Effects of Genetic Origin of Honeybees and Climate on Prevalence and Infestation Levels of Varroa.

The objective of this study was to evaluate the effect of honeybee genetic origin, climate type and the interactions between these variables on the prevalence and infestation levels of Varroa in a large population of honeybee colonies (n = 1134). For each colony, the morphotype, haplotype and climate type were determined. No differences between the Africanized, European and Hybrid morphotypes were found for the prevalence and infestation levels of Varroa (p > 0.05). Differences between honeybee haplotypes were found for the prevalence of Varroa (p < 0.05), and the prevalence was higher in the African haplotype than in the European haplotype. No differences between honeybee haplotypes were found for the infestation levels of Varroa (p > 0.05). Differences were found between climate type for the prevalence and infestation levels of Varroa (p < 0.05): the temperate sub-humid climate had a higher prevalence and higher infestation levels than the semi-warm climate and the warm sub-humid climate. Correlations between the infestation levels of Varroa and mean annual temperature, mean annual precipitation, winter precipitation and Lang index were found.

Management of non-invasive tumours, benign tumours and breast cancer during the COVID-19 pandemic: recommendations based on a Latin American survey.

INTRODUCTION: The COVID-19 pandemic has changed health systems across the world, both in general hospitals and in oncology institutes or centres.For cancer specialists, particularly breast cancer (BC), the COVID-19 pandemic represents a combination of challenges since the hospital resources and staff have become more limited; this has obliged oncology specialists to seek a consensus and establish which patients with BC require more urgent attention and which patients can wait until there is a better control of this pandemic. The health system in Latin America has some special characteristics; in some of the countries, there are shortages which limit access to several specialities (surgery, clinical oncology and radiotherapy) in some regions. OBJECTIVE: After a systematic review of the most recent literature regarding the management of BC during the COVID-19 pandemic, the main objective is to understand the position of the different Latin American Societies of Mastology in terms of available alternatives for the treatment of BC. METHODS: After carrying out a comprehensive and exhaustive search of the most recent guides on the management of BC during the COVID-19 pandemic, the board members of the Latin American Federation of Mastology invited, via email, different specialists, all experts in BC care, to complete an anonymous survey online.The survey was distributed between 30 and 10 May 2020. The survey included 27 questions on four topics: demographic information, consultations, imaging and treatment of BC.The questionnaire was sent and then distributed to various health specialists including breast surgeons, clinical oncologists, radiation oncologists and radiologists via the Presidents of the different Latin American Societies of Mastology in 18 countries. The results are summarised as tallies based on the number of responses to each question. RESULTS: A total of 499 responses were received. The majority of the respondents were males (275 (55.11%)); 290 participants were over 45 years (58.11%).The questionnaire presented those surveyed with three possible answers (agree, disagree and neither agree nor disagree). The results reflect that there was consensus in the majority of situations presented. Only seven questions revealed disagreement among those responding. The results are presented as recommendations. CONCLUSION: The management of patients with BC presents unique challenges during the current world health situation produced by COVID-19 pandemic. Breast care specialists (surgical oncologists, breast care clinicians, clinical oncologists, radiation oncologists and radiologists) from 18 countries in Central and South America submitted through their responses and recommendations for the treatment of BC during the COVID-19 pandemic.

UNC-51-like kinase regulation of fibroblast growth factor receptor substrate 2/3.

UNC-51-like kinases (ULK) are members of an evolutionarily conserved sub-family of ubiquitously expressed serine/threonine-specific protein kinases. Here we report that fibroblast growth factor receptor substrate (FRS) 2/3 are novel ULK2 carboxy-terminal domain interacting proteins. FRS2/3 are homologs that function as adaptor proteins to mediate signaling of multiple receptor tyrosine kinases. ULK2 interacts with the phospho-tyrosine binding (PTB) domain of FRS2/3. We demonstrate that siRNA targeting ULK2 in mouse P19 cells results in elevated FGFR1 mediated FRS3 and SHP2 tyrosyl phosphorylation. In addition, RNAi-mediated decrease in ULK2 causes increased interaction between FGFR1 and FRS3. ULK2 phosphorylates FRS2/3 in vitro, suggesting that ULK2 mediated phosphorylation may be a mechanism of FRS2/3 regulation. The data presented support a model in which ULK2, by interaction with FRS2/3 and inhibition of SynGAP, functions to negatively regulate tyrosyl phosphorylation of signaling proteins downstream of FGFR1.

Akt regulates basic helix-loop-helix transcription factor-coactivator complex formation and activity during neuronal differentiation.

