Gene Expression Behavior of a Set of Genes in Platelet and Tissue Samples from Patients with Breast Cancer.

The tumor microenvironment (TME) is constituted by a great diversity of highly dynamic cell populations, each of which contributes ligands, receptors, soluble proteins, mRNAs, and miRNAs, in order to regulate cellular activities within the TME and even promote processes such as angiogenesis or metastasis. Intravasated platelets (PLT) undergo changes in the TME that convert them into tumor-educated platelets (TEP), which supports the development of cancer, angiogenesis, and metastasis through the degranulation and release of biomolecules. Several authors have reported that the deregulation of PF4, VEGF, PDGF, ANG-1, WASF3, LAPTM4B, TPM3, and TAC1 genes participates in breast cancer progression, angiogenesis, and metastasis. The present work aimed to analyze the expression levels of this set of genes in tumor tissues and platelets derived from breast cancer patients by reverse transcription-quantitative polymerase chain reaction (RTqPCR) assays, in order to determine if there was an expression correlation between these sources and to take advantage of the new information to be used in possible diagnosis by liquid biopsy. Data from these assays showed that platelets and breast cancer tumors present similar expression levels of a subset of these genes' mRNAs, depending on the molecular subtype, comorbidities, and metastasis presence.

Validación teórica de ejercicios de resistencia-fuerza para la prueba combinada de escalada deportiva, categoría juvenil-senior / Validação teórica de exercícios de resistência-força para o teste combinado de escalada desportiva, categoria juvenil-sênior / Theoretical validation of endurance-strength exercises for the combined sport climbing test, junior-senior category

RESUMEN La resistencia a la fuerza es la capacidad física de mantener la fuerza a un nivel constante mientras dure un gesto deportivo determinado, capacidad determinante en muchos deportes, donde la escalada deportiva no es excepción; por tanto, el estudio teórico-práctico que contribuya a mejorar dicha capacidad en la escala deportiva permitirá mejorar la gestión del entrenamiento deportivo en dicho deporte. El objetivo de este trabajo es validar teóricamente una propuesta de ejercicios físicos para el entrenamiento de la resistencia-fuerza, en la prueba combinada de escalada deportiva, en un rango etario comprendido entre 16-21 años. La investigación aplicada es de tipo teórico-descriptiva de orden correlacional y base cualitativa, con estudio de criterios, de 13 especialistas en cuatro ítems (originalidad, calidad, especialización y objetividad) que evalúan teóricamente en dos momentos un grupo de ejercicios físicos especializados para potenciar la resistencia-fuerza. Como resultados, se exponen que se incrementaron cuantitativa y cualitativamente todas las categorías evaluables como parte del postest, en originalidad (pretest: dos puntos; postest: cuatro puntos; p=0.000); en calidad (pretest: tres puntos, postest: cuatro puntos; p=0.000); en especialización (pretest: tres puntos, postest: cuatro puntos, p=0.000) y en objetividad (pretest: cuatro puntos; postest, cinco puntos; p=0.001). La propuesta de ejercicios de resistencia-fuerza para la prueba combinada de escalada deportiva cumple teóricamente con los supuestos de originalidad, calidad, especialización y objetividad, es una propuesta satisfactoria, según el criterio teórico de los especialistas consultados.

RESUMO A resistência à força é a capacidade física de manter a força a um nível constante enquanto durar um gesto desportivo determinado, capacidade determinante em muitos desportos, onde a escalada desportiva não é excepção; portanto, o estudo teórico-prático que contribua para melhorar essa capacidade na escala desportiva permitirá melhorar a gestão do treino desportivo no desporto. O objetivo deste trabalho é validar teoricamente uma proposta de exercícios físicos para o treinamento da resistência-força, na prova combinada de escalada esportiva, em uma faixa etária compreendida entre 16-21 anos. A pesquisa aplicada é de tipo teórico-descritivo de ordem correlacional e base qualitativa, com estudo de critérios, de 13 especialistas em quatro itens (originalidade, qualidade, especialização e objetividade) que avaliam teoricamente em dois momentos um grupo de exercícios físicos especializados para potenciar a resistência-força. Como resultados, é exposto que todas as categorias avaliáveis aumentaram quantitativa e qualitativamente como parte do pós-teste, em originalidade (pré-teste: dois pontos; pós-teste: quatro pontos; p=0.000); em qualidade (pré-teste: três pontos, pós-teste: quatro pontos; p=0.000); em especialização (pré-teste: três pontos, pós-teste: quatro pontos, p=0.000) e em objetividade (pré-teste: quatro pontos; pós-teste, cinco pontos; p=0.001). A proposta de exercícios de resistência para o teste combinado de escalada desportiva obedece teoricamente aos pressupostos de originalidade, qualidade, especialização e objetividade; é uma proposta satisfatória, de acordo com os critérios teóricos dos especialistas consultados.

