Tumor-Suppressive Cross-Linking of Anti-T. cruzi Antibodies in Acute Lymphoblastic Leukemia.

Parasites have been associated with possible anticancer activity, including Trypanosoma cruzi, which has been linked to inhibiting the growth of solid tumors. To better understand this antitumor effect, we investigated the association of anti-T. cruzi antibodies with B cells of the acute lymphoblastic leukemia (ALL) SUPB15 cell line. The antibodies were generated in rabbits. IgGs were purified by affinity chromatography. Two procedures (flow cytometry (CF) and Western blot(WB)) were employed to recognize anti-T. cruzi antibodies on SUPB15 cells. We also used CF to determine whether the anti-T. cruzi antibodies could suppress SUPB15 cells. The anti-T. cruzi antibodies recognized 35.5% of the surface antigens of SUPB15. The complement-dependent cytotoxicity (CDC) results demonstrate the cross-suppression of anti-T. cruzi antibodies on up to 8.4% of SUPB15 cells. For the WB analysis, a band at 100 kDa with high intensity was sequenced using mass spectrometry, identifying the protein as nucleolin. This protein may play a role in the antitumor effect on T. cruzi. The anti-T. cruzi antibodies represent promising polyclonal antibodies that have the effect of tumor-suppressive cross-linking on cancer cells, which should be further investigated.

Modular segmentation, spatial analysis and visualization of volume electron microscopy datasets.

Volume electron microscopy is the method of choice for the in situ interrogation of cellular ultrastructure at the nanometer scale, and with the increase in large raw image datasets generated, improving computational strategies for image segmentation and spatial analysis is necessary. Here we describe a practical and annotation-efficient pipeline for organelle-specific segmentation, spatial analysis and visualization of large volume electron microscopy datasets using freely available, user-friendly software tools that can be run on a single standard workstation. The procedures are aimed at researchers in the life sciences with modest computational expertise, who use volume electron microscopy and need to generate three-dimensional (3D) segmentation labels for different types of cell organelles while minimizing manual annotation efforts, to analyze the spatial interactions between organelle instances and to visualize the 3D segmentation results. We provide detailed guidelines for choosing well-suited segmentation tools for specific cell organelles, and to bridge compatibility issues between freely available open-source tools, we distribute the critical steps as easily installable Album solutions for deep learning segmentation, spatial analysis and 3D rendering. Our detailed description can serve as a reference for similar projects requiring particular strategies for single- or multiple-organelle analysis, which can be achieved with computational resources commonly available to single-user setups.

Sex differences on constitutive long non-coding RNA expression: Modulatory effect of estradiol and testosterone in muscle cells.

INTRODUCTION: Despite the growing awareness of sexual dimorphism between males and females under pathological and physiological conditions, sex bias in biomedical research in animal models and patients is still present nowadays. The main objective of this work was to investigate sex differences in constitutive long non-coding RNA expression in spinal cord and skeletal muscle from wild-type mice. MATERIALS AND METHODS: To assess the influence of gender on long non-coding RNAs, we extracted RNA from tissues of male and female mice and analyzed the expression on nine long non-coding RNAs, selected for being among the most commonly studied or exerting an important role in muscle, at 50, 60, and 120 days of age. RESULTS AND DISCUSSION: We observed age- and tissue-dependent significant sex differences, being more prominent in skeletal muscle. We also studied the effect of sex steroid hormones on long non-coding RNA expression in vitro, noticing a modulation of long non-coding RNA levels upon estradiol and dihydrotestosterone treatment in muscle. CONCLUSIONS: Taken together, results obtained evidenced sex differences on constitutive long non-coding RNA expression and suggested an influence of steroid hormones complementary to other possible factors. These findings emphasize the importance of including both sexes in experimental design to minimize any potential sex bias.

Single-cell spatial multi-omics and deep learning dissect enhancer-driven gene regulatory networks in liver zonation.

In the mammalian liver, hepatocytes exhibit diverse metabolic and functional profiles based on their location within the liver lobule. However, it is unclear whether this spatial variation, called zonation, is governed by a well-defined gene regulatory code. Here, using a combination of single-cell multiomics, spatial omics, massively parallel reporter assays and deep learning, we mapped enhancer-gene regulatory networks across mouse liver cell types. We found that zonation affects gene expression and chromatin accessibility in hepatocytes, among other cell types. These states are driven by the repressors TCF7L1 and TBX3, alongside other core hepatocyte transcription factors, such as HNF4A, CEBPA, FOXA1 and ONECUT1. To examine the architecture of the enhancers driving these cell states, we trained a hierarchical deep learning model called DeepLiver. Our study provides a multimodal understanding of the regulatory code underlying hepatocyte identity and their zonation state that can be used to engineer enhancers with specific activity levels and zonation patterns.

