Osteopontin expression and its relationship with prognostic factors in diffuse large B-cell lymphoma.

The aim of this study is to explore the expression of osteopontin (OPN) and its relationship with prognostic factors and survival in diffuse large B cell lymphoma (DLBCL). A tissue microarray was performed for immunohistochemical evaluation. Contingency tables were analyzed for trends; chi-square test was used to determine differences between groups. Univariate and multivariate Cox proportional hazards-regression analyses were performed to evaluate the impact of prognostic factors on survival. Expression of OPN was observed in 28%. It was different in non-germinal center DLBCL (P=0.04). The mean overall survival (OS) was lower in patients with positive OPN expression (19.762; CI 95% 14.269-25.255) it was not significant (P=0.123). It is not possible to establish a clear relationship between the expression by immunohistochemistry of osteopontin and a poor prognosis but it would be important to complement the analysis with other techniques as PCR or NGS that allow us to assess the influence of the isoforms and post-translational modifications of OPN on the biological behavior of DLBCL. Our findings indicate that OPN expression could be associated with a more aggressive variant of lymphoma: non-germinal center DLBCL.

Educación y promoción para la salud de los adultos mayores: para una vida en movimiento / Education and health promotion in elderly people: keep moving

Resumen:

Objetivo: el presente diseño de educación y promoción para la salud, dirigido a los adultos mayores para el mantenimiento de su movilidad, tiene como objetivo fomentar y sensibilizar a los adultos mayores, a sus cuidadores y familiares, para incrementar los conocimientos dirigidos hacia la modificación de conductas, situaciones e identificación oportuna de riesgos relativos que comprometan la salud de los adultos mayores. Metodología: este diseño educativo se implementó en dos asilos de la ciudad de Chihuahua (México); los participantes fueron 30 adultos mayores, 10 cuidadores y familiares, y se desarrolló en dos sesiones. Para la implementación del diseño educativo se retoma a Paulo Freire, que permite fomentar el proceso educativo y enfatizar una pedagogía emancipadora, dentro de un ambiente de respeto, libertad y compromiso, integrando a ello valores imprescindibles en el acto educativo. Posteriormente, cada responsable del diseño educativo realizó un diario de campo y un reporte en el cual se expuso la experiencia vivida. Resultados: se obtuvo un aprendizaje significativo al relacionar “acto de la vida diaria y del cuidado” con los nuevos conocimientos para fomentar la acción y cambios de conductas que preservaran la funcionalidad, movilidad, salud y plenitud del adulto mayor. Discusión/conclusión: entre las limitaciones para la ejecución del diseño educativo en asilos está el alto número de adultos mayores que residen ahí y que presentan un deterioro físico y cognitivo, factores importantes para la adquisición de conocimientos y mantenimiento de la funcionalidad.

Abstract:

Purpose: the present design for health education and promotion in elderly people for mobility maintenance aims at promoting and increasing awareness among elderly people, caregivers and relatives, in order to increase their knowledge and modify their behavior, condition and timely recognition of potential risks involving elderly health.

Methods: the present educational design was implemented in two nursing homes at Chihuahua, Mexico; participants were 30 elderly individuals, 10 caregivers and relatives; and the study involved two sessions. Educational design implementation was based on revisiting Paulo Freire proposals, which allowed the educational process to be promoted. Emancipating teaching, in a respectful, free, and committed atmosphere was used and integrative appropriate values for educational processed were applied. Later on, a field diary and a report on the personal experience were elaborated by every individual in charge of the program. Results: a significant learning was achieved by relating daily life and healthcare actions to such a novel understanding, in order to implement actions and behavior changes to preserve functioning, mobility, health, and plenitude in elderly people. Discussion/conclusion: limitations to implement an educational design in nursing homes include a high number of residents and the physical and cognitive impairment they show. Such factors are important in knowledge acquisition and function maintenance.

