Effects of anlotinib on the malignant phenotype of glioma cells by mediating NF-κB signaling pathway / 中国药房

OBJECTIVE To investigate the effects of anlotinib on the malignant phenotype of glioma cells by regulating the nuclear factor-κB （NF-κB） signaling pathway. METHODS Human glioma T98G cells were cultured in vitro， and 5-fluorouracil was used as positive control to investigate the effects of different concentrations of anlotinib （5， 10， 20 μmol/L） on the ability of proliferation， adhesion， migration and invasion， the expressions of epithelial-mesenchymal transition （EMT） related proteins [E-cadherin， N-cadherin， vimentin and fibronectin （FN）]. NF- κB signaling pathway inhibitor （BAY 11-7082） and activator （prostratin） were additionally used to verify the possible mechanism of the above effects of anlotinib. RESULTS Anlotinib with 5， 10， 20 μmol/L could significantly decrease the activity of cell proliferation （except for 5 μmol/L anlotinib group）， migration rate， and the number of adherent cells and invasive cells， could significantly up-regulate the expression of E-cadherin protein while down-regulate the expressions of N-cadherin， vimentin and FN protein （P＜0.05）； the effect of 20 μmol/L anlotinib was similar to that of positive control （P＞0.05）. Compared with 10 μmol/L anlotinib， pathway inhibitor could significantly decrease the ability of proliferation， adhesion， migration and invasion， and the expressions of N-cadherin， vimentin， FN and phosphorylated NF-κB p65 protein， while could significantly up-regulate the expression of E-cadherin protein （P＜0.05）； above indexes were reversed significantly by pathway activator （P＜0.05）. CONCLUSIONS Anlotinib may inhibit the proliferation， adhesion， migration and invasion of human glioma T98G cells， which may be associated with the inhibition of the NF-κB signaling pathway， thus inhibiting cell EMT-like processes.

Effect of Qianyang Yuyin Granules on Mesenchymal Transdifferentiation of Renal Tubular Epithelial Cells Induced by TGF-β1 / 中国实验方剂学杂志

ObjectiveBy observing the effect of Qianyang Yuyin granules on the phenotype of renal tubule epithelial cells， the intervention of Qianyang Yuyin granule on renal interstitial fibrosis was investigated. MethodThe renal tubular epithelial cells （HK-2） were treated with different concentrations of transforming growth factor （TGF）-β1 （5， 10， 15， 20， 25 μg·L-1） for 24 hours， and cell morphology and growth state were observed with an inverted phase contrast microscope. The 20 μg·L-1 was selected as the most appropriate concentration of TGF-β1 according to Western blot results for subsequent experiments. HK-2 cells were divided into six groups： blank group， TGF-β1 group （concentration of 20 μg·L-1）， low， medium， and high dose Qianyang Yuyin granule groups （concentration of 0.5， 1， 2 g·L-1）， and valsartan group （1 × 10-5 mol·L-1）. The cell activity was measured by cell proliferation and cell counting kit-8 （CCK-8）. The cell migration ability was detected by scratch test. The Transwell method was used to detect the invasiveness of cells. Western blot was used to detect levels of fibronectin （FN）， E-cadherin， α-smooth muscle activator （α-SMA）， Vimentin， collagen type Ⅰ（Col Ⅰ）， collagen type Ⅳ（Col Ⅳ）， and other related proteins. ResultTGF-β1 stimulating epithelial-mesenchymal transition （EMT） in renal tubular epithelial cells was time- and concentration-dependent. Compared with the blank group， higher concentration in the TGF-β1 group indicates longer intervention time and more obvious long spindle change of cells， and the migration and invasion ability of the cells was significantly enhanced. The protein expression level of FN， α-SMA， Vimentin， Col Ⅰ， and Col Ⅳ increased significantly （P<0.05， P<0.01）， while the expression level of E-cadherin protein decreased （P<0.05）. Compared with the TGF-β1 group， Qianyang Yuyin granule groups could maintain normal cell morphology， and the migration and invasion ability of the cells was inhibited. The protein expression level of FN， α-SMA， Vimentin， Col Ⅰ， and Col Ⅳ decreased （P<0.05， P<0.01）， and the expression of E-cadherin protein was significantly restored （P<0.05）. ConclusionQianyang Yuyin granule can reverse TGF-β1-induced interstitial transformation of renal tubular epithelial cells by reducing the phenotypic expression of mesenchymal cells and increasing the phenotypic expression of epithelial cells.

Avaliação da qualidade do sono e sonolência diurna de um grupo de idosos / Assessment of sleep quality and daytime sleepiness in a group of elderly people

O objetivo do estudo foi avaliar a qualidade do sono e sonolência diurna de um grupo de idosos, verificar se há associação com prática de atividade física, presença de doença crônica, e Índice de Massa Corporal (IMC) e se há correlação com IMC, idade e qualidade de vida. Trata-se de um estudo transversal e descritivo. Para avaliação da qualidade do sono utilizou-se o Pittsburgh Sleep Quality Index (PSQI), para avaliação da sonolência diurna a Escala de Sonolência de Epworth (ESE) e para avaliação da qualidade de vida o WHOQOL-BREF. Foram avaliados 47 idosos com mediana (intervalo interquartil 25-75%) de 66 (62-70) anos de idade e IMC de 28,58 (26,21-30,44). 74,5% apresentaram sono ruim, 61,7% apresentaram Sonolência Diurna Normal e 97,8% classificados com boa qualidade de vida, com destaque para os domínios relações sociais (80%) e autoavaliação da qualidade de vida (80%). Apenas apresentou associação estatisticamente significativa a presença de qualidade de sono ruim com a prática de atividade física. Não houve associação entre presença de qualidade de sono ruim ou sonolência com IMC e presença de doença crônica. Houve uma correlação fraca, negativa e estatisticamente significativa apenas entre qualidade do sono com qualidade de vida (ρ=-0,466) e idade (ρ=-0,297). Conclui-se que os idosos apresentaram qualidade do sono ruim, sonolência diurna normal e qualidade de vida geral boa.