Neural basic helix-loop-helix (bHLH) transcription factors regulate neurogenesis in vertebrates. Signaling by peptide growth factors also plays critical roles in regulating neuronal differentiation and survival. Many peptide growth factors activate phosphatidylinositol 3-kinase (PI3K) and subsequently the Akt kinases, raising the possibility that Akt may impact bHLH protein function during neurogenesis. Here we demonstrate that reducing expression of endogenous Akt1 and Akt2 by RNA interference (RNAi) reduces neuron generation in P19 cells transfected with a neural bHLH expression vector. The reduction in neuron generation from decreased Akt expression is not solely due to decreased cell survival, since addition of the caspase inhibitor z-VAD-FMK rescues cell death associated with loss of Akt function but does not restore neuron formation. This result indicates that Akt1 and Akt2 have additional functions during neuronal differentiation that are separable from neuronal survival. We show that activated Akt1 enhances complex formation between bHLH proteins and the transcriptional coactivator p300. Activated Akt1 also significantly augments the transcriptional activity of the bHLH protein neurogenin 3 in complex with the coactivators p300 or CBP. In addition, inhibition of endogenous Akt activity by the PI3K/Akt inhibitor LY294002 abolishes transcriptional cooperativity between the bHLH proteins and p300. We propose that Akt regulates the assembly and activity of bHLH-coactivator complexes to promote neuronal differentiation.

Regulators of endothelial integrity as severity predictors in dengue.

INTRODUCTION: Dengue is currently among the mosquito-borne diseases of greatest global impact. The clinical course of the disease can be unpredictable, so proper handling in its early stages is critical to ensure optimal outcomes.  OBJECTIVE: To evaluate serum regulators of endothelial integrity (VEGF, sICAM-1, sEndoglina, Ang-1, and Ang-2) as predictive markers of dengue severity.  MATERIALS AND METHODS: We conducted a case-control study nested in an appropriate cohort. Endothelial regulator levels were first measured by ELISA, after which analysis was performed using logistic regression of clinical and regulatory variables, with severity as an output variable. A possible severity prediction model, based on the variables of interest and output, was defined using the best area under the ROC curve.  RESULTS: The median subject age was 24 years. Severe cases were associated with Ang-2 serum levels of ≥1,490 ng/ml (OR=3.1; p=0.015). Serum levels of Ang-2 (≥1,490 ng/ml) contributed to the severity prediction model, as did a 0.73 area under the ROC curve, together with the variables rash, impaired consciousness and abdominal pain, with an OR of 3.2 (CI 95%: 1.16 to 8.9; p=0.024).  CONCLUSION: The endothelial regulator Ang-2 could be a predictor of severity in dengue.

Akt negatively regulates translation of the ternary complex factor Elk-1.

Cross-talk between signaling pathways plays an important role in regulation of cell growth, differentiation, survival, and death. Here, we show that Akt regulates the Elk-1 transcription factor, independent of its negative regulation of Raf kinases. Using a constitutively active Mek1 to bypass the regulation of Raf by Akt, we find that the Elk-1 and Sap1a proteins are dramatically decreased in the presence of activated Akt. Akt catalytic activity is required. Also, Mek-dependent activation of a TCF (Elk-1/Sap-1a)-dependent c-fos reporter is decreased by activated Akt. Neither the level of Elk-1 mRNA nor the stability of the Elk-1 protein is altered by activated Akt. Instead, the rate of incorporation of labeled methionine into Elk-1 protein is decreased in the presence of Akt. In addition, the level of the Elk-1 protein but not GFP is significantly decreased in the presence of activated Akt, when GFP is expressed from an IRES element in a bicistronic message with Elk-1. We conclude that Akt negatively regulates translation of the Elk-1 mRNA. A coding region determinant that maps within the first 279 nts of the Elk-1 message is necessary and sufficient for Akt-mediated regulation of Elk-1.

Variables associated with frailty in a hospital population in Colombia / Variables asociadas a fragilidad en una población hospitalaria en Colombia

INTRODUCTION: Frailty predicts functional decline and could be associated with adverse outcomes such as disability, multiple hospitalizations, falls, loss of mobility, and cardiovascular disease. In Colombia 12.5% of prevalence has been reported. In the present study, the different clinical variables associated with frailty were evaluated in a population of hospitalized patients older than 65 years in Bucaramanga, Colombia, in order to predict the behavior of these variables to generate measurement tools of greater applicability than that of currently existing tools. METHODS: An analytical observational cross-sectional study with non-probabilistic sampling was conducted from January 2016 to June 2017 in patients older than 65 years of follow-up >48 hours by the internal medicine service. Fried criteria were used to evaluate patients on their last day of hospitalization. RESULTS: A total of 155 patients were included, of whom 60.6% were frail. A combined analysis of the variables that showed association with frailty revealed that a calf circumference lower than or equal to 31 cm, a gait speed lower than or equal to 0.8 m/s, and age above 75 years were associated with frailty. It was also shown that being male and having a BMI >27 kg/m2 are protective factors for frailty. CONCLUSIONS: The prevalence of frailty in hospitalized older adults was higher than that reported in local studies for the community population. According to multivariate analysis, the variables, when analyzed together, have a predictive ability of 92% to estimate frailty in hospitalized patients.