Objetivo: este projeto de educação e promoção da saúde endereçado para os idosos para manter a sua mobilidade, tem como objetivo promover e sensibilizar os idosos, seus cuidadores e familiares para aumentar o conhecimento orientado para a mudança de comportamento, situações e identificação dos riscos relativos que ponham em causa a saúde dos adultos mais velhos. Metodologia: este projeto educacional foi implementada em duas casas de repouso da cidade de Chihuahua, os participantes foram 30 idosos, 10 cuidadores e familiares, realizou-se em duas sessões. Para a execução do projeto educacional é retomado para Paulo Freire, permitindo que o processo educativo enfatizando promover uma pedagogia emancipatória, dentro de um ambiente de respeito, à liberdade e compromisso, integrando esses valores essenciais no ato educativo. Posteriormente, cada um responsável por projeto educacional, realizou um diário de campo e um relatório em que discutiu a experiência. Resultados: a aprendizagem significativa foi obtida relacionar ato da vida diária e os cuidados com novos conhecimentos para implantar ação e mudança de comportamento que vai preservar a funcionalidade, mobilidade, saúde e plenitude dos idosos Discussão/conclusão: entre os constrangimentos para a implementação do projeto no asilos, é relacionada ao alto número de pessoas idosas que vivem lá e que têm uma deficiência física e cognitiva, são fatores importantes para a aquisição conhecimento e manutenção de funcionais.

Incidencia de parasitismo en pacientes de zona rural del policlínico Manuel Fajardo Rivero / Incidence of parasitism in patients from Manuel Fajardo Rivero policlinic in rural areas

Fundamento: en Cuba, a pesar de los esfuerzos que realiza el Ministerio de Salud en aras de prevenir la trasmisión de enfermedades parasitarias, se reporta la prevalencia de parasitismo en diferentes provincias.Objetivo: caracterizar variables clínicas y epidemiológicas que pueden incidir en la frecuencia de parasitismo en pacientes de la zona rural del Policlínico Docente Manuel Fajardo Rivero, en el municipio de Las Tunas. Métodos: se realizó un estudio transversal descriptivo en pacientes de consultorios médicos de la familia en la zona rural de la referida institución de salud. Se tuvo en cuenta las variables clínicas y epidemiológicas: edad, sexo, frecuencia por estaciones del año, tipos de especies parasitarias, factores de riesgo, manifestaciones clínicas y tratamiento médico del paciente parasitado. Se analizaron en el laboratorio las muestras de heces fecales mediante los métodos: directo, concentrado y Sumasohb.Resultados: predominaron las edades de 10 a 18 años (35,7 por ciento); en el sexo masculino el parasitismo tuvo su mayor incidencia en la primavera y el factor de riesgo que más favoreció a la parasitosis fue la ingestión de agua de pozo no tratada; la especie entamoeba histolytica se identificó como la de mayor ocurrencia (40 por ciento Policlínico Docente Manuel Fajardo Rivero). La diarrea fue uno de los principales síntomas registrados en historias clínicas. El medicamento de elección más utilizado fue el Secnidazol, 90,9 por ciento del total.Conclusiones: se diagnosticó la especie parasitaria entamoeba histolytica en la mayoría de los pacientes, los cuales presentaron manifestaciones clínicas sintomáticas. La mala calidad sanitaria del agua se consideró como el factor de riesgo fundamental a la infección por parasitosis, se recomendó fortalecer las estrategias de control y prevención de las enfermedades parasitarias en las comunidades rurales (AU)

