Effectiveness and Safety of High- vs Low-Dose Swallowed Topical Steroids for Maintenance Treatment of Eosinophilic Esophagitis: A Multicenter Observational Study.

BACKGROUND & AIMS: Data evaluating efficacy of different doses of swallowed topical corticosteroids (STC) in the long-term management of eosinophilic esophagitis (EoE) are lacking. We assessed long-term effectiveness and safety of different STC doses for adults with EoE after achievement of histological remission. METHODS: We performed a retrospective multicenter study at five EoE referral centers (US and Switzerland). We analyzed data on 82 patients with EoE in histological remission and ongoing STC treatment with therapeutic adherence of ≥75% (58 males; mean age at diagnosis, 37.2±14.4 years). Patients were followed for a median of 2.2 years (interquartile range [IQR], 1.0-3.8 years). We collected data from 217 follow-up endoscopy visits. The primary endpoint was time to histological relapse. RESULTS: Histological relapse occurred in 67% of patients. Relapse rates were comparable in patients taking low dose (≤0.5 mg per day, n = 58) and high dose STC (>0.5 mg per day, n = 24) with 72 vs 54% (ns). However, histological relapse occurred significantly earlier with low dose STC (1.0 vs 1.8 years, P = .030). There was no difference regarding rates of and time to stricture formation for low vs high dose STC. Esophageal candidiasis was observed in 6% of patients (5% for low dose, 8% for high dose, ns). No dysplasia or mucosal atrophy was detected. CONCLUSION: Histological relapse frequently occurs in EoE despite ongoing STC treatment regardless of STC doses. However, relapse develops later in patients on high dose STC without an increase in side-effects. Doses higher than 0.5 mg/day may be considered for EoE maintenance treatment, but advantage over lower doses appears to be small.

Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery.

Background: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery. Objective: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI. Design: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment. (ClinicalTrials.gov: NCT01082874). Setting: 135 centers in 23 countries. Patients: Adults aged 45 years or older who had or were at risk for atherosclerotic disease and were having noncardiac surgery. Exclusions were placement of a bare-metal stent within 6 weeks, placement of a drug-eluting stent within 1 year, or receipt of nonstudy aspirin within 72 hours before surgery. Intervention: Aspirin therapy (overall trial, n = 4998; subgroup, n = 234) or placebo (overall trial, n = 5012; subgroup, n = 236) initiated within 4 hours before surgery and continued throughout the perioperative period. Of the 470 subgroup patients, 99.9% completed follow-up. Measurements: The 30-day primary outcome was death or nonfatal myocardial infarction; bleeding was a secondary outcome. Results: In patients with prior PCI, aspirin reduced the risk for the primary outcome (absolute risk reduction, 5.5% [95% CI, 0.4% to 10.5%]; hazard ratio [HR], 0.50 [CI, 0.26 to 0.95]; P for interaction = 0.036) and for myocardial infarction (absolute risk reduction, 5.9% [CI, 1.0% to 10.8%]; HR, 0.44 [CI, 0.22 to 0.87]; P for interaction = 0.021). The effect on the composite of major and life-threatening bleeding in patients with prior PCI was uncertain (absolute risk increase, 1.3% [CI, -2.6% to 5.2%]). In the overall population, aspirin increased the risk for major bleeding (absolute risk increase, 0.8% [CI, 0.1% to 1.6%]; HR, 1.22 [CI, 1.01 to 1.48]; P for interaction = 0.50). Limitation: Nonprespecified subgroup analysis with small sample. Conclusion: Perioperative aspirin may be more likely to benefit rather than harm patients with prior PCI. Primary Funding Source: Canadian Institutes of Health Research.

Diversity and evolution of centromere repeats in the maize genome.