INTRODUCCIÓN: El síndrome de fragilidad puede asociarse a mayor riesgo de deterioro funcional y desenlaces adversos como discapacidad, múltiples hospitalizaciones, caídas, pérdida de movilidad y enfermedad cardiovascular. En Colombia se ha reportado una prevalencia del 12,5%. En el presente estudio, se evalúan las diferentes variables clínicas asociadas a fragilidad en una población de pacientes mayores de 65 años en una población hospitalaria en Colombia con el fin de predecir el comportamiento de estas variables y poder general herramientas de detección de mayor aplicabilidad que las que existen actualmente. MÉTODOS: Se realizó un estudio observacional analítico de tipo corte transversal con muestreo no probabilístico desde enero de 2016 a junio de 2017 en pacientes mayores de 65 años en seguimiento > 48 horas por el servicio de medicina interna. Se evaluó la presencia de fragilidad a través de los criterios de Linda Fried, medidos previo al egreso. RESULTADOS: Se incluyeron 155 pacientes, el 60,6% cumplió criterios de Fragilidad. Al realizar el análisis combinado de las variables que mostraron asociación con fragilidad se encontró que una circunferencia de la pantorrilla menor o igual a 31 cm, una velocidad de marcha menor o igual de 0,8 m/seg y ser mayor de 75 años tenían asociación de riesgo para tener fragilidad. También se evidenciaron que ser hombre y tener IMC > 27 kg/m2 , son factores protectores para tener fragilidad. CONCLUSIONES: La prevalencia de fragilidad en adultos mayores hospitalizados fue mayor de la reportada en estudios locales para población comunitaria. De acuerdo con el análisis multivariado, los criterios modificados de Fried incluyendo perímetro de pantorrilla, sin tener en cuenta dinamometría, tienen una capacidad predictiva del 92% para estimar fragilidad en pacientes hospitalizados.

Asociación entre los niveles de NO, NO2, SO2, O3, CH4 en el aire y las tasas de hospitalización del Hospital Adriana Cousiño de Quintero durante los años 2012 al 2018 / Association between levels of NO, NO2, SO2, O3, CH4 in the air and hospitalization rates at Hospital Adriana Cousiño de Quintero during the years 2012 to 2018

En el sector de Quintero, desde los últimos 50 años han existido diversos hitos relacionados con la contaminación medioambiental. Iniciando con la instauración de la termoeléctrica "Ventanas" en 1950, Chilectra en 1958. En el año 1993 el ministerio de Agricultura de Chile declaró a Puchuncaví y Quintero como una "zona saturada de contaminación" por dióxido de azufre (SO2) y material particulado (MP10). En el año 2011, 135 trabajadores del complejo Ventana fallecieron producto del cáncer. Durante el 2014 hubo un derrame de petróleo en la Bahía de Quintero, 2015 un informe del Instituto de Fomento Pesquero (IFOP) arrojó cifras de arsénico que superan 23 veces la norma establecida por el Código Sanitario de Alimentos. Frente a dicho escenario, se hace evidente la necesidad de comprender cómo es la situación de los pobladores de dichas comunas. La presente investigación busca asociar los niveles de contaminación de las comuna de Quintero y el número de hospitalizaciones durante los años 2012 hasta el 2018.

In Quintero, since the last 50 years there have been various milestones related to environmental pollution. Starting with the installation of the "Ventanas" thermoelectric plant in 1950, Chilectra in 1958. In 1993, the Chilean Ministry of Agriculture declared Puchuncaví and Quintero as a "zone saturated with contamination" by sulfur dioxide (SO2) and particulate matter (MP10). In 2011, 135 workers at the Ventana complex died of cancer. During 2014 an oil spill emerged in Quintero Bay, 2015 a report by the Institute for Fisheries Development (IFOP) showed arsenic figures that exceed 23 times the norm established by the Sanitary Food Code. Faced with this scenario, the need to understand what the situation of the residents of said communes is like is evident. The present investigation seeks to associate the levels of contamination of the commun of Quintero and the number of hospitalizations during the years 2012 to 2018.

