Frequency of diminished ovarian reserve in women with multiple sclerosis in Chile: An exploratory study.

INTRODUCTION: Multiple Sclerosis (MS) is a chronic disease affecting around 2.8 million people worldwide. Two-thirds are women, and the mean age at diagnosis is about 30 years old. Social trends are moving towards older age at first pregnancy, both in women with and without MS. OBJECTIVES: To determine the frequency of diminished ovarian reserve (DOR) through anti-Mullerian Hormone (AMH) measurement in women with MS at fertile age and Healthy Females (HF) in Chile. METHODS: Case-control, multicentric, cross-sectional study including relapsing-remitting people with MS (pwMS) between 18 and 40 years and sex and age-matched HF. We obtained a blood sample to determine AMH levels. We defined DOR as AMH <1.5 ng/mL and very-low AMH levels as <0.5 ng/mL. Also, we performed questions regarding reproductive decision-making. RESULTS: We included 79 sex and age-matched HF and 92 pwMS, median age 32(19-40) years, median disease duration 6 (1-17)years, median EDSS 1.0 (0-6), 95% were receiving disease-modifying therapy (DMT), 70% high-efficacy DMT and 37% with a treatment that contraindicates pregnancy. DOR was observed in 24% (n = 22) of the pwMS, compared to 14% (n = 11) of the HF (p = 0.09), while very-low AMH levels were observed in 7.6% (n = 7) of pwMS and none of the HF (p = 0.0166). We observed an inverse correlation between age and AMH levels. Age was the only significant risk factor for low AMH levels in pwMS (OR 1.14 95%CI(1.00-1-31), p = 0.04), including smoking, body mass index (BMI), hormonal contraception, autoimmune comorbidity, high/low-moderate efficacy DMT, and active disease as covariables. We did not find statistically significant differences in age at diagnosis, BMI, disease duration, EDSS, autoimmune comorbidity, use of hormonal contraception, or percentage of active disease between MS women with normal vs DOR. Over 70% of pwMS desired to become pregnant in the future, while 60% considered that the diagnosis of MS was a limitation for pregnancy planning. CONCLUSIONS: No differences in DOR, measured by levels of AMH, were observed between pwMS MS and HF in Chile. As expected, AMH levels were correlated only with ageing. This information may be evaluated early during the disease course to help patients and neurologists with fertility counselling and family planning considerations regarding DMT use.

Adaptive cell invasion maintains lateral line organ homeostasis in response to environmental changes.

Mammalian inner ear and fish lateral line sensory hair cells (HCs) detect fluid motion to transduce environmental signals. Actively maintained ionic homeostasis of the mammalian inner ear endolymph is essential for HC function. In contrast, fish lateral line HCs are exposed to the fluctuating ionic composition of the aqueous environment. Using lineage labeling, in vivo time-lapse imaging and scRNA-seq, we discovered highly motile skin-derived cells that invade mature mechanosensory organs of the zebrafish lateral line and differentiate into Neuromast-associated (Nm) ionocytes. This invasion is adaptive as it is triggered by environmental fluctuations. Our discovery of Nm ionocytes challenges the notion of an entirely placodally derived lateral line and identifies Nm ionocytes as likely regulators of HC function possibly by modulating the ionic microenvironment. Nm ionocytes provide an experimentally accessible in vivo system to study cell invasion and migration, as well as the physiological adaptation of vertebrate organs to changing environmental conditions.

Vitrificación de ovocitos en pacientes oncológicas: experiencia en clínica ivi chile y revisión de la literatura / Vitrification of oocytes in oncological patients: experience in clinica ivi chile and review of literature

La sobrevida de pacientes con cáncer ha mejorado con el tiempo, especialmente en pacientes en edad fértil. La criopreservación de los ovocitos a través de la estimulación ovárica controlada (EOC) es la técnica más frecuente de preservación de la fertilidad. El objetivo del presente estudio es realizar un análisis descriptivo de los ciclos de pacientes que, previo al tratamiento de cáncer, realizaron un tratamiento de preservación de fertilidad. Se analizaron datos demográficos como edad, diagnóstico de ingreso y resultados clínicos, tales como tipo de protocolo de estimulación utilizado, número de ovocitos obtenidos, duración de la estimulación y momento de inicio en el ciclo. Resultados: La edad promedio fue 28.9 años. La duración media de la estimulación fue de 12 días, con un promedio de ovocitos obtenidos en total de 12. Se utilizaron 2 protocolos de estimulación ovárica, obteniendo mejores resultados con el esquema de antagonistas de GnRH asociado a letrozole y doble gatillante. Respecto al momento del ciclo en que se inició la estimulación ovárica, no hubo diferencias. Conclusiones: Es posible realizar preservación de la fertilidad previo a un tratamiento oncológico con buenos resultados en pacientes jóvenes, por lo que sugerimos realizarlo en todos los pacientes con diagnóstico oncológico antes el tratamiento del cáncer. Es recomendable comenzar la estimulación ovárica en cualquier fase del ciclo ya que se obtienen los mismos resultados y permite un pronto inicio de la terapia oncológica.