Centromere repeats are found in most eukaryotes and play a critical role in kinetochore formation. Though centromere repeats exhibit considerable diversity both within and among species, little is understood about the mechanisms that drive centromere repeat evolution. Here, we use maize as a model to investigate how a complex history involving polyploidy, fractionation, and recent domestication has impacted the diversity of the maize centromeric repeat CentC. We first validate the existence of long tandem arrays of repeats in maize and other taxa in the genus Zea. Although we find considerable sequence diversity among CentC copies genome-wide, genetic similarity among repeats is highest within these arrays, suggesting that tandem duplications are the primary mechanism for the generation of new copies. Nonetheless, clustering analyses identify similar sequences among distant repeats, and simulations suggest that this pattern may be due to homoplasious mutation. Although the two ancestral subgenomes of maize have contributed nearly equal numbers of centromeres, our analysis shows that the majority of all CentC repeats derive from one of the parental genomes, with an even stronger bias when examining the largest assembled contiguous clusters. Finally, by comparing maize with its wild progenitor teosinte, we find that the abundance of CentC likely decreased after domestication, while the pericentromeric repeat Cent4 has drastically increased.

A randomized prospective controlled trial comparing the laryngeal tube suction disposable and the supreme laryngeal mask airway: the influence of head and neck position on oropharyngeal seal pressure.

BACKGROUND: The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions. METHODS: Eighty patients in each group had either LTS-D or SLMA for airway management. The patients were recruited in two different institutions. Primary outcome variables were the oropharyngeal seal pressures in neutral, flexion, extension, right and left head-neck position. Secondary outcome variables were time to achieve an effective airway, ease of insertion, number of attempts, maneuvers necessary during insertion, ventilatory parameters, success of gastric tube insertion and incidence of complications. RESULTS: The oropharyngeal seal pressure achieved with the LTS-D was higher than the SLMA in, (extension (p=0.0150) and right position (p=0.0268 at 60 cm H2O intracuff pressures and nearly significant in neutral position (p = 0.0571). The oropharyngeal seal pressure was significantly higher with the LTS-D during neck extension as compared to SLMA (p= 0.015). Similar oropharyngeal seal pressures were detected in all other positions with each device. The secondary outcomes were comparable between both groups. Patients ventilated with LTS-D had higher incidence of sore throat (p = 0.527). No major complications occurred. CONCLUSIONS: Better oropharyngeal seal pressure was achieved with the LTS-D in head-neck right and extension positions , although it did not appear to have significance in alteration of management using pressure control mechanical ventilation in neutral position. The fiberoptic view was better with the SLMA. The post-operative sore throat incidence was higher in the LTS-D. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02856672 , Unique Protocol ID:BnaiZionMC-16-LG-001, Registered: August 2016.

Subcutaneous Trastuzumab: An Observational Study of Safety and Tolerability in Patients With Early HER2-Positive Breast Cancer.

Purpose: In Peru, breast cancer (BC) stands as the most predominant malignancy neoplasm among women. Trastuzumab has marked a significant milestone in the management of this disease. It has been shown to improve prognosis in human epidermal growth factor receptor 2 (HER2)-expressing female patients, but its repercussions and efficacy are yet to be analyzed in a context with limited resources. Methods: The study population is made of woman patients aged 18 years and older diagnosed with HER2-positive BC at Instituto Nacional de Enfermedades Neoplásicas (INEN, Lima, Peru) during 2019-2021 and treated with at least one dose of subcutaneous trastuzumab. We reviewed medical records to register treatment characteristics, adverse events (AEs), disease progression, and survival status. We considered a median follow-up time of 36 and 45 months for progression and survival status. Results: The majority of patients were over 50 years old (54.29%). Tumor size averaged 19.7 ± 16.1 mm. Lymph nodes were present in 44.78% of patients. Most patients received adjuvant chemotherapy (63.8%) as first-line treatment. Descriptive analyses of treatment outcomes revealed a 30% toxicity rate, primarily attributed to arthralgia (47.62%), followed by diarrhea, fatigue, and injection site reactions, with relatively lower discontinuation rates compared to larger scale studies. Differences in demographic, clinical, and treatment characteristics were not statistically significant concerning the emergence of AEs (p > 0.05). Progression appeared in nine patients, and the overall survival (OS) rate stood at 98.6% and 92.8%, respectively, during a median follow-up of 36 and 45 months. Conclusion: The research suggests that subcutaneous trastuzumab is comparable in effectiveness and safety to the intravenous administration. Regional-specific studies may provide valuable insights into demographic factors influencing treatment outcomes in Peru or other countries. Furthermore, it could represent a more accessible alternative, potentially enhancing patient adherence and optimizing healthcare resource logistics.

