RESUMEN
Background Fat mass and obesity-associated (FTO) protein is an mRNA demethylase enzyme essential for active genome regulation. The FTO gene codes for a protein that is part of the methylosome complex and has a regulatory role in cancer development. Some studies have shown a relationship between FTO and cancer, where single nucleotide polymorphisms (SNPs) may have some impact on cancer risk. The present study aimed to evaluate the risk of FTO polymorphisms rs9939609, rs1477196, and rs9930506; analyze the methylation status of FTO promoters among Mexican women with breast cancer (BC); and investigate by in silico analysis the methylation status in the region near these polymorphisms. Methods A total of 157 BC patients and 137 healthy controls were genotyped for rs9939609, rs1477196, and rs9930506 FTO polymorphisms by TaqMan SNP Genotyping Assays. Promoter methylation was analyzed by sodium bisulfite and methylation-specific polymerase chain reaction (MSP) for 78 tissue samples. An in silico analysis using The Cancer Genome Atlas Program (TCGA) database was employed to investigate the methylation state in promoter and near polymorphism locations and its relation to survival. Results The AG genotype of FTO rs9930506 was associated with BC protection (P= 0.0025; adjusted OR, 0.27; 95% CI: 0.10-0.70). rs9939609 and rs1477196, according to the results of the present study, had no relation to BC. Promoter methylation status assays by MSP revealed no changes in methylation in BC or healthy tissues. Trying to know more about the methylation in promoters and near polymorphisms' relation to survival, we performed an in silico analysis. Bioinformatics analysis showed a correlation between poor survival and methylation near polymorphisms but not with methylation in the promoter region. Conclusions The AG genotype rs9930506 has a protective function against BC. Whereas high methylation near polymorphisms was related to lower survival, the hypomethylated promoter region does not impact survival.
RESUMEN
INTRODUCTION AND OBJECTIVE: The implementation of Enhanced Recover After Surgery (ERAS) multimodal rehabilitation protocols in radical cystectomy has shown to improve outcomes in hospital stay and complications. The aim of this analysis is to evaluate the impact of laparoscopic surgery on radical cystectomy within a multimodal rehabilitation program. MATERIAL AND METHODS: The study was carried out in a third level center between 2011 and 2020 including patients with bladder cancer submitted to radical cystectomy according to an ERAS (Enhanced Recovery After Surgery) protocol and the Spanish Multimodal Rehabilitation Group (GERM) with 20 items to be fulfilled. RESULTS: A total of 250 radical cystectomies were performed throughout the study period, 42.8% by open surgery (OS) and 57.2% by laparoscopic surgery (LS). The groups are comparable in demographic and clinical variables (pâ¯>â¯0.05). Operative time was longer in the LS group (248.4⯱â¯55.0 vs. 286.2⯱â¯51.9â¯min; pâ¯<â¯0.001). However, bleeding was significantly lower in the LS group (417.5⯱â¯365.7 vs. 877.9⯱â¯529.7 cc; pâ¯<â¯0.001), as was the need for blood transfusion (33.6% vs. 58.9%; pâ¯<â¯0.001). Postoperative length of stay (11.5⯱â¯10.5 vs. 20.1⯱â¯17.2 days; pâ¯<â¯0.001), total and major complications were also significantly lower in this group (LS). The readmission rate was lower in the LS group but not significantly (36.4% vs. 29.4%; pâ¯=â¯0.237). The difference between 90-day mortality in both groups was not statistically significant (2.8% LS vs. 4.3% OS; pâ¯=â¯0.546). The differences were maintained in the multivariate models. CONCLUSIONS: Laparoscopic surgery within a multimodal rehabilitation program increases operative time but significantly decreases intraoperative bleeding, transfusion requirements, postoperative length of stay, and complications.
