológicas para o tratamento da dor num grupo de enfermeiras padrão e auxiliares de enfermagem numa instituição de saúde de Bucaramanga, Colômbia. Materiais e métodos: O instrumento desenvolveu-se em duas fases: a primeira constou da busca de literatura, o desenho, a validação facial e de conteúdo por expertos. Na segunda fase, o questionário aplicou-se duas vezes a 30 enfermeiras e auxiliares de enfermagem com um intervalo de 30 dias para avaliar a confiabilidade. Calculou-se a pontuação total do instrumento e o índice Kappa-Cohen. Resultados: A versão final do questionário tem 30 questões avaliando seis dimensões propostas pelo Instituto Nacional de Medicina Alternativa dos Estados Unidos. Mais do 80% dos participantes teve o 70% das perguntas acertadas, entretanto, a confiabilidade do instrumento foi baixa (Kappa-Cohen <0,60) no 80% dos itens. Conclusão: Este é o primeiro instrumento desenvolvido para aferir conhecimentos sobre terapia não farmacológica para o alivio da dor em enfermeiras e auxiliares de enfermagem na Colômbia, entretanto requer continuar aprimorando a sua confiabilidade e a avaliação da sua validez.

Interventions to alleviate pain are classified in two categories, pharmacological and non/pharmacological; the first ones include the administration of pain relievers and the second ones use complementary therapies. Objective. Design and validate an instrument of measurement to evaluate the level of knowledge about non-pharmacological interventions to manage pain in a group of professional nurses and auxiliary nurses from a health institution in Bucaramanga, Colombia. Materials and Methods: The instrument was developed in two stages: the first stage consisted of the bibliographic research, the design and the facial and content validation by experts. In the second phase, the instrument was applied twice to 30 nurses and auxiliary nurses with an interval of 30 days to evaluate reliability. The total score of the instrument and the Cohen's kappa coefficient were calculated. Results: The final version of the questionnaire contemplates six dimensions proposed by the National Center for Complementary and Integrative Health (NCCIH), with a total of 30 items. More than 80% of the participants had 70% of the answers correct, however, the reliability of this instrument was low (Cohen's kappa < 0.60) in 80% of the items. Conclusion: This is the first instrument designed to measure knowledge about non-pharmacological interventions to alleviate pain for nurses and auxiliary nurses in our country, however, it is required to continue with processes that allow the instrument to improve its reliability and evaluate its validity.

Temporal and Spatial Characterization of Gait Pattern in Rodents as an Animal Model of Cerebrovascular Lesion / Caraterização Temporo - Espacial do Padrão de Marcha em Roedores como Modelo Animal de Lesão Cerebrovascular / Caracterización temporo-espacial del patrón de marcha en roedores como modelo animal de lesión cerebrovascular

RESUMEN En la investigación sobre movimiento, la experimentación animal ha proporcionado fundamentación científica para la investigación clínica, mejorando procedimientos diagnósticos y de rehabilitación. Lesiones cerebrales en roedores pueden ser usadas para modelar síntomas locomotores, sensoriales y/o cognitivos. Con el propósito de determinar la funcionalidad locomotriz y sensorial en roedores, se han propuesto varios métodos de evaluación y pronóstico clínico para identificar y evaluar adaptaciones estructurales y mecanismos de neuro-recuperación. Esto ha permitido que métodos de intervención terapéutica, como el ejercicio físico, sean utilizados para restaurar funciones sensitivo-motoras y cognitivas en roedores y humanos. La extrapolación (translación) de los resultados de investigaciones en ciencias básicas a áreas clínicas, supone la continua cooperación y retroalimentación entre investigadores y profesionales de la salud, favoreciendo la formulación de intervenciones terapéuticas más eficaces basadas en resultados obtenidos de la experimentación animal. El objetivo de esta revisión es exponer las principales deficiencias motoras y los métodos empleados para determinar la dificultad motriz en la marcha en roedores con lesión cerebrovascular, para lo cual se realizó una revisión de literatura, sobre términos definidos (MeSH), en las bases de datos PsychINFO, Medline y Web of Science, entre enero de 2000 y enero de 2017. Se excluyeron artículos de carácter cualitativo o narrativo, sin revisión por pares, disertaciones, tesis o trabajos de grado y resúmenes de conferencias. Se revisan algunas manifestaciones clínicas, su efecto en la locomotricidad en roedores, algunas metodologías usadas para generar lesiones y para estudiar la función motriz, los principales métodos de medición y algunos aspectos translacionales.

