Community-driven evaluation of E. coli levels in domestic-use underground water sources in Angono, Philippines

@#<p style="text-align: justify;"><strong>Objectives:</strong> The authors considered the community-based on-site water sampling-surveys case-study in Angono, Rizal, in the Republic of the Philippines. The study was designed to determine whether individual citizens within the community could successfully collaborate in order to develop a method for quantification of E. coli levels in water (especially underground water) for domestic use.</p><p style="text-align: justify;"><strong>Methods:</strong> We used techniques that had been validated in Japan for on-site evaluation of E. coli. These simple techniques enabled the on-site quantification of E. coli levels in multiple water sources, including underground water.</p><p style="text-align: justify;"><strong>Results:</strong> The techniques used in Japan were successfully adopted in the Philippines, and we cooperated with regional medical technicians, scientists, and citizens, in order to develop a system where ultimately, the people in Angono can perform all the tasks related to on-site water quality evaluation. From societal and economic perspectives, we were able to reduce the traditionally high laboratory cost (including testing cost and samples transit cost) of coliform bacteria and E. coli evaluation to a lower, fixed cost level that is affordable for regional health centers and other sites.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The transfer of a simple inspection method technology, under the supervision of an experienced Japanese research team, allowed us to validate the E. coli on-site quantification strategy at a regional level as "co-creation of science and society". In addition, beyond technology transfer, our collaborative efforts with scientists, regional medical engineers, and citizens, led to the creation of an NGO (non-governmental organization) that serves citizens in the town of Angono with regard to water quality assessment and certification activities.</p><p style="text-align: justify;"><strong>Key Words:</strong> water quality, water management, community, local people, participatory approach, underground water, Escherichia coli, coliform bacteria, Philippines</p>

Concentrations of trace elements in daily life water consumed in Angono, Rizal, Philippines

Objective@#The present study aims to determine the concentrations of seven trace elements [chromium (Cr), arsenic (As), cadmium (Cd), cesium (Cs), lead (Pb), thorium (Th), and uranium (U)] in tap, well, spring, river, and lake waters in the town of Angono, Rizal in the Philippines, consumed for drinking, cooking, bathing, and washing. In the town of Angono, both of the tap and purified tap waters produced in the refilling station are consumed as the water for drinking.@*Methods@#Water samples from six unpurified tap, six purified taps, 10 wells, two springs, two rivers, and one lake water were obtained in October 2015. Samples were analyzed using solution nebulization inductively coupled plasma mass spectrometry. Results were evaluated for health risks of the trace elements in the water samples using WHO guideline values. The provisional WHO guideline values are as follows: Cr: 50 μg/L, As: 10 μg/L, Cd: 3 μg/L, Pb: 10 μg/L, and U: 30 μg/L. That of Cs has not been proposed yet. The WHO guideline value for the naturally occurring radioactive isotope 232Th in drinking water is 1 Bq/L, which is equivalent to 250 μg/L.@*Results@#The concentrations of the trace elements in the tap water samples were <0.5% of the WHO guideline values, except Cs and Cd, with those of Cd being ~9% of the WHO guideline value. Purified tap waters contained the seven trace elements in lower concentrations, with the exception of Pb, which may have been added in small amounts from equipment used for water purification. The concentrations of the trace elements in water samples from the wells and springs in Angono were more variable than those of the tap waters, and these were also below the WHO guideline values. The concentrations of Cs in all water samples were <0.3 μg/L. The trace-element concentrations of the waters from Angono River and Laguna Lake were almost the same as those of the well and spring waters.@*Conclusion@#At present, the concentrations of trace elements in daily life water consumed in Angono are at safe levels.

Orientación para la investigación global sobre educación interprofesional y práctica colaborativa. Documento de trabajo / Guidance on global interprofessional education and collaborative practice research: discussion paper / Orientação sobre pesquisa global em educação interprofissional e prática colaborativa: documento de trabalho

Este documento de trabajo fue elaborado por varios expertos en EIPC de renombre mundial durante el último año para estimular una mayor discusión sobre la investigación global en EIPC. La publicación ofrece perspectivas para informar las discusiones en torno a la agenda de investigación global en EIPC mediante la identificación de prioridades de investigación y proporcionando orientación sobre marcos teóricos, metodologías y composición de equipos de investigación. Un léxico propuesto para el campo interprofesional también se proporciona como un apéndice. El léxico sirve como documento de debate para desarrollar el consenso sobre la terminología relacionada con la educación, el aprendizaje, la práctica y la atención interprofesionales.