Hemoglobina glicosilada y eventos cardiovasculares en pacientes diabéticos de un hospital universitario / Glycosylated hemoglobin and cardiovascular events in diabetic patients of a university hospital

Resumen Introducción: la prevalencia de comorbilidades cardiovasculares generadas por la diabetes mellitus, se desconoce a nivel global en Colombia y más a nivel local. Objetivo: determinar la prevalencia de los eventos cardiovasculares según los niveles de hemoglobina glicosilada (HbA1c), en el Hospital Universitario de Santander. Material y método: estudio observacional analítico retrospectivo tipo corte transversal con pacientes del servicio de medicina interna del Hospital Universitario de Santander en el año 2013. Resultados: la prevalencia de diabetes fue 31.2% (HbA1c>6.5%), de éstos, 52.2% fueron mujeres y la mayoría (70.45%) recibían tratamiento farmacológico. Aunque el infarto agudo de miocardio (10.9%) fue el evento más frecuente, la frecuencia de los diferentes eventos cardiovasculares como motivo de consulta no se relacionaron con algún nivel de HbA1c. Sin embargo, la HbA1c >9% en pacientes >65 años tuvo tendencia de riesgo de ACV, pero sin significancia estadística. Entre los pacientes con HbA1c >9%, 62.02% recibían <4 dosis/día de medicamentos (p=0.000), con una prevalencia alta de muerte intrahospitalaria (88%) siendo el OR de 2.08 (IC95%: 0.85-5.1; p=0.107). Se encontró en el análisis exploratorio, con algunas variables independientes relevantes cierto comportamiento predictivo de niveles de HbA1c no tan altos <9% (AROC 0.67) y otras, para muerte intrahospitalaria (AROC 0.7). Conclusiones: en la población analizada la prevalencia de los eventos cardiovasculares en la población con HbA1c >6.5% fue 31.06%, la categoría HbA1c >9% se relacionó con mayor muerte intrahospitalaria; la HbA1c <9% se relacionó con mayor dosis de tabletas para tratamiento. (Acta Med Colomb 2018; 43: 74-80).

Abstract Introduction: the prevalence of cardiovascular comorbidities generated by Diabetes Mellitus is unknown globally in Colombia and is further unknown locally. Objective: to determine the prevalence of cardiovascular events according to the levels of glycosylated hemoglobin (HbA1c), at the University Hospital of Santander. Material and Method: a cross-sectional, retrospective analytical observational study with patients from the internal medicine service of the University Hospital of Santander in 2013. Results: the prevalence of diabetes was 3l.2% (HbA1c>6.5%); of these 52.2% were women and the majority (70.45%) received pharmacological treatment. Although acute myocardial infarction (10.9%) was the most frequent event, the frequency of the different cardiovascular events as a reason for consultation was not related to any level of HbA1c. However, HbA1c> 9% in patients> 65 years had a risk of stroke, but without statistical significance. Among patients with HbA1c> 9%, 62.02% received <4 doses / day of medication (p = 0.000), with a high prevalence of in-hospital death (88%) with an OR of 2.08 (95% CI: 0.85-5.1; p = 0.107). It was found in the exploratory analysis with some relevant independent variables certain predictive behavior of HbA1c levels not so high <9% (AROC 0.67) and others, for in-hospital death (AROC 0.7). Conclusions: in the population analyzed, the prevalence of cardiovascular events in the population with HbA1c >6.5% was 3l.06%; the category HbA1c> 9% was associated with greater in-hospital death; HbA1c <9% was associated with a higher dose of tablets for treatment. (Acta Med Colomb 2018; 43: 74-80).

Reguladores de integridad endotelial como posibles predictores de la gravedad en casos de dengue / Regulators of endothelial integrity as severity predictors in dengue

Introducción. El dengue es una de las enfermedades trasmitidas por mosquitos de mayor impacto en el mundo. La evolución clínica de la enfermedad suele ser impredecible, por lo cual su adecuado manejo en las fases tempranas podría incidir en la mejoría del paciente. Objetivo. Evaluar los niveles séricos de algunos reguladores endoteliales (VEGF, sICAM-1, endoglina soluble, Ang-1 y Ang-2) como marcadores de predicción de la gravedad del dengue. Materiales y métodos. Se hizo un estudio de casos y controles anidado en una cohorte. En la fase temprana, los niveles de los reguladores endoteliales se midieron con ELISA. La relación entre las variables clínicas y los reguladores se analizó mediante regresión logística utilizando como variable de salida la gravedad del dengue. Con base en la relación entre las variables de interés y el resultado, se estableció un posible modelo predictor de la gravedad empleando la mejor área bajo la curva (ROC). Resultados. La mediana de la edad fue de 24 años. Los casos graves se asociaron con niveles séricos de Ang-2 a partir de un punto de corte mayor o igual a 1.490 pg/ml, ( Odds ratio, OR=3,1 p=0,015). Los niveles séricos de Ang-2, así como un área de 0,73 bajo la curva ROC, contribuyeron al modelo de predicción de la gravedad, conjuntamente con las variables de exantema, trastorno de conciencia y dolor abdominal, con OR de 3,2 (IC 95% 1,16-8,9; p=0,024). Conclusión. El regulador endotelial Ang-2 podría ser un predictor de la gravedad en el dengue.