Background: in Cuba, in spite of the efforts that the Ministry of Health carries out for the sake of preventing the transmission of parasitic diseases, the prevalence of parasitism is reported in different provinces.Objective: to characterize the clinical and epidemiological variables that can have an effect in the frequency of parasitism in patients from the rural area of Manuel Fajardo Rivero Educational Polyclinic in Las Tunas municipality.Methods: a descriptive and cross-sectional study was carried out in patients from the family doctors offices of the rural area of the mentioned health institution. The clinical and epidemiological variables: age, sex, frequency per season, types of parasitic species, risk factors, clinical manifestations and medical treatment of the parasitized patient. Feces samples were analyzed in the laboratory by means of direct, concentrated and Sumasohb methods.Results: ages from 10 to 18 years old prevailed, (35,7 percent); parasitism in males had its highest incidence in the spring and the risk factor that mostly favored parasitosis was the ingestion of not well treated water; the Entamoeba histolytica specie was identified as the most frequent one (40 percent). Diarrhea was one of the main symptoms registered in health histories. Secnidazol was the most used medication: 90,9 percent out of the total.Conclusions: the parasitic species Entamoeba histolytica was diagnosed in most of the patients, who showed symptomatic clinical manifestations. The bad sanitary quality of the water was considered as the main risk factor for parasitosis. It is recommended to strengthen the control strategies and prevention of the parasitic diseases in the rural communities (AU)

Estudio de las fracciones lipídicas de colesterol y triglicéridos en pacientes de dos consultorios médicos de la familia / Study of the lipid fractions of cholesterol and triglycerides in patients from two family doctors office

La segunda causa de muerte en la provincia de Las Tunas son las enfermedades del corazón, estas se asocian a múltiples factores de riesgo, como, por ejemplo, los niveles elevados de colesterol y triglicéridos. La alta frecuencia de valores patológicos de colesterol y triglicéridos en pacientes de los Consultorios Médicos de la Familia (CMF) 19-01 y 20-01 en el Policlínico Docente Manuel Fajardo Rivero motivó a la realización de este trabajo, que tiene como objetivo evaluar el comportamiento de las fracciones lipídicas de colesterol y triglicéridos en pacientes de estos CMF, durante el período comprendido entre enero y junio de 2014. Las variables analizadas fueron: rango de valores de colesterol y triglicéridos, edad, sexo, antecedentes patológicos personales, diagnóstico clínico y tratamiento médico. Se incluyeron los pacientes mayores de 20 años de ambos consultorios, los diabéticos, hipertensos, cardiópatas; se excluyeron de la investigación las gestantes, enfermos hospitalizados o con ingreso domiciliario. Se obtuvo como resultado que casi la mitad de los pacientes presentó valores elevados en las fracciones lipídicas de colesterol y triglicéridos, las edades más afectadas fueron los adultos de 41 a 60 años, con predominio del sexo masculino. En la revisión de historias clínicas se tabularon como principales antecedentes patológicos personales que más de la mitad de los pacientes con alteraciones lipídicas son fumadores y un cuarto de ellos consumen alcohol. En el diagnóstico clínico y tratamiento médico registrado en la historia clínica de los pacientes afectados se constató que dos tercios de ellos son hipertensos y utilizan el captopril, enalapril y atenolol y casi un tercio son diabéticos, que se medican con los hipoglucemiantes, insulina y glibenclamida (AU)

Heart diseases are the second cause of death in Las Tunas province; they are associated to multiple risk factors, such as high levels of cholesterol and triglycerides. The high frequency of pathological values of cholesterol and triglycerides in patients from the doctors office 19-01 and 20-01 of Manuel Fajardo Rivero Educational Polyclinic motivated the implementation of this work, which aim at assessing the behavior of the lipid fractions of cholesterol and triglycerides in patients from that doctors office, from January to June, 2014. The variables were: range of values of cholesterol and triglycerides, age, sex, personal pathological antecedents, clinical diagnosis and medical treatment. The study included cardiopath, hypertensive, and older than 20 years old diabetic patients who belong to both offices, excluding from the investigation the expectant mothers, the inpatients and outpatients. The results are: almost half of the patients showed high values of lipid fractions of cholesterol and triglycerides, the most affected patients were adults from 41 to 60 years old, and males prevailed. In the health histories reviews it was tabulated as main personal pathological antecedents that more than half the patients with lipid alterations are smokers and a quarter of them are alcohol consumers. From the clinical diagnosis and medical treatment registered in the health histories, it was possible to establish that two thirds of the patients are hypertensive and use the captopril, enalapril and atenolol, and almost a third of them are diabetic that are prescribed with hypoglycemic agents, insulin and glibenclamide (AU)

Inhibition of dendritic cell apoptosis by Leishmania mexicana amastigotes.