Survival of patients with cancer has been improving over time, especially in young patient with fertility intention. Cryopreservation of oocytes through controlled ovarian stimulation (EOC) is the most frequent technique of fertility preservation. We analyzed the data obtained from oncological patients who attended IVI Chile between January 2008 and May 2017 in search of fertility preservation. Demographic data were obtained: age, diagnosis of admission, type of stimulation protocol used, number of oocytes obtained, duration of stimulation and pregnancy rate. Results: The average age: 28,9 years; average duration of stimulation:12 days. Number of oocytes obtained in total: 12. Two ovarian stimulation protocols were used. The one with the best results was the protocol with GnRH antagonists associated with letrozole and double triggering. Regarding the moment of the cycle where to start ovarian stimulation, there were no differences. Conclusions: It is possible to carry out a fertility preservation treatment prior to an oncological treatment with good results in young patients, so we suggest the preservation of fertility in all patients with an oncological diagnosis before oncological treatment. It is recommended to start ovarian stimulation at any phase of the cycle since the same results are obtained.

Características sociodemográficas y perfil de consumo de tabaco y drogas en estudiantes de dos universidades de México / Tobacco and drugs consumption in students from two universities in Mexico

Resumen Introducción El consumo de tabaco es la primera causa prevenible de muerte prematura y enfermedad en todo el mundo; asimismo el uso y abuso de drogas constituye un grave problema de salud pública y de altos costos de atención a la salud. Se aborda el consumo de tabaco y drogas, desde el punto de vista epidemiológico y en materia de salud pública, así como los factores sociodemográficos que influyen en la adicción a ellos. Objetivo Describir las características socio-demográficas y de consumo de tabaco y droga en estudiantes universitarios de Yucatán y Coahuila. Material y métodos Encuesta transversal que incluyó 412 universitarios de Yucatán y 344 de Coahuila. Se utilizó estadística descriptiva para las variables numéricas y frecuencias para las cualitativas, estadística inferencial para las coincidencias y diferencias. Resultados La media de edad fue mayor para los estudiantes de Yucatán así como predominio de los hombres, la media de consumidores de tabaco dentro de las personas de su red fue mayor para Coahuila siendo las diferencias estadísticamente significativas p<0.05, no así para las personas de la red respecto al consumo de drogas. Conclusiones El consumo de tabaco en ambos estados fue mayor al esperado para su región, las fumadoras activas estuvieron por encima del promedio nacional, los dos estados se ubicaron arriba del promedio nacional respecto a consumo de drogas y Coahuila por encima del promedio mundial. Se propone un trabajo conjunto para evaluar los spots publicitarios transmitidos en los medios de comunicación y evitar su incorporación al mercado como bienes de consumo.

Abstract Introduction Tobacco consumption is the leading cause of premature preventable death and disease worldwide, as well the drug use and abuse is a serious public health problem and health care high costs. The tobacco and drugs consumption is addressed from the epidemiologic and public health point of view, also the socio-demographic factors influencing addiction to them Objetive Describe the sociodemographic and tobacco and drugs consumption characteristics among college students from Yucatan and Coahuila Materials and methods Cross sectional survey that included 412 college students from Yucatan and 344 from Coahuila. Descriptive statistics were used for the numeric variables, frequencies for the qualitative, inferential statistics for the similarities and differences. Results The mean of the age was higher for Yucatan students and men predominated, the mean of the tobacco consumers within people from their social network was higher for Coahuila being the differences statistically significant p<0.05, not so for the people from their network regarding to drugs consumption Conclusions The tobacco consumption in both states was higher than expected for the region, the active female smokers were above the national mean, the two states were above the national mean regarding to drugs use and Coahuila above the world mean. Joint work is proposed to evaluate the advertising spots broadcast in the media and avoid its incorporation to the market as consumer goods.

