Epigenetic control of the EWS­FLI1 promoter in Ewing's sarcoma.

Ewing sarcoma (ES) is a primary bone marrow tumor that very rarely develops in extra­osseous tissues, such as lung. The hallmark of ES tumors is a translocation between chromosomes 11 and 22, resulting in a fusion protein, commonly referred to as EWS­FLI1. The epigenetic profile (histone acetylation and methylation enrichment of the promoter region) that may regulate the expression of the aberrant transcription factor EWS­FLI1, remains poorly studied and understood. Knowledge of epigenetic patterns associated with covalent histone modification and expression of enzymes associated with this process, can contribute to the understanding of the molecular basis of the disease, as well as to the identification of possible molecular targets involved in expression of the EWS­FLI1 gene, so that therapeutic strategies may be improved in the future. In the present study, the transcriptional activation and repression of the EWS­FLI1 fusion gene in ES was accompanied by selective deposition of histone markers on its promoter. The EWS­FLI1 fusion gene was evaluated in two patients with ES using conventional cytogenetic, fluorescence in situ hybridization and nested PCR assays, which revealed that the aberrant expression of the EWS­FLI1 gene is accompanied by enrichment of H3K4Me3, H3K9ac and H3K27ac at the promoter region.

The use of the health technology assessment for technology acquisition in hospitals / El uso de la evaluación de tecnología de salud para la adquisición de tecnología en hospitales / O uso da avaliação de tecnologia de saúde para a aquisição de tecnologia em hospitais

Decision makers at the national and local level of health systems require evidence of effectiveness, safety and costs of health technologies for resource allocation. In this sense Health Technology Assessment (HTA) is a favorable tool considering it is a multidisciplinary process to evaluate the benefits as well as the social, economic, organizational and ethical issues of a health technology. The aim of this study was to review the literature in order to identify the attributes used in the process of technology acquisition. It was analyzed the attributes of HTA with the purpose of classifying them, to see which are the most recommended for acquisition in hospitals. The identified literature indicated that not only the clinical and economic attributes were considered, but also attributes related to the context of the hospital such as the effect of technology on other hospital services and others associated with the organization.

Los tomadores de decisiones a nivel nacional y local de los sistemas de salud requieren evidencia de la efectividad, seguridad y costos de las tecnologías de la salud para la asignación de recursos. En este sentido, la Evaluación de la Tecnología de la Salud (HTA, por sus siglas en inglés) es una herramienta favorable considerando que es un proceso multidisciplinario para evaluar los beneficios, así como las cuestiones sociales, económicas, organizativas y éticas de una tecnología de la salud. El objetivo de este estudio fue revisar la literatura con el fin de identificar los atributos utilizados en el proceso de adquisición de tecnología. Se analizaron los atributos de HTA con el fin de clasificarlos, para ver cuáles son los más recomendados para adquisición en hospitales. La literatura identificada indicó que no sólo se consideraron los atributos clínicos y económicos, sino también atributos relacionados con el contexto del hospital como el efecto de la tecnología en otros servicios hospitalarios y otros asociados con la organización.

Os tomadores de decisões a nível nacional e local dos sistemas de saúde requerem evidência da efetividade, segurança e custos das tecnologias de saúde para a atribuição de recursos. Neste sentido, a Avaliação da Tecnologia da Saúde (HTA) é uma ferramenta favorável considerando que é um processo multidisciplinar para avaliar os benefícios, bem como as questões sociais, económicas, organizativas e éticas de uma tecnologia da saúde. O objetivo deste estudo foi revisar a literatura com o fim de identificar os atributos utilizados no processo de aquisição de tecnologia. Analisaram-se os atributos de HTA com o fim de classificá-los, para ver quais são os mais recomendados para aquisição em Hospitais. A literatura identificada indicou que não só se consideraram os atributos clínicos e económicos, assim como também alguns atributos relacionados com o contexto do hospital como o efeito da tecnologia em outros serviços hospitalários e outros associados com a organização.

Retinopatía diabética: realidad local en un Centro de Salud Familiar / Diabetic retinopathy: local reality in a Family Health Center

Introducción: la retinopatía diabética es la complicación microvascular más frecuente de la DM y puede acelerar por un mal control metabólico o por años de evolución de la diabetes. Principal causa de ceguera en población adulta. Material y Método: estudio caso y control, utilizando 194 tarjetones del programa cardiovascular que cumplen con criterios de inclusión. Casos: fondo de ojos alterado, Control: fondo de ojo normal. Análisis de datos en STATA 8.0. Resultados: edad promedio 63,37 años, 120 mujeres, 74 hombres. Valor promedio HbA1c 7,83. 40,72 por ciento < a 7 y 59,28 por ciento > o igual a 7.85,05 por ciento con fondo de ojo normal y 14,95 por ciento con fondo de ojo alterado. HbA1c >7 da OR 7,4 para desarrollar fondo de ojo alterado; uso de insulina da OR 11,9 para desarrollar fondo de ojo alterado; uso dosis máxima de HGO da OR 8,746 para desarrollar fondo de ojo alterado. Discusión: el mal control metabólico, así como el uso de dosis máximas de HGO o el uso de insulina, son factores de riesgo significativos para desarrollar retinopatía diabética, estando todos estos factores relacionados. Se requiere realizar un control y ajustes de tratamiento más agresivos con pacientes diabéticos para prevenir o retrasar esta complicación.

Evidence of a role for plant proteases in the degradation of herbage proteins in the rumen of grazing cattle.

Protein breakdown in the rumen is generally regarded as a two-stage process in which proteases produced by rumen microorganisms cleave plant protein into peptides and amino acids. However, many of the fiber-degrading cellulolytic species in the rumen are not in fact proteolytic, and the proteolytic activity of the entire rumen microbial population is only moderate when compared to the gastric and pancreatic secretions in the abomasum. Moreover, plant cell walls remain largely intact after initial chewing (particularly in cattle), presenting a physical barrier that must be breached prior to their effective colonization. The present study considers the hypothesis that the plant enzymes are at least partly responsible for herbage protein degradation in grazing ruminants. Ryegrass, red clover, white clover, and bird's-foot trefoil were incubated in the presence and absence of rumen microorganisms. The production of volatile fatty acids indicated the level of microbial activity, whereas the relative disappearance of the large subunit of ribulose 1,5 bisphosphate carboxylase/oxygenase (Rubisco LSU) indicated proteolytic activity. In all incubations, the relative abundance of the Rubisco LSU decreased as the incubation progressed. When rumen microorganisms were absent, low molecular weight peptides (below 20 kDa) accumulated as the incubation progressed. This accumulation was not observed in the presence of rumen microorganisms. Therefore we suggest that the intrinsic plant proteases contribute to the initial stages of proteolysis of grazed herbage.

Antireflux mechanism of Nissen fundoplication. A manometric study.

To analyze the mechanisms by which Nissen fundoplication controls gastroesophageal reflux, the pre- and post-operative manometric findings in 34 patients were compared. The postoperative assessment showed an increase in both the infradiaphragmatic length and basal pressure of the lower esophageal sphincter and a notable improvement in esophageal motility (increase in the amplitude of the waves and decrease in the mean percentage of deglutitions without response and tertiary waves) in those who preoperatively presented with defective esophageal peristalsis.