Manifestaciones ginecológicas en el curso de las enfermedades reumáticas / Gynecological manifestations in the course of rheumatic diseases

Introducción: Las enfermedades reumáticas se caracterizan por la presencia de manifestaciones articulares y extraarticulares. Entre estas últimas, uno de los sistemas menos estudiados es el reproductor. Objetivo: Caracterizar las manifestaciones ginecológicas que con mayor frecuencia se presentan en el curso de las enfermedades reumáticas. Métodos: Se realizó una investigación básica, no experimental, descriptiva y longitudinal que incluyó un total de 117 pacientes femeninas con diagnóstico de varias enfermedades reumáticas según los criterios del Colegio Americano de Reumatología. La muestra quedó conformada por 108 pacientes. Durante la realización del estudio se identificó la incidencia de manifestaciones ginecológicas en las pacientes reumáticas y el tipo de manifestación que se notifica con mayor frecuencia. Resultados: Pacientes con un promedio de edad de 61,19 años, predominio de procedencia urbana (61,11 por ciento) y con diagnóstico de artritis reumatoide (61,11 por ciento). El 39,81 por ciento de ellas refirió tiempo de evolución de la enfermedad entre 3 y 5 años. El 62,04 por ciento de las pacientes presentó algún tipo de manifestación extraarticular ginecológica. La secreción vaginal (50,75 por ciento), vulvovaginitis (25,37 por ciento), cervicitis (20,90 por ciento) y la dispareunia (14,92 por ciento) fueron las de mayor frecuencia de presentación. Conclusiones: Las manifestaciones ginecológicas son frecuentes en las pacientes con enfermedades reumáticas. Las manifestaciones ginecológicas de origen inflamatorio fueron las de mayor presentación y fueron más frecuente en la artritis reumatoide y el lupus eritematoso. En la esclerosis sistémica las manifestaciones neoplásicas fueron las más frecuentes(AU)

Introduction: Rheumatic diseases are characterized by the presence of articular and extra-articular manifestations. Within the latter, one of the least studied systems. Objective: To characterize the gynecological manifestations that most frequently occur in the course of rheumatic diseases. Methods: A basic, non-experimental, descriptive and longitudinal research was carried out that included a total of 117 female patients diagnosed with various rheumatic diseases according to the criteria of the American College of Rheumatology. The sample was made up of 108 patients. During the study, the incidence of gynecological manifestations in rheumatic patients and the type of manifestation that is most frequently reported were identified. Result: average age of 61.19 years, predominance of patients of urban origin (61.11%) and with a diagnosis of rheumatoid arthritis (61.11 percent). 39.81 percent of the patients reported disease evolution time between three and five years. 62.04% of the patients presented some type of extra-articular gynecological manifestation. Vaginal secretion (50.75 percent), vulvovaginitis (25.37 percent), cervicitis (20.90 percent) and dyspareunia (14.92 percent) were the ones with the highest frequency of presentation. Conclusions: Gynecological manifestations are frequently found in patients with rheumatic diseases. Gynecological manifestations of inflammatory origin were those with the highest frequency of presentation and were more frequent in rheumatoid arthritis and lupus erythematosus. In systemic sclerosis, neoplastic manifestations were the most frequent(AU)

Supervivencia relacionada con la respuesta patológica, luego de quimioterapia neoadyuvante en cáncer de mama / Survival related to pathological response, after Neoadjuvant Chemotherapy in breast cancer