Erratum: Gestational gigantomastia

Introduction: Gigantomastia is a disease of unknown etiology, which can occur in two different situations: gestational and non-gestational phases. The gestational type is a rare complication that affects 1:28,000 to 1:100,000 pregnancies and is usually bilateral. It consists of a diffuse, massive breast increase during pregnancy. In a normal pregnancy, the breasts double in size without sequelae; however, in this disease, the breast tissue may experience a 10 to 20-fold increase. The treatment varies from drug therapy to plastic surgery (mammaplasty) and radical surgery (mastectomy). Objectives: To report a case of gestational gigantomastia, its treatment approach, and outcome. Methods: Data from this study were obtained from a multidisciplinary clinical experience, image records, and literature search. Case Report: An 18-year-old patient, admitted to the mastology department of Hospital Guilherme Álvaro, in Santos, Southeastern Brazil, was diagnosed with gigantomastia in her 23rd week of pregnancy. The exacerbated breast growth during the gestational period caused pain and functional impairment to the patient. Bilateral mastectomy was performed at 27 weeks of pregnancy due to the worsening of her pulmonary condition, leading to the risk of maternal and fetal death. Macroscopic anatomopathological examination revealed breasts with a total weight of 27 kg, lobular hyperplasia, pronounced stromal hyperplasia, and necrosis of the breast parenchyma. She stayed in the intensive care unit during the postoperative period with good progression. The patient had a normal delivery at 38 weeks of gestation with a live fetus. Discussion: The ideal management for gestational gigantomastia is not clear. The treatment includes surgeries (reduction mammaplasty and total mastectomy with or without reconstruction), medications, or a combination of both. In the current case, the treatment chosen was mastectomy during pregnancy due to respiratory distress and the risk of sepsis by ischemic tissue necrosis. During the surgical procedure, there was a risk of hemodynamic instability, given the large volume of breast removed, representing 40% of the total weight of the patient. Conclusion: Gestational gigantomastia is an exceptionally rare condition, and the literature has few reports on the subject. The therapeutic management depends on factors intrinsic to the patient, so each case requires individualization. The therapeutic decision aims at the best prognosis, taking into account possible complications and a reduction in maternal and fetal morbidity.

Evaluation of the Effectiveness of the Fun FRIENDS Program / Avaliação da Eficácia do Programa Amigos Divertidos (fun FRIENDS) / Evaluación de la Eficacia del Programa Amigos Divertidos (fun FRIENDS)

Abstract Anxiety and depression are the main complaints related to mental health in childhood and constitute a public health problem. In Brazil, there are few studies that describe evidence-based early intervention actions for these psychopathologies. Considering the problems related to anxiety and depression in childhood and their relative stability in development, health promotion and prevention actions are justified. One of the evidence-based programs directed toward health promotion and prevention of anxiety and depression in childhood is the FRIENDS Program (Fun FRIENDS). Therefore, this study sought to evaluate the effectiveness of the FRIENDS program regarding the reduction in symptoms of anxiety and depression and increase in socioemotional skills, in a city of Paraná state. A total of 25 children, aged from 5 to 7, and their caregivers participated. The CBCL (Child Behavior Checklist), SDQ (Strengths and Difficulties Questionnaire) and SCAS (Spence Children's Anesthesia Scale) were used as the evaluation instruments. The results demonstrated increases in socioemotional skills and reductions in anxiety and depression symptoms. Thus, it was concluded that there is evidence that supports the effectiveness of the program for the Brazilian population.

Resumo A ansiedade e a depressão são as maiores queixas encontradas em relação à saúde mental na infância, sendo um problema de saúde pública. No Brasil, poucos são os estudos que descrevem ações, baseadas em evidência, para intervenções precoces quanto a essas psicopatologias. Frente as problemáticas relacionadas à ansiedade e depressão na infância, e sua relativa estabilidade no desenvolvimento, justificam-se as ações de promoção e prevenção de saúde. Um dos programas, baseados em evidências, que visam a promoção de saúde e prevenção de ansiedade e depressão na infância é o Método FRIENDS (Amigos Divertidos/Fun FRIENDS). Nesse contexto, esta pesquisa buscou avaliar a eficácia do programa Amigos Divertidos quanto a diminuição de sintomas de ansiedade e depressão e aumento de habilidades socioemocionais, em uma cidade do interior do Paraná. Participaram 25 crianças, com idade entre cinco a sete anos, e seus cuidadores. Como instrumentos de avaliação, utilizou-se os instrumentos CBCL (Child Behavior Check List), SDQ (Strengths and Difficulties Questionnaire) e SCAS (Spence Children's Anxiety Scale). Os resultados demonstraram aumentos das habilidades socioemocionais e redução de sintomas de ansiedade e depressão. Com isso, conclui-se que há evidências que apoiam a eficácia do programa para a população brasileira.