Concordancia del IMC y la percepción de la imagen corporal en adolescentes de una localidad suburbana de Yucatán / Concordance of the body mass index and the perception of body image in adolescents in Yucatán

Resumen Introducción Los problemas de la imagen corporal asociados con los riesgos de trastornos alimenticios entre los adolescentes, en particular, la anorexia nerviosa y la bulimia, son considerados temas de salud emergentes a nivel mundial. Las consecuencias que conllevan son físicas, psicológicas y sociales. Objetivo Determinar la concordancia entre el índice de masa corporal y la percepción de la imagen corporal en un grupo de adolescentes. Materiales y Métodos Estudio cuantitativo, observacional, transversal realizado en 84 alumnos, 54.1% hombres y 45.9%, mujeres, con edades entre 10 y 17 años, que cursaban educación básica y secundaria en una localidad suburbana de alta marginación, en Yucatán. Se auto-administró a los estudiantes, el pictograma de Stunkard, para registrar la percepción de la imagen corporal. Para calcular el índice de masa corporal (IMC) se registraron medidas antropométricas de peso y talla, usando una báscula digital marca Tanita, modelo TBC 310 y un estadímetro marca SECA de 2 metros de longitud. Los puntos de corte fueron los establecidos por la Organización Mundial de la Salud. Resultados Los hallazgos, respecto a la percepción de la imagen corporal, mostraron una concordancia insignificante (k= 0.067, p< 0.5); en mujeres es baja, con un valor de k= .223; se perciben normales aun cuando presentan bajo peso, mientras que, las que presentan obesidad, subestiman su estado. En cuanto a los hombres, en los casos de obesidad, la imagen y el IMC son coincidentes, aunque, al mismo tiempo, subestiman la percepción corporal en bajo peso.

Abstract Introduction Body image problems associated with the risk of eating disorders such as anorexia nervosa and bulimia, are considered emerging health issues among adolescents around the world. These problems have both physical, psychological and social consequences. Objective To determine the correlation between body mass index and the body image perception in a group of teenagers. Material and Methods A quantitative, observational, cross-sectional study was carried out in 84 students, 54.1% men and 45.9% women with an age range between 10 and 17 years who were attending primary or secondary school education in a suburban town of high marginalization in Yucatan. Self-applicable Stunkard pictogram was used to record the body image perceptions. To calculate the body mass index (BMI) anthropometric measurements of weight and height were recorded, using a Tanita brand digital scale, TBC model and a stadiometer SECA 310 2 meters length. The cut-off points were those established by the World Health Organization. Results The findings regarding the perception of body image showed no significant concordance (k = 0.067, p <0.5); for women was a low value of k = 0.223, they perceive themselves as normal despite their low weight, and those with obesity underestimate their status. In the group of men, in cases of obesity, image and BMI are coincident while a body perception underestimates low weight. Conclusion It is important to take into the nutritional diagnosis, contents of emotional aspects as self-esteem and feelings that manifest teenagers about their body image for comprehensive preventive care.

Gene-expression analysis of hair cell regeneration in the zebrafish lateral line.

Deafness caused by the terminal loss of inner ear hair cells is one of the most common sensory diseases. However, nonmammalian animals (e.g., birds, amphibians, and fish) regenerate damaged hair cells. To understand better the reasons underpinning such disparities in regeneration among vertebrates, we set out to define at high resolution the changes in gene expression associated with the regeneration of hair cells in the zebrafish lateral line. We performed RNA-Seq analyses on regenerating support cells purified by FACS. The resulting expression data were subjected to pathway enrichment analyses, and the differentially expressed genes were validated in vivo via whole-mount in situ hybridizations. We discovered that cell cycle regulators are expressed hours before the activation of Wnt/ß-catenin signaling following hair cell death. We propose that Wnt/ß-catenin signaling is not involved in regulating the onset of proliferation but governs proliferation at later stages of regeneration. In addition, and in marked contrast to mammals, our data clearly indicate that the Notch pathway is significantly down-regulated shortly after injury, thus uncovering a key difference between the zebrafish and mammalian responses to hair cell injury. Taken together, our findings lay the foundation for identifying differences in signaling pathway regulation that could be exploited as potential therapeutic targets to promote either sensory epithelium or hair cell regeneration in mammals.