Introduction: Dengue is currently among the mosquito-borne diseases of greatest global impact. The clinical course of the disease can be unpredictable, so proper handling in its early stages is critical to ensure optimal outcomes. Objective: To evaluate serum regulators of endothelial integrity (VEGF, sICAM-1, sEndoglina, Ang-1, and Ang-2) as predictive markers of dengue severity. Materials and methods: We conducted a case-control study nested in an appropriate cohort. Endothelial regulator levels were first measured by ELISA, after which analysis was performed using logistic regression of clinical and regulatory variables, with severity as an output variable. A possible severity prediction model, based on the variables of interest and output, was defined using the best area under the ROC curve. Results: The median subject age was 24 years. Severe cases were associated with Ang-2 serum levels of =1,490 ng/ml (OR=3.1; p=0.015). Serum levels of Ang-2 (=1,490 ng/ml) contributed to the severity prediction model, as did a 0.73 area under the ROC curve, together with the variables rash, impaired consciousness and abdominal pain, with an OR of 3.2 (CI 95%: 1.16 to 8.9; p=0.024). Conclusion: The endothelial regulator Ang-2 could be a predictor of severity in dengue.

Prevalencia de infecciones oportunistas en pacientes con VIH-SIDA con base en el estudio microscópico de médula ósea / Prevalence of opportunistic infections in HIV-AIDS patients based on microscopic examination of bone marrow

Introducción: la utilidad diagnóstica del estudio de médula ósea en pacientes con VIH ha sido evaluada en pocos estudios en Latinoamérica. Se desconoce la frecuencia con la que este estudio aporta a la identificación de infecciones oportunistas en nuestro medio. Diseño: estudio analítico de corte transversal. Métodos: revisión retrospectiva de historias clínicas de pacientes VIH-SIDA, hospitalizados en el Hospital Universitario de Santander entre 2009 y 2012, quienes fueron sometidos a estudio de médula ósea para evaluar citopenias. Se excluyeron casos con historia de neoplasia y quimioterapia tres meses antes del aspirado. Se calculó tamaño de muestra para evaluación de asociaciones. Resultados: se evaluaron 92 muestras de médula ósea de 83 pacientes, encontrando una prevalencia de infección oportunista de 23% con examen directo y 34.5% cuando se realizaron cultivos. La histoplasmosis fue la infección más frecuente 20.6%, seguida de Mycobacterias 10.8%e infección por Criptococcus spp 3.2%. La clínica hematológica que predominó en casos positivos para oportunista fue pancitopenia febril en 41% y monocitopenia en 32%. La deshidrogenasa láctica ≥ 600 UI/dL, se asoció con un diagnóstico positivo para infección oportunista en el estudio microscópico de médula ósea, con OR 5.42 (IC95% 1.09-26.9 p =0.03). Conclusión: el estudio de médula ósea en los pacientes con VIH-SIDA permitió un diagnóstico de infección oportunista en una cuarta parte de los casos, siendo especialmente útil para la identificación temprana de histoplasmosis. Se requieren estudios para evaluar el impacto en estancia hospitalaria, desenlaces clínicos y costos del uso de este examen de forma temprana en el abordaje de pacientes VIH hospitalizados en medicina interna. (Acta Med Colomb 2015; 40: 93-100).

Introduction: the diagnostic utility of the study of bone marrow in patients with HIV has been evaluated in a few studies in Latin America. The frequency with which this study contributes to the identification of opportunists in our country is unknown. Design: Analytical cross-sectional study. Methods: a retrospective review of medical records of HIV-AIDS patients hospitalized at the University Hospital of Santander between 2009 and 2012 who underwent bone marrow study to evaluate cytopenia. Cases with a history of malignancy and chemotherapy three months before vacuuming were excluded. Sample size for evaluation of partnerships was calculated. Results: 92 samples of bone marrow of 83 patients were evaluated, finding a prevalence of opportunistic infection in 23% with direct examination and 34.5% when cultures were performed. Histoplasmosis was the most common infection with 20.6%, followed by 10.8% Mycobacteria and Cryptococcus spp infection 3.2%. The hematologic clinic that prevailed in the positive cases for opportunist was pancitopenia febril (in 41% of the cases) and monocitopenia (in 32% of the cases). The LDH ≥ 600 IU / dL was associated with a positive diagnosis for opportunistic infection in the microscopic study of bone marrow, with OR 5.42 (95% CI 1.09-26.9 p = 0.03). Conclusion: the study of bone marrow in patients with HIV-AIDS allowed a diagnosis of opportunistic infection in a quarter of cases, and is especially useful for early identification of histoplasmosis. Studies to assess the impact on hospital stay, clinical outcomes and costs of using this test early in the approach to HIV patients hospitalized in Internal Medicine are required. (Acta Med Colomb 2015; 40: 93-100).