Resumen La ansiedad y la depresión son las mayores quejas en relación en relación a la salud mental en la infancia, sendo uno problema de la salud pública. En Brasil, pocos son los estudios que describen acciones basados en evidencia, para intervenciones temprano cuanto a esas psicopatologias. Frente a las problemáticas relacionadas a la ansiedad y depresión en la infancia, y su relativa estabilidad en el desenvolvimiento, justificanse las acciones de promoción y prevención de la salud. Uno de los programas basados en evidencias que visan la promoción y la prevención de ansiedad y depresión en la infancia es lo Método FRIENDS (Amigos Divertidos/Fun FRIENDS). Nese contexto, esta pesquisa buscou valuar la eficacia del programa Amigos Divertidos en una ciudad del interior del Paraná. Participaran 25 niños, con edad entre los cinco y siete años, y sus cuidadores. Como instrumiento de avalación, utilizouse los instrumientos (Child Behavior Check List), SDQ (Strengths and Difficulties Qustionnaire) y SCAS (Spence Children's Anxiety Scale). Los resultados demonstraran aumento de las habilidades socioemocionales y reducción de los sintomas de la ansiedad y depresión. Con eso, concluise que hay evidencias que apoyan la eficacia del programa a la población brasileña.

Frecuencia y determinantes del retraso en el diagnóstico de cáncer infantil en Argentina / Frequency and determinants of the delay in the diagnosis of cancer in children, in Argentina

En Argentina, la mortalidad por cáncer infantil es mayor que en países más desarrollados, siendo el diagnóstico tardío una de las posibles causas. Nuestro objetivo fue determinar la frecuencia de obstáculos al diagnóstico enfrentados por las familias de niños con cáncer asistidas por un Organismo No Gubernamental, y algunos factores demográficos, institucionales y médicos asociados. Se realizó un análisis retrospectivo observacional y cuantitativo del recorrido diagnóstico de los niños con cáncer asistidos por la Fundación N.D. Flexer, Argentina, entre el 1/1/2011 y el 31/12/2015. El resultado primario fue la presencia de obstáculos para acceder al diagnóstico. Se consideró que existió un obstáculo cuando tuvieron lugar consultas no orientativas, demora familiar, demora institucional, autoderivación y/o más de 30 días entre la aparición de síntomas y el diagnóstico. La frecuencia dentro de cada categoría se contrastó mediante la prueba de χ2. La influencia de distintas variables se evaluó mediante una regresión logística multivariada. De 1818 familias incluidas, 63.5% enfrentaron algún tipo de obstáculos. Resultaron moduladores negativos el diagnóstico antes del año, de tumor renal y la concurrencia a un hospital público de la Ciudad de Buenos Aires o de capital provincial como centro de primer contacto (todos p < 0.0001). Resultaron moduladores positivos el diagnóstico de tumor óseo (p = 0.009) y los centros de atención primaria (p < 0.0001) y consultorios particulares (p = 0.001) como centros de primer contacto. El principal factor no biológico asociado a la frecuencia de obstáculos al diagnóstico de cáncer infantil fue el tipo de centro de primer contacto.

In Argentina, mortality from childhood cancer is higher than in more developed countries, with late diagnosis being one of the possible causes. Our objective was to determine the frequency of barriers to diagnosis faced by families assisted by a Non-Governmental Organization, and some associated demographic, institutional and medical factors. A retrospective observational and quantitative analysis of the diagnosis pathway of children with cancer assisted by the N.D. Flexer Foundation, Argentina, between 1/1/2011 and 12/31/2015 was carried out. The primary outcome was the presence of barriers to diagnosis. It was considered that there was a barrier when there were consultations without diagnostic suspicion, family delay, institutional delay, self-derivation and/ or more than 30 days between the onset of symptoms and diagnosis. The frequency of barriers within each category was contrasted by the χ2 test. A multivariate logistic regression was used to examine its association with relevant variables. Among the 1818 families included, 63.5% faced delays/ barriers to diagnosis. Negative modulators were diagnosis at age younger than 1-year, renal tumor and first attention at a public hospital of the City of Buenos Aires or a provincial capital hospital (all p < 0.0001). Positive modulators were the diagnosis of bone tumor (p = 0.009) and first attention at a primary healthcare center (p< 0.0001) or private doctor's office (p= 0.001). The main non-biological factor associated with the possibility of facing barriers to diagnosis was the type of first contact-health institution.

Enfermedad de Castleman multicéntrica en una paciente postrasplantada de médula ósea / Multicentric Castleman's disease in a patient post-transplanted of bone marrow

Resumen La enfermedad de Castleman es un grupo heterogéneo de trastornos linfoproliferativos con dos formas de manifestación: variedad unicéntrica y multicéntrica. En términos histológicos se caracteriza por ganglios linfáticos con hiperplasia del centro germinal y aumento en la vascularidad. Se comunica el caso de una paciente de 70 años de edad con antecedente de trasplante autólogo de células troncales y progenitoras hematopoyéticas, que acudió a consulta por padecer astenia, pérdida de peso, dolor abdominal y disnea de evolución progresiva; a la que se le encontró un tumor retroperitoneal y derrame pleural derecho. Se plantea el abordaje del caso y se revisa la bibliografía, ya que se estima la incidencia en 21-25 casos por un millón de habitantes, sólo 14% de los casos reportados con manifestación retroperitoneal.

