Biological maturity vs. relative age: Independent impact on physical performance in male and female youth handball players.

Maturity status and relative age are two of the determining factors in talent development. The aim of the study was to analyze the influence of biological maturity status and relative age on physical performance in young male and female handball players. The sample included 48 males (14.11 ± 1.17 years) and 41 females (14.25 ± 1.64 years) players from one Spanish professional handball academy. Anthropometric data (height, sitting height, body mass and self-reported biological parent heights) and physical performance data (CMJ, DJ, 20 m speed, T-test and throwing velocity) were collected. Biological maturity status was determined as the percentage of predicted adult height, while relative age was estimated in birth quartiles based on biennial age grouping (Q1-Q8). The results showed a positive correlation between maturity status and CMJ in male players (p < 0.01). Differences in CMJ performance according to maturity status were identified (p < 0.05), with higher jump heights being recorded especially in early maturing boys (p < 0.01) and first lines and wings (p < 0.05). The variance in CMJ test scores could be explained by the maturity status by 42.90% in U-15 (p < 0.05) and 72.60% in U-16 male players (p < 0.001). By contrast, no differences were found in girls (p > 0.05). Moreover, no relationships were found between relative age and indices of physical performance (p > 0.05). Overall, maturity status had greater impacts on the tests of physical performance than relative age. Stakeholders should monitor the maturity status of young handball players to avoid physical performance biases that do not allow them to develop their sporting potential.

Diversity of culturable bacteria of freshwater environments from an altitudinal gradient in the eastern Cordillera of Colombia.

Bacteria are an essential biotic component in freshwater environments. A group of 262 bacterial strains of freshwater environments from an altitudinal gradient in the Eastern Cordillera of Colombia was identified using the 16S rRNA gene sequence analysis. Hill numbers and related diversity indices were calculated to know the bacteria diversity in this collection and environments. In addition, the Bray-Curtis index was also calculated to know the differences in genera composition between sampled localities and their relationship with altitudinal gradient. The identified bacterial strains were grouped into 7 major phylogenetic groups (Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, Flavobacteriia, Actinomycetes, Clostridia, and Bacilli), 38 genera, and 84 distinctive species. Diversity analysis based on Hill numbers showed that the diversity concerning bacteria inhabiting freshwater environments was consistently high. Dominant genera were Klebsiella, Serratia, and Pseudomonas, although other genera such as Bacillus, Lelliottia, and Obesumbacterium were well represented per locality. The highest bacterial diversity came from localities Cimitarra and El Carmen del Chucurí, while those originating from Santa Bárbara and Páramo del Almorzadero were relatively lower diverse. Differences in diversity were found to be mainly due to the spatial replacement of one genus by another and, to a lesser extent, to the loss or gain of taxa.

Kinematic Analysis of the Underwater Undulatory Swimming Cycle: A Systematic and Synthetic Review.

The increase of low-cost technology for underwater filming has made quantitative analysis an affordable resource for swimming coaches on a frequent basis. In this context, a synthesis of the kinematic determinants of underwater undulatory swimming (UUS) seems to be lacking. The aim of the present study was to synthesise the scientific evidence on the kinematic characteristics of competitive swimmers during UUS and the main kinematic determinants of UUS performance, as well as to summarise the main methodological considerations for UUS kinematic analysis. A systematic literature search was performed through four electronic databases following the PRISMA guidelines and STROBE for evaluating the quality of the included studies. Twenty-three research studies from the first search and two from the second search were finally considered. In total, 412 competitive swimmers (321 males and 91 females) with a performance standard of international B (11%), national (51%), or regional (35%) level were analysed. Most studies focused on a two-dimensional analysis of the ventral UUS performed from a push start and filmed 6-12 m from the starting wall. Kinematic analysis of UUS included kicking parameters (kicking length, frequency, and amplitude) as well as selected segmental kinematics in 76% of studies and the analysis of UUS performance determinants in 36%. Information about the determinants of UUS performance was inconsistent due in part to inconsistencies in the definition of kinematic parameters. Further research studies where automatic motion capture systems are applied to the analysis of UUS on the aforementioned conditions should be conducted.