The objective of the study was to evaluate the quality of sleep and daytime sleepiness of a group of elderly people, checking whether there is an association with physical activity, presence of chronic disease, and Body Mass Index (BMI) and whether there is a correlation with BMI, age and quality of life. This is a cross-sectional and descriptive study. To assess sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used, the Epworth Sleepiness Scale (ESE) was used to assess daytime sleepiness, and the WHOQOL-BREF was used to assess quality of life. 47 elderly people were evaluated with a median (interquartile range 25-75%) of 66 (62-70) years of age and BMI of 28.58 (26.21-30.44). 74.5% had poor sleep, 61.7% had Normal Daytime Sleepiness and 97.8% classified as having a good quality of life, with emphasis on the domains of social relationships (80%) and self-assessment of quality of life (80%). There was only a statistically significant association between the presence of poor sleep quality and the practice of physical activity. There was no association between the presence of poor sleep quality or sleepiness with BMI and the presence of chronic disease. There was a weak, negative and statistically significant correlation only between sleep quality and quality of life (ρ=-0.466) and age (ρ=- 0.297). It is concluded that the elderly had poor sleep quality, normal daytime sleepiness and good general quality of life.

Reserve mobilization and secondary metabolites during seed germination and seedling establishment of the tree Erythrina velutina (Fabaceae) / Movilización de reservas y metabolitos secundarios durante la germinación de semillas y el establecimiento de plántulas del árbol Erythrina velutina (Fabaceae)

Introduction: The lack of knowledge on seed germination and seedling establishment is a main constraint for the restoration of degraded areas, including the tropical dry forest known as Caatinga. Objective: To assess reserve and secondary metabolite mobilization during seed germination and seedling establishment in Erythina velutina. Methods: We scarified, disinfected, imbibed, sown between towel paper, and incubated seeds under controlled conditions. We hydroponically cultivated seedlings in a greenhouse. We harvested cotyledons at seed imbibition, radicle protrusion, hypocotyl emergence, apical hook formation and expansion of cordiform leaves, first trifoliate leaf, and second trifoliate leaf. Results: Seeds contained approximately 20 % starch, 14.5 % storage proteins, 11.6 % neutral lipids, and 5.7 % non-reducing sugars on a dry weight basis. Soluble sugars were mainly consumed from hypocotyl emergence to apical hook formation, while major reserves were mobilized from apical hook formation to expansion of first trifoliate leaf. Enzymatic activity increased from mid to late seedling establishment, causing the mobilization of starch, oils, and proteins. Terpenoid-derivatives, flavonoids, phenolic acids, and alkaloids were detected. Flavonoids and phenolic acids were present at almost all stages and terpenoid-derivatives disappeared at expansion of cordiform leaves. Conclusion: Soluble sugars support early seedling growth, while starch, oils and proteins are simultaneously mobilized from mid to late establishment by amylases, lipases, and acid proteases. The cotyledons contain secondary metabolites, which may act in seedling defense. High content of reserves and presence of secondary metabolites in the cotyledons could enable E. velutina seedlings endure stress, validating their use in the restoration of degraded areas.

Introducción: La falta de conocimiento sobre la germinación de semillas y el establecimiento de plántulas es una de las principales limitaciones para la restauración de áreas degradadas, incluido el bosque seco tropical conocido como Caatinga. Objetivo: Evaluar la movilización de reservas y metabolitos secundarios durante estas etapas de desarrollo en Erythina velutina. Métodos: Las semillas fueron escarificadas, desinfectadas, embebidas, sembradas entre toallas de papel e incubadas bajo condiciones controladas. Cultivamos las plántulas hidropónicamente en un invernadero. Recolectamos los cotiledones en la imbibición de la semilla, la protrusión de la radícula, la emergencia del hipocótilo, la formación del gancho apical y la expansión de las hojas cordiformes, la primera y segunda hoja trifoliada. Resultados: Las semillas contenían 20 % de almidón, 14.5 % de proteínas de almacenamiento, 11.6 % de lípidos neutros y 5.7 % de azúcares no reductores en peso seco. Los azúcares solubles se consumieron desde la emergencia del hipocótilo hasta la formación del gancho apical. Las principales reservas se movilizaron desde la formación del gancho apical hasta la expansión de la primera hoja trifoliada. La actividad enzimática aumentó desde la mitad hasta el final del establecimiento de las plántulas, movilizando almidón, aceites y proteínas. Se detectaron derivados de terpenoides, flavonoides, ácidos fenólicos y alcaloides. Los flavonoides y los ácidos fenólicos estuvieron en casi todas las etapas y los derivados terpenoides desaparecieron en la expansión de las hojas cordiformes. Conclusión: Los azúcares solubles apoyan el crecimiento temprano de las plántulas; el almidón, los aceites y las proteínas se movilizan simultáneamente desde el establecimiento medio hasta el final por amilasas, lipasas y proteasas ácidas. Los cotiledones contienen metabolitos secundarios, que pueden actuar en la defensa de las plántulas. El alto contenido de reservas y los metabolitos secundarios en los cotiledones podría permitir que las plántulas de E. velutina toleren estrés, validando su uso en la restauración de áreas degradadas.

Desafios da equipe interprofissionalna transição do cuidado hospitalar parao domicílio de pacientes oncológicos / Challenges of the interprofessional team in the transition from hospital care to home care for cancer patients

Os pacientes oncológicos necessitam de uma assistência integral, sobretudo no que se refere à transição do cuidado em saúde entre os diferentes locais e níveis de cuidado. Este estudo tem como objetivo investigar se existem protocolos assistenciais utilizados pela equipe interprofissional sobre a transição do cuidado oncológico hospitalar para o domicílio e identificar as estratégias utilizadas no planejamento e orientações da alta hospitalar. Trata-se de um estudo descritivo de abordagem qualitativa, realizado através de Grupo Focal, com profissionais da equipe interprofissional que atuam diretamente com o cuidado oncológico, em hospital filantrópico, localizado no interior do Estado do Rio Grande do Sul. Construíram-se categorias que elencaram as principais características: Desafios na transição do cuidado para a rede de atenção primária e domiciliar e Sugestões para a mudança nas intervenções do cuidado integrado em oncologia. Constatou-se que a equipe interprofissional apresenta dificuldades na compreensão sobre a transição do cuidado e a necessidade de uma maior quantitativo de colaboradores para a qualificação da assistência.(AU)

Cancer patients need comprehensive care, especially with regard to the transition of health care between different locations and levels of care. This study aims to investigate whether there are care protocols used by the interprofessional team on the transition from hospital to home oncology care and to identify the strategies used in hospital discharge planning and guidance. This is a descriptive study with a qualitative approach, carried out through focus groups with professionals from the interprofessional team who work directly with cancer care in a philanthropic hospital located in the interior of the state of Rio Grande do Sul. Categories were constructed which listed the main characteristics: Challenges in the transition of care to the primary and home care network and Suggestions for change in integrated oncology care interventions. It was found that the interprofessional team has difficulties in understanding the transition of care and the need for a greater number of collaborators to improve care.(AU)

