Post-recurrence survival in patients with cervical cancer.

BACKGROUND: Up to 26% of patients with early-stage cervical cancer experience relapse after primary surgery. However, little is known about which factors influence prognosis following disease recurrence. Therefore, our aims were to determine post-recurrence disease-specific survival (PR-DSS) and to identify respective prognostic factors for PR-DSS. METHODS: Data from 528 patients with early-stage cervical cancer who relapsed after primary surgery performed between 2007 and 2016 were obtained from the SCANN study (Surveillance in Cervical CANcer). Factors related to the primary disease and recurrence were combined in a multivariable Cox proportional hazards model to predict PR-DSS. RESULTS: The 5-year PR-DSS was 39.1% (95% confidence interval [CI] 22.7%-44.5%), median disease-free interval between primary surgery and recurrence (DFI1) was 1.5 years, and median survival after recurrence was 2.5 years. Six significant variables were identified in the multivariable analysis and were used to construct the prognostic model. Two were related to primary treatment (largest tumour size and lymphovascular space invasion) and four to recurrence (DFI1, age at recurrence, presence of symptoms, and recurrence type). The C-statistic after 10-fold cross-validation of prognostic model reached 0.701 (95% CI 0.675-0.727). Three risk-groups with significantly differing prognoses were identified, with 5-year PR-DSS rates of 81.8%, 44.6%, and 12.7%. CONCLUSIONS: We developed the robust model of PR-DSS to stratify patients with relapsed cervical cancer according to risk profiles using six routinely recorded prognostic markers. The model can be utilised in clinical practice to aid decision-making on the strategy of recurrence management, and to better inform the patients.

Distinct patterns of brain Fos expression in Carioca High- and Low-conditioned Freezing Rats.

BACKGROUND: The bidirectional selection of high and low anxiety-like behavior is a valuable tool for understanding the neurocircuits that are responsible for anxiety disorders. Our group developed two breeding lines of rats, known as Carioca High- and Low-conditioned Freezing (CHF and CLF), based on defensive freezing in the contextual fear conditioning paradigm. A random selected line was employed as a control (CTL) comparison group for both CHF and CLF lines of animals. The present study performed Fos immunochemistry to investigate changes in neural activity in different brain structures among CHF and CLF rats when they were exposed to contextual cues that were previously associated with footshock. RESULTS: The study indicated that CHF rats expressed high Fos expression in the locus coeruleus, periventricular nucleus of the hypothalamus (PVN), and lateral portion of the septal area and low Fos expression in the medial portion of the septal area, dentate gyrus, and prelimbic cortex (PL) compared to CTL animals. CLF rats exhibited a decrease in Fos expression in the PVN, PL, and basolateral nucleus of the amygdala and increase in the cingulate and perirhinal cortices compared to CTL animals. CONCLUSIONS: Both CHF and CLF rats displayed Fos expression changes key regions of the anxiety brain circuitry. The two bidirectional lines exhibit different pattern of neural activation and inhibition with opposing influences on the PVN, the main structure involved in regulating the hypothalamic-pituitary-adrenal neuroendocrine responses observed in anxiety disorders.

Efectos de la estimulación eléctrica habenular en la modulación de respuestas emocionales en ratas Wistar / Efeitos da estimulação elétrica habenular na modulação de respostas emocionais em ratos Wistar / Effects of electrical stimulation of the habenula on the modulation of emotional responses in Wistar rats

Resumen A pesar del amplio uso de la estimulación cerebral profunda para controlar patologías neurológicas y neuropsiquiátricas, su mecanismo de acción aún no es claramente conocido, y existen pocos estudios sistemáticos que relacionen la variación de parámetros de estimulación eléctrica (frecuencia, intensidad, duración del pulso) y la ejecución comportamental. La habénula es una estructura reguladora de respuestas emocionales diana en tratamientos para dolor crónico y depresión, pero la relación entre su estimulación crónica y el desempeño animal en pruebas conductuales no se ha establecido con claridad. Con el objetivo de evaluar el efecto emocional de la estimulación habenular crónica, en este estudio se utilizaron ratas Wistar que recibieron estimulación habenular a intensidad baja (10-80 pA) o alta (120-260 pA) y frecuencia baja (80-150 Hz) o alta (240380 Hz): BIBF-AIBF-BIAF-AIAF, durante 15 minutos a lo largo de tres días consecutivos. Al cuarto día, se hizo la evaluación en un laberinto elevado en cruz y en campo abierto. Los resultados indican un efecto de tipo ansiolítico en el tratamiento BIAF, en comparación con BIBF y AIBF (aumento del número de entradas, porcentaje de tiempo en brazos abiertos y de la distancia recorrida en ellos), efecto que no se explica por cambios en la locomotricidad (distancia recorrida en los brazos cerrados y la exploración en el campo abierto). Se concluye que el parámetro frecuencia posee mayor impacto sobre el efecto comportamental que la intensidad -lo que puede explicar algunos hallazgos paradójicos previos-, que los parámetros utilizados no poseen efecto ansiogénico, y que los efectos potencialmente ansiogénicos de la estimulación a baja frecuencia y el papel de los sistemas dopaminérgicos y serotoninérgicos encontrados deben ser estudiados en futuras investigaciones.