Reparación endoscópica transnasal de la atresia de coanas. Estado del arte: resultados en 16 casos Hospital Universitario del Valle - Universidad del Valle. Cali, Colombia / Transnasal endoscopic repair of choanal atresia. State of the Art: results in 16 cases

Objetivo: Describir la epidemiologia local y la experiencia en el manejo de casos de atresia de coanas con la técnica de cirugía endoscópica transnasal e instrumental de poder. Diseño: Estudio retrospectivo. Metodología: Se toman 16 casos con diagnóstico de atresia de coanas, en los que fueron consideradas variables clínicas, método diagnóstico, lateralidad, tipo de atresia, manejo inicial y técnica quirúrgica. Se realizó análisis estadístico en Stata, versión 11.1. Resultados: En esta serie de casos, diez eran mujeres y seis hombres, con una relación mujer-hombre de 1,7:1; 56% de ellos fueron bilaterales, 56% de presentaron anomalías congénitas y la edad al diagnóstico fue postneonatal en el 81%. No se encontró asociación estadística entre sexo, tipo de atresia y lateralidad. El principal método diagnóstico fue la tomografía axial computarizada, en el 87,6% de los estudios. El 94% de los pacientes presentaron buen resultado quirúrgico funcional con la técnica endoscópica…

Objective: Describe the local epidemiology and the experience in the management of choanal atresia with endoscopic transnasal approach and power instruments. Methodology: Retrospective study of 16 cases with diagnosis of choanal atresia was considered variable clinics, diagnosis method, laterality, type of atresia, initial management and surgical technique. We performed statistical analysis in Stata, version 11.1. Results: In this series of cases, 10 was women and 6 was men, relation 1,7:1; 56% had associated congenital anomalies, the age of diagnosis was post neonatal 81%. There was no statistical association between sex, type of atresia and latelality. The main method diagnosis was the TAC in 87.6%. 94% of the patients showed a good surgical outcome with functional endoscopic technique. Conclusions: The experience observed in this series of cases with the use of technique endoscopic transnasal and power instrumentation (Shaver - Drill), represent a form of technique minimal invasive approach for this type of nasal congenital pathology with low degree of morbility, complications and excellent functional results…

Atresia de coanas, tratamiento quirúrgico endoscópico, 5 años de experiencia / Choanal atresia, endoscopic surgical repair, a 5 year experience

Atresia de coanas es la obstrucción congénita de la región posterior de las fosas nasales. Múltiples técnicas quirúrgicas han sido empleadas para su reparación. En el presente estudio se recopiló la información de 5 años de trabajo en el Hospital Universitario del Valle en la ciudad Santiago de Cali - Colombia, entre los años 2003 y 2008. Se obtuvo un total de 16 casos.La información demográfica documentada incluyó datos como edad, sexo, síntomas iniciales, método diagnóstico, lateralidad, tipo de atresia de coanas, comorbilidades, tratamiento inicial, edad de intervención quirúrgica, técnica quirúrgica usada. La técnica quirúrgica consistió en el fresado y apertura de la placa atrésica vía endoscópica transnasal utilizando taladro, previa realización de colgajos mucosos en cruz y resecando parcialmente paredes del vómer.La experiencia observada en estos 5 años de trabajo demuestra que el abordaje endoscópico transnasal presenta grandes ventajas, entre ellas la baja tasa de reestenosis.

Choanal atresia is a congenital disorder where the back of the nasal passage is blocked. Many surgical techniques have been used to repair this disorder. In this study we collected information from 5 years of work at the Hospital Universitario del Valle in the city of Santiago de Cali - Colombia, between 2003 and 2008. A total of 16 cases were obtained. The documented data included demographic information like age, sex, initial symptoms, diagnostic methods, laterality, type of atresia, comorbilities, initial treatment and surgical technique used. The surgical technique consisted in endoscopic opening of the atretic plate using drill. Mucosal flaps and resection of partial plate of vomer were made previously.The experience observed in these 5 years of work shows that the endoscopic transnasal approach has major advantages, including low restenosis rate.

Embryogenesis and laboratory maintenance of the foam-nesting túngara frogs, genus Engystomops (= Physalaemus).