Abstract Castleman's disease is a heterogeneous group of lymphoproliferative disorders (LPD'S), which has two types of presentation, unicentric (UCD) and multicentric (MCD) variety. Histologically it is characterized by lymph nodes with hyperplasia of germinal centers and increased vascularity. This article reports the clinical case of a 70-year-old female with previous autologous haematopoietic stem cell transplant. She arrived with asthenia, weight loss, abdominal pain and progressive dyspnea. A retroperitoneal tumor and right pleural effusion were found. Clinical approach and bibliographic review are reported, the incidence estimation for this disorder is 21-25 cases per million population, and only 14% of reported cases had a retroperitoneal presentation.

Environmental drivers on leaf phenology of ironstone outcrops species under seasonal climate

ABSTRACT Banded iron formations (BIF) have a particular vegetation type and provide a good model system for testing theories related to leaf phenology, due to unique stressful environmental conditions. As a consequence of the stressful conditions of BIF environment, we hypothesize that most species would retain at least some significant canopy cover, even at the end of the dry season, independently of growth form - trees, shrubs, and sub-shrubs. Considering the strong seasonality, we also hypothesize that photoperiod and rainfall act as triggers for leaf fall and leaf flushing in these environments. The majority of the fifteen studied species had a semi-deciduous behavior and shed their leaves mainly during the dry season, with a recovery at the end of this season. In general, leaf flushing increased around the spring equinox (end of the dry season and start of the rainy season). A trade-off between leaf loss and leaf maintenance is expected in a community in which most plants are naturally selected to be semi-deciduous. Our results suggest photoperiod as a dominant factor in predicting leaf phenology.

Cuidado psicosocial en Hematooncología Pediátrica en hospitales públicos en Argentina / Psychosocial care in the Department of Pediatric Hematology and Oncology of public hospitals in Argentina

Introducción. Las enfermedades hemato-oncológicas constituyen un grupo de patologías infrecuentes en pediatría. Los tratamientos oncológicos son, en general, prolongados (meses o años) y el cuidado integral de los pacientes ha incorporado el soporte psicosocial. Objetivo: Explorar el cuidado psicosocial que brindan los hospitales públicos de Argentina a niños y adolescentes con cáncer, tomando como parámetro de calidad las recomendaciones de la Sociedad Internacional de Oncología Pediátrica. Población y métodos. Se envió un cuestionario electrónico a los jefes de Servicio de Hematooncología, Salud Mental y Servicio Social de 27 hospitales públicos que trataban cáncer pediátrico. El cuestionario contenía preguntas referidas al cuidado psicosocial de este grupo de pacientes. Las respuestas se recogieron y procesaron durante 2013-2014. Resultados. Respondió el 62,6% (47/75) de los profesionales contactados. Los hematooncólogos refirieron que las tres disciplinas cumplían las recomendaciones de la Sociedad Internacional de Oncología Pediátrica en un grado mayor que el que informaba el área psicosocial. Esta diferencia se repitió en todas las respuestas obtenidas. La continuidad escolar y el cuidado de los hermanos sanos fueron las pautas que se cumplían en forma más generalizada. Las tres profesiones expresaron carecer de mecanismos formales para detectar tempranamente fallas en la adherencia al tratamiento, si bien se encontraba sistematizado el modo de intervenir ante su abandono. Los profesionales del área psicosocial observaron la falta de recurso humano y percibieron poco trabajo interdisciplinario. Conclusiones. Se reportó un cumplimiento parcial de las pautas recomendadas por la Sociedad Internacional de Oncología Pediátrica. La evaluación de los hematooncólogos difirió de la que hicieron los servicios psicosociales.

Background. Blood diseases and cancer are part of a group of rare conditions in pediatrics. In general, cancer treatments are prolonged (months or years), so psychosocial support has been introduced to provide comprehensive care to these patients. Objective: T o explore psychosocial care provided at the public hospitals of Argentina to children and adolescents with cancer. Population and Methods. An electronic questionnaire was sent to the heads of the Departments of Hematology and Oncology, Mental Health, and Social Services of 27 public hospitals providing care to pediatric patients with cancer. The survey included questions related to psychosocial care provided to this group of patients. Answers were collected and processed in the 2013-2014 period. Results. Of the total number of health care providers contacted, 62.6% (47/75) completed the questionnaire. As per hematologist-oncologists, the three specialties complied with the recommendations made by the International Society of Pediatric Oncology to a greater extent than that reported by the psychosocial area. Such difference was repeatedly observed in all answers. The standards that were observed more consistently were continuation of education and care of healthy siblings. The health care providers from the three specialties indicated that they lacked formal mechanisms to detect failures in treatment adherence in an early manner, although treatment withdrawal interventions were systematized. Providers from the psychosocial area indicated that human resources were lacking and perceived little interdisciplinary work. Conclusions. This study reported partial adherence to the standards recommended by the International Society of Pediatric Oncology. The assessment made by hematologists-oncologists was different from that made by health care providers from the psychosocial area.