Factores asociados con no control metabólico en diabéticos pertenecientes a un programa de riesgo cardiovascular / Factors associated with no metabolic control in diabetics belonging to a program of cardiovascular risk

Antecedentes: se desconoce la prevalencia de la falla en el control metabólico en pacientes diabéticos, así como los factores de riesgo asociados a ello en la ciudad de Bucaramanga. Material y métodos: se realizó un estudio analítico de corte transversal, que midió la prevalencia del no control metabólico en los pacientes diabéticos tipo 2, del programa de promoción y prevención de riesgo cardiovascular en una empresa promotora de salud de Bucaramanga; el no control metabólico se midió a través de la hemoglobina glicosilada (mayor de 7.0%). se estimaron los efectos de las variables evaluadas (personales, clínicas y de percepción de la atención) por medio de razones de prevalencia (RP) y un modelo multivariable. Resultados: se incluyeron 484 pacientes, de los cuales 407 tuvieron registro de Hba1c durante los tres meses previos al estudio. la prevalencia del no control metabólico fue de 65%. las variables asociadas con este desenlace con p < de 0.05, fueron: antecedente de dislipidemia: RP 1,14 (IC 1.00-1.32), no adherencia a los fármacos: RP 1.6 (IC 1.01-1.34), tener entre 50 y 65 años: RP 1,16 (IC 1.01-1.34), consumir más de seis tabletas de medicamentos al día: RP 1.22 (IC 1.06-1.41), estar desempleado: RP 1.38 (IC 1.09-1.76), asistir acompañado a veces a la consulta: RP 1.29 (IC 1.08-1.53), uso de fármacos para gastritis: RP 1.24 (IC 95% 1.07-1.42), diabetes de más de 10 años de duración: RP 1.35 (IC 95% 1.08-1.42), más de dos tabletas de hipoglicemiantes al día: RP 1.29 (IC 1.12-1.48), y uso de insulina: RP 1.29 (IC 95% 1.12-1.47). Las variables o factores que se incluyeron en el modelo multivariable final fueron: uso inadecuado de fármacos, uso fármacos para la gastritis, uso de insulina, diabetes de más de diez años de duración y no cumplimiento de la dieta. Conclusiones: se encontró una alta proporción de pacientes diabéticos con falta de control metabólico, asociado a factores relacionados con la enfermedad como duración de la diabetes, fármacos, dieta e insulina. Otros factores de carácter personal fueron: bajo apoyo familiar, falta de soporte económico y estar desempleado. (Acta Med Colomb 2013; 38: 213-221).

Background: the prevalence of failure in the metabolic control in diabetic patients and the risk factors associated with it in the city of Bucaramanga are not known. Material and Methods: cross- sectional analytical study which measured the prevalence of no metabolic control in type 2 diabetic patients, from the promotion and prevention of cardiovascular risk program in a Health Promoting Company in Bucaramanga. The no metabolic control was measured by glycosylated hemoglobin (greater than 7.0 %). the effects of the assessed variables (personal, clinical and perception of care) were estimated through prevalence ratios (PR) and a multivariate model. Results: 484 patients were included, of whom 407 had Hba1c record during the 3 months preceding the survey. the prevalence of no metabolic control was 65%. the variables associated with this outcome with p < 0.05 were: history of dyslipidemia: Pr 1.14 (Ci 1.00-1.32), non-adherence to medication: Pr 1.6 (Ci 1.01-1.34), having between 50 and 65 years: RP 1.16 (Ci 1.01-1.34), consuming more than six medication tablets daily : RP 1.22 (Ci 1.06-1.41), being unemployed: PR 1.38 (CI 1.09-1.76), assist sometimes accompanied to the medical consultation: PR 1.29 (CI 1.08-1.53), use of drugs for gastritis: Pr 1.24 (95% CI 1.07-1.42), more than 10 years' duration of diabetes: PR 1.35 (95% 1.08-1.42), more than two tablets daily of hypoglycemic drugs: PR 1.29 (CI 1.12-1.48), and use of insulin: PR 1.29 (95% CI 1.12-1.47). The variables or factors that were included in the final multivariate model were: inappropriate use of drugs, use of drugs for gastritis, insulin use, duration of diabetes for more than ten years and non-dietary compliance. Conclusions: we found a high proportion of diabetic patients with poor metabolic control associated with disease-related factors such as duration of diabetes, drugs, diet and insulin. Other personal factors were: low family support, lack of financial support and being unemployed. (Acta Med Colomb 2013; 38: 213-221).