Los pacientes oncológicos requieren una atención integral, especialmente en lo que se refiere a la transición de la asistencia sanitaria entre diferentes lugares y niveles asistenciales. Este estudio pretende investigar si existen protocolos asistenciales utilizados por el equipo interprofesional en la transición de la atención oncológica hospitalaria a la domiciliaria e identificar las estrategias utilizadas en la planificación y guías de alta hospitalaria. Se trata de un estudio descriptivo con abordaje cualitativo, realizado a través de grupos focales con profesionales del equipo interprofesional que trabajan directamente con la atención oncológica en un hospital filantrópico localizado en el interior del estado de Rio Grande do Sul. Se construyeron categorías que enumeraron las principales características: Desafíos en la transición de la atención a la red de atención primaria y domiciliaria y Sugerencias de cambio en las intervenciones de atención oncológica integrada. Se encontró que el equipo interprofesional tiene dificultades en la comprensión de la transición de la atención y la necesidad de un mayor número de colaboradores para mejorar la atención.(AU)

Histological transitional zone pull-through in Hirschsprung disease. Postoperative functional results and current recommendations / Descenso en zona de transición histológica en la enfermedad de Hirschsprung. Resultados funcionales postoperatorios y recomendaciones actuales

Abstract Background: Surgeons create a neorectum to repair patients with Hirschsprung´s disease (HD), which should be formed from a normoganglionic bowel. However, the neorectum is occasionally created with a transition zone (TZ) bowel. A neorectum created with a TZ has been postulated as a cause of postoperative enterocolitis or constipation. This study compares the incidence of enterocolitis and constipation in patients with TZ neorectum and normoganglionic bowel. Methods: We conducted a retrospective review of patients with rectosigmoid HD who underwent primary pull-through. Patients were divided into normoganglionic neorectum (NNR) and TZ neorectum. The diagnosis was based on the final histopathologic report of the proximal margin. The incidence of enterocolitis and constipation was compared between these two groups. Results: A total of 98 HD patients were analyzed. Seventy-one patients fulfilled the inclusion criteria. 65 (92%) had a NNR, and six patients (8%) had a TZ neorectum. From these patients, 42 (59%) presented with enterocolitis or constipation. However, there was no significant difference between both groups. Conclusion: The present study showed no difference in the incidence of enterocolitis or postoperative constipation in HD patients with normoganglionic or TZ neorectum. These results suggest that TZ neorectum does not cause postoperative obstructive symptoms.

Resumen Introducción: Los cirujanos crean un neo-recto para tratar a los pacientes con enfermedad de Hirschsprung (EH), que debe formarse con intestino normogangliónico; sin embargo, en ocasiones el neo-recto se forma con intestino de la zona de transición. Se ha postulado que un neo-recto en zona de transición causa enterocolitis o estreñimiento postoperatorio. El objetivo de este estudio fue comparar la frecuencia de enterocolitis y estreñimiento en pacientes con neo-recto en zona de transición y con neo-recto normogangliónico. Métodos: Se llevó a cabo una revisión retrospectiva de pacientes con EH recto sigmoideo que se sometieron a descenso primario. Los pacientes se dividieron en el grupo neo-recto normogangliónico y el grupo con neo-recto en zona de transición. El diagnóstico del neo-recto se estableció con el informe histopatológico definitivo del margen proximal. Se comparó la frecuencia de enterocolitis y estreñimiento entre estos dos grupos. Resultados: Se analizó un total de 98 pacientes con EH, de los cuales 71 pacientes cumplieron los criterios de inclusión; 65 (92%) con neo-recto normogangliónico y seis (8%) con neo-recto en zona de transición. Posteriormente, 42 (59%) pacientes presentaron enterocolitis asociada a Hirschsprung (HAEC) o estreñimiento; sin embargo, no hubo diferencia significativa entre ambos grupos. Conclusiones: El presente estudio no demostró una diferencia en la frecuencia de HAEC o estreñimiento postoperatorio en pacientes con EH con neo-recto normogangliónico o en zona de transición. Estos resultados sugieren que un neo-recto en zona de transición no causa síntomas obstructivos postoperatorios.

Cambios en la cobertura del matorral seco montano del valle Chota (Imbabura y Carchi, Ecuador) entre 1990 y 2020

El cambio en el uso del suelo es uno de los principales conductores del cambio global, así como una causa de la pérdida de biodiversidad. En el norte del Ecuador, el matorral seco montano es un ecosistema característico de los valles interandinos y que se encuentra amenazado por la intervención antrópica. El presente trabajo estudió el cambio de la cobertura del matorral seco montano en el valle del río Chota en un periodo de 30 años y evaluó su estado de conservación. Se aplicó el método de clasificación supervisada en las imágenes satelitales LANDSAT de los años 1990, 2007 y 2020, para analizar las tasas de variación de las coberturas. El estado de conservación se determinó con una matriz de evaluación que consideró siete variables y 25 indicadores y la sobreposición de capas temáticas con SIG. Los resultados denotaron una pérdida del 20% de la cobertura del matorral seco montano, a un promedio anual de 231.83 ha/año (-0.75%) por causas antrópicas. Estas causas fueron responsables del cambio de cobertura de más de la mitad del 8.34% del área que ocupaba, principalmente la expansión de la frontera agrícola con un 3.96%. La presión y efecto de los factores antrópicos identificados causaron que el estado actual de conservación sea Regular. Se proponen tres estrategias de conservación: buenas prácticas agroecológicas, una gestión ambiental integral y la educación ambiental.

Land use change is one of the main drivers of global change, as well as a cause of biodiversity loss. In northern Ecuador, the montane dry scrub is a characteristic ecosystem of the inter-Andean valleys and is threatened by anthropogenic intervention. This study examined the change in montane dry scrub coverage in the Chota River Valley over a 30-year period and evaluated its conservation status. The supervised classification method was applied to LANDSAT satellite images from 1990, 2007, and 2020 to analyze the rates of coverage variation. The conservation status was determined using an evaluation matrix that considered seven variables and 25 indicators and the overlap of thematic layers with GIS. The results showed a loss of 20% of montane dry scrub coverage, at an annual average of 231.83 ha/year (-0.75%) due to anthropogenic causes. These causes were responsible for the coverage change of more than half of the 8.34% of the area it occupied, mainly the expansion of the agricultural frontier with 3.96%. The pressure and effect of the identified anthropogenic factors caused the current conservation status to be Regular. Three conservation strategies are proposed: good agroecological practices, comprehensive environmental management, and environmental education.

