Diabetes mellitus contribution to the remodeling of the tumor microenvironment in gastric cancer.

Compelling pieces of evidence derived from both clinical and experimental research has demonstrated the crucial contribution of diabetes mellitus (DM) as a risk factor associated with increased cancer incidence and mortality in many human neoplasms, including gastric cancer (GC). DM is considered a systemic inflammatory disease and therefore, this inflammatory status may have profound effects on the tumor microenvironment (TME), particularly by driving many molecular mechanisms to generate a more aggressive TME. DM is an active driver in the modification of the behavior of many cell components of the TME as well as altering the mechanical properties of the extracellular matrix (ECM), leading to an increased ECM stiffening. Additionally, DM can alter many cellular signaling mechanisms and thus favoring tumor growth, invasion, and metastatic potential, as well as key elements in regulating cellular functions and cross-talks, such as the microRNAs network, the production, and cargo of exosomes, the metabolism of cell stroma and resistance to hypoxia. In the present review, we intend to highlight the mechanistic contributions of DM to the remodeling of TME in GC.

[Prevalence of sexual dysfunction in climacteric women. Influence of menopause and hormone replace therapy]. / Prevalencia de los trastornos de la sexualidad en mujeres climatéricas. Influencia de la menopausia y de la terapia de reemplazo hormonal.

BACKGROUND: Few trials have studied the prevalence of sexual dysfunction (SD) and related risk factors in postmenopausal women using the DSM-IV criteria. AIM: To evaluate the prevalence of SD in menopausal women and the impact of risk factors. PATIENTS AND METHODS: Five hundred thirty four healthy women, 40 to 64 years of age were interviewed using the Laumann test (DSM-IV). RESULTS: Mean age was 52.4 +/- 5.7 years. Eighty three percent were peri or postmenopausal, 23% used hormonal substitution therapy and 79.2% were sexually active. Among sexually active women, the prevalence of SD increased along with age, from 22.2% at the 40-44 years old range to 66.0% in the 60-64 years old group. Hormone users and healthy women had a low risk for SD (Odds ratio (OR): 0.1 IC: 0.0-0.1 and OR: 0.6 IC: 0.3-0.9, respectively). The risk increased in menopausal women (OR: 3.3 IC: 1.6-6.9), those older than 49 years (OR: 3.4 IC: 1.8-6.4), those subjected to hysterectomy (OR: 3.7 IC: 1.3-10.6) or those with an impotent sexual partner (OR: 3.2 IC: 1.2-8.6). CONCLUSIONS: There is a high prevalence of SD among climacteric women. Estrogens, either endogenous or exogenous, have a positive influence on sexuality.

Use of hormone replacement therapy among Chilean women: a comparison between socioeconomic levels.

OBJECTIVE: To compare the use of hormone replacement therapy (HRT) among Chilean women according to their socioeconomic level. METHODS: A total of 540 women between 50 and 79 years of age were interviewed in Santiago, Chile. Women were allocated into two groups (H, high; L, low), according to their socioeconomic status. RESULTS: Each group consisted of 270 women. The mean age and percentage of menopausal women were similar in both groups. Of the interviewed women, 47% had taken HRT at some time; marked differences between the two groups were observed (L, 15%; H, 79%; < 0.0001). In group H, the percentage of women who had been advised about HRT was close to 88%, whereas, in group L, the percentage was only 24%. Among the women who were informed about HRT, 83% ( = 253) had used it at some time. The percentage of women who used HRT for >2 years was similar in both groups. The main reason for not taking HRT in group H was fear of adverse effects, whereas the main reason for not taking it in group L was the lack of medical advice. CONCLUSIONS: The percentage of women in the low socioeconomic group who use HRT is low. Medical advice is fundamental to increasing HRT use in this group.

Neumonía adquirida en la comunidad: comunicación de 8 casos de neumonía grave por legionella pneumophila serogrupo 1 en Chile / Community acquired pneumonia: report of 8 cases of severe pneumonia caused by legionella pneumophila seroproup 1 in Chile

Legionella pneumophila is the second cause of severe community acquired pneumonia. In Chile, however, there are few reports of pneumonia caused by Legionella. We report eight patients (6 men, aged 42 to 72 years old) with community-acquired pneumonia caused by Legionella pneumophila serogroup 1, confirmed by the measurement of urinary antigen. Clinical presentation was characterized by fever or hypothermia (in one case), cough, dyspnea and neurological abnormalities in four patients. Cigarette smoking was the most frequently identified risk factor. All patients had at least one American Thoracic Society severity criteria. Complications observed were acute hypoxemic respiratory failure in seven patients, shock in four, renal failure in four and need for mechanical ventilation in three. No patient died

Utilidad de la medición de permeabilidad alveolocapilar con TC99m-DTPA en el compromiso pulmonar de pacientes portadores del virus de inmunodeficiencia adquirida / Value of Tc99m-DTPA alveolar permeability in lung involvement detection of patients with HIV infection

Se evaluó la utilidad de la medición de permeabilidad alveolocapilar con Tc99m -DTPA en pacientes VIH positivo con posible compromiso pulmonar e infección por pneumocystis carinii (PC) . Se incluyeron 20 pacientes con síntomas respiratorios y 4 con síntomas sistémicos usando como control a un grupo de 11 asintomáticos con similar valor de linfocitos CD, todos con suspensión de tabaco previa. Se realizaron radiografía de tórax, hemograma, esputo inducido y/o fibrobroncoscopía, obteniéndose confirmación de presencia o ausencia de PC en 16 pacientes sintomáticos y 3 asintomáticos. Para detección de PC la sensibilidad fue 78 por ciento, la especificidad 40 por ciento y la seguridad diagnóstica 58 por ciento. Para procesos inflamatorios pulmonares los valores fueron 85 por ciento, 60 por ciento y 79 por ciento, respectivamente. Cuatro de seis pacientes falsos positivos para PC tenían cuadros que explicaban la alteración del DTPA. Concluyendo, el DTPA es sensible pero poco específico para detectar infección pulmonar por PC, siendo superior para procesos inflamatorios