Unusual presentation of acquired thrombotic thrombocytopenic purpura (TTP) versus catastrophic antiphospholipid syndrome in a patient with Moya-Moya disease, case report, and literature review.

Coincidences in medicine are not so common. We are presenting a case of a patient diagnosed with Moya-Moya disease and antiphospholipid syndrome (APS) who presented with clinical and laboratory characteristics of catastrophic APS versus TTP. The diagnosis was a challenge because characteristics were overlapping. Nevertheless, a decision to treat the patient for TTP was made with afterward improvement. MMD has been associated with multiple immune disorders; however, only one case of acquired thrombotic thrombocytopenic purpura has been documented in association with this disease. None has been associated with catastrophic antiphospholipid syndrome. We are presenting a challenging case where all these three medical conditions were present at the same time.

Increased oxidative stress contributes to enhance brain amyloidogenesis and blunts energy metabolism in sucrose-fed rat: effect of AMPK activation.

Metabolic disturbances are linked to neurodegenerative diseases such as Alzheimer disease (AD). However, the cellular mechanisms underlying this connection are unclear. We evaluated the role of oxidative stress (OS), during early metabolic syndrome (MetS), on amyloidogenic processes in a MetS rat model induced by sucrose. MetS caused OS damage as indicated by serum and hypothalamus lipid peroxidation and elevated serum catalase activity. Tissue catalase and superoxide dismutase activity were unchanged by MetS, but gene expression of nuclear factor erythroid-derived 2-like 2 (NFE2L2), which up-regulates expression of antioxidant enzymes, was higher. Expression of amyloid-ß cleaving enzyme 1 (BACE-1) and amyloid precursor protein (APP), key proteins in the amyloidogenesis pathway, were slightly increased by sucrose-intake in the hippocampus and hypothalamus. Activation and expression of protein kinase B (PKB) and AMP-dependent protein kinase (AMPK), pivotal proteins in metabolism and energy signaling, were similarly affected in the hippocampus and hypothalamus of MetS rats. Brain creatine kinase activity decreased in brain tissues from rats with MetS, mainly due to irreversible oxidation. Chronic metformin administration partially reversed oxidative damage in sucrose-fed animals, together with increased AMPK activation; probably by modulating BACE-1 and NFE2L2. AMPK activation may be considered as a preventive therapy for early MetS and associated neurodegenerative diseases.

Detecting Cognitive Decline and Dementia in Santa Cruz, Galápagos Islands, Ecuador.

Objective To assess the cognitive function, prevalence, and risk factors associated with cognitive decline and dementia in people above 65 years of age in Santa Cruz Island, Galápagos, Ecuador.  Methods This is a cross-sectional observational study that was carried out in adults over 65 years of age in Santa Cruz Island, Galápagos, Ecuador. The mini-mental state examination (MMSE) and ascertain dementia eight-item informant questionnaire (AD8)-validated Ecuador Spanish versions were used to assess cognition. Results There were a total of 80 participants, 55 (67%) women and 25 (31.2%) men. The majority of participants were Mestizos (85.3%), with the remainder classified as White (4.8%), Afro-Ecuadorians (2.4%), or Indigenous (3.6%). The prevalence of cognitive impairment is 30.0%-43.7%. The MMSE results showed that older age and lack of education are risk factors for cognitive decline (p < 0.01). There was high correlation between MMSE and AD8 scores. The AD8 showed that older age, widowhood, and living in Santa Rosa were risk factors for cognitive decline (p < 0.01). According to the AD8, the group with the highest education (six years or more) had the lowest risk of cognitive decline and dementia (p < 0.01).  Conclusions The main risk factors for cognitive decline and dementia in individuals above 65 years old in Santa Cruz Island, Galápagos, Ecuador are increased age, lack of education, and widowhood. The prevalence of cognitive impairment is similar to previous studies in Ecuador.