Quimioterapia neoadyuvante (NAC) en cáncer de mama permite conocer la sensibilidad del tumor al tratamiento, alcanzar respuesta patológica completa (pRC), está asociada a mejor supervivencia en cáncer de mama localmente avanzado. El objetivo de este estudio fue conocer el impacto de la pRC en la supervivencia en una cohorte de pacientes tratadas con NAC y cirugía. Se realizo un estudio de diseño observacional de tipo retrospectivo, correlacional, con un seguimiento promedio de 90 meses, de una cohorte de pacientes tratadas con NAC y cirugía desde enero del 2009 a diciembre del 2011. El análisis de datos se realizó mediante el software estadístico SPSS v22.0, para el análisis de supervivencia se utilizó el método de Kaplan Meier, para comparar supervivencias se consideró significativa una p<0,05. Entre las características principales de 199 pacientes, se destacan: edad joven a la presentación, elevado índice de proliferación y alta frecuencia del tipo inflamatorio. pRC ocurrió en el 14,1% de pacientes y la supervivencia global (SG) de acuerdo con la respuesta patológica se comparó entre aquellas pacientes que obtuvieron pRC, con las que tuvieron enfermedad residual, con una SG del 71,4% vs 45% respectivamente, con una diferencia significativa (p:0.009). En esta cohorte de pacientes la pRC impactó en la supervivencia en todos los subtipos clínico-patológicos, sobre todo en el subtipo triple negativo. Evaluar los datos en el entorno real es importante para definir estrategias y mejorar los resultados.

Neoadjuvant chemotherapy (NAC) in breast cancer allows knowing the sensitivity of the tumor to treatment, achieving pathological response complete (pRC), and is associated with better survival in locally advanced breast cancer. The objective of this study was to determine the impact of pRC on survival in a cohort of patients treated with NAC and surgery. A retrospective, correlational observational design study was carried out, with an average follow-up of 90 months, of a cohort of patients treated with NAC and surgery from January 2009 to December 2011. Data analysis was performed using the software SPSS v22.0 statistic, for the survival analysis the Kaplan Meier method was used, to compare survivals a p <0.05 was considered significant. Among the main characteristics of 199 patients, the following stand out: young age at presentation, high proliferation index and high frequency of the inflammatory type. pRC occurred in 14.1% of patients and overall survival (OS) according to the pathological response was compared between those patients who obtained pRC, with those who had residual disease, with an OS of 71.4% vs 45% respectively, with a significant difference (p: 0.009). In this cohort of patients, pRC impacted on survival in all clinicopathological subtypes, especially in the triple negative subtype. Evaluating data in the real environment is important to define strategies and improve results.

Niveles de orientación empática en estudiantes de medicina de la Universidad Metropolitana de Barranquilla (Colombia) / Empathy levels in medicine students of Metropolitana University of Barranquilla (Colombia)

Resumen Objetivo: Evaluar el nivel de orientación empática de los estudiantes del Programa de Medicina de la Universidad Metropolitana según género y niveles de enseñanza. Materiales y Métodos: Trabajo de tipo exploratorio con análisis transversal, regido por las normas de Helsinki. La población estuvo formada por los estudiantes de primero a sexto año académico de la carrera de Medicina de la Universidad Metropolitana (Barranquilla, Colombia) (N=2061) de la cual se tomó una muestra (n = 1581) estratificada por año, así: primero: 219; segundo: 324; tercero: 258; cuarto: 278; quinto: 359 y sexto: 143. En el factor Género, la composición muestral fue la siguiente: femenino: 1146 y masculino: 435. La recolección de datos se realizó en julio de 2016. A los participantes se les aplicó la Escala de Empatía Médica de Jefferson (EEMJ) en la versión en español para estudiantes de medicina (versión S), validada en México y Chile. Antes de ser aplicada la EEMJ fue sometida a criterio de jueces (tres académicos de profesión médico) con el objeto de verificar la validez cultural y de contenido. La comprensión de los estudiantes de la escala adaptada culturalmente se realizó mediante una prueba piloto. Resultados: En el factor "Años Académicos" los resultados fueron significativos, no siendo así para el "Género" y la interacción. Se observó que la media disminuyó hasta tercer año, mostrando un leve incremento en cuarto año, bajando en el quinto y aumentando nuevamente en sexto año, siendo el comportamiento semejante en ambos géneros.