Resumo Apesar do amplo uso da estimulação cerebral profunda para controlar patologias neurológicas e neuropsiquiátricas, seu mecanismo de ação ainda não é claramente conhecido e existem poucos estudos sistemáticos que relacionem a variação de parâmetros de estimulação elétrica (frequência, intensidade, duração do pulso) e a execução comportamental. A habênula é uma estrutura reguladora de respostas emocionais específicas em tratamentos para dor crònica e depressão, mas a relação entre sua estimulação crònica e o desempenho animal em testes comportamentais não foi claramente estabelecida. Com o objetivo de avaliar o efeito emocional da estimulação habenular crònica, neste estudo foram utilizados ratos Wistar que receberam estimulação habenular de intensidade baixa (10-80 pA) ou alta (120-260 pA) e frequência baixa (80-150 Hz) ou alta (240-380 Hz): BIBF-AIBF-BIAF-AIAF, durante 15 minutos ao longo de três dias consecutivos. No quarto dia, foi feita a avaliação em um labirinto em cruz elevado e em campo aberto. Os resultados indicam um efeito de tipo ansiolítico no tratamento BIAF, em comparação com BIBF e AIBF (aumento do número de entradas, porcentagem de tempo em braços abertos e da distância percorrida neles), efeito que não se explica por mudanças na locomotividade (distância percorrida nos braços fechados e a exploração no campo aberto). Conclui-se que o parâmetro "frequência" tem mais impacto sobre o efeito comportamental do que a "intensidade" - o que pode explicar algumas descobertas paradoxais prévias -, que os parâmetros utilizados não tenham efeito ansiogênico, e que os efeitos potencialmente ansiogênicos da estimulação de baixa frequência e o papel dos sistemas dopaminérgicos e serotoninérgicos encontrados devem ser estudados em pesquisas futuras.

Abstract Deep brain stimulation is a widely-used approach to the treatment of neurologic and neuropsychiatric diseases. However, its mechanisms remain unclear. There are few systematic studies relating variations on electrical stimulation parameters (frequency, intensity, pulse duration) and behavioral outcome. The habenula relates to emotional behavior and is a main target for chronic pain and depression stimulation treatment. The relation between habenular electrical stimulation and performance in behavioral tests has not been clearly defined. In order to assess the emotional effects of chronic habenular electrical stimulation, Wistar male rats were unilaterally implanted with electrodes aimed to the lateral habenula and assigned to low (10-80 pA) or high (120-260 pA) intensity and low (80-150 Hz) or high (240-380 Hz) frequency conditions: BIBF-AIBF-BIAF-AIAF. They received electrical stimulation 15 minutes/day for three consecutive days and on the fourth day were tested in the elevated plus maze and the open field. The results of these study show that BIAF stimulation has a possible anxiolytic-like effect when compared to BIBF and AIBF (increase in the percentage of open-arms time, entries into the open-arms and total-distance-run in the open-arms). This is not due to any changes in locomotion (total-distance-run and open field exploration). It is concluded that frequency is more important than intensity for behavioral modification. This could explain some previous inconsistent results. The data also suggest that these parameters of stimulation have no anxiogenic effects. The role for dopaminergic and serotonergic systems must be subsequently evaluated as well as potential anxiogenic-like effects of low frequency stimulation.

Neuro-«lo que sea¼: inicio y auge de una pseudociencia para el siglo XXI / Neuro-"whatever": Beginnings of a new pseudoscience for the XXI century

El paso del estado sésil al movimiento activo, requirió del desarrollo de un sistema nervioso capaz de coordinar el movimiento hacia fuentes de alimentación y el escape de posibles amenazas. En respuesta a los cambios en los ambientes macro- y micro-, los sistemas nerviosos fueron integrando habilidades cada vez mejores culminando en el «ensayo mental¼ (León & Cárdenas, 2011): el animal podía «imaginar¼ las consecuencias de algunas de sus acciones (causas y efectos), sin requerir ejecutarlas: la diferencia entre la vida y la muerte. Ya en los albores de la humanidad, esa necesidad imperiosa de buscar causas -ahora en una esfera plenamente mental- se plasmó en la creación de conceptualizaciones animistas de la naturaleza y por ello las primeras manifestaciones culturales fueron las explicaciones del universo en términos de mitos, leyendas, cuentos e historias transmitidas generacionalmente. El desarrollo de las tecnologías que fortalecían la unión cultural y las alianzas entre clanes, impulsó el desarrollo del conocimiento científico que mejoraba la tecnología y satisfacía más profundamente la sed de explicación del mundo. Fue la primera gran escisión entre ciencia y tecnología. Para el común, el impacto de la tecnología sobre la vida diaria es mucho más evidente que el de la ciencia, visión inmediatista que aún hoy rige, lastimosamente, a muchos organismos de gestión de la ciencia y la tecnología en muchos países. La separación ciencia (comprensible por pocos) / tecnología (usable por todos) hizo que paulatinamente se fuera desconociendo el real valor de la ciencia y permitió que muchas formas de conocimiento no científico, mucho más fácil de comprender y de transmitir -las «pseudociencias¼ (pseudo = que quiere ser, pero no es)- fueran instaurándose. Este conocimiento es «comprobado¼ por casos únicos que alguna vez sucedieron o que alguien reporto que vio o escucho (sin importar la veracidad del reporte). Ritos, mitos, magia, leyendas, alquimia y otras muchas ideas surgieron de esa forma.