Transición saludable y sostenible en Argentina / Transition healthy and sustainable in Argentina

Inseguridad alimentaria, malnutrición por exceso, patrones alimentarios poco saludables e insostenibles y encarecimiento diferencial de los alimentos más nutritivos, son los factores que intervienen en el complejo panorama alimentario de la población argentina y constituyen sendos desafíos contemporáneos que requieren de cambios en la forma en que se producen, distribuyen, comercializan y consumen los alimentos. Objetivo. Diseñar un modelo de cambios dietarios de transición alimentaria adecuado en términos nutricionales y adaptado a las particularidades del escenario local. Materiales y Métodos. Sobre las principales brechas de excesos dietarios del patrón alimentario argentino se diseñó una matriz de cambios dietarios, considerando tres dimensiones: cantidades, ocasiones y diversificación, transicionales hacia el modelo de referencia (EAT-Lancet) y se determinaron las implicancias económicas del proceso de cambio dietario propuesto. Resultados. Se identificaron 20 estrategias de adaptación dietaria para acortar parcialmente las brechas de carnes (máximo 25%), alimentos feculentos (máximo en torno a ⅕) y sus productos derivados; priorizando aquellos frescos, estacionales y de cercanía. La combinación de cambios dietarios implicaría un ahorro neto de 11% comparado con una canasta saludable. Conclusión. La transición alimentaria hacia modelos más saludables y sostenibles debe considerar cambios flexibles, progresivos y factibles; resguardando los factores socioculturales característicos de la población argentina. Su implementación y mantenimiento requiere de políticas públicas efectivas y voluntad de los diversos actores involucrados, incluyendo a los propios consumidores(AU)

Introduction. NFood insecurity, overnutrition, unhealthy and unsustainable dietary patterns and disproportionate increase in the cost of nutritious foods are the factors that play an important role in the complex nutritional food landscape of the Argentine population and represent contemporary challenges that require changes in the way food is produced, distributed, marketed, and consumed. Objective. Design a model of dietary transition changes that is nutritionally adequate and adapted to the specificities of local scenario. Materials and methods. Regarding the main excesses in the dietary pattern of the Argentinean population, a matrix of dietary changes was designed, considering three dimensions: quantities, occasions and diversification, transitioning towards the reference model (EAT-Lancet). The economic implications of the change process were determined. Results. 20 dietary adaptation strategies were identified to partially reduce the gaps in meat (maximum 25%), starchy foods (maximum around ⅕) and their derivatives products; prioritizing those that are fresh, seasonal and locally sourced products. The combination of dietary changes would imply a net savings of 11% compared to a healthy food basket. Conclusion. The dietary transition towards healthier and more sustainable models must consider flexible, progressive and feasible changes; the sociocultural factors characteristic of the population. Its implementation and maintenance requires effective public policies and the willingness of the various actors involved, including consumers themselves(AU)

Alteración en la integridad de la membrana basal en agrandamiento gingival inducido por tratamiento ortodóncico

Introducción: El agrandamiento gingival inducido por tratamiento de ortodoncia es un aumento progresivo, localizado o generalizado del tejido gingival. Objetivo: Determinar aspectos morfológicos en la membrana basal del tejido gingival de pacientes con agrandamiento gingival inducido por tratamiento de ortodoncia. Métodos: Estudio descriptivo de corte transversal, donde se analizaron tejidos gingivales de pacientes con agrandamiento gingival inducido por tratamiento de ortodoncia (grupo test: n=5) e individuos sanos (grupo control: n=5) mediante análisis histológicos e inmunohistoquímico con anticuerpo policlonal anti-citoqueratina 14. Las interrupciones de la membrana basal grado 1 y grado 2 fueron identificadas. Fue utilizado el programa estadístico R versión 4.0.2 para Windows. Se declaró significancia si p <0,05. Resultados: Se constató la presencia de rupturas de la membrana basal en todos los pacientes del grupo test. Estos individuos presentaron una mayor cantidad de cambios morfológicos en el tejido gingival. Exponiendo así, valores estadísticamente significativos de rupturas de la membrana basal (Grado I) y rupturas rodeadas de células epiteliales y/o fibroblastos gingivales (Grado II) en comparación con el grupo control (p <0,001). Conclusión: El tejido epitelial de pacientes con agrandamiento gingival inducido por tratamiento de ortodoncia presenta una evidente pérdida en la integridad de la membrana basal. Estas discontinuidades sugieren un aumento considerable de la plasticidad del epitelio en pacientes con agrandamiento gingival inducido por tratamiento de ortodoncia.

Introduction: Orthodontic treatment-induced gingival enlargement is a progressive, localized or generalized increase in gingival tissue. Objective: To determine morphologic aspects in the basal membrane of the gingival tissue in patients with orthodontic treatment-induced gingival enlargement. Methods: A descriptive and cross-sectional study was carried out, in which gingival tissues of patients with orthodontic treatment-induced gingival enlargement (test group: n=5) and healthy individuals (control group: n=5) were analyzed by histological and immunohistochemical analysis with the polyclonal antibody anticytokeratin 14. Grade 1 and grade 2 disrupted basal membrane were identified. The statistical program R (version 4.0.2) for Windows was used. Significance was declared if p was greater than 0.05. Results: The presence of disrupted basal membranes was observed in all the patients from the test group. These individuals presented a greater number of morphological changes in the gingival tissue. Compared to the control group (p < 0.001), statistically significant values were observed for cases of disrupted basal membrane (grade I) and disruptions surrounded by epithelial cells or gingival fibroblasts (grade II). Conclusion: The epithelial tissue of patients with orthodontic treatment-induced gingival enlargement shows an evident loss of the basal membrane integrity. These discontinuities are suggestive of a considerable increase in epithelial plasticity in patients with orthodontic treatment-induced gingival enlargement.