Abstract Objective: To assess the level of empathy of the students of the medical program of the Metropolitan University according to sex and levels of education. Subjects and methods: Is an exploratory and cross-sectional research. The population included students from first to sixth academic year of Medicine School (n = 1581 N =2061) and was distributed per year: first: 219; second: 324; third: 258; fourth 278; fifth: 359 and sixth: 143. Regarding gender, the sample composition was 435 (male) and female (435) = 1146. Data collection was conducted in July 2016. Participants were administered the Scale of Physician Empathy Jefferson (JSPE) in the Spanish version for medical students (S). Before being applied, the JSPE was subject to the discretion of judges in order to verify cultural and content validity. Results: In "Academic Years", results were significant, not being so for "Gender" and interaction. It was observed that the average decreased until the third year, showing a slight increase in the fourth year, to fall again and increase again in the sixth year. Behavior is similar in both genders and both decline from first to third, showing and a slight increase begins from the fourth year.

Bacteriophages in the control of pathogenic vibrios

Vibrios are common inhabitants of marine and estuarine environments. Some of them can be pathogenic to humans and/or marine animals using a broad repertory of virulence factors. Lately, several reports have indicated that the incidence of Vibrio infections in humans is rising and also in animals constitute a continuing threat for aquaculture. Moreover, the continuous use of antibiotics has been accompanied by an emergence of antibiotic resistance in Vibrio species, implying a necessity for efficient treatments. One promising alternative that emerges is the use of lytic bacteriophages; however, there are some drawbacks that should be overcome to make phage therapy a widely accepted method. In this work, we discuss about the major pathogenic Vibrio species and the progress, benefits and disadvantages that have been detected during the experimental use of bacteriophages to their control.

Esclerosis lateral amiotrófica. Presentación de un caso / Amyotrophic Lateral Sclerosis. Presentation of a case

La esclerosis lateral amiotrófica es una enfermedad del sistema nervioso central. Se presenta el caso de un paciente masculino, raza blanca, de 50 años; el que acude a consulta en el Hos-pital Provincial General Docente "Mártires del 9 de abril" por presentar debilidad de los miembros inferiores. El examen físico mostró fasciculaciones musculares diseminadas, debi-lidad muscular próximo-distal (-2) en los cuatro miembros, atrofia muscular que afecta mus-culatura distal y proximal de las extremidades, sialorrea, lenguaje disártrico, reflejos osteo-tendinosos exaltados de forma generalizada y Babinski bilateral. Los exámenes complemen-tarios arrojaron patrón neurógeno dependiente de los miotomas de C6-C8 con signos de denervación. Diagnóstico nosológico: esclerosis lateral amiotrófica. El enfermo refiere histo-rial de esa patología por 14 años, lo que solo se observa en aproximadamente el 10% de los casos

Amyotrophic lateral sclerosis is a disease of the central nervous system. The clinical case of a male patient, white race and 50 years old is presented. This one goes to consultation in the Provincial General Hospital "Mártires del 9 de April" for presenting weakness in lower limbs. The physical examination showed disseminated muscle twitching, proximal-distal muscular weakness (-2) in all four limbs, muscular atrophy affecting the distal and proximal muscles of the extremities, sialorrhea, disartic language, generalized extenuated osteotendi-nous reflexes and bilateral Babinski. The complementary tests showed a neurogenic pattern dependent on the C6-C8 myotomes with signs of denervation. Nosological diagnosis: amyo-trophic lateral sclerosis. The patient refers history of that pathology.

Amplification of tlh gene in other Vibrionaceae specie by specie-specific multiplex PCR of Vibrio parahaemolyticus

Background The surveillance of Vibrio parahaemolyticus in the Chilean coast has been mainly performed by multiplex PCR amplification of three different hemolysin genes, which are specie-specific virulence factors. These genes are also employed in the determination of V. parahaemolyticus pathogenic load in seafood and for characterization of pathogenic strains associated to diarrhea cases in human. During environmental surveillance that we performed every summer, we occasionally observed a thermolabile hemolysin (tlh) PCR product of a slightly smaller size than expected, which was coincident with low loads of V. parahaemolyticus in the environment. In order to understand this observation, we probed the specificity of tlh primers for the detection of V. parahaemolyticus at different bacterial loads and DNA concentrations. Results Primers used for the detection of V. parahaemolyticus specific tlh amplified a slightly smaller tlh gene, which is found in Vibrio alginolyticus and other related strains. These amplicons were observed when V. parahaemolyticus was absent or in undetectable loads in the environment. Conclusions Surveillance of V. parahaemolyticus using tlh primers can be imprecise because amplification of a V. parahaemolyticus specific marker in V. alginolyticus and other related strains occurs. This situation complicates potentially the estimation of bacterial load in seafood, because do not ensure the correct identification of V. parahaemolyticus when his load is low. Additionally, it could complicate the tracking of outbreaks of V. parahaemolyticus infections, considering the genetic markers used would not be specie-specific.