Tubulin-binding cofactor E-like (TBCEL), the protein product of the mulet gene, is required in the germline for the regulation of inter-flagellar microtubule dynamics during spermatid individualization.

Individual sperm cells are resolved from a syncytium during late step of spermiogenesis known as individualization, which is accomplished by an Individualization Complex (IC) composed of 64 investment cones. mulet encodes Tubulin-binding cofactor E-like (TBCEL), suggesting a role for microtubule dynamics in individualization. Indeed, a population of ∼100 cytoplasmic microtubules fails to disappear in mulet mutant testes during spermatogenesis. This persistence, detected using epi-fluorescence and electron microscopy, suggests that removal of these microtubules by TBCEL is a prerequisite for individualization. Immunofluorescence reveals TBCEL expression in elongated spermatid cysts. In addition, testes from mulet mutant males were rescued to wild type using tubulin-Gal4 to drive TBCEL expression, indicating that the mutant phenotype is caused by the lack of TBCEL. Finally, RNAi driven by bam-GAL4 successfully phenocopied mulet, confirming that mulet is required in the germline for individualization. We propose a model in which the cytoplasmic microtubules serve as alternate tracks for investment cones in mulet mutant testes.This article has an associated First Person interview with the first author of the paper.

Suppression of prostate tumor cell growth by stromal cell prostaglandin D synthase-derived products.

Stromal-epithelial interactions and the bioactive molecules produced by these interactions maintain tissue homeostasis and influence carcinogenesis. Bioactive prostaglandins produced by prostaglandin synthases and secreted by the prostate into seminal plasma are thought to support reproduction, but their endogenous effects on cancer formation remain unresolved. No studies to date have examined prostaglandin enzyme production or prostaglandin metabolism in normal prostate stromal cells. Our results show that lipocalin-type prostaglandin D synthase (L-PGDS) and prostaglandin D2 (PGD2) metabolites produced by normal prostate stromal cells inhibited tumor cell growth through a peroxisome proliferator-activated receptor gamma (PPARgamma)-dependent mechanism. Enzymatic products of stromal cell L-PGDS included high levels of PGD2 and 15-deoxy-delta(12,14)-PGD2 but low levels of 15-deoxy-delta(12,14)-prostaglandin J2. These PGD2 metabolites activated the PPARgamma ligand-binding domain and the peroxisome proliferator response element reporter systems. Thus, growth suppression of PPARgamma-expressing tumor cells by PGD2 metabolites in the prostate microenvironment is likely to be an endogenous mechanism involved in tumor suppression that potentially contributes to the indolence and long latency period of this disease.

Índice SatO2/FiO2 versus PaO2/FiO2 para predecir mortalidad en pacientes con COVID-19 en un hospital de altura / SatO2/FiO2 rate versus PaO2/FiO2 rate for predicting mortality in patients with COVID-19 in a high-altitude hospital

RESUMEN Objetivo : comparar el índice SatO2/FiO2 versus PaO2/FiO2 para predecir mortalidad en pacientes con COVID-19 en un hospital de altura. Materiales y métodos : estudio observacional, retrospectivo y transversal, donde se compararon la sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de ambos índices. Resultados : La edad promedio de los pacientes con COVID-19 fue 62.2 ±12.8 años, el 73.7 % fueron varones, las comorbilidades de mayor frecuencia fueron la diabetes mellitus 21.6 % y la hipertensión arterial 27.2 % . Por otro lado, el índice promedio SatO2/FiO2 fue 234.9 ±121.9 y el PaO2/ FiO2 fue 169.7 ± 84 y el 30.5 % de pacientes falleció. Se evidenció relación significativa entre los índices en mención y la mortalidad. Se obtuvo como puntos de corte 114.4 para SatO2/ FiO2, con sensibilidad de 43.1 %, especificidad de 91.2 %, valor predictivo positivo de 68.3 % y valor predictivo negativo de 78.5 %, mientras que el punto de corte para PaO2/FiO2 fue 134.2, con sensibilidad de 63.1 %, especificidad de 67.6 %, valor predictivo positivo de 46.1 % y valor predictivo negativo de 80.7 %. Conclusión : Ambos índices son predictores de mortalidad, sin embargo, el SatO2/FiO2 presentó mejores valores, con respecto a algunos de los criterios de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo.

