Expresión génica de ligandos mica, micb y ulbp (1-6) del receptor NKG2D de células natural killer y metaloproteinasas adam10, adam17 y mmp14 en lineas celulares de cáncer de cervical / Gene expression of mica, micb and ulbp (1-6) ligands of the NKG2D receptor of natural killer cells and metalloproteinases adam10, adam17 and mmp14 in cells lines of cervical cancer

RESUMEN El CCU es la segunda causa de muerte en mujeres de nuestro país. Dentro de los primeros mecanismos de defensa del hospedero se encuentra la respuesta inmune de las células NK y su función lítica a expensas de su receptor activador NKG2D, el cual posee como ligandos mica, micb y ulbp (1-6), los cuales se expresan en células transformadas y/o infectadas por virus. Uno de los mecanismos de evasión por parte de la célula tumoral es el clivaje de estas proteínas a través de metaloproteinasas como adam10, adam17 y mmp14. Se analizó la expresión de estos ligandos y metaloproteinasas mediante PCR tiempo real, en lineas celulares de referencia para cáncer cervical como HeLa (positiva para VPH-18) y C33A (negativa para VPH). Se obtuvieron valores representativos de expresion relativa genica con diferencias significativas asi: mmp14 en linea HeLa (p= 0.006); y mica y ulbp-3 en la linea C33A (p= 0.020 y p=0.003 respectivamente). Por lo tanto, se podría sugerir que la expresión de mmp14 se encuentra posiblemente involucrados con la presencia de VPH causante del cancer cervical y la respuesta inmunne innata desarrollada.

ABSTRACT Cervical cancer is the second leading cause of death in women in our country. Within the first host defense mechanisms is the immune response of NK cells and their lytic function at the expense of its NKG2D receptor activator which has as ligands mica, micb and ulbp (1-6), which are expressed in transformed cells and / or virally infected. One of the mechanisms of evasion by the tumor cell is the cleavage of these proteins through metalloproteinases as adam10, adam17 and mmp14. We analyzed the expression of these ligands and metalloproteinases by real time PCR, in reference to cell lines HeLa cervical cancer (positive for HPV-18) and C33A (negative for HPV). We obtained representing relative gene expression with significant differences from the other lines of study as follows: mmp14 in HeLa (p = 0.006); and mica and ulbp-3 in C33A (p = 0.020 and p = 0.003 respectively). Thus one might suggest that the expression of mmp14 is possible involved with HPV presence causing high risk of cervical cancer and innate inmunne response developed.

Application of nurse-led management in the quality of nursing safety of patients in Transition of CCU / 中国实用护理杂志

Objective To study the application of nurse-led management in the nursing safety quality of CCU transition patients. Methods The control group of 60 patients who were transferred to the general ward after CCU treatment in Wuhan University Renmin hospital from October to December 2017 was selected, and 60 patients from January to March 2018 were set as the experimental groups. The control group carried out routine nursing, and the experimental group adopted nursing leading management model to carry out nursing intervention. To observe and compare the quality of nursing safety, quality of life and satisfaction of patients before and after intervention. Results The nursing safety incidents, nursing gaps and CCU return rates of control group patients were 13.33% (8/60),23.33% (14/60) and 11.67% (7/60), respectively. For the experimental group patients, they were 3.33%(3/60) ,8.33%(8/60) and 3.33%(2/60), respectively. The difference was statistically significant ( χ2 = 4.415, 4.582, 4.312, P<0.05). After the intervention, the quality of life of the patients improved significantly. The conditions of physical function, emotional function, social function and overall quality of life of the control group were 56.07 ± 4.42, 66.62 ± 1.89, 56.34 ± 4.31, and 61.26 ± 4.15, respectively. For the experimental group, they were 71.88 ± 4.67, 73.52 ± 4.28, 63.94 ± 4.12, and 74.62±4.02, respectively. The difference was statistically significant(t=7.657-16.892, P<0.01). After the intervention, the patient's satisfaction also increased significantly. The control group′s psychological support dimension, cooperation dimension, and safety dimension were 7.96 ± 0.86, 7.39 ± 0.61, and 7.63 ± 0.16, respectively. For the experimental group, they were 9.56 ± 0.41, 9.08 ± 0.56, 9.21 ± 0.33, respectively. The difference between the two groups was statistically significant (t= 7.632, 9.116, 7.562, P<0.01). Conclusion Nurse-led management can effectively improve the quality of care safety, quality of life and satisfaction of CCU transition patients, reduce the return rate of CCU, and provide clinical reference for safe care of CCU transition patients.