Efeitos adversos das Tecnologias Computacionais e o limite para o uso abusivo: estratégias de enfrentamento de alunos, pais e professores / Adverse effects of Computational Technologies and the limit for the abusive utilization: students, parents and teachers confronting strategies

Na Universidade, os efeitos adversos do uso das Tecnologias Informacionais e Computacionais (TICs) constituem temas de disciplinas, pesquisas, seminários e trabalhos de conclusão de cursos. Na sociedade, as TICs têm se tornado matéria da mídia, transparecendo um ambíguo imaginário social de endeusamento e demonização. Este artigo tem como objetivo problematizar a inserção das TICs nas relações entre professores, pais e alunos em uma escola da rede pública. Para tal, visa socializar o desenvolvimento do Projeto de Extensão Universitária “Efeitos Adversos das Tecnologias Informacionais e Computacionais”. Metodologicamente, foram realizadas oficinas com pais, professores e alunos entre 2013 e 2015, problematizando o abuso na utilização das TICs e construindo estratégias para o seu enfrentamento tendo como base as narrativas dos participantes. Constatamos que perda auditiva, insônia, isolamento social, dificuldade de memorização constituem alguns efeitos indesejáveis. Concluímos, assim, que as TICs são conquistas contemporâneas cuja adequada utilização exige discussões com participação popular sob a forma de projetos de extensão.

The adverse effects of Informational and Computer Technology (ICT) are often addressed as topics of disciplines, researches, seminars and course conclusion papers at the university. In society, ICTs have increasingly become subject of discussion in the media, which enabled the identification of a rather ambiguous social imagery of the matter, both appreciative and condemning. This article aims to discuss the insertion of ICTs as a tool of improvement of the relationships between teachers, parents and students of a public school by socializing the development of the University Extension Project “Adverse Effects of Informational and Computer Technologies”. The project’s methodology consisted on the implementation of workshops with parents, teachers and students between 2013 and 2015, with the purpose of questioning the abuse of ICTs to help building strategies to face the problem from the participants’ narratives and experiences. It was found that hearing loss, insomnia, social isolation and memorization difficulties are some undesirable effects. As a conclusion, ICTs can be considered contemporary achievements whose proper utilization requires further discussions involving popular participation in university extension projects.

Sofrimento do trabalhador contemporâneo: as estratégias de atenção psicossocial no âmbito do SUS

O Ministério da Previdência Social aponta que os transtornos mentais e comportamentais ocupam o terceiro lugar em número de concessões de auxílio-doença acidentários e não vêm acompanhando a tendência de queda no número de acidentes de trabalho no Brasil. O presente estudo busca identificar as estratégias de atenção psicossocial aos trabalhadores em situação de sofrimento empregadas pelos serviços de saúde no âmbito do SUS contemplados na produção intelectual brasileira, no período 2004-2014. Metodologicamente, recorrermos às seguintes fontes: Banco de Dissertações e Teses da Capes, produções do Ibict e da Bireme e o site SciELO. A seleção do material se fez pelos títulos, resumos e palavras chave e pela leitura na íntegra de artigos, teses, dissertações, capítulos e/ou livros. Para análise das informações obtidas, tomamos como base os estudos de Michel Foucault, Claudine Herzlich e Jurandir Freire Costa. Constatamos que as estratégias estão centradas na prevenção; na utilização do instrumento de sondagem SRQ-20; na escuta, nos cuidados clínicos e na inclusão social oferecidos pelos CAPS. Concluímos que a produção intelectual que aborda as estratégias de atenção psicossocial é precária, quando existente, e a fundamentação teórica é frágil e não contempla a especificidade do usuário na sua condição de trabalhador.

Parálisis cordal izquierda asociada a aneurisma aórtico. Reporte de un caso / Aortic aneurysm associated to left vocal cord palsy. Case report

La parálisis del nervio laríngeo recurrente izquierdo puede estar motivada por múltiples causas, y las de origen vascular son las que con mayor frecuencia se asocian a esta patología. Presentamos un caso poco frecuente de parálisis cordal izquierda, producida por un aneurisma de aorta. Para su diagnóstico se realizó una nasofaringolaringoscopia, así como una tomografía y angiorresonancia de cuello y tórax. Se encontró un aneurisma sacular en la porción ascendente de la aorta, y un trombo intramural, motivo por el cual el paciente fallece en dos semanas, por un episodio agudo de hematemesis. La lesión del nervio laríngeo recurrente, en los aneurismas de la aorta torácica, se produce por alargamiento o estiramiento del nervio, debido al aumento en el diámetro del cayado aórtico. El estudio radiológico torácico de los pacientes con parálisis laríngea puede ayudar al diagnóstico precoz de los aneurismas de la aorta...

Left recurrent laryngeal nerve palsy may be due to multiple causes, being vascular origin the most frequent. We report an infrequent case of left vocal cord palsy caused by an aortic aneurysm. A video nasolaryngoscopy, neck and thoracic tomography and nuclear resonance were performed. A sacular aneurysm and intramural thrombus were found in the ascending aorta portion. The patient died because of aneurysm rupture two weeks later. Impairment of the recurrent laryngeal nerve in thoracic aortic aneurysm is due to elongation or stretching of the nerve. Radiologic study of the thorax in vocal cord palsy patients may be helpful for doing an early diagnosis of aortic aneurysm...

