Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility.

PURPOSE: To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS: 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS: There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of ​​the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION: A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.

The Value of Crop Production and Pollination Services in the Eastern Amazon.

Nature safeguards living organisms and the ecosystem functions and services delivered by them. Animal pollination is an important Ecosystem Service since it plays a key role for achieving the sustainable development goals by safeguarding worldwide food production. Thus, conservation of pollination services is a major priority for guaranteeing global food security in the long term. Here we evaluate the crop pollination services in Pará state (Eastern Amazon, Brazil) focusing on two questions: (1) What is the economic value of crop production and pollination service in Pará? (2) Which municipalities are most dependent on pollination services considering local economies? We found 36 crops produced in the state; 20 (55%) crops are dependent on animal pollinators. In 2016, crop production value (CPV) for Pará state was US$ 2.95 billion and total pollination service value (PSV) was US$ 983.2 million, corresponding to 33% of CPV in Pará. Highest PSV value crops were açaí palm (US$635.6 million), cocoa (US$187.6 million), soybean (US$98.4 million), and watermelon (US$26.1 million), accounting for 96% of Pará's PSV. Two municipalities (Medicilândia and Igarapé Miri) presented more than 50% of their GDP based on pollination services. In general, we found low crop diversity in the municipalities of Pará, suggesting an economic rural vulnerability for the state, mainly supported by the high productions of soy and açaí. Pollinator conservation and ecological intensified farming practices are urgent for supporting sustainable development for the state.

The Dependence of Crops for Pollinators and the Economic Value of Pollination in Brazil.

Food production is challenged by changes in climate and land use and expanding human population growth. Proper pollination can increase the production and quality of fruit, nut, oil, and fiber crops. We reviewed crop dependence on pollinators and estimated the economic value of pollination per year for each crop in Brazil. We analyzed 141 crops and found that 85 depend on pollinators. Almost one-third of these crops have an essential or great dependence on pollinators. The economic contribution of pollinators totals ∼30% (∼US$12 billion) of the total annual agricultural income of the dependent crops (totalizing almost US$45 billion). However, half of these figures includes soybean crop (US$5.7 billion of pollinators' contribution and US$22 billion of annual income). Soybean was considered as having a modest dependence on pollinators, but this remains controversial because pollinator dependence might vary among different varieties cultivated in Brazil. Moreover, we have no information about pollinator dependence regarding some important crops, showing the urgent need for basic research into reproductive biology and pollination ecology.

Linfoma de células cutáneas de células T, tipo micosis fungoide folicular: reporte de un caso / Cutaneous T-cell lymphoma type mycosis fungoides follicular: case report

La Micosis Fungoide (MF) es el linfoma cutáneo más común de células T. Tiene un comportamiento indolente, llevando a algunos a utilizar el término de linfoma cutáneo de células T (LLCT) como sinónimo de la MF. Se caracteriza por una erupción cutánea crónica, generalizada, y clínicamente por la evolución de los parches en placas y tumores. A continuación se presentará un caso clínico que tras un diagnóstico de liquen plano refractario a tratamiento, se diagnostica micosis fungoide folicular.

Mycosis fungoides (MF) is recognized as the most common cutaneous T-cell lymphoma (CTCL). It has an indolent behavior, leading some to use the term cutaneous T-cell lymphoma as synonymous of MF. It is characterized by chronic, widespread rash, and clinically by the evolution of patches in plaques and tumors. We describe our experience with a case that after a diagnosis of lichen planus refractory to treatment, we diagnosed follicular mycosis fungoides.

Buen control local y sobrevida post resección curativa de cáncer de recto medio e inferior: protocolo terapéutico multimodal, selectivo / Good local control and survival post curative resection for middle and lower rectal cancer: therapeutic, multimodal, selective protocol

Objetivo: Evaluar protocolo multimodal, selectivo, midiendo resultados alejados en una serie de cáncer de recto medio e inferior, operada con intención curativa, por un solo cirujano. Material y Método: Entre 1991 y 2000 se atienden 112 cánceres restales. Se resecan 107. Resección paliativa: 27, sin mortalidad; curativa: 80. Esta serie incluye 73 pacientes: recto medio (23) y recto inferior (50). Operaciones: Sin resección total del mesorrecto (RTM): Resección local: 9, Resección anterior baja: 11. Con RTM: Resección anterior ultrabaja: 33, Resección abdominoperineal: 18 y Hartmann: 2. Radioterapia: En 54,8 por ciento. Incluye radioquimioterapia preoperatoria (26 por ciento), especialmente en T3-T4, N+ y/o recto inferior. Seguimiento: Asiduo en 72 pacientes. Promedio 57,4 meses. Resultados: Mortalidad operatoria: 1,4 por ciento. Preservación esfínter funcionante 68,5 por ciento. Recidiva local 5 años: 11 por ciento. Sobrevida a 5 años: Cáncer específica: 73,3 por ciento. Libre de enfermedad: 68,2 por ciento. Conclusión: Estos resultados avalan la aplicación de este protocolo terapéutico multimodal, selectivo, con cifras similares a buenas series extranjeras.