Serum levels of ghrelin, growth hormone, and insulin during growth of cattle under tropical conditions / Niveles séricos de ghrelina, hormona del crecimiento e insulina en la fase de crecimiento de bovinos en condiciones de trópico / Níveis séricos de ghrelina, hormônio do crescimento e insulina na fase de crescimento de bovinos em condições de tropico

From a physiological and animal production standpoint, it is important to know the factors associated with growth and development of the rumen. Calf transition from monogastric into ruminant involves structural and physiological changes of the digestive system. This process involves hormones that affect both the orexigenic (ghrelin) and metabolic phases, and also nutrient utilization (i.e., insulin and growth hormone). The aim of this study was to monitor growth of calves between birth and six months of age and determine serum ghrelin, growth hormone, and insulin, in three breeds. Eight animals were selected from each breed (Harton del Valle, Holstein, and Brahman). Body weight was measured and blood samples collected every 30 days. Protein was analyzed by direct refractometry, insulin and ghrelin by radioimmunoassay (RIA), glucose by enzymatic colorimetry, and growth hormone (HG) by ELISA. A factorial design with two main effects (animal breed and sampling age) was used, blocking by weight groups. Analysis of variance showed differences (p<0.05) for main effects. The observed mean values were: 529 g/ day weight gain, 55.6 g/L protein, 4.99 mmol/L glucose, 297.69 pmol/L insulin, 59.11 pmol/L ghrelin, and 12,87 ug/L HG. Differences were observed for hormone values and indicators by age of calves at the time of sampling.

El conocimiento de los factores asociados al crecimiento y al desarrollo del rumen es importante desde el punto de vista fisiológico y de la producción animal. El paso de monogástrico a rumiante en terneros implica cambios estructurales y fisiológicos en el sistema digestivo. En el proceso intervienen hormonas que inciden en las fases orexigénica (ghrelina), metabólica y de utilización de nutrientes por parte del organismo (insulina y hormona de crecimiento). El objetivo del presente trabajo fue monitorear el crecimiento entre el nacimiento y seis meses de edad de terneros y determinar las concentraciones séricas de Ghrelina, hormona del crecimiento e insulina, en tres grupos raciales de bovinos. Fueron seleccionados ocho animales de cada raza (Hartón del Valle, Holstein y Brahman). Cada 30 días se determinó el peso vivo animal y se recolectaron muestras de sangre. La proteína se analizó por refractometría directa, la glucosa por colorimetría enzimática, la insulina y la ghrelina por radioinmunoanálisis (RIA) y la hormona del crecimiento (HG) por la técnica de Elisa. Se utilizó un diseño factorial con dos efectos principales (raza y edad de muestreo), y un bloqueo final por grupos de peso de los animales. El análisis de varianza mostró diferencia (p<0,05) para los efectos principales. Los valores promedios fueron para ganancia de peso vivo 529 g/día, proteína 55,6 g/L, glucosa 4,99 mmol/L, insulina 297,69 pmol/L, ghrelina 59,11 pmol/L, y HG 12,87 ug/L. Se presentaron diferencias en los valores de hormonas e indicadores según la edad de los terneros al tiempo de muestreo.