The scaffold protein POSH regulates axon outgrowth.

How scaffold proteins integrate signaling pathways with cytoskeletal components to drive axon outgrowth is not well understood. We report here that the multidomain scaffold protein Plenty of SH3s (POSH) regulates axon outgrowth. Reduction of POSH function by RNA interference (RNAi) enhances axon outgrowth in differentiating mouse primary cortical neurons and in neurons derived from mouse P19 cells, suggesting POSH negatively regulates axon outgrowth. Complementation analysis reveals a requirement for the third Src homology (SH) 3 domain of POSH, and we find that the actomyosin regulatory protein Shroom3 interacts with this domain of POSH. Inhibition of Shroom3 expression by RNAi leads to increased process lengths, as observed for POSH RNAi, suggesting that POSH and Shroom function together to inhibit process outgrowth. Complementation analysis and interference of protein function by dominant-negative approaches suggest that Shroom3 recruits Rho kinase to inhibit process outgrowth. Furthermore, inhibition of myosin II function reverses the POSH or Shroom3 RNAi phenotype, indicating a role for myosin II regulation as a target of the POSH-Shroom complex. Collectively, these results suggest that the molecular scaffold protein POSH assembles an inhibitory complex that links to the actin-myosin network to regulate neuronal process outgrowth.

Programa piloto para pacientes beneficiarios de Fonasa, que padecen esclerosis multiple: tratamiento con inmunomoduladores en el sistema público de salud de Chile: Informe del primer año, 10 de julio 2008-30 de Junio 2009 / Pilot national treatment program for multiple sclerosis patients belonging to the public health care system of Chile (FONASA) with immunomodulating disease-modifying therapies: first year report from July 2008 to June 2009

Multiple Sclerosis (MS) is a chronic disease of the central nervous system. It is manifested in the young adult who presents at the beginning alternation between transient neurological dysfunction and normality, followed by a progressive level of disability. MS affects the quality of life in the young adults in their full productive and creative age limiting not only in their personal lives but also affects to the whole society in terms of "dreams and life projects". Besides, this illness also influences the family group who has to assume progressively the help and care for the patient. In healthcare aspect MS implies intensive and progressive resources. In Chile, although we don't have epidemiological studies that indicate which is the MS prevalence it exist a projection that states 14 per 100.000 inhabitants. Considering a population of 16.5 million of inhabitants our expectative of patients with MS is of 2310 cases in our country. The MS immunomodulating injectable disease-modifying therapies are of high cost and were not available in a regular way in the state health care system of Chile (FONASA) that attends the 70 percent of the population; the other 30 percent has different private health insurances. In 2008 the ministry of health decided to initiate and pilot (exploratory) program which had a great meaning and impact concerning to start offering immunomodulating therapies to relapsing remitting MS, for patients belonging to FONASA system. The pilot program was thought with a double mission, on the one hand to achieve that a very limited group of MS patients belonging to FONASA system (80 cases) from all over the country had access to immunomodulating injectable disease-modifying therapies of high cost in a regular way. The second objective was to obtain clinical and epidemiological information which let us to evaluate the clinical and administrative obstacles generated by the incorporation of this treatment in the public health...

Introducción El presente documento corresponde al informe del primer año de trabajo operativo del "Programa piloto de tratamiento con inmunomoduladores, para pacientes beneficiarios de Fonasa1, que padecen esclerosis múltiple (EM)", elaborado por el equipo del centro de referencia nacional, para este programa, con sede en el Servicio de Neurología del Complejo Asistencial Barros Luco (CABL) del SSMS2. Dado su origen no incluye antecedentes del proceso de gestión ni toma de decisiones del nivel Minsal3 o Fonasa. Este trabajo, no es ni aspira ser: un ensayo clínico, una guía de práctica clínica, una revisión bibliográfica, ni una puesta al día sobre el tratamiento de la Esclerosis Múltiple (EM), es simplemente el informe anual de un centro de referencia, para una tarea específica, a la autoridad ministerial competente. El informe incluye algunos antecedentes generales y referencias presentadas como "notas al pie", sólo para contextualizar la información presentada4. La EM es una enfermedad crónica del SNC, de origen incierto, inmunológicamente mediada, bien definida en sus características inmunopatogénicas, patológicas, imagenológicas y clínicas. Se expresa en el adulto joven, quien presenta inicialmente alternancia entre disfunción neurológica transitoria y normalidad y cuya progresión determina múltiples efectos discapacitantes. La EM afecta la calidad de vida de adultos jóvenes en plena edad productiva y creativa limitando tanto los "sueños y proyectos de vida" como el desarrollo laboral, social y afectivo. Además trasciende al grupo familiar, cuando deben asumir la asistencia del paciente. En lo sanitario, la EM, genera uso intensivo y progresivo de recursos. Las terapias inmunomoduladores para la EM, que tienen la posibilidad de detener o reducir la evolución de la modalidad recurrente remitente de la EM, no se encontraban disponibles en forma regular en el sector público de salud de nuestro país, por esto el presente programa piloto...