Imunoexpressão de clic4, α-sma, e-caderina e vimentina em lesões odontogênicas epitelias benígnas / Immunoexpression of clic4, α-sma, e-cadherin and vimentin in benign epithelial odontogenic lesions

As lesões odontogênicas epiteliais benignas constituem um grupo heterogêneo de lesões. A proteína CLIC4 atua na regulação dos processos de parada de crescimento e apoptose, participando também do processo de transdiferenciação dos fibroblastos em miofibroblastos que passam a expressar α-SMA. Além disso, a expressão de CLIC4 pode interferir no processo de transição epitélio-mesenquima (TEM) em neoplasias. Este trabalho avaliou a imunoexpressão de CLIC4, α-SMA, E-caderina e Vimentina em ameloblastomas (AM) (n = 16), ceratocistos odontogênicos (n = 20) e tumores odontogênicos adenomatóides (TOA) (n = 8). A análise da expressão imunoistoquímica das proteínas CLIC4, E-caderina e vimentina no componente epitelial das lesões e de CLIC4 e α-SMA no tecido conjuntivo foi realizada de forma semi-quantitativa por um avaliador previamente calibrado. A expressão no componente epitelial de CLIC4 foi analisada separadamente no núcleo e no citoplasma, bem como a marcação de E-caderina que foi avaliada na membrana e no citoplasma. As comparações dos percentuais de imunorreatividade em relação aos grupos estudados foram realizadas por meio dos testes não paramétricos de Kruskal-Wallis e Mann-Whitney. Possíveis correlações entre a expressão de CLIC4, α-SMA, E-caderina e Vimentina foram avaliadas por meio do teste de correlação de Spearman. O nível de significância foi estabelecido em 5% (p < 0,05). Foram observados diferentes padrões de marcação entre os grupos analisados, observando-se que a imunoexpressão exclusivamente citoplasmática da CLIC4 no componente epitelial dos AM (p < 0,001) e TOA (p < 0,001) foi significativamente superior a dos CO, não demonstrarando significância estatística entre os AM e TOA. A imunoexpressão (nuclear e citoplasmática) da CLIC4 no revestimento epitelial CO foi significativamente superior à encontrada no componente epitelial dos AM (p < 0,001) e dos TOA (p < 0,001). A imunoexpressão estromal de CLIC4 foi significativamente superior nos AM (p = 0,009) e CO (p = 0,004) quando comparados aos TOA. A imunoexpressao de α-SMA significativamente maior em AM (p = 0,016) e CO (p = 0,034) quando comparados aos TOA. Para a imunoexpressão membranar da E-caderina em CO foi significativamente superior em comparação à encontrada nos AM (p = 0,009) e nos TOA (p = 0,024). Foi observada maior imunoexpressão de E-caderina (membranar e citoplasmática) nos COs, quando comparados aos AM (p < 0,001) e aos TOAs (p < 0,001). A expressão de Ecaderina citoplasmática foi significativamente maior nos AM e TOA (p < 0,001) quando comparados aos CO. Observou-se diferença estatisticamente significativa na imunoexpressão de vimentina entre os casos de AM e os casos de TOA (p = 0,038) e CO (p < 0,001), bem como entre o TOA e CO (p < 0,001). As correlações testadas entre os escores das proteínas estudadas evidenciou que no grupo dos AM foi possível evidenciar moderada correlação positiva e estatisticamente significativa (r = 0,527; p = 0,036) entre a expressão citoplasmática da CLIC4 e a expressão citoplasmática da E-caderina. Também foi verificada fraca correlação negativa e estatisticamente significativa (r = -0,499; p = 0,049) entre a expressão núcleo-citoplasmática da CLIC4 e a expressão citoplasmática da E-caderina nos AM. Além disso, uma moderada correlação positiva e estatisticamente significativa entre a expressão estromal da CLIC4 e a expressão da α-SMA nos AM (r = 0,648; p = 0,007) e nos CO (r = 0,541; p = 0,014). Foi observada forte correlação negativa e estatisticamente significativa (r = -0,813; p < 0,001) entre a expressão da E-caderina e a expressão da vimentina nos AM. Os resultados deste estudo sugerem um potencial envolvimento de CLIC4 no processo de transdiferenciação de miofibroblastos, e que a presença destas células é mais frequentemente associada a lesões de comportamento biológico mais agressivo como os AM e CO, além de uma possível atuação desta proteína na regulação do ciclo celular e na TEM nas lesões estudadas (AU).

Benign epithelial odontogenic lesions constitute a heterogeneous group of lesions. the CLIC4 protein acts in the regulation of growth arrest and apoptosis processes, also participating in the process of transdifferentiation of fibroblasts Into myofibroblasts that begin to express α-SMA. Furthermore, CLIC4 expression can interfere with the epithelialmesenchymal transition (EMT) process in neoplasms. This work evaluated the immunoexpression of CLIC4, α-SMA, e-cadherin and vimentin in ameloblastomas (AM) (n = 16), odontogenic keratocysts (OK) (n = 20) and adenomatoid odontogenic tumors (AOT) (n = 8). The analysis of the immunohistochemical expression of the proteins CLIC4, ecadherin and vimentin in the epithelial component of the lesions and of CLIC4 and α-SMA in the connective tissue was carried out in a semi-quantitative way by a previously calibrated evaluator. Expression in the epithelial component of CLIC4 was analyzed separately in the nucleus and cytoplasm, as well as e-cadherin labeling, which was evaluated in the membrane and cytoplasm. Comparisons of the percentages of immunoreactivity in relation to the studied groups were carried out using the nonparametric kruskal-wallis and mann-whitney tests. Possible correlations between the expression of CLIC4, α-SMA, e-cadherin and vimentin were evaluated using the spearman correlation test. The significance level was set at 5% (p < 0.05). Different staining patterns were observed between the groups analyzed, observing that the exclusively cytoplasmic immunoexpression of CLIC4 in the epithelial component of AM (p < 0.001) and AOT (p < 0.001) was significantly higher than that of OK, not demonstrating statistical significance between the AM and AOT. The immunoexpression (nuclear and cytoplasmic) of CLIC4 in the co epithelial lining was significantly higher than that found in the epithelial component of AM (p < 0.001) and AOT (p < 0.001). Stromal CLIC4 immunoexpression was significantly higher in AM (p = 0.009) and OK (p = 0.004) when compared to AOT. The immunoexpression of α-SMA is significantly higher in AM (p = 0.016) and OK (p = 0.034) when compared to AOT. For e-cadherin membrane immunoexpression in co was significantly higher compared to that found in AM (p = 0.009) and AOT (p = 0.024). Greater immunoexpression of e-cadherin (membrane and cytoplasmic) was observed in OK, when compared to AM (p < 0.001) and AOT (p < 0.001). Cytoplasmic ecadherin expression was significantly higher in AM and AOT (p < 0.001) when compared to OK. A statistically significant difference in vimentin immunoexpression was observed between cases of AM and cases of AOT (p = 0.038) and OK (p < 0.001), as well as between AOT and OK (p < 0.001). The correlations tested between the scores of the proteins studied showed that in the am group it was possible to demonstrate a moderate positive and statistically significant correlation (r = 0.527; p = 0.036) between the cytoplasmic expression of clic4 and the cytoplasmic expression of e-cadherin. A weak and statistically significant negative correlation (r = -0.499; p = 0.049) was also found between the nucleus-cytoplasmic expression of clic4 and the cytoplasmic expression of e- cadherin in AM. Furthermore, a moderate positive and statistically significant correlation between the stromal expression of CLIC4 and the expression of α-SMA in AM (r = 0.648; p = 0.007) and OK (r = 0.541; p = 0.014). Additionally, a strong negative and statistically significant correlation (r = -0.813; p < 0.001) was observed between the expression of ecadherin and the expression of vimentin in AM. The results of this study suggest a potential involvement of CLIC4 in the myofibroblast transdifferentiation process, and that the presence of these cells is more frequently associated with lesions with more aggressive biological behavior such as AM and OK, in addition to a possible role of this protein in the regulation of cell cycle and EMT in the lesions studied (AU).