Asunto(s)
Cistectomía , Laparoscopía , Neoplasias de la Vejiga Urinaria , Humanos , Cistectomía/rehabilitación , Cistectomía/métodos , Masculino , Laparoscopía/rehabilitación , Femenino , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/rehabilitación , Anciano , Resultado del Tratamiento , Persona de Mediana Edad , Recuperación Mejorada Después de la Cirugía , Estudios Retrospectivos , Complicaciones Posoperatorias/epidemiología , Protocolos Clínicos , Tiempo de Internación/estadística & datos numéricos , Terapia CombinadaRESUMEN
Introducción y objetivos: La cistectomía radical con derivación urinaria asociada a linfadenectomía pélvica ampliada continúa siendo el tratamiento de elección en el cáncer vesical musculoinvasivo. Un 64% de los pacientes presentan complicaciones postoperatorias, siendo la infección urinaria responsable en un 20-40% de los casos. El objetivo del presente proyecto es valorar la tasa de infección urinaria como causa de reingreso tras cistectomía, e identificar factores protectores y predisponentes de infección urinaria en nuestro medio. Por último, conocer los resultados obtenidos al aplicar el protocolo de profilaxis antibiótica tras la retirada de los catéteres ureterales.Material y métodosEstudio descriptivo retrospectivo de pacientes cistectomizados en el Servicio de Urología del Hospital Clínico Universitario desde enero de 2012 hasta diciembre de 2018. Desde octubre de 2017, de forma estandarizada, a todo paciente se le aplica un protocolo de prevención de infección del tracto urinario (ITU) tras la retirada de catéteres.ResultadosLa ITU es responsable del 54,7% de los reingresos, siendo un 55,1% de estos por causa de una ITU tras la retirada de los catéteres ureterales. El 9,5% de los pacientes con profilaxis presenta ITU tras la retirada, frente a un 10,6% en el grupo de pacientes sin profilaxis. El paciente que reingresa por ITU tras la retirada tiene un tiempo de catéteres medio de 24,3±7,2 días, frente a los 24,5±7,4 días en el grupo sin ITU (p=0,847).ConclusionesEl tipo de derivación urinaria empleada no guarda relación con la tasa de infección urinaria. El modelo de regresión no identifica la profilaxis antibiótica, ni tampoco el tiempo de catéteres, como factores independientes de ITU tras la retirada de los catéteres. (AU)
Introduction and objectives: Radical cystectomy with urinary diversion associated with extended pelvic lymphadenectomy continues to be the treatment of choice in muscle invasive bladder cancer. Sixty-four percent of patients submitted to this procedure present postoperative complications, with urinary infection being responsible in 20-40% of cases. The aim of this project is to assess the rate of urinary infection as a cause of re-admission after cystectomy, and to identify protective and predisposing factors for urinary infection in our environment. Finally, we will evaluate the outcomes after the establishment of a prophylactic antibiotic protocol after removal of ureteral catheters.Material and methodsRetrospective descriptive study of cystectomized patients in the Urology Service of the Hospital Clínico Universitario of Zaragoza, from January 2012 to December 2018. A urinary tract infection (UTI) prevention protocol after catheter removal is established for all patients since October 2017.ResultsUTI is responsible for 54.7% of readmissions, with 55.1% of these being due to UTI after removal of ureteral catheters. Of the patients who received with prophylaxis, 9.5% presented UTIs after withdrawal, compared to 10.6% in the group of patients without prophylaxis. The patient who is re-admitted for UTI after withdrawal has a mean catheter time of 24.3±7.2 days, compared to 24.5±7.4 days for patients in the group without UTI (P=.847).ConclusionsThe type of urinary diversion performed is not related to the rate of urinary infection. The regression model does not identify antibiotic prophylaxis, nor catheter time, as independent factors of UTI after catheter removal. (AU)
Asunto(s)
Humanos , Profilaxis Antibiótica , Cistectomía/efectos adversos , Derivación Urinaria/efectos adversos , Infecciones Urinarias/epidemiología , Estudios RetrospectivosRESUMEN
INTRODUCTION AND OBJECTIVES: Radical cystectomy with urinary diversion associated with extended pelvic lymphadenectomy continues to be the treatment of choice in muscle invasive bladder cancer. Sixty-four percent of patients submitted to this procedure present postoperative complications, with urinary infection being responsible in 20-40% of cases. The aim of this project is to assess the rate of urinary infection as a cause of re-admission after cystectomy, and to identify protective and predisposing factors for urinary infection in our environment. Finally, we will evaluate the outcomes after the establishment of a prophylactic antibiotic protocol after removal of ureteral catheters. MATERIAL AND METHODS: Retrospective descriptive study of cystectomized patients in the Urology Service of the Hospital Clínico Universitario of Zaragoza, from January 2012 to December 2018. A urinary tract infection (UTI) prevention protocol after catheter removal is established for all patients since October 2017. RESULTS: UTI is responsible for 54.7% of readmissions, with 55.1% of these being due to UTI after removal of ureteral catheters. Of the patients who received with prophylaxis, 9.5% presented UTIs after withdrawal, compared to 10.6% in the group of patients without prophylaxis. The patient who is re-admitted for UTI after withdrawal has a mean catheter time of 24.3±7.2 days, compared to 24.5±7.4 days for patients in the group without UTI (P=.847). CONCLUSIONS: The type of urinary diversion performed is not related to the rate of urinary infection. The regression model does not identify antibiotic prophylaxis, nor catheter time, as independent factors of UTI after catheter removal.