Akt2 negatively regulates assembly of the POSH-MLK-JNK signaling complex.

We demonstrate that POSH, a scaffold for the JNK signaling pathway, binds to Akt2. A POSH mutant that is unable to bind Akt2 (POSH W489A) exhibits enhanced-binding to MLK3, and this increase in binding is accompanied by increased activation of the JNK signaling pathway. In addition, we show that the association of MLK3 with POSH is increased upon inhibition of the endogenous phosphatidylinositol 3-kinase/Akt signaling pathway. Thus, the assembly of an active JNK signaling complex by POSH is negatively regulated by Akt2. Further, the level of Akt-phosphorylated MLK3 is reduced in cells expressing the Akt2 binding domain of POSH, which acts as a dominant interfering protein. Taken together, our results support a model in which Akt2 binds to a POSH-MLK-MKK-JNK complex and phosphorylates MLK3; phosphorylation of MLK3 by Akt2 results in the disassembly of the JNK complex bound to POSH and down-regulation of the JNK signaling pathway.

Enfermedad celíaca: conocimientos actuales: [revisión] / Celiac disease: current knowledge

La enfermedad celíaca es una condición genética y autoinmune causada por la intolerancia de por vida al gluten; una proteina que se encuentra en el trigo, centeno y cebada. en indivíduos genéticamente susceptibles, la ingesta de gluten causa una reacción inmunológica que resulta en la inflamación y atrofia de la mucosa del intestino delgado. anteriormente se creía que la enfermedad celíaca era una enfermedad rara de la niñez. Actualmente se reconoce como una condición común que se puede presentar a cualquier edad. Estudios de prevalencia recientes demuestran que la enfermedad celíaca ocurre aproximadamente en 1 de 300 individuos. aunque es más común en caucásicos, en especial en personas con descendencia europea, la enfermedad celíaca puede afectar a todos los grupos étnicos. A pesar de la alta prevalencia de la enferemedad...

El Psicoballet; definición: sistema dinámico integral / The Psichoballet; definition: an integral dynamic system

Se establece una difinición dialéctica del psicoballet como un sistema dinámico integral que engrana dos subsistemas en una armónica interrelación. Dentro del sistema integral psicoballet, cada elemento que él agrupa ejerce una determinada influencia dentro del sistema como un todo. Los efectos que cada uno de estos elementos, en íntima y armónica relación, produce sobre los pacientes son óptimos, mucho mayores que los resultados que cada elemento produciría en ellos aisladamente. Por tanto, las características que el psicoballet posee como sistema dinámico integral nos permite lograr en nuestros pacientes resultados muy exitosos que se darán a conocer en trabajos posteriores(AU)

Oncogénesis y antioncogénesis: Un modelo de biología molecular aplicado a la genética del cáncer

La biología molecular ha entregado las primeras bases teóricas concretas para el estudio de la genética del cáncer. Dos tipos de genes han sido implicados: oncogenes y antioncogenes. Ambas clases de genes han sido identificadas en el genoma celular normal, siendo los primeros promotores de tumores cuando son actividados y los segundos participantes en el desarrollo de neoplasias cuando no están presentes p se inactivan. Los mecanismos implicados en la activación e inactivación de los oncogenes y antioncogenes respectivamente, junto el análisis de los productos alterados de expresión de estos genes y una descripción general de las posibles implicaciones terapéuticas son reseñados en la siguiente revisión

Comunicación y psicoballet / Psycoballet and communication

Se dan a conocer los distintos niveles de comunicación que se establecen en el psicoballet, dentro del sistema dinámico integral que éste constituye. Estos niveles de comunicación están estructurados de acuerdo con su grado de complejidad y su importancia dentro del sistema, y es lo que permite llevar a cabo la psicoterapia a través de la cual se logra en el pacienye la adecuación de sus relaciones afectivas e interpersonales, la liberación de sus tensiones emocionales y el aprendizaje de lo preliminar de la técnica de ballet(AU)