[Update on neuroendocrine tumors]. / Tumores Neuroendocrinos: un desafío transversal.

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.

Incorporating genomic medicine into primary-level health care for chronic non-communicable diseases in Mexico: A qualitative study.

OBJECTIVE: To analyze the viability of incorporating genomic medicine technology into the process of detecting and diagnosing chronic non-communicable diseases (CNCDs) at primary-care facilities in Mexico, and to discuss its implications for health systems in other countries with similar characteristics. MATERIAL AND METHODS: We conducted 29 semi-structured interviews with health authorities as well as providers and users of health services in the state of Morelos. We investigated knowledge of genomic technology among interviewees; the accessibility, management, and organization of health services; and CNCDs prevention, control, and care practices. RESULTS: The incorporation of genomic medicine technology into the CNCDs primary-care process is viable. However, the following challenges were identified: a lack of knowledge and limited information among interviewees regarding the effectiveness and benefits of genomic medicine technology, coupled with the need to mobilize and reassign trained human resources for drawing, registering, safeguarding, transporting, and controlling the quality of the genetic samples, as well as for the outsourcing of private laboratory services. CONCLUSION: Using genetic information to detect CNCDs at an early stage offers an enormous potential for upgrading CNCDs prevention and control efforts. This, in turn, could translate into more efficient and financially sustainable health systems in Mexico and other low- and middle-income countries.

Patient inflammatory status and CD4+/CD8+ intraepithelial tumor lymphocyte infiltration are predictors of outcomes in high-grade serous ovarian cancer.

BACKGROUND: High-grade serous ovarian cancer (HGSOC) is the most prevalent and aggressive histologic type of ovarian cancer. To date, there are no reliable biomarkers to effectively predict patient prognosis. Studies have demonstrated inflammation and tumor infiltrating lymphocytes (TILs) correlate with a bad and good prognosis, respectively. Here, we sought to evaluate systemic inflammation and TILs as early prognostic markers of survival. METHODS: Neutrophil-to-lymphocyte ratio (NLR) and serum Lactate Dehydrogenase (LDH) were used as indicators of systemic inflammation. NLR, serum LDH, tumor infiltrating lymphocytes (TILs), PDL1 and quality of debulking surgery were evaluated as determinants of progression-free survival (PFS) and overall survival (OS) in a cohort of 128 HGSOC patients. RESULTS: Initial univariate analysis showed that systemic inflammation measures (NLR and serum LDH), debulking surgery, and intra-epithelial TILs have a significant impact on both PFS and OS. After adjustment for several variables, multivariate analyses confirmed intraepithelial CD4+ T-cells, systemic inflammation measures, PDL1 and debulking surgery as determinants of better OS and PFS. CONCLUSIONS: Systemic inflammation and TILs are early determinants of OS in HGSOC. Other variables such as the quality of debulking surgery and PDL1 also improve survival of patients. Regarding TIL sub-populations, intraepithelial CD4+ cells are associated to an increase in both PFS and OS. We also confirmed previous reports that demonstrate intraepithelial CD8+ cells correlate with an increase on PFS in ovarian cancer. A combined score using systemic inflammation and TILs may be of prognostic value for HGSOC patients.

Genetic admixture estimates by Alu elements in Afro-Colombian and Mestizo populations from Antioquia, Colombia.

AIM: This work was intended to gain insights into the admixture processes occurring in Latin American populations by examining the genetic profiles of two ethnic groups from Antioquia (Colombia). SUBJECTS AND METHODS: To analyse the genetic variability, eight Alu insertions were typed in 64 Afro-Colombians and a reference group of 34 Hispanics (Mestizos). Admixture proportions were estimated using the Weighted Least Squares and the Gene Identity methods. The usefulness of the Alu elements as Ancestry Informative Markers (AIMs) was evaluated through differences in weighted allelic frequencies (delta values) and by hierarchical analysis of the molecular variance (AMOVA). RESULTS: The Afro-Colombian gene pool was largely determined by the African component (88.5-88.8%), but the most prominent feature was the null contribution of European genes. Mestizos were characterized by a major European component (60.0-63.8%) and a comparatively low proportion of Amerindian (19.2-20.7%) and African (17.0-19.3%) genes. Five of the Alu loci examined (ACE, APO, FXIIIB, PV92 and TPA25) showed an adequate resolving power to differentiate between continental groups, as indicated by delta values and AMOVA results. CONCLUSIONS: The peculiarity of the Afro-Colombian gene pool seems to be associated with intense genetic drift episodes that occurred in isolated communities founded by small groups of runaway slaves. ACE, APO, FXIIIB, PV92 and TPA25 could be efficiently utilized in studies dealing with demographic history and biogeographical ancestry in human populations.

Tumores Neuroendocrinos: un desafío transversal / Update on neuroendocrine tumors

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.

Paclitaxel-PHBV nanoparticles and their toxicity to endometrial and primary ovarian cancer cells.