Índice pronóstico nutricional en pacientes con cáncer de páncreas avanzado tratados con nimotuzumab combinado a quimioterapia / Nutritional prognostic index in patients with advanced pancreatic cancer treated with nimotuzumab combined with chemotherapy

Introducción: El índice pronóstico nutricional es un marcador inmuno-nutricional que puede ser útil como factor pronóstico en tumores gastrointestinales. Objetivo: Evaluar supervivencia de pacientes con adenocarcinoma pancreático avanzado tratados con quimioinmunoterapia según índice pronóstico nutricional, según parámetros clínico-patológicos y tratamiento. Métodos: Se realizó estudio retrospectivo y observacional en pacientes que recibieron quimioterapia gemcitabina-oxaliplatino combinado a nimotuzumab (n=118), en el Hospital Ameijeiras, entre 2014 y 2019. Se evaluó supervivencia por método Kaplan-Meier, y regresión de Cox, para determinar los factores pronósticos independientes de supervivencia. Resultados: El punto de corte seleccionado fue 40 (sensibilidad 52,9 por ciento y especificidad 85,7 por ciento (p = 0,019), con área bajo la curva de 0,693. Para pacientes con índice menor de 40, la supervivencia fue más baja respecto a los pacientes con índice ≥ 40 (11,4 meses frente a 16,0 meses; p=0,001), con un HR de 1,7 (1,13-2,60; p=0,011). Las variables mayormente asociadas con índice pronóstico nutricional altos son pacientes con sesenta años o menos; ECOG cero, índice de masa corporal ≥25 Kg/m2 y albúmina sérica >3,5g/dL (x² < 0,05). Los pacientes con índice ≥ 40 tienen medianas de supervivencia más altas que pacientes con índice < 40 en las variables seleccionadas con p < 0,05, excepto el índice de masa corporal. Conclusiones: Este trabajo constituye el primer reporte nacional de utilización del índice pronóstico nutricional como pronóstico de supervivencia en pacientes con cáncer de páncreas avanzado(AU)

Background: The nutritional prognostic index is an immuno-nutritional marker that can be useful as a prognostic factor in gastrointestinal tumors. Aim: To evaluate the survival of patients with advanced pancreatic adenocarcinoma treated with chemoimmunotherapy according to the nutritional prognostic index, according to clinical-pathological parameters and treatment. Methods: A retrospective and observational study was carried out in patients who received gemcitabine-oxaliplatin chemotherapy combined with nimotuzumab (n=118), at the Ameijeiras Hospital, between 2014 and 2019. Survival was evaluated by the Kaplan-Meier method, and Cox regression, for determine independent prognostic factors for survival. Results: The selected cut-off point was 40 (52.9 percent sensitivity and 85.7 percent specificity) (p=0,019), with an area under the curve of 0,693. For patients with an index less than 40, survival was lower compared to patients with index ≥ 40 (11, 4 months vs. 16, 0 months; p=0,001), with a HR of 1, 7 (1, 13-2, 60; p=0,011). The variables mostly associated with nutritional prognostic index patients with 60 years or less, ECOG 0, body mass index ≥ 25 kg/m2 and serum albumin >3,5g/dL (x2 < 0, 05). Patients with index ≥ 40 have higher median survival than patients with index < 40 in the selected variables with p < 0, 05, except body mass index. Conclusions: This work constitutes the first national report on the use of the nutritional prognostic index as a prognosis of survival in patients with advanced pancreatic cancer(AU)

Diagnóstico y tratamiento de los feocromocitomas y paragangliomas / Pheochromocytomas and Paragangliomas Diagnosis and Treatment