Aproximación Neurodinámica a la Cognición Social / Neurodimanic Approach to Social Cognition

En las últimas décadas ha crecido el estudio los mecanismos involucrados en el comportamiento social, gran parte de estas indagaciones se han realizado desde una aproximación de la neurociencia social cognitiva, la cual se basa en un modelo representacional del procesamiento de información. No obstante, esta aproximación ha sido ampliamente criticada por desconocer la participación del cuerpo, la dinámica afectiva, el contexto social, el cambio durante el desarrollo y suponer un procesamiento modular endógeno. En este sentido, este artículo presenta un modelo neurodinámico de la cognición social (CS), comprendiéndola desde una aproximación enactiva, situada, relacional y sistémica. Desde este modelo se describen los principales cambios en esperados la actividad cerebral durante las interacciones sociales en tiempo real y durante la ontogenia. Se concluye resaltando los desafíos y oportunidades que este tipo de aproximaciones puede proporcionar a la neurociencia y psicología social del futuro.

In recent decades it has seen a growing interest to study the mechanisms involved in social behavior, much of these inquiries fall within social cognitive neuroscience approach, which is based on a representational model of information processing. However, this approach has been widely criticized for ignoring the body participation, emotional dynamics, social context, developmental changes and assuming an endogenous modular processing. In this regard, this article presents a neurodynamic model of social cognition, which understand social process from an enactive, embodied, situated, relational and systemic perspective. This model let us described the main expected changes in brain activity during ongoing social interactions and ontogeny. The conclusion highlights the challenges and opportunities that this kind of approach can provide for a coming neuroscience and social psychology.

La Enfermedad de Parkinson: Etiología, Tratamientos y Factores Preventivos / Parkinson Disease: Etiology, Treatments and Preventive Factors

La enfermedad de Parkinson (EP) es la patología neurodegenerativa motora con mayor incidencia a nivel mundial, cuyas causas aún no son claras. Actualmente no existe cura, pero es posible contar con diferentes tratamientos que permiten aliviar algunos de sus síntomas y enlentecer su curso. Debido a la gran cantidad de informaciones, en ocasiones contradictorias sobre los llamados "factores de riesgo" (entendidos éstos como situaciones que pueden exacerbar la posibilidad de aparición de la enfermedad, incluyendo desde la predisposición familiar hasta la exposición prolongada a substancias exógenas), en esta revisión se pretende ofrecer una panorámica actual sobre factores asociados a la aparición de EP Se revisan también algunos tratamientos que buscan contrarrestar la pérdida de la función dopaminérgica de la substancia nigra (SN) y algunas de las aproximaciones terapéuticas tanto farmacológicas, como por estimulación cerebral profunda (ECP) o por implante celular. Se revisan también investigaciones sobre el potencial terapéutico de compuestos con alta especificidad a receptores colinérgicos (nAChRs) y antagonistas de receptores de adenosina, específicamente del subtipo A2A. Posiblemente durante las próximas décadas, nuestro conocimiento en epigenética pueda arrojar nuevas luces sobre esta interacción, así como sobre las relaciones entre ciertas líneas de microbios intestinales y aparición de EP. En este momento, la alternativa terapéutica que ofrece mayor eficacia es la ECP, sin embargo, a futuro se espera que el desarrollo de nuevas estrategias de implante cerebral pueda ofrecer una cura real de la EP.

Parkinson's disease (PD) is the most prevalent neurodegenerative motor pathology worldwide, the causes of which are still unclear. Currently there is no cure, but it is possible to have different treatments that allow to alleviate some of its symptoms and slow its course. Due to the large amount of information, sometimes contradictory, about the so-called "risk factors" (understood as situations that may exacerbate the possibility of the onset of the disease, from family predisposition to prolonged exposure to exogenous substances), in this review aims to provide a current overview of factors associated with the occurrence of PD. We also review some treatments that seek to counteract the loss of the dopaminergic function of the substance nigra (SN) and some of the therapeutic approaches both pharmacologically, by deep brain stimulation (DBS) or by cellular implantation. Also reviewed investigations on the therapeutic potential of compounds with high specificity to cholinergic receptors (nAChRs) and adenosine receptor antagonists, specifically the A2A subtype. Possibly, during the next decades, our knowledge in epigenetics may shed new light on this interaction, as well as on the relationships between certain lines of intestinal microbes and onset of PD. At this time, the most effective therapeutic alternative is DBS; however, in the future it is expected that the development of new brain implant strategies may offer a real cure for PD.