Abstract Objective : To compare the SatO2/FiO2 rate against PaO2/FiO2 rate for predicting mortality in COVID-19 patients in a high altitude hospital. Materials and Methods : This is an observational, retrospective, and cross-sectional study, where sensitivity (S), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) for both rates were compared. Results : The average age of COVID-19 patients was 62.2 ± 12.8 years. Three quarters (73.7 %) of all patients were male, most frequent comorbidities were diabetes mellitus (21.6 %), and high blood pressure (27.2 %). On the other hand, average SatO2/FiO2 rate was 234.9 ± 121.9, and PaO2/FiO2 was 169.7 ± 84, and 30.5 % of all patients died. A significant relationship between the aforementioned rates and mortality was evidenced. The cutoff point for SatO2/FiO2 was 114.4, with 43.1 % sensitivity, 91.2 % specificity, 68.3 % positive predictive value, and 78.5 % negative predictive value. The cutoff point for PaO2/FiO2 was 134.2, with 63.1 % sensitivity, 67.6 % specificity, 46.1 % positive predictive value, and 80.7 % negative predictive value. Conclusion : Both rates are predictors for mortality; however, SatO2/FiO2 showed better results with respect to the following parameters: sensitivity, specificity, positive predictive value, and negative predictive value.

Sleeve gastrectomy is a safe and efficient procedure in HIV patients with morbid obesity: a case series with results in weight loss, comorbidity evolution, CD4 count, and viral load.

BACKGROUND: The efficacy and safety of bariatric surgery have been poorly studied in patients affected with HIV. Although sleeve gastrectomy (SG) is the most widely used procedure in many countries, most of the published literature reported results with the gastric bypass (GBP) procedure on morbidly obese HIV patients. METHODS: We have evaluated retrospectively, in eight consecutive patients who underwent a SG, its effect in weight loss and its impact on the treatment and on the markers of HIV infection. RESULTS: Seven out of eight patients were females. The mean age was 46 years, with a median preoperative BMI of 42 kg/m(2). The mean duration of HIV infection and CD4 cell count were 13.4 years and 457 cells/mm(3), respectively. The mean weight loss was 37 kg in 20 months, the excess BMI loss was 80.8 ± 30.9 %, and the excess weight loss is 81.5 ± 28.9 % with one minor complication. CD4 counts were unchanged. Three patients had therapy modifications that were unrelated to bariatric surgery. Two patients had a therapeutic drug monitoring before and after the intervention. Plasma concentrations remained in therapeutic levels after the SG. Most comorbidities disappeared postoperatively, decreasing the cardiovascular risk. CONCLUSIONS: The sleeve gastrectomy was safe and effective with no consequences on CD4 counts and viral load in HIV-affected obese patients. It should be considered as a part of the treatment in morbidly obese HIV patients.

Asociación entre desenlaces clínicos y cumplimiento del protocolo de recuperación mejorada después de la cirugía (ERAS) en procedimientos colorrectales: estudio multicéntrico / Association between clinical outcomes and compliance with the Enhanced Recovery After Surgery (ERAS) protocol in colorectal procedures: A multicenter study