ABSTRACT Strength endurance is the physical capacity to maintain strength at a constant level for the duration of a given sporting gesture, a determining capacity in many sports, where sport climbing is no exception; therefore, the theoretical-practical study that contributes to improve this capacity in sport climbing will allow improving the management of sport training in this sport. The objective of this work is to theoretically validate a proposal of physical exercises for endurance-strength training, in the combined sport climbing test, in an age range between 16-21 years old. The applied research is of theoretical-descriptive type of correlational order and qualitative base, with a study of criteria, of 13 specialists in four items (originality, quality, specialization and objectivity) that evaluate theoretically in two moments a group of specialized physical exercises to enhance endurance-strength. As results, it is presented that all the evaluable categories increased quantitatively and qualitatively as part of the post-test, in originality (pre-test: two points; post-test: four points; p=0.000); in quality (pre-test: three points, post-test: four points; p=0.000); in specialization (pre-test: three points, post-test: four points, p=0.000) and in objectivity (pre-test: four points; post-test, five points; p=0.001). The proposal of endurance-strength exercises for the combined sport climbing test theoretically complies with the assumptions of originality, quality, specialization and objectivity; it is a satisfactory proposal, according to the theoretical criteria of the specialists consulted.

Current practice of rectal biopsies for the diagnosis of Hirschsprung's disease in Latin America: an international online survey.

PURPOSE: The gold standard for the diagnosis of Hirschsprung's disease (HD) is a rectal biopsy. The sample may be obtained using a transanal excisional biopsy (TEB) or suction technique. Rectal suction biopsy (RSB) is not a standard procedure in Latin-America. AIM: To evaluate the current practice in rectal biopsy for HD among pediatric surgeons. METHODS: We distributed an online questionnaire among Latin-American pediatric surgeons. RESULTS: One hundred forty-nine pediatric surgeons from 15 countries completed the anonymous survey (71.4% of Latin-American countries), grouped into 81.9% pediatric surgeons; 8.9% pediatric colorectal surgeons, 8.9% trainees, and 1 pediatric colorectal surgeon fellow. 50.4% reported less than 5 new patients with HD per year, 36.2% 5-10 new cases, and 13.4% more than 10. Only 14.1% of surgeons have access to perform a RSB in the diagnostic work-up of patients with suspected HD, 90% in our study perform an TEB under general anesthesia. When we ask if they could perform both procedures in babies up to 6 months, 52.3% indicate that they prefer an RSB, and for patients older than 6 months, 35.4% favor an RSB. Regarding the number of samples obtained performing an TEB, 30.9% get one biopsy, 29.5% two biopsies, and 39.6% three or more samples. Surgeons obtained the most proximal biopsy at a median of 2.3 cm (range 1-4 cm) above the pectinate line. 67.8% of surgeons prescribed antibiotic prophylaxis. Overall, 16.1% experienced complications, including rectal blood loss (n = 18), and rectal perforation (n = 3). The most frequently used staining methods for rectal biopsies are hematoxylin/eosin (87%), calretinin (56, 8%), and acetylcholinesterase (21.9%). CONCLUSIONS: In Latin-America, the accessibility for RSB is limited only 18 out of 149 surgeons have access to rectal suction tool. There is no consensus regarding sample number, site of proximal biopsy, and antibiotics use. The complications associated with the procedure seems to be less than reported with RSB. Therefore, we should standardize this common surgical practice and establish universal guidelines for rectal biopsy procedure (RBP).

