RESUMEN
La atención a la salud y la formación del profesional de la salud son procesos sociales que garantizan la salud individual de los miembros de la sociedad cubana. Ambos tienen en Cuba la misma dirección para garantizar salud para todos. Es por tanto objetivo, revelar la naturaleza esencial de integración de lo social en correspondencia con los procesos de atención a la salud y formación de profesionales de la salud en el paradigma sociomédico. Se emplean métodos teóricos: análisis-síntesis, inducción-deducción y el histórico lógico. Se revela el principio de formación del profesional de la salud en la integración a lo social en correspondencia con los procesos de Atención de Salud, y conceptos fundamentales del que parte, así como su función, rasgos y acciones didácticas.(AU)
Health care and the formation of health professionals are social processes that guarantee the individual health of the members of the Cuban society. Both are directed to the same goal which is to assure health for all. Therefore, the objective of this paper was to reveal the essential nature of integration of the social aspects in line with the health care and health professional formation processes within the socio-medical paradigm. Theoretical methods such as analysis/synthesis, induction/deduction and the logical and historical method were used. The paper showed the principle of formation of the health professional within the integration to the social aspects, in conformity with the health care processes and the fundamental concepts from which they stem, as well as their function, traits and didactic actions.(AU)
Asunto(s)
Atención a la Salud , Desarrollo de PersonalRESUMEN
La atención a la salud y la formación del profesional de la salud son procesos sociales que garantizan la salud individual de los miembros de la sociedad cubana. Ambos tienen en Cuba la misma dirección para garantizar salud para todos. Es por tanto objetivo, revelar la naturaleza esencial de integración de lo social en correspondencia con los procesos de atención a la salud y formación de profesionales de la salud en el paradigma sociomédico. Se emplean métodos teóricos: análisis-síntesis, inducción-deducción y el histórico lógico. Se revela el principio de formación del profesional de la salud en la integración a lo social en correspondencia con los procesos de Atención de Salud, y conceptos fundamentales del que parte, así como su función, rasgos y acciones didácticas.
Health care and the formation of health professionals are social processes that guarantee the individual health of the members of the Cuban society. Both are directed to the same goal which is to assure health for all. Therefore, the objective of this paper was to reveal the essential nature of integration of the social aspects in line with the health care and health professional formation processes within the socio-medical paradigm. Theoretical methods such as analysis/synthesis, induction/deduction and the logical and historical method were used. The paper showed the principle of formation of the health professional within the integration to the social aspects, in conformity with the health care processes and the fundamental concepts from which they stem, as well as their function, traits and didactic actions.
Asunto(s)
Desarrollo de Personal , Atención a la SaludRESUMEN
PURPOSE: To investigate whether nuclear factor kappaB (NF-kappaB)/interleukin 6 (IL-6) was linked to docetaxel response in human prostate cancer cell lines, and whether inhibition of NF-kappaB sensitized tumor cells to docetaxel. We also aimed to correlate IL-6 (as a surrogate marker of NF-kappaB) and docetaxel response in hormone-independent prostate cancer (HIPC) patients. EXPERIMENTAL DESIGN: Hormone-dependent (LNCaP) and hormone-independent (PC-3 and DU-145) prostate cancer cell lines were exposed to docetaxel alone or combined with the NF-kappaB inhibitor PS-1145 (an inhibitor of IkappaB kinase-2). Effects of dose, exposure time, and schedule dependence were assessed. Activation of NF-kappaB was assayed by electrophoresis mobility shift assay and luciferase reporter assay, IL-6 levels by ELISA, and cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Cell cycle and apoptosis were assessed by fluorescence-activated cell sorting analysis. Apoptosis was also measured by detection of cleavage of poly(ADP-ribose) polymerase. In patients with metastatic HIPC receiving docetaxel-based chemotherapy, IL-6 serum levels were assayed before chemotherapy and every 3 to 4 weeks thereafter. RESULTS: PC-3 and DU-145 cells had higher NF-kappaB activity, secreted more IL-6, and were more resistant to docetaxel than LNCaP cells. NF-kappaB activity was induced by docetaxel. Cotreatment with docetaxel and PS-1145 prevented docetaxel-induced NF-kappaB activation, reduced IL-6 production, and increased docetaxel effects on cell viability in PC-3 and DU-145 cells but not in LNCaP. Synergism with docetaxel and PS-1145, as assayed by median-effect principle, was observed in DU-145 and PC-3. In HIPC patients, pretreatment IL-6 serum levels correlated to prostate-specific antigen (PSA) response: median IL-6 level was 10.8+/-9.5 pg/mL in PSA responders versus 36.7+/-20.8 pg/mL (P=0.006) in nonresponders. A PSA response was also linked to a decline in IL-6 levels during treatment. Median overall survival was 6.8 months in patients with high IL-6 versus 16.6 months in those with low IL-6 (P=0.0007). On multivariate analysis, pretreatment IL-6 (P=0.05) was an independent prognostic factor for time to disease progression and survival. CONCLUSIONS: Inhibition of NF-kappaB emerges as an attractive strategy to enhance docetaxel response in prostate cancer. The interest of this view is further supported by a significant association between high IL-6 in sera of HIPC patients and decreased response to docetaxel.