RESUMEN Los feocromocitomas y los paragangliomas son tumores neuroendocrinos productores de catecolaminas provenientes del sistema nervioso simpático o parasimpático. Se originan en las células cromafines de la medula suprarrenal y los ganglios simpáticos extra-adrenales. Su incidencia anual es de 2-8 casos por un millón de personas. El 70 % son esporádicos y un 30 % están asociados a síndromes genéticos familiares con mutaciones en la línea germinal de genes como: NF1, VHL, RET y SDHx. Los pacientes generalmente presentan la triada clásica de cefaleas, palpitaciones y diaforesis. La hipertensión puede presentarse de forma sostenida o paroxística. El diagnóstico requiere de la confirmación por métodos bioquímicos de elevación de las catecolaminas y metanefrinas fraccionadas en plasma u orina de 24 horas, además de evidencia imagenológica de localización del tumor. El tratamiento de elección es la cirugía, aunque previo a su realización los pacientes deben tener controlada la hipertensión. En los casos de tumores malignos se recomienda el tratamiento con radiaciones y quimioterapia. En la actualidad se estudia el beneficio de muchas terapias dirigidas contra dianas moleculares en estos pacientes. El presente artículo se propone realizar una revisión de los aspectos biológicos de este tumor, su presentación clínica, métodos para el diagnóstico y estrategias terapéuticas más recientes.

ABSTRACT Pheochromocytomas and paragangliomas are catecholamine-producing neuroendocrine tumors from the sympathetic or parasympathetic nervous system. They originate in the chromaffin cells of the adrenal medulla and the extra-adrenal sympathetic ganglia. Its annual incidence is 2-8 cases per one million people. The 70 % are sporadic and the 30 % are associated with familial genetic syndromes with mutations in the germ line of genes such as: NF1, VHL, RET and SDHx. Patients generally suffer from headaches, palpitations, and sweating. Hypertension can present in a sustained or paroxysmal form. Diagnosis requires confirmation by biochemical methods of elevation of fractionated catecholamines and metanephrines in plasma or urine for 24 hours, in addition to imaging evidence of tumor location. The treatment of choice is surgery, although prior to its performance, patients must have hypertension under control. In cases of malignant tumors, treatment with radiation and chemotherapy is recommended. The benefit of many therapies directed against molecular targets in these patients is currently being studied. This article aims to carry out a review of this tumor biological aspect, its clinical presentation, diagnostic methods and the most recent therapeutic strategies.

Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: A systematic review.

BACKGROUND: Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function. PURPOSE: to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves. METHODS: A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves. RESULTS: Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance. CONCLUSIONS: The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.

Induction of the SOS response of Escherichia coli in repair-defective strains by several genotoxic agents.

DNA is exposed to the attack of several exogenous agents that modify its chemical structure, so cells must repair those changes in order to survive. Alkylating agents introduce methyl or ethyl groups in most of the cyclic or exocyclic nitrogen atoms of the ring and exocyclic oxygen available in DNA bases producing damage that can induce the SOS response in Escherichia coli and many other bacteria. Likewise, ultraviolet light produces mainly cyclobutane pyrimidine dimers that arrest the progression of the replication fork and triggers such response. The need of some enzymes (such as RecO, ExoI and RecJ) in processing injuries produced by gamma radiation prior the induction of the SOS response has been reported before. In the present work, several repair-defective strains of E. coli were treated with methyl methanesulfonate, ethyl methanesulfonate, mitomycin C or ultraviolet light. Both survival and SOS induction (by means of the Chromotest) were tested. Our results indicate that the participation of these genes depends on the type of injury caused by a genotoxin on DNA.

Peak Match Demands in Young Basketball Players: Approach and Applications.