Introducción. Los protocolos de recuperación mejorada después de cirugía se han diseñado como una innovación en salud tras demostrarse que la mejora en los dispositivos médicos y la depuración de técnicas alcanzaron la meseta en disminución de complicaciones. Con estas estrategias de la medicina perioperatoria, en cirugía colorrectal se reducen la morbilidad y estancia hospitalaria. El objetivo del estudio fue evaluar si la tasa de adherencia al programa de recuperación mejorada después de la cirugía (ERAS) está asociada con los resultados quirúrgicos. Métodos. Estudio multicéntrico, observacional, retrospectivo de cohorte (2015-2019), en cinco hospitales latinoamericanos certificados por la sociedad ERAS. Se calculó la incidencia de complicaciones quirúrgicas durante el posquirúrgico inmediato (30 días) y la duración de la estancia hospitalaria. Se utilizaron análisis bivariado y regresión logística multivariada para evaluar los factores asociados con la tasa de complicaciones. Resultados. Fueron incluidos en el estudio 648 pacientes en cinco hospitales ERAS, con edad promedio de 61 años y mayor porcentaje de hombres (51 %). El cumplimiento global al protocolo ERAS fue de 75 % y la estancia promedio de 6,2 días (mediana: 4 días). Se tuvo un cumplimiento óptimo del protocolo ERAS (igual o mayor al 80 %) en 23,6 % de los pacientes. Se documentó fuga de la anastomosis en 4 %, complicaciones infecciosas en 8,4 %, íleo en 5,7 %, reingreso en 10,2 % y mortalidad de 1,1 %. El análisis multivariado mostró que los niveles de adherencia óptima al protocolo ERAS reducen significativamente la aparición de complicaciones como fuga de la anastomosis (OR 0,08; IC95% 0,01-0,48; p=0,005) y complicaciones infecciosas (OR 0,17; IC95%0,03-0,76; p=0,046).Discusión. Los resultados sugieren que un cumplimiento del programa ERAS mayor al 80 % se asocia a menor frecuencia de complicaciones en pacientes con cirugía electiva colorrectal

Introduction. Enhanced Recovery After Surgery (ERAS) protocol has been designed as an innovation in health after demonstrating that the improvement in medical devices and the refinement of techniques reached the plateau in reducing complications. With these strategies of perioperative medicine, in colorectal surgery morbidity and hospital stay are reduced. The aim of the study was to evaluate whether the rate of adherence to the ERAS protocol is associated with surgical outcomes.Methods. Multicenter, observational, retrospective cohort study (2015-2019), in five Latin American hospitals certified by the ERAS Society. The incidence of surgical complications during the immediate postoperative period (30 days) and length of hospital stay were calculated. Bivariate analyzes and multivariate logistic regression were used to assess factors associated with complication rates.Results. 648 patients were included in the study in five ERAS hospitals, with an average age of 61 years and a higher percentage of men (51%). Overall compliance with the ERAS protocol was 75% and the average stay was 6.2 days (median: 4 days). There was optimal compliance with the ERAS protocol (equal to or greater than 80%) in 23.6% of the patients. Anastomotic leak was documented in 4%, infectious complications in 8.4%, ileus in 5.7%, readmission in 10.2%, and mortality in 1.1%. Multivariate analysis showed that optimal adherence levels to the ERAS protocol significantly reduce the appearance of complications such as anastomotic leakage (OR 0.08; 95%CI 0.01-0.48; p=0.005) and infectious complications (OR 0.17; 95%CI 0.03-0.76; p=0.046).Discussion. The results suggest that compliance with the ERAS program greater than 80% is associated with a lower frequency of complications in patients with elective colorectal surgery

Necesidades de tratamiento periodontal en pacientes de la Facultad de Odontología de la Universidad Autónoma de Chihuahua / Periodontal treatment needs in patients of the Faculty of Dentistry, Autonomous University of Chihuahua