Asunto(s)
Derivación Urinaria , Infecciones Urinarias , Profilaxis Antibiótica , Cistectomía/efectos adversos , Humanos , Estudios Retrospectivos , Derivación Urinaria/efectos adversos , Infecciones Urinarias/epidemiologíaAsunto(s)
Aborto Inducido/psicología , Violación/psicología , Delitos Sexuales/psicología , Adolescente , Niño , Femenino , Humanos , EmbarazoRESUMEN
We present the case of a suprahepatic tumor related to mature cystic teratoma, extragonadal germ cell tumors are rare and represent from 1.6 to 5% of all germ cell tumors, the most common site and the extragonadal presentation is the mediastinum (50-70%), retroperitoneum (30-40%), other rare locations pineal gland, sacrococcal region, prostate and bladder; however, the supra-hepatic location is not so common and is not documented in the literature.
El tumor suprahepático se relaciona con el teratoma quístico maduro. Los tumores de células germinales extragonadales son raros y representan del 1,6 al 5% de todos los tumores de células germinales. El sitio más común y la presentación extragonadal es el mediastino (50-70%), seguido del retroperitoneo (30-40%) Otras localizaciones raras son la glándula pineal, la región sacrococcígea, la próstata y la vejiga; sin embargo, la localización suprahepática no es tan común y no está documentada en la literatura.
Asunto(s)
Teratoma , Humanos , Masculino , Mediastino , Teratoma/diagnóstico por imagen , Teratoma/cirugíaAsunto(s)
Enfermedades del Pene , Induración Peniana , Humanos , Masculino , Necrosis , Enfermedades del Pene/cirugía , Erección Peniana , Pene , PielRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Pene/cirugía , Enfermedades del Pene/patología , NecrosisRESUMEN
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants. Their CSF was studied for suspicion of infection and a bivariate analysis was performed between the dependent variable (confirmed/probable NM) and the identified independent variables. Those variables with a p value ≤ 0.2 were fitted in a multiple logistic regression analysis with the same dependent variable. After determining the best model according to its discrimination and calibration, the ß coefficient for each selected dichotomized variable obtained from the logistic regression model was used to construct the score for the prediction rule. RESULTS Among 320 patients recruited for the study, 154 had confirmed or probable NM. Using bivariate analysis, 15 variables had statistical associations with the outcome: aneurysmal subarachnoid hemorrhage (aSAH), traumatic brain injury, CSF leak, positioning of external ventricular drains (EVDs), daily CSF draining via EVDs, intraventricular hemorrhage, neurological deterioration, age ≥ 50 years, surgical duration ≥ 220 minutes, blood loss during surgery ≥ 200 ml, C-reactive protein (CRP) ≥ 6 mg/dl, CSF/serum glucose ratio ≤ 0.4 mmol/L, CSF lactate ≥ 4 mmol/L, CSF leukocytes ≥ 250 cells, and CSF polymorphonuclear (PMN) neutrophils ≥ 50%. The multivariate analysis fitted a final model with 6 variables for the prediction rule (aSAH diagnosis: 1 point; CRP ≥ 6 mg/dl: 1 point; CSF/serum glucose ratio ≤ 0.4 mmol/L: 1 point; CSF leak: 1.5 points; CSF PMN neutrophils ≥ 50%: 1.5 points; and CSF lactate ≥ 4 mmol/L: 4 points) with good calibration (Hosmer-Lemeshow goodness of fit = 0.71) and discrimination (area under the receiver operating characteristic curve = 0.94). CONCLUSIONS The prediction rule for diagnosing NM improves the diagnostic accuracy in neurosurgical patients with suspicion of infection. A score ≥ 6 points suggests a high probability of neuroinfection, for which antibiotic treatment should be considered. An independent validation of the rule in a different group of patients is warranted.