A new species of Bestiolina (Crustacea, Copepoda, Calanoida, Paracalanidae) from coastal waters of the Colombian Pacific, including a worldwide key for the identification of the species.

Plankton samples obtained from estuarine waters of the Colombian Pacific yielded adults specimens of an undescribed species of a paracalanid copepod of the genus Bestiolina. It most closely resembles two Asian species; B.sinica (Shen & Lee, 1966) from China and B.arabica (Ali, Al-Yamani & Prusova, 2007) from the Arabian Gulf. These three species share the absence of spinules on the posterior surfaces of exopod segments of legs 2, 3 and 4. Bestiolinasarae Dorado-Roncancio & Gaviria, sp. n. can be easily separated from B.sinica by the number of spinules on the anterior surface of endopod 2 of legs 2 and 3, and by the absence of spinules on the posterior surface of second endopod of leg 4. It can be distinguished from B.arabica by the presence of spinules on the posterior surface of endopod 2 of same legs (absent in B.arabica), and the size of spinules on the anterior surface of the same segments. The only other species known from the Americas, B.mexicana (Suárez-Morales & Almeyda-Artigas, 2016), can be distinguished from Bestiolinasarae Dorado-Roncancio & Gaviria, sp. n. by the presence of spinules on the posterior surface of the leg 2 first exopodal segment and the morphology of the mandible blade. The morphological and meristic differences to the eight known species of the genus are presented. An identification key to the species of Bestiolina is provided.

Pediatric Dental Care in Fanconi Anemia: A Case Report / Cuidado dental pediátrico en paciente con anemia de Fanconi: Reporte de un caso

ABSTRACT Fanconi Anemia (FA) is an autosomal-recessive genetic disease that is linked to Chromosome X, which is reported in studies with pancytopenia, congenital malformations, and a predisposition to develop cancer. FA 1,360,000 births, and is a condition that occurs in heterozygous subjects in 0.5% of the population. In Mexico, there are, to our knowledge, no epidemiological data on FA, and it is thought that many cases are underdiagnosed. This document reports the clinical case of a patient diagnosed with FA who the cardinal signs of this rare pathology. The pediatric approach involved was performed with a preventive and restorative approach, in addition to the design and placement of a palatal shutter. After a follow-up of more than 12 months, a significant reduction in the recurrence of infections, such as otitis, tonsillitis, and pharyngitis, was observed, suggesting a positive influence of the use of the obturator. In turn with the latter, there was a lower need for transfusions, which may also be related to control of the foci of the infection. The pediatric approach employed in to patients with FA may have significant repercussions on both quality of life and on their patients' general systemic condition, although this is scarcely verifiable due to the rarity of this pathology.

RESUMEN La anemia de Fanconi es una enfermedad genética, autosómica recesiva, ligada al cromosoma X, la cual cursa con pancitopenia, malformaciones congénitas y predisposición a desarrollar cáncer. Afecta a 1:360,000 nacimientos, es un padecimiento que se presenta en sujetos heterocigotos en el 0.5% de la población, en México no existen datos epidemiológicos y se cree que muchos casos se encuentran sub diagnosticados. En el presente documento se reporta el caso clínico de una paciente con diagnóstico de Anemia de Fanconi, que presenta los signos cardinales de esta rara patología. Se realizó el abordaje odontopediátrico con un enfoque preventivo y restaurador, además del diseño y colocación de un obturador palatino. Tras un seguimiento mayor a 12 meses se logró observar una reducción importante en la recurrencia de infecciones como otitis, amigdalitis y faringitis, lo que sugiere una influencia positiva del uso del obturador, y a su vez se pudo constatar una menor necesidad de transfusiones, lo cual puede también estar relacionado con el control de los focos de infección. El abordaje odontopediátrico dirigido a pacientes con Anemia de Fanconi puede tener repercusiones importantes tanto en la calidad de vida como en su condición sistémica general, aunque esto es difícilmente comprobable debido la rareza de dicha patología.