Transición en las enfermedades crónicas gastrointestinales. Del cuidado pediátrico al del adulto / Transition in chronic gastrointestinal diseases. From pediatric to adult care

Los avances tecnológicos y del conocimiento hicieron que un mayor número de pacientes con enfermedad crónica gastrointestinal pasen de ser atendidos por el pediatra al control por los médicos de adultos durante una de las etapas más vulnerables de la vida: la adolescencia. El Grupo de Trabajo de Transición del Comité de Gastroenterología de la Sociedad Argentina de Pediatría realizó una búsqueda de literatura exhaustiva y convocó a especialistas referentes del país, con el objeto de unificar los criterios basados en la evidencia y la experiencia. De esta manera, se proponen una serie de recomendaciones para todo el equipo de salud (pediatra, gastroenterólogo infantil, nutricionista, gastroenterólogo de adultos, psicólogo, enfermería), incluso para pacientes y familias, que faciliten el proceso de transición y optimicen el seguimiento, el control, la prevención de complicaciones y la calidad de vida de los pacientes con enfermedades crónicas gastrointestinales

Technological advances and the globalization of knowledge have led to a considerable increase in the number of patients with chronic gastrointestinal disease who transition from pediatric to adult care during one of the most vulnerable life stages: adolescence. The Transition Working Group of the Gastroenterology Committee of the Sociedad Argentina de Pediatría conducted an exhaustive literature search and summoned leading specialists in the most frequent chronic pathologies from all over the country to unify criteria based on evidence and experience. As a result, a series of recommendations are proposed for the whole health team (pediatrician, pediatric gastroenterologist, nutritionist, adult gastroenterologist, psychologist, and nurse) including patients and families, to facilitate the transition process, optimize follow-up, prevent complications, and improve the quality of life of patients with chronic gastrointestinal diseases.

Factors related to the readiness of Brazilian chronic pediatric patients to transition to care in adult clinics

Abstract Objective Advances in medicine have increased the life expectancy of pediatric patients with chronic illnesses, and challenges with the guided transition of adolescents and young adults from pediatric clinics to adult clinics have grown. The aim of this study was to better understand readiness and factors related to this transition process in Brazil. Method In this cross-sectional study of 308 patients aged from 16 to 21 years under follow-up in pediatric specialties, the degree of readiness for transition was assessed using the Transition Readiness Assessment Questionnaire (TRAQ) and its domains. Associations with demographic data, clinical data, socio-economic level, medication adherence, family functionality, and parental satisfaction with health care were evaluated. Results The median TRAQ score was 3.7 (3.2 - 4.2). Better readiness was associated with female patients, socio-economic class A-B, current active employment, higher level of education, not failing any school year, attending medical appointments alone, functional family, and a good knowledge of disease and medications. A low correlation was observed between TRAQ and age. TRAQ presented good internal consistency (alpha-Cronbach 0.86). In the multiple linear regression, TRAQ score showed a significant association with female gender, advanced age, socio-economic class A-B, better knowledge of disease and medications, and independence to attend appointments alone. Conclusion TRAQ instrument can guide healthcare professionals to identify specific areas of approach, in order to support adolescents with chronic disease to set goals for their own personal development and improve their readiness to enter into the adult healthcare system. In this study, some factors were related to better TRAQ scores.

Osteometabolic profile and bone mass in the transition phase: ethnic differences in Brazilians treated with somatropin during childhood

Abstract Objective: The main growth hormone action is to promote linear growth increasing protein synthesis stimulation and osteoblastic activity. Peak bone mass extends from adolescence to 30 years of age. Several factors may influence this acquisition and prevent fracture risk in adulthood, such as genetic potential, GH, ethnicity, and lifestyle factors. This study aims to compare bone mass and osteometabolic profile of white and Afro-descendant Brazilian adolescents in the transition phase, who were treated with human recombinant growth hormone in childhood. Methods: The authors selected 38 adolescents from the Transition Outpatient Clinic of the University of São Paulo. Lumbar spine and total body bone mineral density (BMD) and bone mineral content (BMC), serum calcium, 25-OH-vitamin D and bone markers were analyzed at the rhGH withdrawal. Results: The mean age was 16.8 ± 1.6 years. There were 21 Afro-descendant and 17 whites. Thirty-four percent of the sample presented vitamin D insufficiency, 66% inadequate calcium intake and 44.7% physical inactivity. The Afro-descendants showed a lower lumbar spine and total body Z scores than those of the whites (p = 0.04 and p = 0.03, respectively), as well as their mean body weight (p = 0.03). There were no differences in the remaining osteometabolic parameters. Conclusion: As most adolescents had vitamin D insufficiency, low calcium intake, and physical inactivity, calcium, and cholecalciferol supplementation and lifestyle changes should be encouraged. The Brazilian Afro-descendant may be a vulnerable group for low bone mass, requiring

Determinantes de la transición de la escuela al trabajo en Chile

(analítico) En Chile, actualmente la población categorizada como jóvenes que ni estudian ni trabajan (conocidos como nini) asciende a cerca de medio millón de personas, lo que presenta un desafío en la orientación de estrategias que les permitan insertarse en el mercado del trabajo o continuar sus estudios. Esta investigación tiene por finalidad determinar los factores que influyen en la transición de la escolaridad al trabajo en la población de jóvenes chilenos, por medio de modelos probabilísticos a partir de datos representativos a nivel nacional. Los resultados muestran que son determinantes la pobreza, la existencia de menores en el hogar, el género y la paternidad o maternidad adolescente. Se establecen algunas estrategias y se hace hincapié en continuar el estudio considerando la multitud de factores que están involucrados.