The vast majority of embryological research on amphibians focuses on just a single genus of frogs, Xenopus. To attain a more comprehensive understanding of amphibian development, experimentation on non-model frogs will be essential. Here, we report on the early development, rearing, and embryological analysis of túngara frogs (genus Engystomops, also called Physalaemus). The frogs Engystomops pustulosus, Engystomops coloradorum, and Engystomops randi construct floating foam-nests with small eggs. We define a table of 23 stages for the developmental period in the foam-nest. Embryos were immunostained against Lim1, neural, and somite-specific proteins and the expression pattern of RetinoBlastoma Binding Protein 6 (RBBP6) was analyzed by in situ hybridization. Due to their brief life-cycle, frogs belonging to the genus Engystomops are attractive for comparative and genetic studies of development. Developmental Dynamics 238:1444-1454, 2009. (c) 2009 Wiley-Liss, Inc.

Cardiopatía congénita del adulto: tratamiento percutáneo de un caso complejo / Adult congenital cardiopathy: percutaneous treatment of a complex case

La cardiopatía congénita del adulto, es una entidad clínica de difícil diagnóstico y tratamiento. Desde 1982, la terapia endovascular cambió su enfoque de manera radical (1) y en los últimos años el diseño de nuevos dispositivos y mejores catéteres de balón, facilitó la implementación de la terapéutica para mayor número de pacientes (2). Es el tratamiento de elección para entidades como estenosis valvular pulmonar (3), comunicación ínter-auricular (4) y ductus arterioso persistente (5).Se presenta un caso de cardiopatía congénita compleja en el adulto, que consistía en comunicación ínter-auricular amplia, estenosis valvular pulmonar con severa repercusión sobre el ventrículo derecho, ductus arterioso permeable persistente con severa calcificación e hipertensión arterial pulmonar, con hipertensión arterial sistémica esencial, las cuales se trataron de manera exitosa mediante terapia intervencionista endovascular en el Hospital Militar Central de Bogotá.

In vivo and in vitro estrogenic and progestagenic actions of Tibolone.

Estrogen and progestin combination in hormone replacement therapy (HRT) increases the incidence of breast cancer, but decreases the endometrial cancer risk of unopposed estrogen. Therefore, a SERM such as Tibolone, that delivers the beneficial, but not the adverse side effects, of steroid hormones would be clinically advantageous. However, data from the Million Women Study suggests that Tibolone increases the risk of both breast and endometrial cancer. Herein, we assessed the estrogenic and progestagenic actions of Tibolone using transvaginal sonography studies and an in vitro model of breast (ZR-75, MCF7) and endometrial cancer (Ishikawa). The known cancer associated proteins (ER, EGFR, STATS, tissue factor and Bcl-xL) were selected for study. Transvaginal sonography demonstrated that postmenopausal women treated with Tibolone displayed a thinner endometrium than in the late proliferative phase, but had a phenotype characteristic of the secretory phase, thus demonstrating the estrogenic and progestagenic actions of this SERM. In vitro, Tibolone acted as an estrogen in downregulating ER and upregulating Bcl-xL, yet as progesterone, increasing STAT5 and tissue factor in breast cancer cells. The increase in tissue factor by Tibolone correlated with its coagulative potential. Interestingly, EGFR was up-regulated by progesterone in the breast and by estrogen in endometrial cells, while Tibolone increased protein levels in both cell types. In conclusion, this study further demonstrates the estrogenic and progestagenic nature of Tibolone. The pattern of regulation of known oncogenes in cells of breast and endometrial origin dictates caution and vigilance in the prescription of Tibolone and subsequent patient monitoring.

Tissue factor is regulated by epidermal growth factor in normal and malignant human endometrial epithelial cells.

Tissue Factor (TF), the initiator of the extrinsic coagulation cascade, is overexpressed in a variety of cancers. TF is also expressed in normal human endometrium but little is known about its expression or regulation in endometrial cancer. We demonstrate herein that TF is expressed in the endometrial adenocarcinoma cell line Ishikawa. Furthermore, epidermal growth factor (EGF) induces a rapid and sustained increase in TF expression. Estradiol and progesterone had no effect on basal or EGF-induced TF expression in Ishikawa cells. In contrast to the pronounced and sustained upregulation at the protein level, EGF treatment elicited only a modest and transient increase in TF mRNA levels. This activity corresponded to the response observed from an exogenous TF promoter construct. However, the induction of TF was abrogated by cycloheximide as well as actinomycin-D, inhibitors or protein- and mRNA-synthesis, respectively, demonstrating that EGF mediates its effect through activation of the TF gene. Fractionation experiments showed that EGF increases TF presence in caveolin-I containing membrane fractions. Coagulation and invasion assays were used to explore the physiological implications of TF regulation. The results demonstrate that EGF-mediated induction of TF increases the procoagulant activity and invasive potential of Ishikawa cells. Furthermore, immunocytochemistry confirmed that TF is regulated by EGF in primary cultures of normal endometrial epithelial cells and malignant tumor cells. In conclusion, EGF-mediated upregulation of TF results in accumulation of this glycoprotein in caveolae-like membrane fractions and increased coagulative and invasive potential. Our results suggest that TF may play an integral role in endometrial carcinogenesis.