O conhecimento dos fatores associados ao crescimento e ao desenvolvimento do rumem é importante tanto desde o ponto de vista fisiológico quanto da produção animal. A mudança dos vitelos de monogástrico para ruminante implica mudanças estruturais e fisiológicas no sistema digestivo. No processo intervém hormônios que incidem nas fases orexigénica (ghrelina), metabólica e de utilização de nutrientes por parte do organismo (insulina e hormônio do crescimento). O objetivo do presente trabalho foi monitorar o crescimento entre o nascimento e os seis meses de idade de vitelos e assim determinar as concentrações séricas de ghrelina, hormônio do crescimento e insulina, em três grupos raciais de bovinos. Foram selecionados oito animais de cada raça (Hartón del Valle, Holandês e Brahman). A cada 30 dias determinou-se o peso vivo do animal e se coletaram amostras de sangue. A proteína analisou-se por refractometria direta, a glucose por colorimetria enzimática, a insulina e a ghrelina por radioimunoanalise (RIA) e o hormônio do crescimento (HG) pela técnica de ELISA. Utilizou-se um desenho fatorial com dois efeitos principais (raça e idade de amostragem), e um bloqueio final por grupos de peso dos animais. O analise de variância apresentou diferença significativa (p<0,05) para os efeitos principais. Os valores médios foram para ganho de peso vivo, 529 g/dia; proteína, 55,6 g/L; glucose, 4,99 mmol/L; insulina, 297,69 pmol/L; ghrelina, 59,11 pmol/L, e HG, 12,87 µg/L. Apresentaram-se diferenças nos valores de hormônios e indicadores segundo a idade dos vitelos ao tempo de amostragem.

Nitric oxide is not involved in Neisseria gonorrhoeae-induced cellular damage of human Fallopian tubes in vitro

In the present study, we investigated whether cellular damage, as demonstrated by lactate dehydrogenase (LDH) release in the human fallopian tube (FT) infected by Neisseria gonorrhoeae (Ngo), correlated with high levels of nitric oxide synthase (NOS) mRNA and enzyme activity. Infection with Ngo induced a significant increase (~35-fold) in mRNA transcripts of the inducible isoform of NOS. Paradoxically, a reduction in NOS enzyme activity was observed in infected cultures, suggesting that gonococcal infection possibly influences translation of iNOS mRNA to the enzyme. In addition, treatment with the NOS inhibitor TRIM did not prevent gonococcal-induced cellular damage. In contrast, the addition of the inhibitor L-NAME induced a 40 percent reduction in LDH release, which correlated with a ~50 percent reduction in gonococcal numbers. Moreover, treatment of normal FT explants with an exogenous NO donor, SNAP, did not induce significant cellular damage. Taken together, our data suggest that NO does not contribute to cellular damage during infection of the human FT with Neisseria gonorrhoeae.

Apoptosis related genes expressed in cultured Fallopian tube epithelial cells infected in vitro with Neisseria gonorrhoeae

Background: Infection of the Fallopian tubes (FT) by Neisseria gonorrhoeae (Ngo) can lead to acute salpingitis, an inflammatory condition resulting in damage primarily to the ciliated cells, with loss of ciliary activity and sloughing of the cells from the epithelium. Recently, we have shown that Ngo infection induced apoptosis in FT epithelium cells by a TNF-alpha dependent mechanism that could contribute to the cell and tissue damage observed in gonococcal salpingitis. Aim: To investigate the apoptosis-related genes expressed during apoptosis induction in cultured FT epithelial cells infected in vitro by Ngo. Materials and Methods: In the current study, we used cDNA macroarrays and real time PCR to identify and determine the expression levels of apoptosis related genes during the in vitro gonococci infection of FT epithelial cells. Results: Significant apoptosis was induced following infection with Ngo. Macroarray analysis identified the expression of multiple genes of the TNF receptor family (TNFRSF1B, -4, -6, -10A, -10B and -10D) and the Bcl-2 family (BAK1, BAX, BLK, HRK and MCL-1) without differences between controls and infected cells. This lack of difference was confirmed by RT-PCR of BAX, Bcl-2, TNFRS1A (TNFR-I) and TNFRSF1B (TNFR-II). Conclusion: Several genes related to apoptosis are expressed in primary cultures of epithelial cells of the human Fallopian tube. Infection with Ngo induces apoptosis without changes in the pattern of gene expression of several apoptosis-related genes. Results strongly suggest that Ngo regulates apoptosis in the FT by post-transcriptional mechanisms that need to be further addressed.