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The increasing burden of cancer represents a substantial problem for Latin America and the Caribbean. Two Lancet Oncology Commissions in 2013 and 2015 highlighted potential interventions that could advance cancer care in the region by overcoming existing challenges. Areas requiring improvement included insufficient investment in cancer control, non-universal health coverage, fragmented health systems, inequitable concentration of cancer services, inadequate registries, delays in diagnosis or treatment initiation, and insufficient palliative services. Progress has been made in key areas but remains uneven across the region. An unforeseen challenge, the COVID-19 pandemic, strained all resources, and its negative effect on cancer control is expected to continue for years. In this Series paper, we summarise progress in several aspects of cancer control since 2015, and identify persistent barriers requiring commitment of additional resources to reduce the cancer burden in Latin America and the Caribbean.
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COVID-19/epidemiologia , Neoplasias/prevenção & controle , SARS-CoV-2 , Região do Caribe/epidemiologia , Efeitos Psicossociais da Doença , Atenção à Saúde/economia , Detecção Precoce de Câncer , Acessibilidade aos Serviços de Saúde , Humanos , América Latina/epidemiologia , Oncologia/educação , Neoplasias/epidemiologiaRESUMO
Introduction: Initially known for its deleterious health effects, hydrogen sulfide (H2S) has recently been recognized as a biologically important gas carrier, like nitric oxide and carbon monoxide. H2S is produced endogenously in mammalian cells by enzymatic and non-enzymatic pathways. When it is produced by the enzymatic pathway, its synthesis is carried out from the amino acid L-cysteine through the transsulfuration pathway. It can also be produced endogenously from exogenous compounds that function as H2S donors as, for example, the naturally occurring organic donors found in some plants. Currently, the role of S2H is well known as brain and cardiac protector, and its research as a therapeutic adjuvant in metabolic diseases such as obesity and type-2 diabetes is becoming increasingly important. The objective of this review is to examine how the contribution of donors and precursors of hydrogen sulfide by the diet impacts health and disease.
Introducción: Conocido originalmente por sus efectos deletéreos en la salud, recientemente se ha reconocido al sulfuro de hidrógeno (H2S) como un gasotransmisor de importancia biológica, al igual que el óxido nítrico y el monóxido de carbono. El H2S puede producirse de forma endógena en las células de mamíferos por dos vías: la vía enzimática y la vía no enzimática. Cuando se produce por la vía enzimática, su síntesis se lleva a cabo a partir de los aminoácidos L-cisteína o metionina mediante transulfuración y transmetilación. También se puede producir el H2S a partir donadores de grupos sulfuro como, por ejemplo, compuestos orgánicos que se encuentran presentes en algunos vegetales. Actualmente es bien conocido el papel del H2S como protector a nivel cerebral y cardiaco, y cada vez adquiere mayor relevancia su estudio como coadyuvante terapéutico en padecimientos metabólicos como la obesidad y la diabetes mellitus de tipo 2. El objetivo de esta revisión es examinar cómo impacta el aporte de donadores y precursores del sulfuro de hidrogeno por la dieta en la salud y la enfermedad.
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Metabolic syndrome (MS) is a condition that includes obesity, insulin resistance, dyslipidemias among other, abnormalities that favors type 2 Diabetes Mellitus (T2DM) and cardiovascular diseases development. Three main diet-induced metabolic syndrome models in rats exist: High carbohydrate diet (HCHD), high fat diet (HFD), and high carbohydrate-high fat diet (HCHHFD). We analyzed data from at least 35 articles per diet, from different research groups, to determine their effect on the development of the MS, aimed to aid researchers in choosing the model that better suits their research question; and also the best parameter that defines obesity, as there is no consensus to determine this condition in rats. For the HCHD we found a mild effect on body weight gain and fasting blood glucose levels (FBG), but significant increases in triglycerides, fasting insulin, insulin resistance and visceral fat accumulation. HFD had the greater increase in the parameters previously mentioned, followed by HCHHFD, which had a modest effect on FBG levels. Therefore, to study early stages of MS a HCHD is recommended, while HFD and HCHHFD better reproduce more severe stages of MS. We recommend the assessment of visceral fat accumulation as a good estimate for obesity in the rat.
Assuntos
Dieta Hiperlipídica/efeitos adversos , Carboidratos da Dieta/efeitos adversos , Modelos Animais de Doenças , Síndrome Metabólica/metabolismo , Animais , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dislipidemias/metabolismo , Humanos , Insulina/sangue , Resistência à Insulina , Gordura Intra-Abdominal/metabolismo , Masculino , Síndrome Metabólica/etiologia , Obesidade/metabolismo , Ratos , Triglicerídeos/sangue , Aumento de PesoRESUMO
RESUMEN A partir de visualización por electroforesis capilar de 9 regiones micro-satélites amplificadas con cebadores fluoromarcados se determinó el polimorfismo de los marcadores Hmct5, 102, HV 30, 548, HV 15, 416, m574, 103 y 358 identificados en el ADN de muestras de tejido foliar de 12 clones de caucho (Hevea brasiliensis) conservados en jardines clonales de AGROSAVIA en Colombia y 25 clones en jardines clonales de origen en Brasil. Con base en los resultados del análisis se consolidó una base de datos que permite corroborar la identidad por conformidad de clones de caucho a partir de muestras foliares. El protocolo establecido consiste en una aproximación metodológica para la amplificación de dichas regiones micro-satélites por PCR punto final y la visualización de los fragmentos obtenidos de este procedimiento por electroforesis capilar multiplexada, reduciendo costos y optimizando el tiempo en laboratorio. Adicionalmente se encontraron discrepancias entre el perfil electroforético obtenido del clon FX 3864 muestreado en Colombia con el obtenido en Brasil. Se propone considerar la necesidad de corroborar la identidad de los clones reproducidos en jardines clonales para su comercialización en Colombia, utilizando metodologías sensibles y reproducibles, como la estandarizada en este estudio.