BACKGROUND: The aim of this study is to describe the peak match demands and compare them with average demands in basketball players, from an external load point of view, using different time windows. Another objective is to determine whether there are differences between positions and to provide an approach for practical applications. METHODS: During this observational study, each player wore a micro technology device. We collected data from 12 male basketball players (mean ± SD: age 17.56 ± 0.67 years, height 196.17 ± 6.71 cm, body mass 90.83 ± 11.16 kg) during eight games. We analyzed intervals for different time windows using rolling averages (ROLL) to determine the peak match demands for Player Load. A separate one-way analysis of variance (ANOVA) was used to identify statistically significant differences between playing positions across different intense periods. RESULTS: Separate one-way ANOVAs revealed statistically significant differences between 1 min, 5 min, 10 min, and full game periods for Player Load, F (3,168) = 231.80, ηp2 = 0.76, large, p < 0.001. It is worth noting that guards produced a statistically significantly higher Player Load in 5 min (p < 0.01, ηp2 = -0.69, moderate), 10 min (p < 0.001, ηp2 = -0.90, moderate), and full game (p < 0.001, ηp2 = -0.96, moderate) periods than forwards. CONCLUSIONS: The main finding is that there are significant differences between the most intense moments of a game and the average demands. This means that understanding game demands using averages drastically underestimates the peak demands of the game. This approach helps coaches and fitness coaches to prepare athletes for the most demanding periods of the game and present potential practical applications that could be implemented during training and rehabilitation sessions.

Quimioterapia metronómica en pacientes con cáncer de mama metastásico / Metronomic chemotherapy in patients with metastatic breast cancer

RESUMEN La quimioterapia metronómica es un tipo de quimioterapia cuya toxicidad es mínima. Consiste en administrar agentes antineoplásicos habituales a intervalos muy próximos uno del otro y a dosis relativamente bajas durante un tiempo prolongado y sin periodos de descanso farmacológico. Esta terapia reduce la toxicidad y elimina la necesidad de tratamientos de soporte, por lo tanto, el empleo de esta modalidad de tratamiento en pacientes con enfermedad metastásica resulta de gran interés. Muchas investigaciones han evaluado la administración de medicamentos antineoplásicos en esquemas metronómicos, tanto en monoterapia como en combinación. Los fármacos mayormente estudiados son la ciclofosfamida, vinorelbina y capecitabina. Diversos estudios han mostrado la eficacia y tolerancia de esta terapia combinada con la hormonoterapia e inmunoterapia. Es necesaria mayor evidencia científica para definir cuestiones como: pacientes que más beneficio puedan obtener y las combinaciones terapéuticas a emplear de acuerdo al tipo de paciente.

ABSTRACT Metronomic chemotherapy is a type of chemotherapy whose toxicity is minimal. It consists of administering usual antineoplastic agents at intervals very close to each other and at relatively low doses for a prolonged time without periods of pharmacological rest. This therapy reduce toxicity and eliminates the need for supportive treatments, therefore, the use of this treatment modality in patients with metastatic disease is of great interest. Many investigations have evaluated the administration of antineoplastic drugs in metronomic schemes, both in monotherapy and in combination. The most studied drugs are cyclophosphamide, vinorelbine and capecitabine. Several studies have shown the efficacy and tolerance of this therapy combined with hormone therapy and immunotherapy. More scientific evidence is needed to define issues such as: patients who can obtain more benefit and the therapeutic combinations to be used according to the type of patients.

Tumores del estroma gastrointestinal / Gastrointestinal stromal tumors

Los tumores del estroma gastrointestinal (GIST) son neoplasias mesenquimales originadas en el tracto gastrointestinal. Su localización más frecuente es en estómago e intestino delgado. Pueden originarse a cualquier edad, pero más del 80% de los casos son mayores de 50 años sin predilección de sexo, aunque puede observarse en pacientes más jóvenes asociados a síndromes que predisponen el desarrollo de estos tumores. Presentan sintomatología inespecífica. La tomografía axial computarizada está recomendada para realizar el estudio de extensión y seguimiento de estos pacientes. Los marcadores inmunohistoquímicos más sensibles y específicos son el KIT y DOG1. El tratamiento en caso de lesiones primarias localizadas es la resección quirúrgica, con o sin terapia adyuvante con imatinib durante 3 años en dependencia del riesgo de recidiva. En los casos avanzados o metastásicos se recomienda terapia neoadyuvante con imatinib por tiempo indefinido; el tratamiento en casos de progresión o intolerancia a imatinib es el sunitinib.