Fibrobroncoscopía en pacientes onco-hematológicoscon infiltrados pulmonares, estudio transversal / Fibrobronchoscopy in onco-hematological patients with pulmonary infiltrates, cross-sectional study

Introducción: Las enfermedades infecciosas y masas pulmonares son una causa importante de mortalidad en los pacientes onco-hematológicos. El objetivo del presente estudio fue determinar la sensibilidad y especificidad de la fibrobroncoscopía (FBC) en el diagnóstico temprano de pacientes hemato-oncológicos. Métodos: El presente estudio descriptivo transversal se realizó en pacientes onco-hematológicos con hallazgos anormales en imágenes de tórax que fueron sometidos a FBC en el Instituto Oncológico de Solca-Guayaquil entre el periodo enero 2014 -diciembre 2016. Resultados: Ingresaron al estudio 98 pacientes: 54 mujeres (55.1%), de 61 ±18 años, 39 (39.8 %) con tumores sólidos, 76 (77.6 %) con síntomas respiratorios, 88 (89.8 %) con alta sospecha de lesión maligna. La sensibilidad del diagnóstico con líquido bronquial fue del 62.5 %; con cepillado, 88 % y del esputo post FBC fue de 14.3 %. La especificidad del diagnóstico con líquido bronquial fue del 89.7 %; con cepillado, 73.9 % y del esputo post FBC fue de 93.3 %. Conclusiones: En el presente estudio existe mayor sensibilidad con el cepillado bronquial comparativamente al líquido bronquial y el esputo post FBC para el diagnóstico de lesiones malignas

Introduction:Infectious diseases and lung masses are an important cause of mortality in onco-hematological patients. The aim of this study was to determine the sensitivity and specificity of Fiber Optic Bronchoscopy (FOB) in the early diagnosis of haemato-oncological patients. Methods:The present descriptive cross-sectional study was performed in onco-hematological patients with abnormal findings in chest images that were submitted to BCF in the Oncology Institute of Solca-Guayaquil between the period January 2014 to December 2016. Results: 98 patients, 54 women (55.1 %), 61 ± 18 years old, 39 (39.8 %) with solid tumors, 76 (77.6 %) with respiratory symptoms, 88 (89.8%) with high suspicion of malignant injury, entered the study. The sensitivity of the diagnosis with bronchial fluid was 62.5 %, with brushing 88 % and sputum post FOB was 14.3 %. The specificity of the diagnosis with Bronchial fluid was 89.7 %, with Brush 73.9 % and sputum post FOB was 93.3 %. Conclusions: In the present study there is greater sensitivity with Bronchial Brush comparatively to bronchial fluid and sputum post FOB.

[Clinicopathological features, prognosis and influence in the adjuvant treatment of the risk recurrence groups determined by the 21 gene expression profile, Oncotype Dx®, in early breast cancer]. / Características clinicopatológicas, pronóstico e influencia en el tratamiento adyuvante en los grupos de riesgo de recurrencia determinados por el perfil de expresión de 21 genes, Oncotype Dx®, en cáncer de mama temprano.

BACKGROUND: Adjuvant chemotherapy (ACT) reduces recurrence and mortality in breast cancer (BC); however, not all patients require ACT. Oncotype Dx® (ODX) explores the expression of 21 genes and the risk of recurrence BC. OBJECTIVES: To determine the clinicopathologic characteristics, prognosis, and the prescription for ACT in early BC according to ODX risk groups. METHODS: 36 patients with resected stage I-IIA BC, axillary lymph node-negative or 1-3+, hormonal receptor (HR)-positive, HER2 negative. Three groups were designed by ODX: low (LG), medium (MG) and high-risk groups (HG). RESULTS: LG 23 patients (63.9%), MG eight (22.2%) and HG five (13.9%). We detected high expression of Ki-67 in MG and HG in relation to LG, 21.1 and 32.5 versus 10.1%, respectively (p = 0.007) and lower ER-positive, 85.3, 85.4 and 56.9%, respectively (p = 0.005). Recurrence score: LG 12 (0-18), MG 23 (19-27) and HG 47 (36-57); p < 0.000. Pre-ODX, we planned ACT in 21/36 patients (58.3%) and post-ODX only 9/36 patients (25%) received it. No recurrences or deaths were observed in all groups. CONCLUSIONS: In early BC, 64% have low recurrence risk. High-risk cases presented elevated Ki-67 and lower ER expression. ODX modifies the therapeutic recommendation in 57.2% of cases.

Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms.

The transanal endorectal pull-through emerged in the late 1990s as the most recent step in the evolution of the surgical correction of Hirschsprung disease. This operation provides the advantages of a minimal access approach with shorter hospital stay, shorter time to full feeding, less pain, and improved cosmesis with excellent outcomes. This article will review the technical principles of the transanal endorectal pull-through, and will address ongoing controversies in the application of this technique. We will also discuss an organized approach to the problem of obstructive symptoms that may affect a subgroup of patients after the transanal pull-through.

Incidencia de anticuerpos antifosfolipídicos y síndrome antifosfolipídico en pacientes con lupus eritematoso sistémico. Hospital Luis Vernaza 2001 / Incidence of antiphospholypidic antibodies and antiphospholypidic syndrome in patients with systemci erythematous lupus Luis Vernaza Hospital 2001

Tipo de estudio: retrospectivo, longitudinal y descriptivo realizado en el Hospital Luis Vernaza en el año 2001. Objetivo: establecer la incidencia de anticuerpos antifosfolípidos y síndrome antifosfolípido en pacientes con lupus eritematoso sistémico y la relación entre los hallazgos de dichos anticuerpos y el desarrollo de complicaciones tromboembólicas. Los anticuerpos anticardiolipina fueron valorados mediante el método ELISA y el anticoagulante lupico por el test de veneno de la víbora de Rusell. Resultados: 14 (17,5 por ciento) pacientes fueron anticoagulante lupico positivo y 25 (31,25 por ciento) anticardiolipina positivo. 14 pacientes reunieron los criterios para el diagnóstico del síndrome. La mayoría debutó como lupus...

Vascular malformations of the colon in children.

PURPOSE: The aim of this study was to evaluate clinical, radiologic, surgical, and histopathologic characteristics of vascular malformations of the colon (VMC) in children. METHODS: Eighteen patients with lower intestinal bleeding (LIB) and VMC were included. Clinical data, angiographic features, surgical treatments, and histopathologic findings were analyzed. RESULTS: Age of clinical onset was from 1 week to 16 years. Duration of LIB before diagnosis was from 1 month to 9 years. Admission hemoglobin level was 2 to 9 g/dL in 13 patients and in the other 5 was normal. Scintigraphy, colonoscopy, and barium enema results were normal or suggested a vascular problem. Mesenteric arteriography detected VMC in all 18 cases. Left hemicolon and rectum were affected in 83% of the cases. VMC were resected in 14 patients, 10 were anastomosed or pulled-through, and the other 4 required an intestinal stoma. Ten patients are asymptomatic, and 4 have minimal postoperative bleeding. The histopathologic study made in 15 cases (14 surgical specimens and 1 endoscopic biopsy), revealed arterial-venous VMC in 12 and arterial-venous-lymphatic VMC in 3 cases. CONCLUSIONS: The identification of VMC in children with LIB often is delayed. An early mesenteric arteriography should be added to the routine evaluation. Surgical treatment presents a challenge in rectal cases. To avoid confusion in the nomenclature a simplified morphologic classification is suggested.

Dislipidemias en la infancia / Dislipidemia in infancy

La realización de exámenes de rastreo de colesterol en todos los niños no parece ser una realidad adecuada. En poblaciones de individuos adultos con obesidad, riesgo elevado de ateroesclerosis y enfermedad coronaria, el cambio de hábito alimentario tanto en los niños como en los adultos, a una dieta con menor contenido de colesterol y grasas saturadas, parece una conducta adecuada, pero no se sabe con certeza si esta intervención dietética interferirá o no con el crecimiento y desarrollo de los mas jóvenes. El diagnóstico de hiperlipidemia en la infancia parece estar directamente asociado con los antecedentes familiares de enfermedad coronaria precoz, obesidad, diabetes, hipertensión y trastornos hiperlipidémicos en los progenitores. La mejor forma de tratamiento consiste en la dietoterapia, basada en la ingestión de un menor contenido de grasas saturadas y colesterol, poco enriquecida de grasas poliinsaturadas. La terapéutica farmacológica puede ser indicada en ciertos casos; las resinas secuestradoras de ácidos biliares son la mejor opcion