ABSTRACT The polymorphism of 9 regions identified in the DNA of leaf tissue sampled from 12 rubber clones conserved in clonal gardens of AGROSAVIA in Colombia and 25 clones in clonal gardens of origin in Brazil was visualized by capillary electrophoresis after amplification with the fluorolabeled primer microsatellite markers Hmct5, 102, HV 30, 548, HV 15, 416, m574, 103 and 358. Upon the results analysis, a database was consolidated that allows to corroborate the genetical identity by conformity with 37 rubber clones from leaf samples. The established protocol is a methodological approach using end-point PCR towards the amplification by multiplexed capillary electrophoresis of micro-satellite regions and their visualization, reducing costs and optimizing time in the laboratory. Additionally, discrepancies were found between the electrophoretic profile obtained from clone FX 3864 sampled in Colombia with that obtained in Brazil. It is proposed to consider the need to corroborate the identity of the clones reproduced in clonal gardens for their commercialization in Colombia, using sensitive and reproducible methodologies, such as the one standardized in this study.
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In California, black tar heroin (BTH) use among injection drug users (IDUs) has resulted in an increased number of cases of wound botulism due to Clostridium botulinum, tetanus due to Clostridium tetani, and necrotizing soft-tissue infections due to a variety of clostridia. From December 1999 to April 2000, nine IDUs in Ventura County, California, developed necrotizing fasciitis; 4 died. Cultures of wound specimens from 6 case patients yielded Clostridium sordellii. Some of the patients appeared to have the toxic shock syndrome previously reported to be characteristic of toxin-mediated C. sordellii infection, which is characterized by hypotension, marked leukocytosis, and hemoconcentration. The suspected source of this outbreak was contaminated BTH that was injected subcutaneously or intramuscularly ("skin popped"). This outbreak of C. sordellii infection serves as another example of how BTH can potentially serve as a vehicle for transmitting severe and often deadly clostridial infections, and reinforces the need to educate IDUs and clinicians about the risks associated with skin popping of BTH.
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Infecções por Clostridium/epidemiologia , Clostridium , Surtos de Doenças , Fasciite Necrosante/epidemiologia , Dependência de Heroína/complicações , Adulto , California/epidemiologia , Infecções por Clostridium/complicações , Fasciite Necrosante/complicações , Feminino , Dependência de Heroína/microbiologia , Hospitalização , Humanos , Pessoa de Meia-Idade , Abuso de Substâncias por Via Intravenosa/complicaçõesRESUMO
El carcinoma córtico-adrenal es una entidad que se presenta raras veces; su evolución es agresiva, con una alta probabilidad de recaída y una supervivencia a 5 años que no supera el 60%. El único tratamiento curativo es la cirugía, siempre y cuando esta sea completa y a los pacientes se los diagnostique en estadios tempranos. Otras intervenciones que se pueden brindar son la radioterapia, la quimioterapia y el control de secreción hormonal en el contexto adyuvante o paliativo. En algunos casos (síndrome de Cushing) el bloqueo hormonal previo a la cirugía es imperativo. En esta revisión se describen la patogénesis, el diagnóstico, los factores pronósticos y el tratamiento del carcinoma córtico-adrenal, con el propósito de guiar el enfoque diagnóstico y el tratamiento.
Adrenal-cortical carcinoma is a rarely occurring entity; it evolves aggressively, has a high probability of relapse and survival at 5 years does not surpass 60%. Surgery provides the only curative treatment, but only when it is complete and carried out on patients with early-stage diagnosis. Additional treatments that may be used include radiotherapy, chemotherapy and control of hormonal secretion in an adjuvant or palliative context. In some cases (Cushing´s syndrome), it is imperative to provide hormonal block before surgery. The pathogenesis, diagnosis, prognostic factors and treatment of adrenal-cortical carcinoma are described in this review in order to sharpen the focus on diagnosis and treatment.
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Humanos , Carcinoma Adrenocortical , Síndrome de Cushing , Metástase Neoplásica , Cirurgia Geral/métodosRESUMO
Se estudió a 35 pacientes con respuesta alérgica perenne para conocer la eosinofilia después del reto nasal con antigeno especifíco. Los pacientes se seleccionaron al azar. A todos se les realizó historia clínica, pruebas cutáneas y cuantificación de eosinófilos en la mucosa nasal a la media hora y a las ocho horas después del reto con alergeno de Dermatophagoides. Los resultados mostraron aumento significativo de eosinófilos después del reto (p.006). No se observaron diferencias significativas en el número de eosinófilos a la media hora y a las ocho horas después del reto
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Humanos , Eosinófilos/imunologia , Eosinofilia/diagnóstico , Eosinofilia/imunologia , Mucosa Nasal/imunologia , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/imunologiaRESUMO
El objetivo de este proyecto es mejorar la capacidad instalada, resolutiva y administrativa de la red de servicios de salud con la participación comunitaria en este proceso, para contribuir la demanda y mejora de la salud de la población del municipio de Cotagaita.