Gastrointestinal stromal tumors (GIST) are mesenchymal neoplasms that arise in the gastrointestinal tract, usually in the stomach or the small intestine. GISTs can arise at any age, but more than 80% are reported in individuals older than 50 years men and women are affected at a roughly similar frequency. The few patients are who younger frequently have GIST associated with a syndrome. The clinical manifestations are non-specifics. The computer-tomography is recommended for staging and follow-up. The KIT and DOG1 are the most sensitive and specific immunohistochemistry markers. The standard treatment of localized GIST is complete surgical excision of the lesion, with or without adjuvant imatinib in dependence with the relapse risk. Neoadjuvant imatinib is the standard treatment for locally advanced and metastatic disease. In locally advanced and metastatic disease the imatinib treatment should be continued indefinitely. Following confirmed progression, or intolerance, to imatinib the standard second-line treatment is sunitinib.

Long-Term Analysis of Elite Basketball Players' Game-Related Statistics Throughout Their Careers.

The aim of the present study was to analyze the changes of game-related statistics in expert players across their whole sports careers. From an initial sample including 252 professional basketball players competing in Spanish first division basketball league (ACB) in the 2017-2018 season, 22 met the inclusion criteria. The following game-related statistics were studied: average points, assist, rebounds (all normalized by minute played), 3-point field goals percentage, 2-point field goals percentage, and free throws percentage per season. Each variable was individually investigated with a customized excel spreadsheet assessing individual variations and career trends were calculated. The results showed a positive trend in most of the investigated players in assists (91% of cases) and free throw percentages (73% of cases). Similar percentages of positive and negative trends were observed for all the other game-related statistics (range: 41-59% for negative and positive, respectively). In conclusion, an increase in assist and free throw performance was shown in the investigated players across their playing career. This information is essential for basketball coaches suggesting the use of most experienced players in the final moments of the game.

Proteomic Analysis Reveals That an Extract of the Plant Lippia origanoides Suppresses Mitochondrial Metabolism in Triple-Negative Breast Cancer Cells.

Triple-negative breast cancer is an aggressive subtype of breast cancer with low 5-year survival rates, high 3-year recurrence rates, and no known therapeutic targets. Recent studies have indicated that triple-negative breast cancers possess an altered metabolic state with higher rates of glycolysis, mitochondrial oxidative phosphorylation, and increased generation and utilization of tricarboxylic acid cycle intermediates. Here, we utilized label-free quantitative proteomics to gain insight into the anticancer mechanisms of a methanolic extract from the Central American plant Lippia origanoides on MDA-MB-231 triple-negative breast cancer cells. The L. origanoides extract dysregulated mitochondrial oxidative phosphorylation by suppressing the expression of several subunits of Complex I of the electron transport chain, and inhibited cellular metabolism by down-regulating key tricarboxylic acid cycle enzymes and mitochondrial lipid and amino-acid metabolic pathways. Our study also revealed that treatment with the extract activated the stress response and pathways related to cell-cycle progression and DNA repair. Overall, our results reveal compelling new evidence that the extract from L. origanodes triggers rapid irreversible apoptosis in MDA-MB-231 cells by effectively 'starving' the cells of metabolites and ATP. We continue to study the specific bioactive components of the extract in the search for novel, highly effective mitochondrial inhibitors to selectively target triple-negative breast cancer.

[Response capacity and challenges of the Cuban health system against communicable diseasesCapacidade de resposta e desafios do sistema de saúde cubano contra doenças transmissíveis]. / Capacidad de respuesta y desafíos del sistema de salud cubano frente a las enfermedades transmisibles.