(analytical) In Chile, the population currently categorized as young people who neither study nor work (known as NEETs) is nearly half a million people, which presents a challenge in terms of developing policies that allow them to enter the labor market or continue their studies. The purpose of this study is to identify the factors that influence the transition from school to work for the population of young Chileans using probabilistic models based on nationally representative data. The results show that poverty, the existence of children in households, gender and adolescent parenthood are determining factors. Some strategies are highlighted and an emphasis is placed on the need to continue research in this area, taking into account the multitude of factors involved.

(analítico) No Chile, a população actualmente classificada como jovens que não estudam nem trabalham (doravante, NEM-NEM) ascende a quase meio milhão de pessoas, o que representa um desafio em termos de orientação de políticas que lhes permitam entrar no mercado de trabalho ou continuar os seus estudos. O objectivo deste estudo é determinar os fatores que influenciam a transição da escola para o trabalho na população de jovens chilenos, utilizando modelos probabilísticos baseados em dados representativos a nível nacional. Os resultados mostram que a pobreza, a existência de menores no lar, o gênero e a paternidade adolescente são fatores determinantes. Algumas estratégias são delineadas e a ênfase é colocada em estudos mais aprofundados, considerando a multiplicidade de fatores envolvidos.

Immunohistochemical appraisal of epithelial mesenchymal transition type III in gall bladder cancer

Background: Epithelial-mesenchymal transition (EMT) is the heart of invasion. EMT associated with cancer progression and metastasis is known as type III EMT. Beta-catenin, E-cadherin, and MMP9 markers of EMT are routinely employed for diagnostic purposes. Aims: We employed these markers to study EMT by immunohistochemistry (IHC) in gall bladder cancer (GBC) with respect to depth of tumor invasion, clinical outcome, and disease-free survival. Settings and Design: This was a prospective case-control study. Material and Methods: Seventy gall bladders were included (50 GBC and 20 CC). After detailed histology, immunoexpression was studied in terms of percentage and strength of expression. Statistics Analysis Used: Expression was compared between CC and GBC by Student t test and analysis of variance. Kaplan–Meier was used for survival analysis, and the extent of agreement (“Kappa”) was calculated. Results and Conclusions: The age of incidence of GBC was 49.40 (+11.6) years with female predominance (F:M = 4:1). In 88% (44/50) of GBC, the fundus was involved. Moderately differentiated adenocarcinoma was most frequent [54%; 27/50]. Significant downregulation of E-cadherin (P = 0.022) and beta-catenin (P < 0.001) and upregulation in MMP9 (P < 0.001) were seen in GBC with respect to CC with significant association among them. MMP9 expression was significantly associated with higher tumor stage but with chemotherapeutic response. Our results display that epithelial-mesenchymal transition type III plays a role in GBC invasion. MMP9 overexpression and loss of membranous beta-catenin may be considered a marker for poor clinical outcomes and advanced disease.

Evaluation of tumor budding and its correlation with histomorphological prognostic markers in oral squamous cell carcinoma and its association with the epithelial-mesenchymal transition process

Objective: To evaluate the association of tumor budding (TB) with prognostic histomorphological parameters in oral squamous cell carcinoma (OSCC) and to investigate the correlation of TB intensity with epithelial to mesenchymal transition (EMT). Material and Method: A total of 200 cases diagnosed as OSCC were selected and their TB status was reviewed using Hematoxylin and eosin (H and E) and Immunohistochemistry (IHC). Correlation with histomorphological prognostic parameters was done. Also, IHC for Vimentin and E-cadherin was performed to look for EMT. Results: On H and E examination, TB was observed in 154/200 (77%). About 88/154 (57.14%) cases showed a high TB (>5 TB/10 hpf) which increased to 100/154 (64.9%) cases on IHC staining. The intensity of TB was significantly associated with tumor grade and depth of invasion. It was also significantly associated with reduced expression for E-Cadherin and upregulation of Vimentin establishing a pathogenetic correlation between the TB and EMT. Conclusion: Therefore, our results suggest that TB is associated with poor prognosis and histologically represents EMT in OSCC which further adds to the aggressiveness of the tumor.

Revisão sistemática de intervenções com pais na transição para parentalidade / Systematic review of interventions with parents in the transition to parenthood / Revisión sistemática de intervenciones con padres en la transición a la parentalidad

This study analyzed the effects of intervention programs aimed at mothers and fathers who were expecting their first child on the individual, marital, and parental domains of the transition to parenthood. We selected research articles published between 2008 and 2019 from the PsycINFO, PubMed/MEDLINE, Scopus, and Web of Science databases. Data collection was carried out between November and December 2019 by two independent judges, according to the recommendations of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyzes). After applying the inclusion criteria, we classified the results of 30 articles and 6782 participants into three themes corresponding to each assessed domain. Positive effects on each domain of the transition to parenthood were obtained, mostly from interventions on couple communication, problem-solving, and co-parenting. Enhancements in the couple's relationship improve parents' mental health and marital satisfaction, which may promote parental emotional availability and responsiveness.

Este estudo analisou os efeitos de programas de intervenção com mães e pais à espera do primeiro filho sobre os domínios individual, conjugal e parental da transição para a parentalidade. Foram selecionados artigos empíricos publicados entre 2008 e 2019 nas bases de dados PsycINFO, PubMed/MEDLINE, Scopus, e Web of Science. A coleta de dados foi realizada por dois juízes independentes, conforme as recomendações do PRISMA (Preferred Reporting Items for Systematic Review e Meta-Analyzes). Após a aplicação dos critérios de inclusão, os resultados de 30 artigos e 6782 participantes foram classificados em três temas correspondentes a cada domínio avaliado. Foram verificados efeitos positivos em cada domínio da transição para a parentalidade, principalmente com intervenções sobre a comunicação de casal, solução de problemas e coparentalidade. Os benefícios para o relacionamento do casal favoreceram a saúde mental e a satisfação conjugal dos pais, o que pode promover maior disponibilidade emocional e capacidade de resposta dos pais.