This report is an integrated study to include the molecular simulation, physicochemical characterization and biological analysis of a paclitaxel-loaded PHBV nanoparticle that demonstrates uptake, release and cytotoxicity in cancer cell lines. Taking this nanoparticle one step closer to its use in a clinical setting, we demonstrate that it causes significant cell death in primary cultures of stage IIIc serous ovarian cancer cells isolated from six patients. Molecular simulations revealed a high affinity of paclitaxel for the water-polymer interface, thus the drug is delivered only when the polymer near it is degraded. The Fourier transform infrared spectroscopy suggests the formation of a short-lived crystalline phase, also observed in the CG simulations, and transmission electron microscopy revealed branched structures on the surface of particles, which disappeared after 4 days. Biological analyses indicated that these particles have a 48-h window of toxicity protection, allowing for the endocytosis of the particle by the cells; this finding was corroborated by confocal microscopy and flow cytometry. The low cost to synthesize PHBV using microorganisms and the potential chemical modifications of the polymer make it attractive for inexpensive, large-scale pharmaceutical production.

Perfil lipídico en neonatos / Lipid profile in neonates

Se evalúa el perfillipídico de 101 neonatos de ambos sexos, de la Sección de Clasificados Económicos del Hospital Universitario San Vicente de Paúl, de Medellín, y se comparan los resultados con los valores encontrados en otras poblaciones. Las determinaciones se realizaron en sangre del cordón umbilical. El valor promedio del colesterol total (CT) en varones fue de 71.4 mg/dl y en mujeres de 77 .1 mg/dl y el de los triglicéridos (TG) 43.4 mg/dl y de 39.0 mg/dl respectivamente; no hubo en estas determinaciones diferencias significativas entre los sexos. El colesterol de alta densidad (c-HDL) fue de 26.7 mg/dl para varones y de 31.0 mg/dl para las mujeres (p = 0.0037) y el promedio de la relación CT/c-HDL fue de 2.9 y de 2.6, significativamente menor en las mujeres (p = 0.027). Las concentraciones de CT y TG apenas alcanzan un 50 porciento de los valores establecidos para la edad escolar y son similares a las encontradas en neonatos de poblaciones caucasoides norteamericanas y europeas occidentales y orientales pero ligeramente mayores que las de los negroides norteamericanos. Los resultados de este estudio pueden constituir un marco de referencia de los lípidos séricos para neonatos de estrato socioeconómico bajo y medio bajo en la población antioqueña

Serum lipid profile was evaluated in cord blood from 101 neonates (41 males and 60 females) from low income families, attending Hospital San Vicente de Paúl. in Medellín, Colombia; comparisons were made with results from other populations. Mean values for serum total cholesterol (TC) were 71.4 and 77.1 mg/dl in males and females respectively, and those for triglycerides were 43.4 and 39.0 mg/dl; these differences were not significant; in contrast. mean HDl-cholesterol (HDl-C) levels were significantly different: 26.7 in males vs 31.0 mg/dl in females (p = 0.0037). Females had a lower TC/HDl-C ratio than males (2.6 vs 2.9, p = 0.027). Serum concentrations of lipids in our sample reached only 50% of school-age children levels and were similar to those reported from neonates of caucasian North American and European populations. both western and eastern. But somewhat different from those of North American black children. Results of this study might become reference levels of serum lipids from low income neonates in this colombian region.

Efecto del germinado de maíz sobre el perfil lipídico, la hemoglobina y la uricemia / Effect of clorophilic juice from germinateo corn on seric lipids, hemoglobin, ano uric acid

Se investigó el efecto del jugo clorofílico de germinado de maíz, con una dosis de 30 ml diarios durante dos meses, sobre el perfil lipídico, la glicemia, la uricemia, la hemoglobina y el hematocrito, en nueve adultos con edad promedio de 44 años y que presentaban hipertrigliceridemia como trastorno principal. Las concentraciones promedio iniciales en mgl dl que eran de 6.9 (ácido úrico), 259 (triglicéridos) y 199 (colesterol total) descendieron en forma progresiva y significativa a los 30, 45 y 60 días de tratamiento hasta valores respectivos de 5.0, 171 y 169 (p = 0.010,0.015 y 0.034 respectivamente). La hemoglobina ascendió de manera progresiva y significativa (p = 0.008) durante el experimento. Este tratamiento natural podría ser útil en la regulación de los lípidos sanguíneos y otros factores biológicos de riesgo para el desarrollo de ateromatosis coronaría, sin los efectos tóxicos que se han demostrado con algunas drogas hipolipemiantes.

The effect was studied of clorophilic juice from germinated corn on blood seric lipids, uric acid, glucose, hemoglobine and hematocrite. Nine adults with average age 44 years and who presented hypertriglyceridemia received daily 30 ml doses of the juice during 2 months. Initial average concentrations in mg/dl were 6.9 (uric acid), 259 (triglycerides) and 199 (total cholesterol); they decreased progressively and significantly at 30, 45 and 60 days of treatment reaching values of 5.0, 171 and 169 respectively (p:0.01 0,0.015 and 0.034). Hemoglobin increased significantly (p:0.008). This natural treatment could be useful in regulating blood lipids and other biologic risk factors for coronary arteriosclerosis, without the toxic efects shown by some lipid control drugs.

Estudios moleculares en pacientes colombianos con Fibrosis quística

La fibrosis quística (FQ), la enfermedad autosómica recesiva más frecuente en poblaciones caucásicas, tiene una incidencia promedio de 1/2.500 recién nacidos