Progesterone increases tissue factor gene expression, procoagulant activity, and invasion in the breast cancer cell line ZR-75-1.

Progesterone in hormonal preparations increases the incidence of breast cancer. Tissue factor (TF), the initiator of the extrinsic coagulation pathway, is associated with metastasis in a wide variety of cancers. We demonstrate herein that TF mRNA and protein are up-regulated by progesterone in the breast cancer cell line ZR-75. Epidermal growth factor, also associated with increased breast cancer risk, did not regulate TF. The increase in TF is both rapid and transient; increasing after 6 h, reaching a maximum at 24 h, before decreasing to basal levels at 72 h. Sucrose gradient experiments demonstrated that TF is located in the heavy fraction of the plasma membrane, although caveolin-1 is not expressed in ZR-75. To understand the physiological implications of an increase in TF, we performed coagulation and invasion assays. An increase in TF corresponded to an increase in procoagulant activity. Furthermore, progesterone increased the invasion of ZR-75 cells through a matrigel, an effect that was blocked by an antibody against TF. Because TF expression is associated with an enhanced risk of metastasis, we postulate that the progesterone-dependent up-regulation of TF provides a survival advantage to burgeoning breast cancer cells and may contribute to the increased risk of cancer associated with combined hormone replacement therapy.

Differential regulation of glucose transporter expression by estrogen and progesterone in Ishikawa endometrial cancer cells.

Estrogen replacement therapy and other unopposed estrogen treatments increase the incidence of endometrial abnormalities, including cancer. However, this effect is counteracted by the co-administration of progesterone. In the endometrium, glucose transporter (GLUT) expression and glucose transport are known to fluctuate throughout the menstrual cycle. Here, we determined the effect of estrogen and progesterone on the expression of GLUT1-4 and on the transport of deoxyglucose in Ishikawa endometrial cancer cells. Cells were incubated with estrogen, progesterone or combined estrogen and progesterone for 24 h and the effect on the expression of GLUT1-4 and on deoxyglucose transport was determined. We show that GLUT1 expression is upregulated by estrogen and progesterone individually, but that combined estrogen and progesterone treatment reverses this increase. Hormonal treatments do not affect GLUT2, GLUT3 or GLUT4 expression. Transport studies demonstrate that estrogen increases deoxyglucose transport at Michaelis-Menten constants (Kms) corresponding to GLUT1/4, an effect which disappears when progesterone is added concomitantly. These data demonstrate that different hormonal treatments differentially regulate GLUT expression and glucose transport in this endometrial cancer cell line. This regulation mirrors the role played by estrogen and progesterone on the incidence of cancer in this tissue and suggests that GLUT1 may be utilized by endometrial cancer cells to fuel their demand for increased energy requirement.

Estrogen and progesterone up-regulate glucose transporter expression in ZR-75-1 human breast cancer cells.

Breast cancer incidence increases in women receiving combined estrogen and progesterone therapy. Breast tumors show increased expression of the glucose transporter GLUT1. We determined the effect of these hormones on GLUT1-4 expression and deoxyglucose transport in ZR-75-1 breast cancer cells. Immunoblotting, immunocytochemistry, flow cytometry, and RT-PCR showed that GLUT1 expression is up-regulated by progesterone and, to a greater degree, combined therapy. GLUT2 expression is unaffected by hormonal treatment. GLUT3 protein and RNA is up-regulated by progesterone and combined therapy, and GLUT4 protein expression is up-regulated by all hormonal treatments. Deoxyglucose transport studies revealed the presence of three transport components with characteristics corresponding to GLUT1/4, GLUT2, and GLUT3. 17beta-Estradiol produced a slight increase in transport at the Michaelis constant (Km) corresponding to GLUT3. Progesterone produced a small increase in transport at the Km corresponding to GLUT1/4, and combined 17beta-estradiol and progesterone produced a small increase in transport at the Km corresponding to GLUT3 and a large increase in transport at the Km corresponding to GLUT1/4. This indicates that 17beta-estradiol and progesterone differentially regulate GLUT1-4 expression and that these changes correlate to changes in glucose uptake. We postulate that combined hormone replacement therapy provides a survival advantage to developing ZR-75 breast cancer cells.