ABSTRACT Animal experimentation is crucial for the advance in the understanding of pathophysiological mechanisms and their application on both clinical diagnosis and neuro-rehabilitation. Particularly, rodent brain lesion is commonly used in the modeling of locomotor, somatosensory and cognitive symptoms. The automated rodent gait analysis has been proposed as a tool for studying locomotor and sensory abilities and its use includes the identification of functional alterations, structural adaptations as well as neuro-rehabilitation mechanisms. From that standpoint, the effectiveness of many therapeutic interventions (i.e. physical exercises) has been documented in rodents and humans. The translation from experimental data to clinical conditions requires the continuous collaboration and feedback between researchers and health clinicians looking for the selection of the best rehabilitation protocols obtained from animal research. Here we will show some locomotor alterations, the traditional methods used to assess motor dysfunction and gait abnormalities in rodent models with stroke. The aim of this review is to show some motor deficiencies and some methods used to establish gait disturbances in rodents with cerebrovascular lesion. The review included the search of defined terms (MeSH) in PychINFO, Medline and Web of Science, between January 2000 and January 2017. Qualitative and narrative reports, dissertations, end course works and conference resumes were discarded. The review focuses on some clinical signs, their effects on rodent locomotor activity, some methodologies used to create lesion and to study motor function, some assessment methods and some translational aspects.

RESUMO No estudo do movimento, a experimentação animal tem proporcionado sólida fundamentação científica para a pesquisa clínica, permitindo melhorar procedimentos diagnósticos e de reabilitação. Lesões cerebrais em roedores são utilizadas para modelar sintomas locomotores, sensoriais e cognitivos. Para determinar a funcionalidade locomotora e sensorial em roedores, têm sido desenvolvidas várias metodologias para avaliar o prognóstico clínico e identificar adaptações estruturais e mecanismos da recuperação. Todos esses achados têm favorecido que alguns métodos de intervenção terapêutica sejam utilizados para restaurar funções sensitivo-motoras e cognitivas em roedores e pacientes. A extrapolação (translação) de resultados de pesquisas em ciências básicas para as áreas clínicas, supõe a contínua cooperação e retroalimentação entre pesquisadores e profissionais da saúde, desenhando intervenções terapêuticas mais eficazes, baseadas em resultados obtidos na experimentação animal. Nesta revisão se expõem metodologias utilizadas para criar e avaliar alterações motoras, em modelos animais com acidente cerebral vascular. O objetivo é apresentar deficiências motoras e métodos utilizados para determinar a dificuldade na marcha em roedores com lesão cerebrovascular. Para isso foi feita uma revisão da literatura, usando termos definidos (MeSH), nas bases de dados PsychINFO, Medline e Web of Science, entre janeiro de 2000 e janeiro de 2017. Foram excluídos artigos qualitativos, narrativas, sem revisão por pares, dissertações, teses ou trabalhos de grado e resumos de palestras. Se revisam manifestações clínicas, seus efeitos na locomoção de roedores, algumas metodologias usadas para gerar lesões e para estudar a função motora, os principais métodos de medição e alguns aspectos translacionais.

Implementación de la guía de valoración y manejo del dolor, de la Registered Nurses' Association of Ontario (RNAO) en el programa de Enfermería de la Universidad Autónoma de Bucaramanga / Implementation of the Assessment and Pain Management Guidelines of the Registered Nurses' Association of Ontario (RNAO) in the Nursing program of the Autonomous University of Bucaramanga / Implementação do guia de avaliação e gerenciamento de dor da Associação de Enfermeiros Registrados de Ontário (RNAO) no programa de Enfermagem da Universidade Autônoma de Bucaramanga