Asunto(s)
Infección Hospitalaria/diagnóstico , Meningitis/diagnóstico , Meningitis/etiología , Procedimientos Neuroquirúrgicos , Complicaciones Posoperatorias/diagnóstico , Adulto , Biomarcadores/sangre , Biomarcadores/líquido cefalorraquídeo , Infección Hospitalaria/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Meningitis/epidemiología , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Pronóstico , Curva ROC , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Patients with autoimmune rheumatic diseases are at increased risk for developing infections and these are associated with increased morbidity and mortality from these diseases, especially in patients with systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and autoimmune inflammatory myopathies. The objective of this paper is to address the challenges in detecting latent tuberculosis in immunosuppressed patients and the initiation of prophylactic treatment because currently there are no well-defined guidelines indicating what action to take for detection and treatment; so far the available scientific evidence is scarce and some methodological shortcomings.
Los pacientes con enfermedades reumáticas autoinmunes tienen un elevado riesgo para el desarrollo de infecciones, y estas se asocian al incremento de la morbimortalidad de estas enfermedades, principalmente en pacientes con lupus eritematoso sistémico, artritis reumatoide, esclerosis sistémica y con miopatías inflamatorias autoinmunes. El objetivo de este trabajo es abordar los retos en la detección de tuberculosis latente en pacientes inmunosuprimidos y el inicio del tratamiento profiláctico ya que en la actualidad no existen lineamientos bien definidos que indiquen la conducta a seguir para su detección y tratamiento; por el momento la evidencia científica disponible es escasa y con algunas deficiencias metodológicas.
Asunto(s)
Tuberculosis Miliar/diagnóstico , Enfermedades Indiferenciadas del Tejido Conectivo/complicaciones , Adulto , Femenino , Humanos , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/inmunología , Tuberculosis Miliar/complicaciones , Tuberculosis Miliar/inmunología , Tuberculosis Miliar/prevención & control , Enfermedades Indiferenciadas del Tejido Conectivo/diagnósticoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias del Pene/diagnóstico por imagen , Disuria/etiología , Carcinoma Verrugoso/diagnóstico por imagen , Papillomaviridae/patogenicidadRESUMEN
We have previously shown that in vitro transduction with bovine adeno-associated viral (BAAV) vectors restores connexin expression and rescues gap junction coupling in cochlear organotypic cultures from connexin-deficient mice that are models DFNB1 nonsyndromic hearing loss and deafness. The aims of this study were to manipulate inner ear connexin expression in vivo using BAAV vectors, and to identify the optimal route of vector delivery. Injection of a BAAV vector encoding a bacterial Cre recombinase via canalostomy in adult mice with floxed connexin 26 (Cx26) alleles promoted Cre/LoxP recombination, resulting in decreased Cx26 expression, decreased endocochlear potential, increased hearing thresholds, and extensive loss of outer hair cells. Injection of a BAAV vector encoding GFP-tagged Cx30 via canalostomy in P4 mice lacking connexin 30 (Cx30) promoted formation of Cx30 gap junctions at points of contacts between adjacent non-sensory cells of the cochlear sensory epithelium. Levels of exogenous Cx30 decayed over time, but were still detectable four weeks after canalostomy. Our results suggest that persistence of BAAV-mediated gene replacement in the cochlea is limited by the extensive remodeling of the organ of Corti throughout postnatal development and associated loss of non-sensory cells.