Efecto de la aplicación aguda de fluoxetina sobre una tarea de miedo condicionado al contexto en ratas sometidas a restricción comportamental / Effect of acute Fluoxetine application on a context fear conditioned task in behaviorally restrained rats Laura A

Para estudiar el efecto del aumento comportamental o farmacológico de la ansiedad sobre la adquisición del miedo condicionado al contexto, 32 ratas Wistar (275±25 gm) divididas en dos grupos (restricción comportamental y control) recibieron fluoxetina (ig, 4 mg/kg; 1ml) o solución salina (ig, 0.9%). Luego fueron entrenadas en una tarea de miedo condicionado al contexto. El ANOVA de dos vías mostró diferencias significativas para el factor tratamiento (F[1,28] = 25.261; P < 0.001). Los sujetos tratados con fluoxetina presentaron menor tiempo de congelamiento (Student Newman-Keuls; P < 0.05). No hubo diferencias significativas para la restricción, ni para la interacción entre factores (F[1,28] = 0.115; P = 0.737 y F[1,28] = 0.016; P = 0.899). Así, la restricción no alteró la adquisición del miedo condicionado indicando que el aumento de liberación de 5-HT así inducido, no es comparable al inducido por fluoxetina. La fluoxetina deterioró la adquisición de la respuesta de miedo, indicando que el mecanismo por el cual la ansiedad interrumpe el aprendizaje puede ser serotoninérgico...

In order to study the effect of behavioral or pharmacologically enhanced anxiety on the acquisition of contextual fear conditioning, thirty two Wistar rats (275±25 gm) were divided in two groups (behavioral restriction and control). Half of each group received saline solution (ig.; 0.9%) or fluoxetine (ig.; 4mg/Kg) before the fear conditioning procedure. The two way ANOVA showed significant differences for treatment (F[1,28] = 25.261; P < 0.001). Student Newman-Keuls showed that subjects treated with fluoxetine had lower freezing times. There were no significant differences nor for restriction neither for the interaction between the factors (F[1,28] = 0.115; P = 0.737 y F[1,28] = 0.016; P = 0.899). Thus, the restriction procedure used did not modify the acquisition of the conditioned fear response suggesting that the putative 5-HT enhancement induced is not comparable to that induced by fluoxetine. Acute fluoxetine disrupted the acquisition of the conditioned fear response, suggesting that the mechanism by means of which anxiety disrupts learning could be serotonergic in nature...

Efectos de la aplicación intrahipocampal del péptido BLMP-101 sobre una tarea de memoria espacial en ratas Wistar / Effects of intrahypocampal administration of the BLMP-101 peptide on a spatial memory task in Wistar rats

El péptido BLMP-101 posee potencial para el tratamiento de deficiencias de la memoria. Esta investigación tuvo como objetivo corroborar los resultados obtenidos en investigaciones anteriores con respecto a la evaluación del péptido BLMP-101, en cuanto a la efectividad del péptido diseñado por el grupo de Bioquímica Computacional y estructural de la Pontificia Universidad Javeriana. Sin embargo, y a diferencia de las investigaciones anteriores, el objetivo del presente estudio consistió en medir la efectividad del BLMP-101, en dosis diferentes y haciendo la aplicación intrahipocampal del péptido, para corroborar sus efectos en la facilitación de la memoria espacial. Se utilizaron 31 ratas Wistar divididas en cuatro grupos, tres experimentales y uno de comparación. El grupo de comparación, fue inyectado con solución salina y a uno de los grupos experimentales se le administró NMDA y, a los otros dos, dosis diferentes del péptido BLMP-101 (0.3, 3.0 ug/ul). Los resultados sugieren que el péptido BLMP-101 con dosis de 3.0 ug/ul, facilitan la memoria espacial, mejor que el NMDA.

The BLMP-101 peptide has the potential features to treat memory deficiency. The herein research aimed at corroborating the results obtained in previous researches and tests conducted on the effectiveness of the peptide BLMP-101 designed by the Computational and Structural Biochemestry Unit of the Pontificia Universidad Javeriana, Colombia. However, and unlike previous researches, the objective of this paper measured the effectiveness of the BLMP-101peptide, when supplied in different dozes and through intrahipocampal application to confirm its effects to facilitate spatial memory. 31 Wistar rats were used into 4 different groups: three treatment groups and one control group. The control group was infused with saline solution, and one of the treatment groups was infused with NMDA, while the other two experimental groups were infused with different dozes of the BLMP-101peptide (0.3, 3.0 ug/ul). Results suggest that the BLMP-101 peptide, when supplied in 3.0 ug/ul, facilitates spatial memory showing better results than the NMDA.

Redundancia de la información visual en el condicionamiento aversivo: papel del colículo superior / Redundancy of visual information in aversive conditioning: role of the superior colliculus

Una característica de casi todos los sistemas biológicos es el procesamiento en paralelo o distribuido,el cual otorga al sistema una redundancia funcional que garantiza la permanencia de procesosincluso en ausencia de porciones del sistema. En el sistema visual existen tres vías que simultáneamentese encargan de varios aspectos de la percepción. El procesamiento realizado por la ramacolicular de este sistema está muy relacionado con los sistemas de valoración emocional límbicos,gracias a la vía colículo superior —núcleo suprageniculado— amígdala. En el presente trabajo seevaluó el efecto de la inactivación del colículo superior en la formación de un condicionamientoaversivo visual. Para esto ratas Wistar recibieron una microinyección intracolicular de lidocaína (1%)durante la adquisición del condicionamiento. Los resultados obtenidos mostraron claramente que elcolículo superior no es una estructura indispensable para la formación de tal condicionamiento, loque sugiere que otros sistemas de relevo subcortical deben estar implicados. A partir de ello esposible hipotetizar nuevas formas de aproximación al estudio de las características de redundanciafuncional en el sistema visual.