Salud-enfermedad reproductiva: una aproximación de los derechos, reproductivos en Yucatán / Reproductive health-disease: a review about reproductive rights in Yucatán

Objetivo. Caracterizar el perfil de salud-enfermedad reproductiva para Yucatán.Fuentes de obtención de la información. Instituto Nacional de Estadística, Geografía e Informática (INEGI) y Secretaría de Salud. Revistas de las Conferencias Internacionales (Cairo, 1994 y Beijin, 1995) sobre políticas de salud.Resultados. El acceso a la salud y los derechos reproductivos está vinculado a la solución de rezagos sociales tales como desempleo (47.2 por ciento), analfabetismo (15 por ciento), entre otros. Las muertes femeninas durante el proceso reproductivo, seguidas de las muertes por cáncer cervicouterino y mamario, son prevenibles. Accidentes, tuberculosis y SIDA ocupan un lugar importante de este perfil, y afectan a uno u otro sexo. El aborto y la violencia de género son problemas que subyacen y que, junto a enfermedades congénitas, deficiencias en la calidad de atención médica, no se registran adecuadamente; menos se discuten y se atienden. Aspecto que recrudece para la población femenina, su condición marginal al interior de la marginalidad de otros. Conclusiones. La importancia de nuevas política radica en su instrumentación local, partiendo de las diferencias socioculturales. Será importante fomentar cambios substanciales en la calidad de vida de los yucatecos; incorporar elementos innovadores en la búsqueda de nuevos indicadores; en las formas de registro estadístico; en la organización de servicios de salud; y, en las alianzas entre sector gubernamental y no gubernamental; mismas en las que la participación ciudadana adquiera un papel determinante en la transformación en materia de salud y derechos reproductivos.

Caracteristicas operativas de la perfusion miocardica de reposo en la evaluacion del dolor toracico en urgencias / Myocardial perfusion at rest in chest pain

Objetivo: evaluar las características operativas de la perfusión miocárdica de reposo con sestamibi-Tc99m, en pacientes que consultan a urgencias con dolor torácico y electrocardiograma normal o no diagnóstico. Métodos: se condujo un estudio de pruebas diagnósticas para establecer la sensibilidad, la especificidad, el valor predictivo negativo, el valor predictivo positivo y la razón de verosimilitud de la perfusión miocárdica de reposo. Se utilizó la arteriografía coronaria como patrón de oro. Se midió la variabilidad entre los observadores con un coeficiente kappa. Los evaluadores del resultado de la perfusión miocárdica no conocían los hallazgos de la arteriografía coronaria. Resultados: se incluyeron 52 pacientes entre mayo de 1996 y mayo de 1997. Todos ellos se sometieron a estudio de perfusión miocárdica de reposo. Se utilizó la arteriografía como patrón de oro y el seguimiento a seis meses. La perfusión miocárdica de reposo mostró una sensibilidad de 96 por ciento con especificidad de 92.5 por ciento. El valor predictivo negativo encontrado fue de 97.3 por ciento para el diagnóstico de síndrome coronario agudo. La razón de verosimilitud negativa indica que el resultado negativo identificó en forma correcta, como sanos, al 92 por ciento de los pacientes. Conclusión: debido al alto valor predictivo negativo de la perfusión miocárdica de reposo y a su adecuada capacidad para clasificar correctamente los pacientes sanos como tales, se podría considerar su uso como una estrategia razonable en el tamízale de pacientes que consultan a urgencias con dolor torácico y electrocardiograma normal o no diagnóstico. La perfusión miocárdica de reposo es adecuada para definir cuáles de los pacientes con dolor precordial deben hospitalizarse y cuáles son susceptibles de ser estudiados en forma ambulatoria.