This article presents distinctive and essential features in the transformations of the Cuban health system that have allowed the eradication and reduction of the incidence rates of some communicable diseases at levels lower than 0.1 per 100 000 inhabitants. The results obtained are a consequence of the importance given to the prevention and control, as well as to the risks and potential damages, of these diseases. The structure and functioning of the hygiene and epidemiology subsystem and its interrelations with the rest of the system, based on the different models of service provision, have been permanent integration scenarios for decision making. Diseases such as poliomyelitis, malaria, diphtheria, whooping cough, rubella, mumps, post-mumps meningitis, measles, yellow fever, cholera, severe forms of tuberculosis, human rabies transmitted by canines, leishmaniasis, Chagas disease, vertical transmission of HIV, congenital syphilis and clinical forms such as neonatal tetanus and congenital rubella syndrome were eliminated. Some communicable diseases are analyzed in more detail and, in particular, the social response developed against tuberculosis, leprosy, AIDS and vector-borne diseases. However, the current health context presents challenges for the sustainability of the achievements made in the country. Assuring the maintenance of universal coverage with access of the Cuban population to health services will always be a principle of Cuban public health.

No presente artigo se identificam características específicas e essenciais nas transformações do sistema de saúde cubano que permitiram a erradicação e redução das taxas de incidência de algumas doenças transmissíveis a níveis inferiores a 0,1 por 100 000 habitantes. Os resultados obtidos são uma conseqüência da importância dada à prevenção e controle dessas doenças, bem como aos riscos e danos potenciais. A estrutura e o funcionamento do subsistema de higiene e epidemiologia e suas inter-relações com o resto do sistema, com base nos diferentes modelos de prestação de serviços, constituíram cenários de integração permanente para a tomada de decisões. Foram eliminadas doenças como a poliomielite, malária, difteria, coqueluche, rubéola, parotidite, meningite pós-parotidite, sarampo, febre amarela, cólera, formas graves de tuberculose, raiva humana transmitida por cães, leishmaniose, doença de Chagas, a transmissão vertical do vírus da imunodeficiência humana, sífilis congênita e formas clínicas como o tétano neonatal e a síndrome da rubéola congênita. É dada ênfase a algumas doenças transmissíveis e, em particular, à resposta social desenvolvida contra a tuberculose, a hanseniasis, a AIDS e as doenças transmitidas por vetores. Mostra-se que o atual contexto de saúde revela desafios para a sustentabilidade das realizações no país. Garantir a manutenção da cobertura universal com acesso da população cubana aos serviços de saúde sempre será um princípio da saúde pública cubana.

Relative Age Effect and Long-Term Success in the Spanish Soccer and Basketball National Teams.

The aims of this study were: i) to analyze whether relative age effect occurs in the athletes of the junior national teams and professional athletes in Spain in general and in soccer and basketball, and ii) to compare the long-term success of the players selected for the junior national team between these sports. The samples for this study were Spanish professional soccer (n = 461) and basketball (n = 250) players in the 2013-2014 premier league and players from the junior Spanish soccer (i.e., n = 273; U-17: n = 107; U-19: n = 166) and basketball (i.e., n = 240; U-18: n = 120, U-16: n = 120) teams that classified to play in the European Championships (from 2004 to 2013). Junior players (42.3%) were more frequently born in the 1st quarter of the year than the professional players (30.7%) (χ2(3) = 30.07; p = .001; Vc = .157). This was found in both basketball (χ2(3) = 12.2.; p = .007; Vc = .158) and soccer (χ2(3) = 20.13; p < .001; Vc = .166). Long-term success is more frequent in soccer, where 59.9% of the juniors selected for the national team played later in the premier league, while in basketball that percentage was 39.6% (χ2(1) = 14.64; p < .001; Vc = .201). On the other hand, 79.4% and 39.8% of the professional soccer and basketball players had been previously selected for junior national teams (χ2(1) = 60.2; p < .001; Vc = .386), respectively. The talent selection process should be reviewed as players born in the second half of the year have fewer opportunities to stand out.