Con el propósito de determinar el estado de salud periodontal en pacientes mayores de edad que acudieron a recibir atención en las clínicas de la Facultad de Odontología de la Facultad de Odontología de la Universidad Autónoma de Chihuahua, 408 pacientes fueron revisados y clasifi cados por grupos de sexo, edad, grado de escolaridad y lugar de residencia, evaluando los grados de profundidad de los surcos gingivales en diferentes áreas, y clasifi cándolos de acuerdo a los códigos descritos por el índice de necesidad de tratamiento periodontal comunitario (CPITN), el cual determina la complejidad de las alteraciones manifi estas en periodonto de acuerdo a cinco niveles o códigos. Los resultados mostraron una alta necesidad de tratamiento periodontal distintos grados en la población revisada, de hasta el 96%, mientras que el 4% requirió solamente tratamiento preventivo y de instrucción, coincidiendo con estudios similares realizados por otros autores. Se observó también que el sexo y el lugar de residencia no infl uyeron en la prevalencia de las alteraciones periodontales detectadas, por otro lado la necesidad de tratamiento periodontal en los distintos grupos de edad, se manifestaron solamente en el grado más alto expresado como código 4 (C4), con una tendencia ascendente de necesidad de tratamiento periodontal relacionado a la tendencia ascendente de las distintas edades. Se evidenció una mayor frecuencia de alteraciones periodontales en personas con grado de educación media con un 34%. Se concluye que resulta necesario fomentar en el paciente la cultura del autocuidado como un elemento de contrapeso, pues es ahí donde se puede incidir en la prevención más efectiva (AU)

With the purpose of determining the periodontal health status in adults patients of who receive dental attention in to the Dental School clinics of the Autonomous University of Chihuahua, 408 patients were reviewed and categorized by groups of sex, age, level of education and place of residence, evaluating the depth of the gingival grooves in diff erent gingival areas, classifying them according to the codes described by the community periodontal index of treatment needs (CPITN), which determines the complexity of the gross alterations in periodontal tissues according to 5 levels or codes. The results showed high needs of periodontal treatment by diff erent degrees in the population, up to 96%, while 4% required only preventive treatment and instruction, coinciding with similar studies carried out by other authors. It was also noted that the sex and place of residence did not infl uence the prevalence of periodontal alterations, on the other hand the need of periodontal treatment in the various age groups, is expressed only in the highest degree expressed as code 4 (C4), with an upward trend of need of periodontal treatment related to the upward trend of the diff erent ages. Higher frequency of periodontal alterations evidenced in people with middle education degree with a 34%. Concluding that it is necessary to encourage the culture of the self-care to the patient as a counterweight element, because is there the most eff ective prevention impact achieves (AU)

ETS2 mediated tumor suppressive function and MET oncogene inhibition in human non-small cell lung cancer.

PURPOSE: The ETS2 transcription factor is an evolutionarily conserved gene that is deregulated in cancer. We analyzed the transcriptome of lung adenocarcinomas and normal lung tissue by expression profiling and found that ETS2 was significantly downregulated in adenocarcinomas. In this study, we probed the yet unknown functional role of ETS2 in lung cancer pathogenesis. EXPERIMENTAL DESIGN: Lung adenocarcinomas (n = 80) and normal lung tissues (n = 30) were profiled using the Affymetrix Human Gene 1.0 ST platform. Immunohistochemical (IHC) analysis was conducted to determine ETS2 protein expression in non-small cell lung cancer (NSCLC) histologic tissue specimens (n = 201). Patient clinical outcome, based on ETS2 IHC expression, was statistically assessed using the log-rank and Kaplan-Meier tests. RNA interference and overexpression strategies were used to assess the effects of ETS2 expression on the transcriptome and on various malignant phenotypes. RESULTS: ETS2 expression was significantly reduced in lung adenocarcinomas compared with normal lung (P < 0.001). Low ETS2 IHC expression was a significant predictor of shorter time to recurrence in NSCLC (P = 0.009, HR = 1.89) and adenocarcinoma (P = 0.03, HR = 1.86). Moreover, ETS2 was found to significantly inhibit lung cancer cell growth, migration, and invasion (P < 0.05), and microarray and pathways analysis revealed significant (P < 0.001) activation of the HGF pathway following ETS2 knockdown. In addition, ETS2 was found to suppress MET phosphorylation and knockdown of MET expression significantly attenuated (P < 0.05) cell invasion mediated by ETS2-specific siRNA. Furthermore, knockdown of ETS2 augmented HGF-induced MET phosphorylation, cell migration, and invasion. CONCLUSION(S): Our findings point to a tumor suppressor role for ETS2 in human NSCLC pathogenesis through inhibition of the MET proto-oncogene.