A relevant feature of biological systems is the distributed processing. This kind of informationprocessing ensures a functional redundancy that allows a functional level even in the absence ofsome regions of the system. In the case of visual system, the parallel processing relies on threesimultaneous pathways, each one of them carrying out certain aspects of visual information processing.The collicular branch of this parallel system is related to emotional aspects. This pathway transmitsinformation from the superior colliculus to the amygdala, via the suprageniculate nucleus. Here wetest the effect of the transient inhibition of the superior colliculus on the acquisition of a classicalaversive conditioning. Wistar rats received an intracollicular microinjection of lidocaine (1%)immediately before the training session. Our results clearly show that the superior colliculus is notthe main structure involved in the acquisition of this kind of associative learning suggesting thecontribution of other subcortical structures.

Contribution of the dopaminergic system to the effect of chronic fluoxetine in the rat forced swim test

Chronic administration of selective serotonin reuptake inhibitors (SSRI) enhances dopaminergic activity. However, the role of enhanced dopaminergic transmission in the therapeutic effects of this kind of antidepressants is still unclear. Drugs producing dopaminergic activation lead to an increment in general activity. Thus, it is reasonable to assume that some of the therapeutic effects of SSRIs are due to dopaminergic enhanced functionality. The forced swim test (FST) is a widely used test in the screening of new compounds with potential antidepressant activity. In this study the effects of pretreatment with low doses of the DA release inductor cocaine and the D2, D3 and D4 antagonist haloperidol were analyzed in the FST on rats submitted to chronic intragastric administration of the SSRI fluoxetine. Our results show that animals treated with fluoxetine and pre-treated with cocaine had significantly higher latencies than saline or haloperidol pre-treated subjects. Among both fluoxetine and saline treated animals, those pre-treated with cocaine had significant lesser immobility time. Haloperidol pre-treated animals had significantly higher immobility time than those pre-treated with saline. From these results, it is clear that the pharmacological modification of dopaminergic systems leads to behavioral changes in rats treated with both saline and fluoxetine. The FST does not have enough precision as to distinguish between dopaminergic and nondopaminergic components in the antidepressant effects of SSRIs, for this reason the use of the FST in combination to other models is mandatory.

Description of a seven-year prospective study of human papillomavirus infection and cervical neoplasia among 10000 women in Guanacaste, Costa Rica,.

OBJECTIVE: The Guanacaste study ("Guanacaste Project," or GP), was designed to investigate the role of human papillomavirus (HPV) infection and its cofactors in the development of cervical neoplasia and to evaluate new cervical cancer screening technologies. The follow-up phase of the GP was designed to study why a small proportion of women infected with HPV develop cervical intraepithelial neoplasia grade 2 (CIN 2), CIN 3, or cancer (these three together are globally referred to as > or = CIN 2, that is, CIN 2 or worse). The purpose of this article is to describe this prospective study in detail and to present the preliminary findings regarding the incidence of cervical neoplasia. METHODS: A cohort of 10 049 randomly selected women from 18 to 97 years old from Guanacaste, a province in northwestern Costa Rica, was intensively screened in 1993-1994 and then followed up for seven years after being enrolled. A questionnaire for demographic and risk factors was administered, and a pelvic examination was performed on sexually active women at each follow-up visit in order to obtain samples for screening tests and for research purposes. The final diagnosis given at the end of the enrollment phase categorized women into several groups according to the perceived risk of their developing either high-grade precursors of cancer or cancer. These groups were followed up at different intervals according to the risk of developing > or = CIN 2. The most active follow-up (every 6-12 months) was concentrated on the women most likely to develop >or = CIN 2, based on cytology (n = 492). The remainder of the cohort was followed either annually (n = 2 574) or after five to seven years of passive follow-up (n = 3 926). All women with possibly severe lesions detected by any technique were referred to colposcopy for further evaluation and treatment, and they were also censored from the study. Lesions >or = CIN 2 served as both the censoring outcome and our surrogate for cancer risk. RESULTS: Participation during follow-up was high (near 90%). Suspected > or = CIN 2 by any screening technique censored 4.6% of women. Most of the women censored because of suspected > or = CIN 2 came from the large group perceived at entry as being at low risk of developing > or = CIN 2, but the greatest rates of progression to > or = CIN 2 were observed among women perceived at entry to be at highest risk of > or = CIN 2, based on their cytology, virology, or sexual behavior. CONCLUSIONS: The GP is the largest population-based longitudinal cohort for the study of HPV and cervical neoplasia in the world, and its results will hopefully let us soon plan future worldwide prevention strategies. Research projects such as this one require the long-term commitment of a large multidisciplinary team and ample financial resources. The intensive effort and expertise applied in all aspects of this study were key factors in its success as a model of cooperative, interdisciplinary cancer research in Latin America. Quality control played an important role at all times during the study and made it possible to adapt new diagnostic and screening technology to Guanacaste. The systematic follow-up of a population-based group of close to 10 000 women in Guanacaste should permit careful, time-dependent evaluation of factors postulated to be linked to the development of cervical cancer as well as the evaluation of clinical markers of disease progression. The study results that have already been published have validated sensitive screening techniques and have also promoted the use of more affordable screening techniques in resource-poor, developing countries. The GP has also contributed to building knowledge for the search for vaccines against HPV as part of the effort to develop an effective tool to reduce the incidence and mortality of cervical cancer worldwide.