Introducción: El programa de enfermería de la Universidad Autónoma de Bucaramanga busca innovar con un currículo globalizado que responda a las necesidades tanto del país como del mundo, para ello se ha vinculado con el proyecto International Best Practice Spotlight Organization, para la implementación a nivel curricular de la guía de buenas prácticas clínicas de valoración y manejo del dolor basadas en la evidencia científica de la Registered Nurses' Association of Ontario. Objetivo: Reflexionar sobre la experiencia de la implementación de la guía de buenas prácticas clínicas para la valoración y manejo del dolor de la Registered Nurses' Association of Ontario en el programa de Enfermería de la Universidad Autónoma de Bucaramanga. Discusión: Para la metodología de la implementación se consideró como marco de referencia el Proyecto Educativo Institucional, proyecto educativo del programa de la Universidad Autónoma de Bucaramanga, la herramienta de Implementación de buenas prácticas propuesta por la Registered Nurses' Association of Ontario y el levantamiento de información que permitiera identificar los vacíos y las acciones de implementación en los contenidos curriculares respecto al uso de recomendaciones de práctica clínica, para la valoración y manejo del dolor en el currículo del programa de enfermería. Conclusiones: Realizar el levantamiento de información de los contenidos curriculares según las recomendaciones permitió identificar los mínimos curriculares a garantizar tales como: mecanismos del dolor, clasificación, intervenciones farmacológicas, no farmacológicas, implicaciones éticas, gestión y fortalecimiento de la actitud profesional que permita brindar un plan de atención integral del ser humano en cada una de las etapas del ciclo vital. La implementación de la guía de buenas prácticas clínicas de valoración y manejo del dolor permitirá tener un impacto académico en la formación de los futuros profesionales del programa de enfermería, una vez se incluyan transversalmente los contenidos relacionados con las buenas prácticas en las diferentes asignaturas del componente básico, profesional y específico del nuevo plan curricular.[Bonilla-Marciales AP, Jaimes-Valencia ML, Serrano-Gomez SE, Arenas-Luna GI, Padilla-García CI, Criado-Morales ML. Implementación de la guía de valoración y manejo del dolor, de la Registered Nurses' Association of Ontario(RNAO) en el programa de Enfermería de la Universidad Autónoma de Bucaramanga. MedUNAB 2017; 20(2): 148-164].

Introduction: The nursing program of the Autonomous University of Bucaramanga seeks to innovate with a globalized curriculum that responds to the needs of both the country and the world, to that end, it has been linked to the international project International Best Practice Spotlight Organization, for the implementation at the curricular level of good clinical practices for the assessment and pain management guidelines based on the scientific evidence of the Registered Nurses' Association of Ontario. Objective: To reflect on the experience of the implementation of good clinical practices for the assessment and management of pain guidelines of the Registered Nurses'Association of Ontario in the Nursing program of the Autonomous University of Bucaramanga. Discussion: For the methodology of its implementation, the Institutional Educational Project was considered as a reference framework, educational project of the program of the Autonomous University of Bucaramanga, the implementation tool of good practices proposed by the Registered Nurses' Association of Ontario and the gathering of information that would allow to identify the gaps and the implementation actions in the curricular contents regarding the use of clinical practice recommendations, for the assessment and management of pain in the curriculum of the nursing program. Conclusions: Carrying out the information gathering of the curricular contents according to the recommendations allowed identifying the minimum curricula to be guaranteed such as mechanisms of pain, classification, pharmacological and non-pharmacological interventions, ethical implications, management and strengthening of the professional attitude that allows providing an integral attention program for the human being in each stage of the life cycle. The implementation of good clinical practices of assessment and pain management guidelines will allow an academic impact in the training of future professionals at the nursing program, once the contents related to good practices in the different subjects of the basic, professional and specific component of the new curricular plan are included transversally. [Bonilla-Marciales AP, Jaimes-Valencia ML, Serrano-Gomez SE, Arenas-Luna GI, Padilla-García CI, Criado-Morales ML. Implementation of the Assessment and Pain Management Guidelines of the Registered Nurses' Association of Ontario (RNAO) in the Nursing Program of the Autonomous University of Bucaramanga. MedUNAB 2017; 20(2): 148-164].