Asunto(s)
Cóclea/metabolismo , Conexinas/fisiología , Sordera/terapia , Oído Interno/metabolismo , Terapia Genética , Vectores Genéticos/administración & dosificación , Parvovirinae/genética , Animales , Bovinos , Conexina 26 , Sordera/genética , Sordera/patología , Dependovirus , Femenino , Integrasas , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones NoqueadosRESUMEN
Se plantean los componentes de un currículo crítico en filosofía, ética y religión, partiendo de una aproximación reflexiva a la didáctica y el currículum. Los resultados permitieron develar tres tendencias en los diseños curriculares: historicista, estandarizado y problematizador, que orientan las prácticas formativas en los humanismos, así mismo, se evidencian las experiencias pedagógicas significativas tales como: la disertación filosófica, los encuentros de oratoria, el foro intercolegial de filosofía, el uso de las tecnologías de la información y la comunicación aplicadas a la formación ética y religiosa, todas, asociadas a diversos enfoques didácticos. Finalmente, se presenta la construcción de un currículo crítico octagonal y la posibilidad abierta de plantear diversas cartografías curriculares, según cada contexto institucional, como propuesta de innovación educativa y consolidación creativa del colectivo docente de la Mesa de Humanismos.
The components of a critical curriculum in philosophy, ethics, and religion, are considered, on the basis of a reflective approach to didactics and the curriculum. The results allowed to unveil three trends in curriculum designs: historicist, standardized and problematic, which guide the educational practices in Humanisms. Likewise, significant pedagogical experiences such as philosophical dissertation, public speaking meetings, the philosophy intercollegiate forum, the use of information and communication technologies applied to the ethical and religious education, are highlighted, all of which are associated with various didactic approaches.
Asunto(s)
Curriculum , Humanismo , Educación , Educación ContinuaRESUMEN
Para explorar la frecuencia y peso con que los factores de riesgo psicosocial predisponen a los desenlaces de embarazo temprano y deserción escolar en las adolescentes, se realizó una revisión descriptiva. Materiales y métodos: Se realizó una búsqueda y revisión de los resultados presentados por los estudios observacionales en la base de datos indexada de Pubmed desde el 27 de julio de 2010 hasta el 25 de julio de 2013, restringiendo la búsqueda a estudios en humanos, escritos en español o inglés, no realizados en países de África o Asia; se amplió la búsqueda a la base de lilacs para los años entre 2006-2013, para países de América Latina. Fueron elegibles para inclusión, todos los estudios de casos y controles que compararan diferentes tipos de intervenciones y factores de riesgo psicosocial en adolescentes. Resultados: La revisión sugiere, como principales factores psicosociales relacionados con el embarazo y la deserción escolar en las adolescentes, la violencia experimentada durante la adolescencia, el abuso sexual, pertenecer a un estrato socioeconómico bajo, baja autoestima, trastornos en la conducta alimentaria, el tabaquismo, alcoholismo y drogadicción, los trastornos mentales, el inicio temprano de relaciones sexuales, baja unidad familiar y falta de acceso a información y recursos para la planificación. Conclusiones: Se describieron los factores de riesgo relacionados con embarazo y deserción escolar, intervenciones dirigidas a los factores de riesgo descritos potencialmente podrían contribuir a la disminución de estos desenlaces.
To explore the frequency and weight that psychosocial risk factors predispose to outcomes of early pregnancy and scholar dropout, a descriptive review was conducted. Materials and Methods: A search and review of the results reported by observational studies in the PubMed database indexed from July 27, 2010 until July 25, 2013 was performed, restricting the search to studies in humans, Spanish or English written, not made in countries in Africa or Asia. Search was widened to LILACS database for the years 2006 to 2013 for Latinamerican countries. For inclusion, all case-control studies comparing different types of interventions and psychosocial risk factors in adolescents were eligible. Results: The review suggests violence experienced during adolescence, sexual abuse, belonging to a low socioeconomic status, low self-esteem, eating behavior disorders, smoking, alcoholism and drug addiction, mental disorders, early initiation of sex, poor family ties, lack of access to information, and resources for family planning as main psychosocial factors related to early pregnancy and scholar dropout in adolescents. Conclusions: Both risk factors associated with pregnancy and scholar dropout were described, and interventions targeting the described risk factors could potentially contribute to the reduction of these outcomes were described.