Glomus carotídeo bilateral. Reporte de un caso / Bilateral glomus caroticum. case report

Los glomus o paragangliomas carotídeos son tumores de crecimiento lento, hipervascularizados, poco frecuentes, derivados del cuerpo carotídeo. El objetivo es presentar un caso poco frecuente de tumores glómicos carotídeos bilaterales. Para su diagnóstico se realizó angiorresonancia magnética y angiografía de cuello. Se encontró una tumoración bilateral hipervascularizada a nivel de la división de la arteria carótida común, con signo de la lira...

Carotid glomus or paragangliomas are slow growing tumors, highly vascularized, rare, originated from the carotid body. The objective is to present a very rare case of bilateral carotid glomic tumors. Neck angioresonance was performed for diagnosis. A highly vascularized tumor was found bilaterally in the bifurcation of the common carotid artery, showing the lyre sign...

El estrés oxidativo y los antioxidantes en la prevención del cáncer / Oxidative stress and antioxidants in cancer prevention

Introducción: el estrés oxidativo participa en la carcinogénesis; por ello, se ha considerado como estrategia para la prevención del cáncer el reforzamiento de los mecanismos celulares de defensa antioxidante. Objetivo: evaluar el papel del estrés oxidativo en el proceso de carcinogénesis, así como la utilidad y modalidades de uso de los antioxidantes en su prevención. Métodos: se realizó un trabajo de revisión bibliográfica a través de la consulta de Google, LILACS, PubMed y Hinari. Se seleccionaron artículos de revisión sobre el tema, de los últimos 5 años, así como revisiones sistemáticas y meta-análisis publicados que evalúan la utilización de suplementos de antioxidantes sintéticos en la prevención del cáncer. Desarrollo: se abordan los mecanismos carcinogénicos de las especies reactivas del oxígeno y se discuten los beneficios y amenazas del uso preventivo de suplementos de antioxidantes. También se analiza el posible impacto en el control del estrés oxidativo, la aplicación de las recomendaciones plasmadas en la Estrategia Global sobre la Dieta, la Actividad Física y la Salud de la Organización Mundial de la Salud. Finalmente, se enfatiza en los mecanismos anticarcinogénicos de diferentes fitoquímicos. Conclusiones: la promoción de hábitos saludables que evita la generación de las especies reactivas del oxígeno, unido a la ingestión de antioxidantes como componentes de la dieta, pueden conducir al equilibrio apropiado oxidantes/antioxidantes y consecuentemente a la prevención del cáncer.

Introduction: oxidative stress is involved in carcinogenesis. Consequently, the reinforcement of cellular defensive antioxidant mechanisms has been considered as strategy for cancer prevention. Objective: to evaluate the role of oxidative stress in the carcinogenesis process as well as the utility and modalities of the use of antioxidants in cancer prevention. Methods: a review was performed through the consultation of Google, LILACS, PubMed and Hinari. Review articles published in the last five years, systematic reviews and meta-analysis about the evaluation of antioxidants for cancer prevention were selected. Results: the carcinogenic mechanisms of oxygen reactive species, and the benefits and threats of antioxidant supplementation are discussed. Finally, the possible impact on oxidative stress control, of implementation of the WHO Global Strategy on Diet Physical Activity and Health is analyzed, empathizing in the anticarcinogenic mechanisms of different phytochemicals. Conclusions: the promotion of healthy habits which avoid the generation of oxygen reactive species, together with the intake of antioxidants as dietary components could lead to the appropriate balance oxidants/antioxidants and consequently to cancer prevention.

Identificación de Microsporidium spp en pacientes con diagnóstico de leucemia linfoblástica aguda / Identification of Microsporidium spp in patients with acute lymphoblastic leukemia

Introducción. El grupo Microsporidia incluye parásitos intracelulares obligados que afectan varios huéspedes. Los géneros que infectan humanos son Enterocytozoon y Encephalitozoon . Microsporidia es considerado un organismo oportunista en pacientes inmunocomprometidos e inmunocompetentes, que se ha convertido en un importante problema de salud pública. El objetivo del trabajo fue identificar Microsporidium spp en muestras fecales de pacientes con leucemia linfoblástica aguda, en diferente etapa de su tratamiento. Métodos. Se analizaron 77 muestras de niños con diagnóstico de leucemia linfoblástica aguda menores de 12 años, por análisis coproparasitoscópico de Faust. Las muestras se tiñeron con Ziehl Nielsen, tricrómica de Masson y calcoflúor. Finalmente se realizó la amplificación por PCR del gen ribosomal. Resultados. De los pacientes analizados, 16/77 (20.77%) resultaron positivos para Microsporidia, independientemente de que presentaran diarrea. El PCR fue más efectivo para la identificación que el análisis microscópico de las muestras teñidas. Conclusiones. Este trabajo enfatiza la importancia de la microsporidiosis como infección emergente en pacientes con leucemia linfoblástica aguda bajo tratamiento quimioterapéutico, incrementando las complicaciones clínicas adicionales a la leucemia.