Introdução: O programa de enfermagem da Universidade Autônoma de Bucaramanga procura inovar com um currículo globalizado que responde às necessidades do país e do mundo, pois isso tem sido associado ao projeto internacional International Best Practice Spotlight Organization, para a implementação no nível curricular do guia de boas práticas clínicas de avaliação e gerenciamento de dor com base na evidência científica da Associação de Enfermeiros Registrados de Ontário. Objetivo: Reflectir sobre a experiência da implementação do guia de boas práticas clínicas para avaliação e manejo da dor de Associação de Enfermeiros Registrados de Ontário no programa de Enfermagem da Universidade Autônoma de Bucaramanga. Discussão: para a metodologia da implementação, o Projeto Educacional Institucional, o projeto de programa educacional da Universidade Autônoma de Bucaramanga, a ferramenta de implementação de boas práticas proposta pelo Associação de Enfermeiros Registrados de Ontário e a coleta de informações que foi considerada como um quadro de referência permitiu identificar as lacunas e as ações na implementação dos conteúdos curriculares sobre o uso das recomendações da prática clínica, para a avaliação e o gerenciamento da dor no currículo do programa de enfermagem. Conclusões: Realização da coletade informação dos conteúdos curriculares de acordo com as recomendações permitidas para identificar os currículos mínimos a serem garantidos, tais como: mecanismos de dor, classificação, intervenções farmacológicas, implicações não-farmacológicas, éticas, gerenciamento e fortalecimento da atitude profissional que permita fornecer um plano de atenção integral do ser humano em cada dos estágios do ciclo de vida. Aimplementação da guia de boas práticas clínicas na avaliação e o gerenciamento de dor permitirá um impacto acadêmico no treinamento dos futuros profissionais do programa de Enfermagem, uma vez que os conteúdos relacionados às boas práticas nos diferentes assuntos do programa sejam incluídos transversalmente. Componente básico, profissional e específico do novo programa curricular. [Bonilla-Marciales AP, Jaimes-Valencia ML, Serrano-Gomez SE, Arenas-Luna GI, Padilla-García CI, Criado-Morales ML. Implementação do guia de avaliação e gerenciamento de dor da Associação de Enfermeiros Registrados de Ontário (RNAO) no programa de Enfermagem da Universidade Autônoma de Bucaramanga. MedUNAB 2017; 20(2): 148-164].

Prevalencia de factores de riesgo cardiovascular en académicos universitarios de una institución pública de Oaxaca / Prevalence of cardiovascular risk factors in university academics of a public institution in Oaxaca

Objetivo: Determinar la prevalencia de factores de riesgo cardiovascular en académicos universitarios de una institución pública del estado de Oaxaca. Metodología: El diseño de estudio fue descriptivo de alcance transversal, con una muestra de 87 académicos seleccionados por muestreo aleatorio estratificado. Resultados: La muestra final se integró por 68 académicos, 57.4% del sexo masculino y 42.6% femenino, con una edad promedio de 36.15 años (DE = 8.19). Con respecto a los antecedentes familiares como factores de riesgo, se encontró una prevalencia para diabetes mellitus de 58.8%, hipertensión arterial 57.4%, hipercolesterolemia 41.2% y cáncer 32.4%. En relación a los factores de riesgo cardiovascular personales, se evidenció una prevalencia para sobrepeso de 42.6%, obesidad 17.6%, hipercolesterolemia 35.3%, tabaquismo 11.7% y diabetes mellitus 8.8%. Discusión: El sobrepeso, obesidad e hipercolesterolemia representaron los factores de riesgo de mayor prevalencia; hallazgos que coinciden con los reportados en la Encuesta Nacional de Salud y Nutrición 2006 y 2012, como también por los estudios realizados en los estados de Guanajuato, Michoacán y Chiapas. Conclusión: La investigación reveló que el sobrepeso, obesidad e hipercolesterolemia son los factores de mayor prevalencia; por ello se hace imprescindible la consumación de estrategias preventivas orientadas a la adopción de estilos de vida saludable, ya que gran parte de los factores presentes en el estudio son derivados de éstos.

Objective: To determine the prevalence of cardiovascular risk factors in university academics from a public institution in the state of Oaxaca. Methodology: The study design was descriptive cross range, with a sample of 76 scholars selected by stratified random sampling. Results: The final sample was composed of 68 academics, 57.4% male and 42.6% female, with an average age of 36.15 years (SD = 8.19). Regarding family history as risk factors for diabetes mellitus prevalence was 58.8%, 57.4% hypertension, hypercholesterolemia 41.2% and 32.4% cancer was found. In relation to personal cardiovascular risk factors, a prevalence of 42.6% for overweight, obesity 17.6%, 35.3% hypercholesterolemia, smoking 11.7% and diabetes mellitus 8.8% was evident. Discussion: Overweight, obesity and high cholesterol risk factors accounted for most prevalent; findings are consistent with those reported in the National Health and Nutrition Survey 2006 and 2012, as well as by studies in the states of Guanajuato, Michoacan and Chiapas. Conclusion: The investigation revealed that overweight, obesity and high cholesterol are the most prevalent factors; therefore it is essential to the completion of bearings to the adoption of healthy lifestyle preventive strategies, as much of the factors present in the study are derived from these.