Cultivable microbiota of Lithobates catesbeianus and advances in the selection of lactic acid bacteria as biological control agents in raniculture.

The cultivable microbiota of skin and cloaca of captive Lithobates catesbeianus includes microorganisms generally accepted as beneficial and potentially pathogenic bacteria. In order to select a group of potentially probiotic bacteria, 136 isolates were evaluated for their surface properties and production of antagonistic metabolites. Then, 11 lactic acid bacteria (LAB) strains were selected and identified as Lactobacillus plantarum, Lb. brevis, Pediococcus pentosaceus, Lactococcus lactis, L. garvieae and Enterococcus gallinarum. Studies of compatibility indicate that all the strains could be included in a multi-strain probiotic, with the exception of Ent. gallinarum CRL 1826 which inhibited LAB species through a bacteriocin-like metabolite. These results contribute to the design of a probiotic product to improve the sanitary status of bullfrogs in intensive culture systems, to avoid the use of antibiotics and thus to reduce production costs. It could also be an alternative to prevent infectious diseases during the ex situ breeding of amphibian species under threat of extinction.

Oleandrin-mediated inhibition of human tumor cell proliferation: importance of Na,K-ATPase alpha subunits as drug targets.

Cardiac glycosides such as oleandrin are known to inhibit the Na,K-ATPase pump, resulting in a consequent increase in calcium influx in heart muscle. Here, we investigated the effect of oleandrin on the growth of human and mouse cancer cells in relation to Na,K-ATPase subunits. Oleandrin treatment resulted in selective inhibition of human cancer cell growth but not rodent cell proliferation, which corresponded to the relative level of Na,K-ATPase alpha3 subunit protein expression. Human pancreatic cancer cell lines were found to differentially express varying levels of alpha3 protein, but rodent cancer cells lacked discernable expression of this Na,K-ATPase isoform. A correlation was observed between the ratio of alpha3 to alpha1 isoforms and the level of oleandrin uptake during inhibition of cell growth and initiation of cell death; the higher the alpha3 expression relative to alpha1 expression, the more sensitive the cell was to treatment with oleandrin. Inhibition of proliferation of Panc-1 cells by oleandrin was significantly reduced when the relative expression of alpha3 was decreased by knocking down the expression of alpha3 isoform with alpha3 siRNA or increasing expression of the alpha1 isoform through transient transfection of alpha1 cDNA to the cells. Our data suggest that the relative lack of alpha3 (relative to alpha1) in rodent and some human tumor cells may explain their unresponsiveness to cardiac glycosides. In conclusion, the relatively higher expression of alpha3 with the limited expression of alpha1 may help predict which human tumors are likely to be responsive to treatment with potent lipid-soluble cardiac glycosides such as oleandrin.

Comparación del crecimiento del lactante alimentado con leche humana vs. fórmula de inicio / Growth comparison of nursing infants fed with human milk vs. formula

En la actualidad han surgido un gran número de fórmulas láctantes que aportan cantidades similares de proteínas, grasas y minerales, todas ellas derivadas de la leche de vaca. En este estudio se analizó el incremento en peso, talla y perímetro cefálico de 50 lactantes alimentados con leche materna (grupo I) y 50 lactantes alimentados con fórmulas láctantes (grupo II) por un periodo de cuatro meses, todos con peso entre 2,500 y 3,800 g, talla de 48-51 cm y perímetro cefálico de 33.36 cm al nacer. Estos parámetros fueron evaluados mensualmente. Se observó un incremento de peso para el grupo I de 4.274 kg y para el grupo II de 3.375 kg al término del estudio, con diferencias estadísticas significativas. En relación con la talla se observó incremento de 15.25 cm (grupo I) y de 13.16 cm (grupo II), mientras que para el perímetro cefálico se observó incremento de 7.85 cm (grupo I) y de 6.2 cm (grupo II), las diferencias significativas fueron importantes para ambos valores. Se concluye que la leche materna es el alimento ideal debido al mayor incremento ponderal observado en estos lactantes