RESUMO
Multiple sclerosis is a tissue-specific autoimmune disease of the central nervous system in which the antigen(s) remains elusive. Antibodies targeting the flotillin-1/2 complex have been described in 1-2% of the patients in a recent study. Other candidate antigens as anoctamin-2 or neurofascin-155 have been previously described in multiple sclerosis patients, although their clinical relevance remains uncertain. Our study aims to analyse the frequency and clinical relevance of antibodies against neurofascin-155, anoctamin-2 and flotillin-1/2 complex in multiple sclerosis. Serum (n = 252) and CSF (n = 50) samples from 282 multiple sclerosis patients were included in the study. The control group was composed of 260 serum samples (71 healthy donors and 189 with other neuroinflammatory disorders). Anti-flotillin-1/2, anti-anoctamin-2 and anti-neurofascin-155 antibodies were tested by cell-based assays using transfected cells. We identified six multiple sclerosis patients with antibodies against the flotillin-1/2 complex (2.1%) and one multiple sclerosis patient with antibodies against anoctamin-2 (0.35%). All multiple sclerosis patients were negative for anti-neurofascin-155 antibodies. Three of the anti-flotillin-1/2 positive patients showed anti-flotillin-1/2 positivity in other serum samples extracted at different moments of their disease. Immunoglobulin G subclasses of anti-flotillin-1/2 antibodies were predominantly one and three. We confirm that antibodies targeting the flotillin-1/2 complex are present in a subgroup of patients with multiple sclerosis. Further studies are needed to understand the clinical and pathological relevance of anti-flotillin-1/2 autoantibodies in multiple sclerosis.
RESUMO
INTRODUCTION: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. CONCLUSIONS: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.
Assuntos
Neoplasias Ovarianas , Assistência ao Convalescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Terapia Combinada , Resistencia a Medicamentos Antineoplásicos , Diagnóstico Precoce , Feminino , Genes Neoplásicos , Humanos , Laparoscopia , Excisão de Linfonodo , Terapia Neoadjuvante , Estadiamento de Neoplasias/normas , Síndromes Neoplásicas Hereditárias/genética , Omento/cirurgia , Compostos Organoplatínicos/administração & dosagem , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Ovariectomia/métodos , Cuidados Paliativos , Qualidade de Vida , Radioterapia Adjuvante , Terapia de Salvação , Taxoides/administração & dosagemRESUMO
Objetivo: Conocer los cambios morfológicos de la macula por tomografía de coherencia óptica en pacientes operados de cirugía extracapsular de catarata en el HN Luis N. Sáenz PNP en el periodo comprendido de Julio 2012 a marzo 2013. Métodos: Se realizaron medidas del espesor macular central o espesor foveal (EF), volumen macular total (VMT) y promedio del espesor macular (PEM) con tomógrafo SD cirrus 4000, en pacientes sometidos a cirugía extracapsular de catarata antes de la cirugía y en el segundo mes postquirúrgico. Los datos fueron analizados utilizando SPSS 20.0 software. Resultados: Se incluyeron 33 ojos de 33 pacientes, de los cuales 16 fueron ojos derechos, 17 ojos izquierdos de 15 varones y 18 mujeres. Los valores medidos del EF, VMT y PEM de este grupo con Signal Strength por encima de 6, antes de la cirugía de catarata fueron 244.2±16.5 um, 9.4±0.6 mm3, 261.8±17.9 um. Al segundo mes de cirugía extracapsular de catarata fueron EF 263.3±35.1 um, VMT 10.0±0.8 mm3, PEM 277.7±21.9 um. Encontramos diferencias estadísticamente significativas (P<0.001) en el espesor macular central, volumen macular y en el promedio del espesor macular. Conclusiones: Encontramos cambios morfológicos de la macula por tomografía de coherencia óptica en pacientes operados de cirugía extracapsular de catarata.
Objective: To determine the morphological changes of the macula by optical coherence tomography in patients undergoing extra capsular cataract surgery in the National Hospital Luis N. Saenz-PNP in the period from July 2012 to March 2013. Methods: Measurements were performed of the central macular thickness, the foveal thickness (VF), total macular volume (VMT) and average macular thickness (PEM) with an SD scanner Cirrus 4000, in patients undergoing extra-capsular cataract surgery before surgery, and in the second postoperative month. Data was analyzed using SPSS 20.0 software. Results: We included 33 eyes of 33 patients, of whom 16 were right eyed, 17 left eyed of 15 men and 18 women. The measured values of EF, VMT and PEM in this group with signal strength above 6 before cataract surgery were 244.2±16.5 um, 9.4±0.6 mm3, 261.8±17.9 um. The second month after extra-capsular cataract surgery they were 263.3±35.1 um VF, VMT 10.0±0.8 mm3, 277.7±21.9 um PEM. We found statistically significant differences (P<0.001) in the central macular thickness, macular volume and average macular thickness. Conclusions: We found morphological changes of the macula by optical coherence tomography in patients undergoing extra-capsular cataract surgery.