Introduçäo de genes em segmentos foliares de cupuaçu ( Theobroma grandiflorum schumm. ) usando biobalística / Genes introduction in foliar segments of cupuassu ( Theobroma grandiflorum schumm. ) using biolistic

A técnica da biobalística foi utilizada com o objetivo de adaptar um protocolo para transformaçäo de plantas de cupuaçu. Segmentos foliares de cupuaçu foram bombardeados com um plasmídio contendo o gene reportador da antocianina, utilizando-se as pressöes de hélio de 650, 1000 e 1100psi. Após o bombardeamento, os explantes foram transferidos para meio MS por 24 horas e, após este período de incubaçäo, pontos vermelhos foram detectados utilizando-se um estereomicroscópio Stemi SV11 Zeiss (Germany). A expressäo do gene da antocianina foi observada nas pressöes de 650 e 1000psi, entretanto necroses foram encontradas na pressäo de 1100psi. Demonstrou-se que os genes C1 e RÆ da síntese de antocianina, sob o controle do promotor 35S, podem ser utilizados como repórteres para o monitoramento dos eventos de transformaçäo em cupuaçu.

Description of a seven-year prospective study of human papillomavirus infection and cervical neoplasia among 10 000 women in Guanacaste, Costa Rica

OBJETIVOS: El estudio de cohorte de Guanacaste, o Proyecto Epidemiológico Guanacaste, fue diseñado para investigar el papel que desempeñan la infección por el virus del papiloma humano (VPH) y sus cofactores en el desarrollo de neoplasias cervicouterinas y para evaluar nuevas tecnologías de tamizaje del cáncer del cuello de útero. La fase de seguimiento de este proyecto se diseñó para analizar por qué una pequeña parte de las mujeres infectadas por el VPH desarrollan neoplasias intraepiteliales cervicouterinas (NIC) grados 2 y 3, o cáncer (que en lo adelante se llamarán en conjunto > NIC 2, es decir, NIC 2 o peor). El propósito de este artículo es describir en detalle ese estudio prospectivo y presentar los resultados preliminares relacionados con la incidencia de neoplasias cervicouterinas. MÉTODOS: Se realizó el tamizaje intensivo de una cohorte de 10 049 mujeres de 18 a 97 años de edad seleccionadas aleatoriamente en Guanacaste, provincia del noroeste de Costa Rica, en 1993-1994 con un seguimiento ulterior de siete años. A las participantes se les aplicó un cuestionario para conocer sus características demográficas y sus factores de riesgo, y a las sexualmente activas se les realizó además un examen pélvico en cada una de las visitas de seguimiento, a fin de obtener muestras para las pruebas de tamizaje y la investigación. El diagnóstico obtenido al final de la fase de captación permitió clasificar a las mujeres en varios grupos de acuerdo con el riesgo que presentaban de desarrollar cáncer o alguno de sus precursores de alto grado. Estos grupos tuvieron seguimientos a intervalos diferentes, según su riesgo de desarrollar > NIC 2. El seguimiento más activo (cada 6-12 meses) se concentró en las mujeres con mayores probabilidades de desarrollar > NIC 2, según los resultados citológicos (n = 492). Las mujeres restantes recibieron visitas de seguimiento anualmente (n = 2 574) o después de cinco a siete años de seguimiento pasivo (n = 3 926). A todas las mujeres en quienes se detectaron lesiones que pudieran ser graves, por cualquiera de las técnicas empleadas, se les remitió a una evaluación ulterior mediante colposcopia y a tratamiento médico, y se retiraron del estudio. Las lesiones > NIC 2 se utilizaron como criterio para la salida del estudio y como indicadores indirectos del riesgo de cáncer. RESULTADOS: La participación durante la fase de seguimiento fue alta (cercana al 90%). Cualquier indicio de > NIC 2, según cualquiera de las técnicas...

Correlates of IL-10 and IL-12 concentrations in cervical secretions.

Interindividual variations in host immune responses to HPV infection are thought to be important determinants of viral persistence and progression to cervical intraepithelial neoplasia and cancer. However, few studies have measured local immune markers at the site of infection (e.g., the cervical mucosa). We sought to determine biologic correlates of IL-10 and IL-12 concentrations in cervical secretions. Cervical secretions were passively collected using a WeckCel sponge from 247 women participating in a natural history study of human papillomavirus infection as part of an immunologic ancillary study. IL-10 and IL-12 concentrations were determined using standard ELISA assays. In general, IL-10 and IL-12 levels were significantly intercorrelated (Pearson's correlation coefficient = 0.6) but had somewhat different determinants. Significant increases (P < 0.05) in IL-10 concentrations were observed for nonovulatory phases of the menstrual cycle, postmenopausal status, recent use of oral contraceptives (OC), low secretion volume, macrolevels of heme contamination, and high vaginal pH. Increasing IL-10 levels were also observed among smokers, women with increasing numbers of lifetime sex partners, and women who report having less frequent sex (less than once per week), however, these results were not statistically significant. Significantly higher IL-12 concentrations were observed among recent OC users, women with low secretion volume, and women with a high vaginal pH. There was a non-statistically significant observation of increasing IL-12 levels among nonsmokers, women with increasing numbers of lifetime and recent pregnancies, and increasing levels of heme contamination. We failed to observe a significant association between HPV and IL-10 or IL-12 levels in this crosssectional sample. Future analyses of cervical cytokine levels and HPV infection should control for the inherent variation of local cytokine levels due to hormonal influences, hemoglobin contamination, pH, and cervical secretion volume differences.