Este estudio analizó los efectos de programas de intervención con madres y padres en los dominios individual, matrimonial y parental de la transición a la parentalidad. Se seleccionaron artículos publicados entre 2008 y 2019 de las bases de datos PsycINFO, PubMed/MEDLINE, Scopus y Web of Science. La recolección se realizó por dos jueces independientes, según las recomendaciones de PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyzes). Después de aplicar los criterios de inclusión, se clasificaron los resultados de 30 artículos y 6782 participantes en tres temas correspondientes a cada dominio. Se obtuvieron efectos positivos en cada dominio de la transición, principalmente con intervenciones sobre la comunicación de la pareja, la resolución de problemas y la coparentalidad. Los beneficios en la relación de pareja mejoran la salud mental de los padres y la satisfacción marital, lo que puede promover la disponibilidad emocional y la capacidad de respuesta de los padres.

Diagnóstico precoce de acetonemia subclínica em vacas holandesas por mensuração de corpos cetônicos / Early diagnosis of subclinical acetonemia in holstein cows by measuring ketone bodies / Diagnóstico precoz de acetonemia subclínica en vacas holstein mediante la medición de cuerpos cetónicos

O trabalho foi realizado em uma fazenda de exploração leiteira em Castrolanda, no município de Castro ­ PR. O sistema de manejo é free-stall, com 220 vacas da raça Holandesa com RHA305 de 6.740 litros. Foram coletadas amostras de sangue de 18 vacas de pré-parto, 4 dias antes da data prevista para o parto; e nos dias 4, 7 e 12 pós-parto, mediante punção venosa coccígea, utilizando-se SnapTest digital Ketovet®, constituindo 72 amostras, no período de fevereiro a maio de 2020. Em 4 vacas o BHB do sangue total apresentou-se acima do limite para cetose subclínica no quarto dia após o parto e 17 apresentaram-se acima do limite no sétimo dia, declinando em seguida, principalmente devido às intervenções clínicas. As médias e desvios-padrão foram: D - 4: 0,89 ± 0,257061; D 4: 1,05 ± 0,283279; D 7: 1,81 ± 0,456131; e D 12: 1,19 ± 0,437762. O benefício do monitoramento de BHB foi a imediata intervenção clínica, evitando-se a severidade por instalação de quadro clínico e as enfermidades concomitantes.(AU)

The study was carried out on a dairy farm in Castrolanda, in the county of Castro - PR. The management system is free stall, with 220 Holstein cows with RHA305 of 6,740 liters. Blood samples were collected from 18 pre-calving cows, 4 days before the expected date of calving; and on days 4, 7 and 12 postpartum, by means of coccygeal venipuncture, using SnapTest digital Ketovet®, constituting 72 samples, from February to May 2020. In 4 cows the BHB of whole blood was shown above the limit for subclinical ketosis on the fourth day after delivery and 17 presented above the limit on the seventh day, then declining mainly due to clinical interventions. The means and standard deviations were D -4: 0.89 ± 0.257061; D 4: 1.05 ± 0.283279; D 7: 1.81 ± 0.456131; and D 12: 1.19 ± 0.437762. The benefit of monitoring BHB was immediate clinical intervention, avoiding clinical ketosis and concomitant illnesses.(AU)

El estudio se realizó en una explotación lechera de Castrolanda, en la comarca de Castro - PR. El sistema de manejo es estabulación libre, con 220 vacas Holstein con RHA305 de 6.740 litros. Se recogieron muestras de sangre de 18 vacas pre- parto, 4 días antes de la fecha prevista de parto; y en los días 4, 7 y 12 postparto, mediante venopunción coccígea, utilizando SnapTest digital Ketovet®, constituyendo 72 muestras, desde febrero a mayo de 2020. En 4 vacas la BHB de sangre total se mostró por encima del límite para cetosis subclínica en el cuarto día después del parto y 17 presentaron por encima del límite en el séptimo día, disminuyendo después debido principalmente a intervenciones clínicas. Las medias y desviaciones estándar fueron D -4: 0,89 ± 0,257061; D 4: 1,05 ± 0,283279; D 7: 1,81 ± 0,456131; y D 12: 1,19 ± 0,437762. El beneficio de monitorizar la BHB fue la intervención clínica inmediata, evitando la cetosis clínica y las enfermedades concomitantes.(AU)

"La covid no ha podido con nosotrxs": impacto de la pandemia en el acceso efectivo de personas trans a tratamientos hormonales integrales en Córdoba, Argentina / "Covid couldn't get us down": pandemic impact on effective access to transgender hormone therapy in Cordoba, Argentina

Resumen El objetivo de este trabajo fue indagar el impacto de la pandemia de la covid-19 en el acceso de personas trans a tratamientos hormonales en los servicios de salud pública de la provincia de Córdoba, Argentina. En los meses de junio/julio de 2020, se realizaron 16 entrevistas telefónicas a personas trans en proceso de hormonización y usuarias de servicios públicos de salud, a profesionales sanitarios de dispositivos específicos de atención a personas trans, integrantes de organizaciones sociales y de gestión. Se aplicó un análisis temático que identificó tres temas y subtemas: 1) Estar a la deriva en relación al tratamiento hormonal: Reestructuración de servicios de salud; Sentimientos de incertidumbre; 2) Lo necesito, el cuerpo lo pide: suministro de hormonas: Significados en torno al tratamiento; Estrategias y resistencias; 3) Oportunidad de visibilizar fallas estructurales: las hormonas como la punta del iceberg: Déficit en las políticas públicas: en pandemia desde hace muchos años; Exclusiones del CIStema de salud. Se concluyó que la pandemia acarreó un grave retroceso para los derechos de las personas trans. Sin embargo, se identificaron estrategias claves de acceso, vinculadas principalmente a las organizaciones y activistas trans y travestis.

Abstract The purpose of this research was to study the impact of covid-19 pandemic on transgender people's access to healthcare and hormone gender-affirming treatments in public healthcare services of the province of Córdoba, Argentina. Between June/July-2020, sixteen telephone interviews were conducted with people in gender-affirming hormone treatments in public healthcare services, professionals, members of social organizations and management. A thematic analysis was carried out, identifiying three themes and sub-themes: 1) Being adrift in relation to hormonal treatment: Restructuring of healthcare services; Feelings of uncertainty. 2) I need it, the body asks for it: supply of hormones: Meanings around treatment; Strategies and resistance. 3) Opportunity to make visible structural failures: hormones as the tip of the iceberg: Deficit in public policies: in a pandemic for many years; Exclusions from the CISHealthcare System. We conclude that the pandemic implied a serious setback for transgender people's rights. However, strategies were identified, mainly linked to transgender organizations and activists, which were key to access.