Background. The phylum Microsporidia includes obligate intracellular parasites that affect several hosts. The most frequent genera to affect humans are Enterocytozoon and Encephalitozoon. Microsporidium is considered an opportunistic parasite in both immunocompromised and immunocompetent patients and have become an important health problem. The aim of this study was to identify Microsporidium spp in fecal samples of patients with acute lymphoblastic leukemia (ALL), with and without diarrhea, at different treatment stages. Methods. Seventy seven samples from children <12 years old with diagnosis of ALL were analyzed by the Faust coproparasitoscopic method, Ziehl-Nielsen, trichrome and calcofluor staining methods and polymerase chain reaction. Results. Results showed that 16/77 (20.77%) children presented Microsporidium and there was no relationship between microsporidial infection and diarrhea. Polymerase chain reaction was more effective than analysis by light microscopy of staining samples in the identification of the parasite. Conclusions. This work emphasizes the importance of microsporidiosis as an emerging infection in patients with ALL undergoing chemotherapy, increasing the additional clinical complications of leukemia.

Valoración gerontologica cognitivo-motriz y afectiva en marco de la atención primaria de la salud / Cognitive-motor and affective gerontological assessment in the context of primary health care

Uruguay es uno de los países más envejecidos del continente, este hecho requiere realizar un abordaje de los adultos mayores en el ámbito comunitario, como forma de valorar sus funciones cognitivas y motrices, detectando precozmente las posibles alteraciones que puedan ser generadoras de discapacidad. El objetivo de este estudio ha sido identificar alteraciones cognitivas, afectivas y antecedentes de caídas en una muestra de 54 adultos mayores de ambos sexos, de edades entre los 65 y 94 años, residentes en viviendas públicas de la ciudad de Montevideo. Los resultados muestran un predominio de mujeres 89% con una edad media de 77 años, con un nivel educativo de primaria incompleta 43% y completa 30%. En cuanto a la dimensión cognitiva un 60% manifiesta quejas de memoria un 95 % presenta un nivel de deterioro cognitivo de normal a leve, evaluado con el Minimental State Examination (MMSE). Con el Test del Reloj el deterioro en el nivel normal a leve desciende a un 50%. Un 73% no presenta aspectos de depresión evaluados con la Escala de Yesavage y el 89% presenta un muy bajo nivel de ansiedad en el Inventario de Beck. La mayoría (93%) presenta un nivel de bienestar psicológico medio y alto. El 56% de los participantes en el estudio, manifiesta haberse caído en el último año al menos una vez. Se concluye en la necesidad de realizar talleres de multiestimulación para las funciones cognitivas y de educación para la salud sobre el tema caídas, con seguimiento longitudinal de la población a los 6 meses y al año.

Uruguay is the country which has the oldest population of the contnent. This aspect requires making an approach for the elderly at the community as a way to assess their cognitive and motor functions and the early detection of possible changes that may be generating disability. The aim of this study was to identify cognitive impairment, affective disorders and history of falls in a sample of 54 residents of both sexes, aged between 65 and 94 years living in public housing in the city of Montevideo. The results show a 89% prevalence of women with a mean age of 77 years, with incomplete primary education level 43% and with primary complete 30%. Cognitive dimension shows 60% of subjects with memory complaints, 95% with results indicating normal to mild cognitive impairment, assessed with the Mini Mental State Examination (MMSE). With the Clock Test the results from normal to mildt level drops to 50%. About depression 73% of subjects did not manifest indicators of depression assessed with the Scale of Yesavage and 89% have a very low level of anxiety on the Beck Inventory. 93% had a level of psychological well-being from medium to high. 56% of the elderly have fallen at least once in the past year. The study concludes about the need for multiestimulación workshops and health education for cognitive functions and the importance to prevent falls. It was considered to perform a longitudinal follow-up of the population at 6 months and one year.

Prevalence and patterns of HIV transmitted drug resistance in Guatemala / Prevalencia y patrones de farmacorresistencia transmitida del VIH en Guatemala

Objective. To assess human immunodeficiency virus (HIV) diversity and the prevalence of transmitted drug resistance (TDR) in Guatemala. Methods. One hundred forty-five antiretroviral treatment-naïve patients referred to the Roosevelt Hospital in Guatemala City were enrolled from October 2010 to March 2011. Plasma HIV pol sequences were obtained and TDR was assessed with the Stanford algorithm and the World Health Organization (WHO) TDR surveillance mutation list. Results. HIV subtype B was highly prevalent in Guatemala (96.6%, 140/145), and a 2.8% (4/145) prevalence of BF1 recombinants and 0.7% (1/145) prevalence of subtype C viruses were found. TDR prevalence for the study period was 8.3% (12/145) with the Stanford database algorithm (score > 15) and the WHO TDR surveillance mutation list. Most TDR cases were associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) (83.3%, 10/12); a low prevalence of nucleoside reverse transcriptase inhibitors and protease inhibitors was observed in the cohort (< 1% for both families). Low selection of antiretroviral drug resistance mutations was found, except for NNRTI-associated mutations. Major NNRTI mutations such as K101E, K103N, and E138K showed higher frequencies than expected in ART-naïve populations. Higher literacy was associated with a greater risk of TDR (odds ratio 4.14, P = 0.0264). Conclusions. This study represents one of the first efforts to describe HIV diversity and TDR prevalence and trends in Guatemala. TDR prevalence in Guatemala was at the intermediate level. Most TDR cases were associated with NNRTIs. Further and continuous TDR surveillance is necessary to gain more in-depth knowledge about TDR spread and trends in Guatemala and to optimize treatment outcomes in the country.