Adjuvant radiochemotherapy in the treatment of completely resected, locally advanced gastric cancer.

PURPOSE: To analyze the efficacy and toxicity of adjuvant whole abdomen irradiation (WAI) and concomitant chemotherapy in the treatment of completely resected, high-risk gastric cancer. METHODS AND MATERIALS: Between October 1990 and September 1997, 52 patients with completely resected gastric cancer, with lymph node and/or serosal involvement, were treated. Ages were 16-78 (median, 53.5) years. Treatment was either total- or sub-total gastrectomy, followed by WAI, 2100 cGy/21 fractions plus a 2400 cGy/16 fractions boost to the tumor bed. Chemotherapy consisted of either 5-fluorouracil (5-FU) 450-500 mg/m(2) i.v. for 5 days first and 5th week or 200-300 mg/m(2) continuous infusion during irradiation. No further chemotherapy was given. RESULTS: With a minimum follow-up of 30 months and a median follow-up of 43.5 months, 25 of the 52 patients have died. Overall 5-year survival rate is 54%. Three patients sustained Grade 3-5 complications. Two patients with Grade 5 complications (malabsorption syndrome) died 31 and 56 months after the beginning of the treatment, respectively, with no evidence of recurrent tumor. For patients with involvement of the lymph nodes alone (n = 19) the 5-year survival was 69%, which was significantly better than the 36% 5-year survival observed for those patients with both serosal and lymph node involvement (n = 26, p = 0.004). CONCLUSION: Adjuvant radiochemotherapy, WAI, and concomitant 5-FU, is a feasible and a fairly well-tolerated treatment for patients with locally advanced (involvement of the lymph nodes or serosa) gastric carcinoma who undergo complete resection. The 54% overall 5-year survival compares favorably with the survival reported after surgery alone for those patients.

Computer-assisted analysis of molecular mimicry between human papillomavirus 16 E7 oncoprotein and human protein sequences.

The immunology of human papillomavirus (HPV) infections has peculiar characteristics. The long latency for cervical cancer development after primary viral infection suggests mechanisms that may aid the virus in avoiding the host immunosurveillance and establishing persistent infections. In order to understand whether molecular mimicry phenomena might explain the ability of HPV to avoid a protective immune response by the host cell, sequence similarity between HPV16 E7 oncoprotein and human self-proteins was examined by computer-assisted analysis. Data were obtained showing that the HPV16 E7 protein has high and widespread similarity to several human proteins involved in a number of critical regulatory processes. In addition, multiple identical and different E7 peptide motifs are present in the same human protein. Thus, sharing of common motifs between viral oncoproteins and molecules of normal cells may be one cause underlying the scarce immunogenicity of HPV infections. The hypothesis is advanced that synthetic peptides harbouring viral motifs not and/or scarcely represented in the host's cellular proteins may represent a valuable immunotherapeutic approach for cervical cancer treatment.

TGF-beta 1 and IGF-1 expression in atrophic post-menopausal endometrium.

OBJECTIVES: Endometrial cells may synthetize cytokines and growth factors which may modulate some of the molecular mechanisms of endometrial proliferation and differentiation. PATIENTS AND METHODS: We investigated the role of transforming growth factor beta-1 (TGF-beta 1), insulin-like growth factor-1 (IGF-1) and relative receptors in five tissue samples from atrophic post-menopausal endometria. The control group was represented by proliferative and secretory endometria from 10 healthy, normally-menstratued women. TGF-beta 1 and IGF-1 m-RNA expression was evaluated by Northern hybridization analysis, while TGF-beta 1 and IGF-1 receptors distribution was studied by immunohistochemistry. RESULTS: In atrophic endometria Northern hybridization analysis showed a significant decrease of IGF-1 expression, and an increase of TGF-beta 1 expression compared to proliferative and secretory endometria. By immunohistochemistry it was demonstrated that TGF-beta 1 and IGF-1 receptors were both localized in cell cytoplasm, mainly in the stromal compartment. CONCLUSIONS: The results of our study would suggest a possible role of IGF-1 and TGF-beta 1 in maintaining the quiescent differentiative state of atrophic post-menopausal endometrium. The persistence of IGF-1 and TGF-beta 1 receptors in epithelial compartment could play a key role in proliferative response of atrophic endometrium to exogenous hormone replacement therapy (HRT) or endogenous intervening high estrogens levels.