Capacidad de respuesta y desafíos del sistema de salud cubano frente a las enfermedades transmisibles / Response capacity and challenges of the Cuban health system against communicable diseases / Capacidade de resposta e desafios do sistema de saúde cubano contra doenças transmissíveis

RESUMEN En el presente artículo se identifican rasgos distintivos y esenciales en las transformaciones del sistema de salud cubano que han permitido la erradicación y disminución de las tasas de incidencia de algunas enfermedades transmisibles a niveles inferiores a 0,1 por 100 000 habitantes. Los resultados obtenidos son consecuencia de la importancia otorgada a la prevención y control de estas enfermedades, así como a los riesgos y daños potenciales. La estructura y funcionamiento del subsistema de higiene y epidemiología y sus interrelaciones con el resto del sistema a partir de los diferentes modelos de prestación de servicios han constituido escenarios de integración permanentes para la toma de decisiones. Se eliminaron enfermedades como la poliomielitis, paludismo, difteria, tosferina, rubéola, parotiditis, meningitis posparotiditis, sarampión, fiebre amarilla, cólera, formas graves de la tuberculosis, rabia humana transmitida por caninos, leishmaniasis, enfermedad de Chagas, la transmisión vertical del virus de inmunodeficiencia humana, sífilis congénita y formas clínicas como el tétanos neonatal y el síndrome de rubéola congénita. Se hace énfasis en algunas enfermedades transmisibles y, en especial, en la respuesta social desarrollada contra la tuberculosis, la lepra, el sida y las enfermedades transmitidas por vectores. Se demuestra que el contexto sanitario actual revela aún desafíos para la sostenibilidad de los logros alcanzados en el país. Garantizar el mantenimiento de la cobertura universal con acceso de la población cubana a los servicios de salud será siempre un principio de la salud pública cubana.

ABSTRACT This article presents distinctive and essential features in the transformations of the Cuban health system that have allowed the eradication and reduction of the incidence rates of some communicable diseases at levels lower than 0.1 per 100 000 inhabitants. The results obtained are a consequence of the importance given to the prevention and control, as well as to the risks and potential damages, of these diseases. The structure and functioning of the hygiene and epidemiology subsystem and its interrelations with the rest of the system, based on the different models of service provision, have been permanent integration scenarios for decision making. Diseases such as poliomyelitis, malaria, diphtheria, whooping cough, rubella, mumps, post-mumps meningitis, measles, yellow fever, cholera, severe forms of tuberculosis, human rabies transmitted by canines, leishmaniasis, Chagas disease, vertical transmission of HIV, congenital syphilis and clinical forms such as neonatal tetanus and congenital rubella syndrome were eliminated. Some communicable diseases are analyzed in more detail and, in particular, the social response developed against tuberculosis, leprosy, AIDS and vector-borne diseases. However, the current health context presents challenges for the sustainability of the achievements made in the country. Assuring the maintenance of universal coverage with access of the Cuban population to health services will always be a principle of Cuban public health.

RESUMO No presente artigo se identificam características específicas e essenciais nas transformações do sistema de saúde cubano que permitiram a erradicação e redução das taxas de incidência de algumas doenças transmissíveis a níveis inferiores a 0,1 por 100 000 habitantes. Os resultados obtidos são uma conseqüência da importância dada à prevenção e controle dessas doenças, bem como aos riscos e danos potenciais. A estrutura e o funcionamento do subsistema de higiene e epidemiologia e suas inter-relações com o resto do sistema, com base nos diferentes modelos de prestação de serviços, constituíram cenários de integração permanente para a tomada de decisões. Foram eliminadas doenças como a poliomielite, malária, difteria, coqueluche, rubéola, parotidite, meningite pós-parotidite, sarampo, febre amarela, cólera, formas graves de tuberculose, raiva humana transmitida por cães, leishmaniose, doença de Chagas, a transmissão vertical do vírus da imunodeficiência humana, sífilis congênita e formas clínicas como o tétano neonatal e a síndrome da rubéola congênita. É dada ênfase a algumas doenças transmissíveis e, em particular, à resposta social desenvolvida contra a tuberculose, a hanseniasis, a AIDS e as doenças transmitidas por vetores. Mostra-se que o atual contexto de saúde revela desafios para a sustentabilidade das realizações no país. Garantir a manutenção da cobertura universal com acesso da população cubana aos serviços de saúde sempre será um princípio da saúde pública cubana.