Eritema Gyratum Repens: a proposito de un caso / Erythema Gyratum Repens

Se presenta el caso de un paciente masculino de 20 años de edad,con lesiones eritematosas figuradas en torax y extremidades de aparicion subita, asintomaticas, sin hallazgos fisico-patologicos adicionales a la afeccion cutanea y examenes complementarios que descartan posible proceso neoplasico asociado. Se describe el caso al tratarse de una entidad de rara frecuencia

The distribution of fos immunoreactivity in rat brain following freezing and escape responses elicited by electrical stimulation of the inferior colliculus.

Several sources of evidence indicate that the inferior colliculus also integrates acoustic information of an aversive nature besides its well-known role as a relay station for auditory pathways. Gradual increases of the electrical stimulation of this structure cause in a hierarchical manner alertness, freezing and escape behaviors. Independent groups of animals implanted with bipolar electrodes into the inferior colliculus received electrical stimulation at one of these aversive thresholds. Control animals were submitted to the same procedure but no current was applied. Next, analysis of Fos protein expression was used to map brain areas activated by the inferior colliculus stimulation at each aversive threshold and in the controls. Whereas alertness elicited by stimulation of the inferior colliculus did not cause any significant labeling in any structure studied in relation to the respective control, electrical stimulation applied at the freezing threshold increased Fos-like immunoreactivity in the central amygdaloid nucleus and entorhinal cortex. In contrast, escape response enhanced Fos-like immunoreactivity in the nucleus cuneiform and the dorsal periaqueductal gray matter of the mesencephalon. This evidence supports the notion that freezing and escape behaviors induced by electrical stimulation of the inferior colliculus activate different neural circuitries in the brain. Both defensive behaviors caused significant expression of c-fos in the frontal cortex, hippocampus and basolateral amygdaloid nucleus. This indistinct pattern of c-fos distribution may indicate a more general role for these structures in the modulation of fear-related behaviors. Therefore, the present data bring support to the notion that amygdala, dorsal hippocampus, entorhinal cortex, frontal cortex, dorsal periaqueductal gray matter and cuneiform nucleus altogether play a role in the integration of aversive states generated at the level of the inferior colliculus.

Prospecting sugarcane genes involved in aluminum tolerance

Alumínio (Al) é um dos principais fatores que afetam o desenvolvimento de plantas em solos ácidos, reduzindo substancialmente a produtividade agrícola. Na América do Sul, cerca de 66 por cento da superfície do solo apresentam acidez, onde a alta saturaçäo de alumínio é uma das maiores limitações à prática agrícola. Apesar do crescente número de estudos, uma compreensäo completa das bases bioquímicas e moleculares da tolerância ao alumínio em plantas está longe de ser alcançada. No caso da cana-de-açúcar, näo há nada publicado sobre a regulaçäo gênica induzida durante o stress por alumínio. O objetivo deste trabalho foi identificar genes de cana-de-açúcar relacionados com as várias vias metabólicas reconhecidamente envolvidas na resposta à toxidez do alumínio em outras espécies de plantas e leveduras. Para a maioria dos genes relacionados com alumínio em outras espécies foram identificados similares em cana-de-açúcar, tais como aqueles que codificam enzimas que combatem o stress oxidativo ou a infestaçäo por patógenos, proteínas responsáveis pela exudaçäo de ácidos orgânicos e pela transduçäo de sinais. O papel desses genes na tolerância ao alumínio é revisado. Devido ao alto grau de conservaçäo do genoma entre espécies próximas de gramíneas como milho, cevada, sorgo e cana-de-açúcar, esses genes seräo uma ferramenta valiosa para a melhor compreensäo e manipulaçäo da tolerância ao alumínio nestas espécies.