Lactation inhibits the potentiating effect of galanin upon the GnRH-induced LH release observed in diestrous-1 rat

Recent demonstrations of no changes in hypothalamic gonadotropin releasing hormone (GnRH) gene expression nd GnRH levels detected at the pituitary gland in diestrous and lactating rats, indicate that lactational hypogonadotropism in this species is not associated with inhibition of hypothalamic GnRH synthesis and secretion. Hypothalamic galanin potentiates GnRH effects on luteinizing hormone (LH) secretion in male and cycling rats. To explore the interaction between GnRH and galanin during lactation, we studied in vitro the effects of pulsatile stimulation with those peptides upon LH synthesis and secretion from rat pituitaries on diestrous 1 or day 10 of lactation. Hemipituitaries were separately incubated in 1 ml Dulbecco's Minimal Essential Medium supplemented with 1 per cent penicillin-streptomycin and fetal calf serum, at 37 degrees Celsius in 5 per cent CO2-air. The hemipituitaries were stimulated during 12 h with hourly pulses, 6 min each, of (a) gonadotropin releasing hormone (GnRH 25 ng/pulse), (b) rat galanin (600 ng/pulse), (c) GnRH plus galanin, or (d) saline. Medium was collected before each pulse to determine LH by radioimmunoassay. After the 12 h pulsatile regime total RNA was extracted and both actin and beta-LH mRNA were determined by reverse transcriptase polymerase chain reaction. There was a significant stimulation of LH secretion by GnRH (ANOVA, p<0.001) without significant differences between diestrous and lactation pituitaries. Galanin alone did not modify LH secretion but it potentiated the effect of GnRH upon pituitaries from diestrous (p=0.036) but not lactating rats. Neither peptide alone or its combination modified pituitary beta-LH mRNA levels. Results show that galanin regulates differently the secretion and synthesis of LH at the pituitary level. The disappearance of galanin-induced potentiation of GnRH effects upon LH secretion during lactation might contribute to the hypogonadotropism of lactation in the rat.

Factor de crecimiento epidérmico en orina y pepsinogeno I serico en pacientes ulcerosos duodenales / Urinary epidermic growth factor and serum pepsinogen I in duodenal ulcer patients

Se determinaron los valores urinarios del Factor de Crecimiento Epidérmico (FCE) absolutos y corregidos por la excreción de creatinina en 23 ulcerosos duodenales y se compararon con un grupo control. En los pacientes se dosificaron valores basales de Pepsinógeno I sérico. Los valores absolutos de FCE urinario de los ulcerosos fueron más bajos que los controles, pero tal diferencia ni la de FCE corregido por la excreción urinaria de creatinina fueron estadísticamente significativas (p > 0,05). La excreción absoluta de FCE de los ulcerosos varones fue mayor que en las damas (p<0,05), pero al establecer la relación FCE/Creatinina, la diferencia desapareció. No hubo correlación entre FCE y Pepsinógeno I, fue inversa con la edad y positiva con la excreción de creatinina. Varios mecanismos se plantean para explicar la normalidad urinaria del FCE en estos pacientes. La importancia creciente que se da al FCE en enfermedad ulcerosa y ulteriores investigaciones, son analizadas

Glucogenosis hepática: aspectos clínicos, bioquímicos y enzimáticos en un grupo de pacientes pediátricos / Hepaticglucogenoses: clinical biochemical and enzymatic aspects in a group of pediatric patients

Se estudiaron nueve niños con el diagnóstico clínico de Glucogenosis, sus tipos fueron confirmados mediante determinación de la concentración y estructura del glucógeno, prueba de estimulación con glucagon y análisis del defecto enzimático. Ocho pacientes presentaron Glucogenosis tipo III y uno, tipo I. El grupo etario predominante en la tipo III fue el de lactantes (62.5%) y la tipo VI se diagnosticó en un preescolar. Los hallazgos predominantes fueron: hepatomegalia, facies de muñecas y talla baja. Las principales alteraciones bioquímicas fueron: elevación de transaminasas en Glucogenosis III y VI; hipertrigliceridemia, hipoglicemia, acidosis metabólica, hiperuricemia únicamente en Glucogenosis III. Un paciente tipo III presentó alteraciones cardiovasculares. Todos mostraron aumento de la concentración de glucógeno, con estructura normal en tipo VI y anormal en el 75% de la tipo III. 75% de las Glucogenosis tipo III tuvieron respuesta positiva a la estimulación con glucagon. Ningún niño presentó reducción de la Glucosa 6 Fosfatasa