Insulin-like growth factor-I expression in normal and diseased endometrium.

While the role of steroid hormones in the regulation of endometrial proliferation and differentiation is well established, the effects of growth factors and their receptors in normal and neoplastic endometrium remain a matter of debate. Previous studies have documented the positive effects of insulin-like growth factor-I (IGF-I) on epithelial cell proliferation and the active production of this growth factor in endometrial tissues. In view of decreased expression of transforming growth factor-beta1 (TGF-beta1), an antagonist of IGF-I, in endometrial carcinoma, we investigated the expression of IGF-I, at both the mRNA and protein levels, and the immunoreactivity for type I IGF-I receptor in 30 formalin-fixed, paraffin-embedded tissue samples of normal and neoplastic endometrium, in order to possibly clarify the role of IGF-I in endometrial proliferation and differentiation. Our results demonstrate a reduced expression of IGF-I mRNA in endometrial carcinomas compared with non-neoplastic tissues, despite equivalent immunohistochemical expression of IGF-I and IGF-I receptor. Our data suggest that IGF-I and its corresponding receptor may not be directly involved in endometrial cancer cell proliferation and differentiation in vivo, though other components of the IGF-I system (e.g., IGF binding proteins) may affect endometrial malignant transformation and tumor progression.

Down-regulated expression of transforming growth factor beta 1 mRNA in endometrial carcinoma.

Transforming growth factor beta1 (TGF-beta1) is a potent modulator of cell proliferation in vitro, and recent studies have demonstrated its overexpression in several different tumours; nevertheless, the molecular mechanisms of TGF-beta1 action on cell growth and differentiation have not been fully elucidated. To clarify the role of TGF-beta and its receptor in human endometrial proliferation and differentiation, TGF-beta1 expression at both the mRNA and protein levels has been evaluated by using Northern blotting and immunohistochemistry, in both normal (atrophic, proliferative and secretory) and neoplastic (adenocarcinoma) endometrial samples. This study demonstrates that TGF-beta1 mRNA expression is dramatically reduced in endometrial carcinomas with respect to non-neoplastic tissues, whereas the immunohistochemical expression of TGF-beta1 is enhanced in the epithelial component of endometrial carcinomas compared with non-neoplastic tissues. These data suggest that TGF-beta1 acts as a paracrine regulator of endometrial cell proliferation and that it may contribute to the carcinogenic mechanisms of endometrial carcinoma.

Análisis de resultados de los tratamientos en cáncer cérvico uterino: etapas II B y III B / Analysis of treatment results in carcinoma of the uterine cervix: stages II B and III B

Entre 1975 y 1984, 40 pacientes en etapa II B y 8 en etapa III B fueron operadas posteriormente a haber recibido tratamiento radiante. Se comparan los resultados en cuanto a sobrevida y complicaciones del tratamiento con un grupo al azar de 58 pacientes tratadas con radioterapia radical exclusiva. En la etapa II B la sobrevida a 5 años fue de un 81,4% en el grupo con Radioterapia Exclusiva y 83,4% con Radioterapia pre-operatoria más cirugía y 80,1% con Radioterapia Radical más cirugía (p > 0.05). En la etapa III B la sobrevida a 5 años fue de un 55% en el grupo irradiado y de un 42.8% cuando se agregó cirugía (p > 0.05). Las complicaciones menores se observaron con mayor frecuencia cuando se agregó cirugía al tratamiento (50% v/s 9%) (p < 0.05). Las complicaciones mayores también se presentaron con mayor frecuencia cuando se operaron las pacientes (p > 0.05). En el grupo de pacientes en que la radioterapia se consideró "completa" y se operaron, en ninguna se observó tumor residual en el estudio histopatológico de la pieza operatoria. Los resultados obtenidos demuestran cifras comparables o superiores a los informados en la literatura. Se concluye que el agregar cirugía a este tipo de pacientes aumenta la posibilidad menor y mayor del tratamiento sin modificar la sobrevida