Macrophages (Mφ) and dendritic cells are the major target cell populations of the obligate intracellular parasite Leishmania. Inhibition of host cell apoptosis is a strategy employed by multiple pathogens to ensure their survival in the infected cell. Leishmania promastigotes have been shown to protect Mφ, neutrophils, and dendritic cells from both natural and induced apoptosis. Nevertheless, the effect of the infection with Leishmania amastigotes in the apoptosis of these cell populations has not been established, which results are very important since amastigotes persist in cells for many days and are responsible for sustaining infection in the host. As shown in this study, apoptosis of monocyte-derived dendritic cells (moDC) induced by treatment with camptothecin was downregulated by infection with L. mexicana amastigotes from 42.48 to 36.92% as detected by Annexin-V binding to phosphatidylserine. Also, the infection of moDC with L. mexicana amastigotes diminished the fragmentation of DNA as detected by terminal deoxynucleotidyl transferase-mediated fluorescein-dUTP nick end labeling assay, and changes in cell morphology were analyzed by electron microscopy. The observed antiapoptotic effect was found to be associated with an 80% reduction in the presence of active caspase-3 in infected moDC. The capacity of L. mexicana amastigotes to delay apoptosis induction in the infected moDC may have implications for Leishmania pathogenesis by favoring the invasion of its host and the persistence of the parasite in the infected cells.

Sodium butyrate inhibits Staphylococcus aureus internalization in bovine mammary epithelial cells and induces the expression of antimicrobial peptide genes.

A distinctive feature of bovine milk fat is the presence of butyrate, molecule with recognized antimicrobial and antiinflammatory properties. Bovine mastitis is a pathology characterized by inflammatory and infectious processes; however, the role of sodium butyrate on Staphylococcus aureus infection in mammary epithelium has not been studied. In this work we assess the role of sodium butyrate on the invasion of bovine mammary epithelial cells (bMEC) by S. aureus responsible of mastitis and on the expression of antimicrobial peptide genes. Our data show that sodium butyrate (0.25-0.5mM) reduces approximately 50% the internalization of S. aureus (ATCC 27543) into bMEC. By RT-PCR analysis, we showed that sodium butyrate is able to up-regulate the expression of tracheal antimicrobial peptide (TAP), beta-defensin and inducible nitric oxide synthase (iNOS) mRNAs, as well as nitric oxide production. Also, sodium butyrate and infection increased acetylation of histone H3 in bMEC. These results indicate that sodium butyrate could be effective to modulate innate immune gene expression in mammary gland that leads to a better defense against bacterial infection. To our knowledge, this is the first report that shows a role of sodium butyrate during the internalization of S. aureus into bMEC.

Uso de sufractante en el manejo de casi ahogamiento con agua dulce: a propósito de un caso / Using sufractante in the handling of nearly drowning in fresh water: a case

Se describe un caso de casi ahogamiento en un lactante mayor de 16 meses quien sufre accidente por inmersión en agua con detergente y restos de alimentos por tiempo no precidado, en apnea al momento de ser encontrada, trasladada a centro donde practican maniobras de reanimación básica y calentamiento, presentando luego signos de dificultad respiratoria que se exacerba progresivamente, siendo referida a la unidad de terapia intensiva del Hospital "J. M. de los Ríos". Se conecta a ventilación mecánica manteniéndose estable por 24 horas, posterior a lo cual presenta trastornos de oxigenación por alteración perfusional y cortocircuito, requiriendo incremento de los parámetros ventilatorios. Radiológicamente se observó infiltrado alveolar con microatelectasias múltiples bilaterales. A las 60 horas del evento, se realiza lavado alveolar con surfactante con mejoría progresiva y rápida de los índices de oxigenación, que permiten disminuir los parámetros ventilatorios hasta la descontinuación de la ventilación mecánica en las 30 horas posteriores.