Objetivo. Evaluar la diversidad del virus de la inmunodeficiencia humana (VIH) y la prevalencia de la farmacorresistencia transmitida en Guatemala. Métodos. Entre octubre del 2010 y marzo del 2011 se incluyeron en el estudio 145 pacientes no tratados anteriormente con antirretrovirales, derivados al Hospital Roosevelt en la Ciudad de Guatemala. Se obtuvieron las secuencias pol a partir del VIH plasmático y se evaluó la farmacorresistencia transmitida con el algoritmo de Stanford y la lista de mutaciones para la vigilancia de la farmacorresistencia transmitida de la Organización Mundial de la Salud (OMS). Resultados. El subtipo B del VIH fue sumamente prevalente en Guatemala (96,6%, 140/145), y se encontró una prevalencia de formas recombinantes BF1 de 2,8% (4/145) y una prevalencia del subtipo C del virus de 0,7% (1/145). La prevalencia de la farmacorresistencia transmitida durante el período de estudio fue de 8,3% (12/145) según el algoritmo de la base de datos de Stanford (puntuación > 15) y la lista de mutaciones para la vigilancia de la farmacorresistencia transmitida de la OMS. En la mayoría de los casos, la farmacorresistencia transmitida se asoció con los inhibidores de la transcriptasa inversa no análogos de nucleósidos (ITINN) (83,3%, 10/12); en la cohorte se observó una baja prevalencia asociada con los inhibidores de la transcriptasa inversa análogos de nucleósidos y con los inhibidores de la proteasa (< 1% para ambas familias de fármacos). Se encontró una baja selección de mutaciones causantes de farmacorresistencia debidas a los antirretrovirales, excepto en las mutaciones asociadas a los ITINN. Las mutaciones importantes relacionadas con los ITINN, como K101E, K103N y E138K, mostraron frecuencias más elevadas que las esperadas en las poblaciones vírgenes de tratamiento antirretroviral. En las personas con un nivel de escolaridad más elevado se encontró un mayor riesgo de farmacorresistencia transmitida (razón de posibilidades 4,14; P = 0,0264). Conclusiones. Este estudio representa uno de los primeros intentos de describir la diversidad del VIH, y la prevalencia de la farmacorresistencia transmitida y sus tendencias en Guatemala. La prevalencia de la farmacorresistencia transmitida en Guatemala presentó un nivel intermedio y en la mayoría de los casos se asoció con los ITINN. Se necesita una vigilancia más intensa y sostenida de la farmacorresistencia transmitida para conocer más exhaustivamente su grado de diseminación y sus tendencias en Guatemala, al igual que para optimizar los resultados del tratamiento antirretroviral en el país.

Resistencia a los antirretrovirales: Informe preliminar del capítulo de Guatemala, del estudio de epidemiología molecular del VIH en la región de mesoamerica / Antiretroviral resistance: initial report of Guatemala chapter, the study of molecular epidemiology of HIV in the region of Mesoamerica

El uso más extendido de los fármacos antirretrovirales ha traído como consecuencia la transmisión de variantes virales con mutaciones de resistencia que se pueden mantener en individuos sin tratamiento antirretroviral. La frecuencia de estas mutaciones de resistencia transmitida es relativamente alta en países desarrollados, muchas veces con tendencias de aumento. En países en vías de desarrollo, en los que la terapia antirretroviral (ARV) se introdujo posteriormente, las frecuencias de resistencia primaria tienden a ser menores, probablemente porque su uso se encuentra basado en una disponibilidad relativamente limitada...

Resistencia primaria del VIH a los antirretrovirales: informe preliminar del capítulo de Guatemala del estudio de epidemiología molecular del VIH en la región Mesoamericana / Primary HIV resistance to antiretroviral drugs: preliminary report of Guatemala chapter of molecular epidemiology study of HIV in Mesoamerica

Métodos: se seleccionaron pacientes adultos con diagnóstico reciente de infección por VIH, o con diagnóstico previo y que no habían iniciado terapia antirretroviral, que fueron enrolados como parte del estudio Epidemiología Molecular y vigilancia de farmacorresistencia del VIH-1 en la Región Mesoamericana, durante los meses de octubre de 2010 y agosto de 2011 en el Hospital Roosevelt, ciudad de Guatemala. La participación fue debidamente informada y voluntaria...