Manifestaciones ácido-pépticas en pacientes con enfermedades reumáticas bajo tratamiento con AINE y medicamantos que modifican el curso y progreción (MMPC) de la enfermedad; su asociación con Helicobacter pylori / Relation of rheumatic diseases with peptic manifestation and H. pylori infection

La enfermedad ácido péptica se asocia al uso de AINE y está estrechamente relacionada con Helicobacter pylori. Frecuentmente se requiere de AINE y MMCP en las enfermedades reumáticas. Por lo anterior, decidimos realizar un estudio prospectivo observacional en pacientes con lupus eritematoso generalizado bajo tratamiento con AINE y con artritis reumatoide que recibían ambos tipos de tratamiento. A estos grupos de pacientes se les realizó endoscopia gastrointestinal alta y toma de biopsia para la búsqueda del H. pylori y así conocer los potenciales asociaciones entre manifestaciones de la enfermedad ácido-péptica, la modalidad terapéutica y la presencia de este microorganismo. Se utilizó el método de Fisher para análisis estadístico. La mayoría de los pacientes con osteoartrosis presentaron síntomas (14 de 17), alteraciones endoscópicas y 13 de los 14 con síntomas tuvieron H. pylori. Sólo 3 de los 7 con lupus tuvieron manifestaciones clínicas y alteraciones mínimas en el estudio endoscópico; 3 de 4 que recibían MMCP tuvieron H. pylori y sólo uno lo tuvo sin este tratamiento. De aquellos con artritis reumatoide, 18 tuvieron H. pylori, 9 de los cuales refirieron síntomas y de éstos, 8 tenían alteraciones

Desing and methods of a population-based natural history study of cervical neoplasia in a rural province of Costa Rica: the Guanacaste Project / Diseño y métodos usados en un estudio poblacional sobre la historia natural de las neoplasias de cuello uterino en una provincia rural de Costa Rica: el Proyecto de Guanacaste

En el presente trabajo se describe la fase de reclutamiento de un estudio poblacional sobre la historia natural de las neoplasias de cuello uterino en Guanacaste, provincia rural costarricense donde las tasas de cáncer cervicouterino invasor son invariablemente altas. Las metas principales del estudio son investigar el papel que desempeñan la infección por el virus del papiloma humano (VPH) y sus cofactores en la etiología de las neoplasias cervicouterinas de alto grado, y evaluar las nuevas tecnologías empleadas en el tamizaje del cáncer cervical. Para empezar se seleccionó una muestra aleatoria de segmentos censuales y, con la ayuda de trabajadores de acción comunitaria del Ministerio de Salud de Costa Rica, se hizo un recuento de todas las habitantes de 18 años de edad o mayores. De las 10 738 mujeres que cumplían con los requisitos para participar, 10 049 (93,6%) fueron entrevistadas después de haber dado su consentimiento informado por escrito. Después de la entrevista sobre los factores de riesgo del cáncer cervicouterino, se hizo un examen pélvico a las mujeres que dijeron haber tenido actividad sexual. El examen pélvico incluyó la determinación del pH vaginal y la obtención de células para análisis citológico mediante tres técnicas distintas. También se obtuvieron células cervicales para determinar la presencia y cantidad de ADN de 16 tipos de VPH diferentes y se tomaron dos fotografías del cérvix que fueron interpretadas en un local distinto por un experto en colposcopia. Por último, se sacaron muestras de sangre para hacer ensayos inmunológicos y determinaciones de micronutrientes. Las mujeres con un diagnóstico citológico anormal o un cervigrama positivo, más una muestra del grupo en general, fueron remitidas para hacerles colposcopia y se tomaron biopsias cuando se observaron lesiones. El tamizaje con fines de reclutamiento servirá de base para un estudio de prevalencia de casos y controles, y las integrantes de la cohorte sin enfermedad avanzada tendrán un seguimiento activo a intervalos mínimos de un año, con el propósito de estudiar la historia natural de la infección por VPH y los orígenes de las lesiones escamosas intraepiteliales de alto grado. Se describe en detalle la operación de campo y se hace especial alusión a la realización de estudios de este tipo en países en desarrollo. También se presentan datos descriptivos sobre la prevalencia de la enfermedad y la exposición a diversos factores de riesgo

This paper reports on the enrollment phase of a population-based natural history study of cervical neoplasia in Guanacaste, a rural province of Costa Rica with consistently high rates of invasive cervical cancer. The main goals of the study are to investigate the role of human papillomavirus (HPV) infection and its co-factors in the etiology of high-grade cervical neoplasia, and to evaluate new cervical cancer screening technologies. To begin, a random sample of censal segments was selected and enumeration of all resident women 18 years of age and over was conducted with the aid of outreach workers of the Costa Rican Ministry of Health. Of the 10 738 women who were eligible to participate, 10 049 (93.6%) were interviewed after giving written informed consent. After the interview on cervical cancer risk factors was administered, a pelvic examination was performed on those women who reported previous sexual activity. The pelvic examination included a vaginal pH determination and collection of cervical cells for cytologic diagnosis using three different techniques. Additional cervical cells were collected for determination of the presence and amount of DNA from 16 different types of HPV, and two photographic images of the cervix were taken and interpreted offsite by an expert colposcopist. Finally, blood samples were collected for immunologic and micronutrient assays. Women with any abnormal cytologic diagnosis or a positive Cervigram, as well as a sample of the whole group, were referred for colposcopy, and biopsies were taken when lesions were observed. The enrollment screening will serve as the basis for a prevalent case-control study, and the members of the cohort free from serious disease will be followed actively, at intervals of no more than a year, to study the natural history of HPV infection and the origins of high-grade squamous intraepithelial lesions (HSIL). Details of the field operation are outlined, with particular reference to the realization of this kind of study in developing countries. Descriptive data on the prevalence of disease and exposure to various risk factors are also presented.