Quality of life and nutritional status among cancer patients on chemotherapy.

OBJECTIVES: Malnutrition is prevalent among cancer patients, and maybe correlated with altered quality of life. The objective of this study is to determine wether quality of life among cancer patients on chemotherapy at the National Kidney and Transplant Institute- Cancer Unit differs from patients with normal nutrition based on the Subjective Global Assessment scale. METHODS: A cross sectional study was conducted among cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute-Cancer Unit from January to May 2011. Demographic profile, performance status by Eastern Cooperative Oncology Group performance scale, nutritional status assessment by Subjective Global Assessment, and quality of life assessment by the European Organization for Research and Treatment of Cancer QoL-30 core module were obtained. Descriptive statistics and ANOVA were performed for analysis of quality of life parameters and nutritional status. RESULTS: A total of 97 subjects were included in this study, 66 subjects (68.04%) were females and 31 (31.96%) were males. Mean age was 54.55 ± 11.14 years, while mean performance status by the Eastern Cooperative Oncology Group classification was 0.88 ± 0.83 with a range of 0-3. According to the Subjective Global Assessment, there were 58 patients with SGA A, classified to have adequate nutrition, and 39 patients (40.21%) were considered malnourished. Among these 39 patients, 32 were classified SGA-B (moderately malnourished) and 7 were classified SGA C (severely malnourished) mean global quality of life was 68.73 ± 19.05. Results from ANOVA test revealed that patients were statistically different across the Subjective Global Assessment groups according to global quality of life (p<0.001), physical (p<0.001), role (p<0.001), emotional (p<0.001), and cognitive functioning (p<0.001); fatigue (p<0.001), nausea and vomiting (p<0.001), pain (p<0.001), insomnia (p<0.001), and appetite loss (p<0.001). CONCLUSION: GLOBAL QUALITY OF LIFE AND ITS PARAMETERS: physical state, role, emotional state, cognitive functioning, cancer fatigue, nausea and vomiting, pain, insomnia, and loss of appetite were statistically different across all Subjective Global Assessment groups. Moreover, there was no difference between financial difficulties, social functioning, constipation and diarrhea among the Subjective Global Assessment groups.

Anticancer immune reactivity and long-term survival after treatment of metastatic ovarian cancer with dendritic cells.

Hematopoietic stem cells collected by leukapheresis of a patient with metastatic ovarian carcinoma (OVCA) were induced into dendritic cell (DC) differentiation and fused with liposomal constructs of autologous and allogeneic ovarian carcinoma antigens (DC-OVCA). The proliferation of autologous T cells induced by DCs was determined by [(3)H]-thymidine uptake. Maximal T-cell proliferation was observed in co-cultures of DCs fused with liposomal OVCA constructs compared with intact autologous OVCA cells. The combination of autologous and allogeneic liposomal OVCA constructs induced greater T-cell proliferation than either alone. The cytotoxicity of DC-activated T cells against various target cells were analyzed by a (51)Cr-release assay. The combination of autologous and allogeneic liposomal OVCA constructs showed the highest stimulation of T cell-mediated cytotoxicity against OVCA cells, but had minimal cytotoxicity against normal fibroblasts or leukemia cells. The liposomal preparations of DC-OVCA were injected monthly into a patient with metastatic ovarian carcinoma whose tumors progressed following multiple courses of chemotherapy. DCs analyzed from the patient post-immunization showed 2- to 3-fold greater OVCA cytotoxicity compared to pre-immunization DCs. Immunoblots using the patient's serum showed reactivity with a number of proteins from ovarian cancer extracts, but not in normal fibroblasts and breast cancer. Following the DC-OVCA treatment, the metastatic lesions progressively decreased in size to the point of being undetectable by serial CAT scans. Seven years following the initial diagnosis, the patient continues to be free of cancer. This report described the anticancer immune reactivity and anti-tumor response induced by DCs sensitized with liposomal constructs of OVCA antigens. Immune cell therapy may therefore be a useful adjunct to surgery and chemotherapy for the treatment of ovarian cancer.

Socioeconomic impact of cancer in member countries of the Association of Southeast Asian Nations (ASEAN): the ACTION study protocol.

Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.