Para explorar a frequência e peso com que os fatores de risco psicossocial predispõem aos desenlaces de gravidez precoce e deserção escolar nas adolescentes, se realizou uma revisão descritiva. Materiais e métodos: realizou-se uma busca e revisão dos resultados apresentados pelos estudos observacionais na base de dados indexada de Pubmed desde o 27 de julho de 2010 até o 25 de julho de 2013, restringindo a busca a estudos em humanos, escritos em espanhol ou inglês, não realizados em países da África o da Ásia. Ampliou-se a busca à base de lilacs para os anos compreendidos de 2006 ao 2013, para países da América Latina. Foram elegíveis para inclusão, todos os estudos de casos e controles que compararam diferentes tipos de intervenções e fatores de risco psicossocial em adolescentes. Resultados: a revisão sugere, como principais fatores psicossociais relacionados com a gravidez e a deserção escolar nas adolescentes, à violência experimentada durante a adolescência, o abuso sexual; pertencer a um estrato socioeconómico baixo; baixa autoestima; transtornos na conduta alimentaria; o tabaquismo, alcoolismo e toxicomania; os transtornos mentais; o início precoce de relações sexuais, baixa unidade familiar e falta de acesso a informação e recursos para a planificação. Conclusões: descreveram-se os fatores de risco relacionados com gravides e deserção escolar, intervenções dirigidas aos fatores de risco descritos potencialmente poderiam contribuir à diminuição destes desenlaces.
Asunto(s)
Humanos , Femenino , Adolescente , Embarazo en Adolescencia , Abandono Escolar , Anorexia , Bulimia , Factores de Riesgo , Exposición a la ViolenciaRESUMEN
(AU) IntroducciónEn Colombia, a la fecha, se desconoce la prevalencia de artritis reumatoide (AR). El propósito de este estudio fue hacer una aproximación a la prevalencia de la AR en Colombia con respecto a bases documentales.Materiales y métodosMediante una revisión de bases administrativas, se identificaron los casos prevalentes de AR, notificados por el estudio Carga de Enfermedad Colombia 2005, de los Registros Individuales de Prestación de Servicios de Salud, correspondientes a la clasificación internacional de enfermedades, décima revisión, M05 y M06; dividiendo los casos prevalentes por las bases de población reportadas por el Departamento Nacional de Estadística en Colombia para el mismo año, se estimaron las prevalencias específicas por edad y sexo.ResultadosSe encontraron 267.628 casos prevalentes en el año 2005 en Colombia, la prevalencia global de AR correspondió a 0,9/100 habitantes, la razón mujer/hombre de AR fue 4:1, se apreció un incremento progresivo con la edad (pico en el grupo de mayores de 80 años).ConclusiónEste es el primer estudio de prevalencia de AR en Colombia con base en registros administrativos, la prevalencia por esta metodología fue similar a la encontrada por otros estudios en poblaciones de Europa y Sudamérica
Asunto(s)
Humanos , Artritis Reumatoide , PrevalenciaRESUMEN
Presentación del caso: Se incluyen los antecedentes maternos, los hallazgos clínicos y paraclínicos que llevaron al diagnóstico, el seguimiento paraclínico del cuadro infeccioso, el tratamiento instaurado y el desenlace de muerte neonatal. Se realiza una revisión de la literatura nacional e internacional acerca de las características infecciosas y epidemiológicas de la infección porL. monocytogenes, así como su presentación clínica y repercusiones durante el periodo gestacional y en la etapa neonatal. Discusión: la listeriosis neonatal es una patología con alta letalidad, cuya epidemiología no está claramente descrita en el ámbito nacional y regional, lo que dificulta la creación de estrategias de prevención en grupos de alto riesgo. Se sugiere hacer de esta infección un evento de notificación obligatoria para permitir la identificación de factores de riesgo, letalidad, desenlace y presentación usual de esta enfermedad infecciosa en Colombia.