This Discussion Paper aims to provide guidance on IPECP research. We provide a perspective of the current situation and the needs in IPECP research around the globe, make recommendations for research teams to advance IPECP theory-informed research by 2022, and invite collaborators to join us in this initiative. The appendix provides a proposed lexicon for the interprofessional field based on the current interprofessional literature. This lexicon serves as a starting point in developing a global consensus on a set of definitions and descriptions related to interprofessional education, learning, practice, and care. In doing so, and in response to the Article 4 of the Sydney Interprofessional Declaration (All Together Better Health V, 2010), IPR.Global and Interprofessional. Global plan to conduct a web-based global Delphi panel in early 2020.

Este Documento de trabalho visa orientar pesquisas na área da EIPC. Nele fornecemos uma perspectiva sobre a situação atual e as necessidades mundiais em termos de pesquisa nessa área, fazemos recomendações para equipes de esquisas, informadas por teorias, para que alcancem avanços na EIPC até 2022, e convidamos colaboradores a participarem conosco nesta iniciativa. O Apêndice propõe um léxico para o campo interprofissional com base na literatura interprofissional atual. Esse léxico serve como ponto de partida para o desenvolvimento de um consenso global sobre uma série de definições e descritores relacionados à educação, ao aprendizado, à prática e à atenção interprofissional. Após propô-lo, e em resposta ao Artigo 4º da Declaração Interprofissional de Sydney (All Together Better Health V, 2010), o IPR.Global e o plano da Interprofessional.Global têm por objetivo conduzir um encontro com especialistas de todo o mundo, via Internet, no início de 2020.

Regulation of Pharmacogene Expression by microRNA in The Cancer Genome Atlas (TCGA) Research Network

Individual differences in drug responses are associated with genetic and epigenetic variability of pharmacogene expression. We aimed to identify the relevant miRNAs which regulate pharmacogenes associated with drug responses. The miRNA and mRNA expression profiles derived from data for normal and solid tumor tissues in The Cancer Genome Atlas (TCGA) Research Network. Predicted miRNAs targeted to pharmacogenes were identified using publicly available databases. A total of 95 pharmacogenes were selected from cholangiocarcinoma and colon adenocarcinoma, as well as kidney renal clear cell, liver hepatocellular, and lung squamous cell carcinomas. Through the integration analyses of miRNA and mRNA, 35 miRNAs were found to negatively correlate with mRNA expression levels of 16 pharmacogenes in normal bile duct, liver, colon, and lung tissues (p<0.05). Additionally, 36 miRNAs were related to differential expression of 32 pharmacogene mRNAs in those normal and tumorigenic tissues (p<0.05). These results indicate that changes in expression levels of miRNAs targeted to pharmacogenes in normal and tumor tissues may play a role in determining individual variations in drug response.

La tuberculosis genitourinaria en el siglo XXI / Genitourinary tuberculosis in the 21st century

Tuberculosis is a major health problem in both underdeveloped and industrialized nations. Each year there is an estimated 8 million new cases of tuberculosis (TB) with 2 million deaths. TB is an opportunistic infection affecting primarly lower social economic classes and individuals whose immune system are compromised by age (very young and elderly), infection (HIV) and recipients of immune modulators (organ transplantation, collagen disease). Twenty percent of patients with TB may develop genitourinary (GU) tuberculosis. Pelvic infection in the female can mimic malignancy. In the past "classic" genito-urinary tuberculosis has developed in conjunction with pulmonary or miliary infection. Patients now present with isolated (i.e. adrenal, renal, genital or pelvic) infection. Diagnosis of GU TB infection is difficult. Newer molecular biologic tools i.e. polymerase chain reaction (PCR) provide improved diagnostic methods. CT scans are an effective imaging tool. Retropeirtoneal and intraperitoneal TB disease can be evaluated and treated by laparoscopic surgical procedures. Despite the advantages of the newer technology, TB of the genito-urinary continues to significant challenge to the practitioner because of Mycobacterium tuberculosis that is resistant to current anti-TB drugs and "non-classic" presentation of GU infection.