Lippia origanoides extract induces cell cycle arrest and apoptosis and suppresses NF-κB signaling in triple-negative breast cancer cells.

Treatments targeting hormone receptors typically fail to provide a positive clinical outcome against triple-negative breast cancers (TNBC), which lack expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2/neu). Towards identifying viable treatments for aggressive breast cancer, we have tested an extract of the tropical plant Lippia origanoides (LOE) on TNBC and normal cells lines to uncover its potential anticancer effects. Treatment with LOE reduced TNBC cell viability in a dose-dependent manner to a greater extent than in normal mammary epithelial MCF10A cells. In MDA-MB­231 cells, LOE was found to halt the cell cycle in the G0/G1 phase via cyclin D1 and cIAP2 regulation, and induce apoptosis without promoting necrosis via caspase-8/-3 and PARP cleavage. Constitutive nuclear factor-κB (NF-κB) signaling has been shown to contribute to the heightened inflammatory state and survival in TNBC cells. Herein, we also provide evidence that LOE inhibits NF-κB signaling by reducing RIP1 protein levels in MDA-MB-231 cells. These studies reveal that LOE suppresses key features of the progression of aggressive breast cancer cells and provides a basis for further definition of its underlying mechanisms of action and anticancer potential.

Carcinoma papilar intraquístico de la mama. Reporte de un caso / Intracystic papillary carcinoma of mamma. Case report

El carcinoma papilar intraquístico es una forma rara de cáncer de mama, con una incidencia del 0,5-1 % de todos los cánceres de mama. Es un tumor que predominantemente afecta a las mujeres de avanzada edad. Aunque esta rara entidad se creyó que era una variante de carcinoma ductal in situ, algunas lesiones pueden ser tumores de bajo riesgo de invasividad. El tumor tiene un excelente pronóstico sin tener en cuenta que sea in situ o invasivo. Por lo tanto, un diagnóstico preciso juega un papel crucial en el manejo de pacientes con esta entidad. Se reportó un caso de carcinoma papilar intraquístico, en una mujer de 75 años de edad. Entre los hallazgos patológicos se encontró que el tumor midió 2 cm y se encontraba situado en el cuadrante inferoexterno de la mama derecha. En el ultrasonido realizado se informó una imagen “ecolúcida”, de bordes bien definidos, y en la mamografía se planteó la presencia de una imagen nodular de contornos irregulares. El diagnóstico histopatológico fue el de un carcinoma papilar no invasivo, dentro de una lesión quística que midió 1 cm, con nódulo sólido en su interior de 0,5 cm con grado nuclear bajo. Se le realizó una tumorectomía amplia. Actualmente se mantiene bajo control. Para la confección del presente trabajo se consultó 17 materiales entre revistas y libros de Cirugía. El mismo se propuso reportar un caso de carcinoma papilar intraquístico, demostrando cuan extraño resulta esta patología para los especialistas del tema.

The intracystic papillary carcinoma is a rare form of mamma cancer, with an incidence of 0.5-1 % of all mamma cancers. It is a tumor predominantly affecting women in advanced age. Although it was believed that this rare entity was a variant of ductal carcinoma in situ, some lesions might be tumors of low risk invasiveness. The tumor has an excellent prognosis despite being in situ or invasive one. Therefore, the precise diagnosis plays an important role in the management of patients with this entity. We report the case of an intracystic papillary carcinoma in a woman aged 75 years. Among other pathological findings, the tumor was 2 cm and was located in the low external quadrant of the right mamma. In the carried out ultrasonography, it was informed an echo lucid image, of well defined edges, and the mammography showed the presence of a nodular image with irregular edges. The histopathologic diagnosis was non-invasive papillary carcinoma, inside a 1 cm cystic lesion, with an 0,5 cm solid nodule inside of low nuclear grade. A wide tumorectomy was carried out. Currently it is controlled. For the elaboration of the current paper we consulted 17 materials of journals and Surgery textbooks. The aim was reporting an intracystic papillary carcinoma case, showing how rare this pathology is for the specialists on the theme.