Case: The case is presented including maternal history, clinical and laboratory findings that led to diagnosis, paraclinical monitoring of the infection, the established treatment and outcomes in neonatal death.A review of national and international literature on infectious and epidemiology characteristics of L.-monocytogenes infection, and its clinical presentation and implications during the gestational and the neonatal period was made. Discussion: Neonatal listeriosis is a high fatality disease whose epidemiology is not clearly described at the national and regional levels, hindering the development of prevention strategies in high-risk groups.We suggest this infection becomes a notifiable event to allow the identification of risk factors, lethality, usual presentation and outcome of this infectious disease in Colombia.
Apresentação de caso: Se include os antecedentes maternos, os achados clínicos e o tratamento instaurado e o desenlace de morte neonatal. Se realiza uma revisão da literatura nacional e internacional acerca das características infecciosas e epidemiológicas da infeção por L. monocytogenes assim como sua apresentação clínica e repercussões durante o período gestacional e na etapa neonatal. Discussão: a listeriose neonatal é uma patologia com alta letalidade cuja epidemiologia não está claramente descrita no âmbito nacional e regional o que dificulta a criação de estratégias de prevenção em grupos de alto risco. Se sugere fazer desta infeção um evento de notificação obrigatória para permitir a identificação de fatores de risco, letalidade, desenlace e apresentação usual desta doença infeciosa na Colômbia.
Asunto(s)
Humanos , Masculino , Recién Nacido , Listeria monocytogenes , Recién Nacido , Mortalidad Infantil , Sepsis Neonatal , Infecciones , ListeriosisRESUMEN
The tumor suppressor p53 is a key protein in preventing cell transformation and tumor progression. Activated by a variety of stimuli, p53 regulates cell-cycle arrest and apoptosis. Along with its well-documented transcriptional control over cell-death programs within the nucleus, p53 exerts crucial although still poorly understood functions in the cytoplasm, directly modulating the apoptotic response at the mitochondrial level. Calcium (Ca(2+)) transfer between the endoplasmic reticulum (ER) and mitochondria represents a critical signal in the induction of apoptosis. However, the mechanism controlling this flux in response to stress stimuli remains largely unknown. Here we show that, in the cytoplasm, WT p53 localizes at the ER and at specialized contact domains between the ER and mitochondria (mitochondria-associated membranes). We demonstrate that, upon stress stimuli, WT p53 accumulates at these sites and modulates Ca(2+) homeostasis. Mechanistically, upon activation, WT p53 directly binds to the sarco/ER Ca(2+)-ATPase (SERCA) pump at the ER, changing its oxidative state and thus leading to an increased Ca(2+) load, followed by an enhanced transfer to mitochondria. The consequent mitochondrial Ca(2+) overload causes in turn alterations in the morphology of this organelle and induction of apoptosis. Pharmacological inactivation of WT p53 or naturally occurring p53 missense mutants inhibits SERCA pump activity at the ER, leading to a reduction of the Ca(2+) signaling from the ER to mitochondria. These findings define a critical nonnuclear function of p53 in regulating Ca(2+) signal-dependent apoptosis.
Asunto(s)
Apoptosis/fisiología , Calcio/metabolismo , Retículo Endoplásmico/metabolismo , Mitocondrias/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Aequorina/metabolismo , Animales , Western Blotting , Línea Celular , Citosol/metabolismo , Citometría de Flujo , Transferencia Resonante de Energía de Fluorescencia , Fura-2 , Técnicas de Silenciamiento del Gen , Humanos , Inmunoprecipitación , Ratones , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/metabolismo , Proteína p53 Supresora de Tumor/genéticaRESUMEN
One challenge in biology is signal transduction monitoring in a physiological context. Intravital imaging techniques are revolutionizing our understanding of tumor and host cell behaviors in the tumor environment. However, these deep tissue imaging techniques have not yet been adopted to investigate the second messenger calcium (Ca²âº). In the present study, we established conditions that allow the in vivo detection of Ca²âº signaling in three-dimensional tumor masses in mouse models. By combining intravital imaging and a skinfold chamber technique, we determined the ability of photodynamic cancer therapy to induce an increase in intracellular Ca²âº concentrations and, consequently, an increase in cell death in a p53-dependent pathway.