La tuberculosis es un problema de salud importante en las naciones industrializadas como también en los países en vías de desarrollo. Cada año se estiman 8 millones de nuevos casos de tuberculosis (TBC) con 2 millones de muertes. La TBC es una infección oportunista que afecta en forma primaria a individuos de clases sociales mas bajas o a aquellos que presentan compromiso del sistema inmune debido a la edad (niños o ancianos), infecciones (HIV) o al tratamiento con moduladores del sistema inmune (trasplante de órganos, enfermedad del colágeno). El 20% de los pacientes con TBC pueden contraer tuberculosis genitourinaria (TGU). La infección pelviana en la mujer puede simular una enfermedad maligna. En el pasado, la tuberculosis genitourinaria "clásica" se desarrollaba junto con la infección pulmonar o miliar. Ahora los pacientes se presentan con la infección aislada (suprarrenal, renal, genital o pelviana). El diagnostico de la TGU es difícil. Nuevas herramientas de la biología molecular, por ejemplos la reacción en cadena de la polimerasa, ofrecen mejores métodos diagnósticos. La tomografía computarizada es una herramienta efectiva para obtener imágenes. Las TBC retroperitoneal e intraperitoneal pueden ser evaluadas y tratadas mediante procedimientos quirúrgicos laparoscópicos. A pesar de las ventajas de las nuevas tecnologías, la TBC es aún un desafío para el medico debido a que Mycobacterium tuberculosis es resistente a los antibióticos actuales y a la forma de presentación atípica de la infección genitourinaria.

Pelvic actinomycosis: urologic perspective

PURPOSE: Actinomycosis is a chronic granulomatous infection caused by the gram-positive anaerobic bacteria, Actinomyces israelli. This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy. MATERIALS AND METHODS: A combination of patients treated by the authors in the recent past and a literature review of patients with pelvic Actinomycosis were assessed for diographic, clinical and predisposing co-factors. An analysis is made of age distribution, gender, diagnostic methods and treatment concepts. RESULTS: Thirty-three patients were included in the study that included 2 current patients and 31 obtained from literature review. There were 27 fiales (age range 16 - 69 years, mean 38 years) and 6 males (16 - 55 years, mean 36 years). Presenting signs and symptoms were lower abdominal mass in 28 (85 percent); lower abdominal pain in 21 (63 percent); vaginal discharge or hiaturia in 7 (22 percent). Two patients developed fistulae (entero-vesico 1; vesico-cutaneous 1). Nineteen (70 percent) of the 27 fiale patients had intra-uterine contraceptive devices (IUD). Four patients (12.5 percent) (3 males and 1 fiale) had urachus or urachal rinants. Cystoscopy in 12 patients noted an extrinsic mass effect, bullous edia and in one patient vegetative proliferation proven to be a chronic inflammatory change. Exploratory laparotomy was performed in 32 of the 33 patients who had excision of mass and involved organs. Diagnosis was established by histologic examination of rioved tissue. Penicillin (6 weeks) therapy was utilized to control infections. CONCLUSION: Pelvic actinomycosis mimics pelvic malignancy and may be associated with the long-term use of intra-uterine contraceptive devices, and persistent urachal rinants. Rioval of infected mass and antibiotic therapy will eradicate the inflammatory process.

Mutaciones de línea germinal del proto oncogen ret en pacientes chilenos con cáncer medular tiroideo hereditario y esporádico / Germline mutations of the ret proto oncogen in chilean patients with hereditary and sporadic medullary thyroid carcinoma

Background: Medullary thyroid carcinoma (MTC) may occur either as a sporadic or familial disease. Multiple endocrine neoplasia (MEN) type 2, inherited as an autosomal dominant disease, is characterized by MTC only (FMTC) or coexistence of MTC with other endocrine neoplasia (NEM 2A, 2B). Germline mutations of the RET proto-oncogene (cRet) are found in the inherited forms and in some apparently sporadic MTC cases. Aim: To study RET mutations in 8 families with MEN 2. Material and methods: RET mutations were screened in peripheral blood DNA from 18 patients and 87 high risk carriers belonging to 8 MEN 2 families and 52 sporadic MTC. Exons 10, 11, 13, 14, 15 and 16 of the c-Ret were amplified by polymerase chain reaction (PCR) and examined by direct sequencing of PCR products and/or restriction enzyme analysis. Results: Five MEN 2A and one FMTC families with a germline mutation at codon 634, one MEN 2A and one FMTC family carrying a mutation at codon 620 were identified. Mutations were found in 23 out of 87 high risk carriers. In addition, we detected a S891A (exon 15) germline mutation in a sporadic MTC patient and in one out of her three sons and V804M (exon 14) in another sporadic MTC case and in one out of his six relatives, indicating in both cases the presence of a sporadic misclassified familial disease. Conclusions: These results underscore the importance of routine application of c-Ret testing in all cases of MTC either familial or sporadic