Application of nurse-led management in the quality of nursing safety of patients in Transition of CCU / 中国实用护理杂志

Objective@#To study the application of nurse-led management in the nursing safety quality of CCU transition patients.@*Methods@#The control group of 60 patients who were transferred to the general ward after CCU treatment in Wuhan University Renmin hospital from October to December 2017 was selected, and 60 patients from January to March 2018 were set as the experimental groups. The control group carried out routine nursing, and the experimental group adopted nursing leading management model to carry out nursing intervention. To observe and compare the quality of nursing safety, quality of life and satisfaction of patients before and after intervention.@*Results@#The nursing safety incidents, nursing gaps and CCU return rates of control group patients were 13.33%(8/60),23.33%(14/60) and 11.67%(7/60), respectively. For the experimental group patients, they were 3.33%(3/60),8.33%(8/60) and 3.33%(2/60), respectively. The difference was statistically significant (χ2= 4.415, 4.582, 4.312, P<0.05). After the intervention, the quality of life of the patients improved significantly. The conditions of physical function, emotional function, social function and overall quality of life of the control group were 56.07 ± 4.42, 66.62 ± 1.89, 56.34 ± 4.31, and 61.26 ± 4.15, respectively. For the experimental group, they were 71.88 ± 4.67, 73.52 ± 4.28, 63.94 ± 4.12, and 74.62±4.02, respectively. The difference was statistically significant(t=7.657-16.892, P<0.01). After the intervention, the patient's satisfaction also increased significantly. The control group′s psychological support dimension, cooperation dimension, and safety dimension were 7.96 ± 0.86, 7.39 ± 0.61, and 7.63 ± 0.16, respectively. For the experimental group, they were 9.56 ± 0.41, 9.08 ± 0.56, 9.21 ± 0.33, respectively. The difference between the two groups was statistically significant(t= 7.632, 9.116, 7.562, P<0.01) .@*Conclusion@#Nurse-led management can effectively improve the quality of care safety, quality of life and satisfaction of CCU transition patients, reduce the return rate of CCU, and provide clinical reference for safe care of CCU transition patients.

Periodic evaluation of drug utilization in intensive coronary care unit patients in a tertiary care hospital

Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class.

Prevalencia del virus del papiloma humano en mujeres con citología negativa / Prevalence of Human Papillomavirus Infection in Women with Negative Cytology

Introducción: la infección persistente por los subtipos oncogénicos del virus del papiloma humano es la causa principal del desarrollo del cáncer cérvico-uterino. Las mujeres que presentan citología normal pueden estar infectadas por subtipos de alto riesgo carcinogénico. Objetivo: brindar información actualizada existente en la literatura científica internacional acerca de la prevalencia de la infección por el virus del papiloma humano a nivel mundial y de la importancia de la detección temprana de estos virus en mujeres con citología negativa. Método: se realizó una revisión de los estudios desarrollados a nivel global y para esto se utilizaron las bases de datos PubMed, MedLine, BioMed Central y SciELO. Resultados: la prevalencia de la infección por los subtipos de alto riesgo del virus del papiloma humano en las mujeres con citología normal fue del 10 - 12 por ciento, con algunas diferencias entre países. El mayor pico de frecuencia de esta infección viral se localizó en jóvenes menores de 25 años y, en algunas regiones geográficas, se observó un segundo pico en mayores de 49 años. Los cinco subtipos oncogénicos más frecuentes de estos virus fueron 16, 18, 31, 52 y 58 con ciertas variaciones a nivel global. Conclusiones: el diagnóstico precoz de la infección por el virus del papiloma humano, especialmente los genotipos de alto riesgo, es un factor importante para una mejor prevención del cáncer cérvico-uterino(AU)

Introduction: Persistent infection with the oncogenic subtypes of human papillomavirus is the leading cause of cervical cancer. Women with normal cytology may be infected with subtypes of high carcinogenic risk. Objective: Provide updated information on the prevalence of human papillomavirus infection worldwide and the importance of their early detection in women with negative cytology. Methods: A review of the studies developed at a global level was carried out and PubMed, MedLine, BioMed Central, and SciELO databases were used. Results: The prevalence of infection with high - risk subtypes of human papillomavirus in women with normal cytology was 10 - 12 percent, with some differences between countries. The highest peak of frequency of this viral infection was located in young women under 25 years old and, in some geographic regions a second peak could be observed in those older than 49 years. The five most frequent oncogenic subtypes of these viruses were 16, 18, 31, 52 and 58 with certain variations globally. Conclusions: Early diagnosis of human papillomavirus infection, especially high-risk genotypes, is an important factor for better prevention of cervical-uterine cancer(AU)

Infección por Chlamydia trachomatis como cofactor en la etiología del cáncer cervical / Chlamydia trachomatis: a cofactor in the etiology of cervical cancer

Se ha demostrado que la infección por el virus del papiloma humano es una condición necesaria pero no suficiente para el desarrollo del cáncer de cuello de útero, ya que solo un pequeño número de las mujeres expuestas progresan a neoplasia cervical. El objetivo de este estudio fue revisar la literatura científica reciente acerca del papel de Chlamydia trachomatis como cofactor en el establecimiento del virus del papiloma humano y en el desarrollo del cáncer de cuello de útero. Entre los cofactores propuestos se incluyen otras infecciones de transmisión sexual, hábito de fumar, hormonas, deficiencias nutricionales, obesidad y respuesta genético-inmunológica del individuo. Chlamydia trachomatis es la más común de las infecciones de transmisión sexual de origen bacteriano y se ha asociado con el desarrollo del cáncer de cuello de útero en muchos estudios poblacionales y de casos y controles. Sin embargo, todavía es necesario esclarecer algunos aspectos de la relación causa-efecto entre la infección por Chlamydia trachomatis, la persistencia del virus del papiloma humano y la progresión a cáncer. La prevención de la infección por Chlamydia trachomatis puede ser importante en la reducción de este tipo de neoplasia, fundamentalmente en mujeres jóvenes.

It has been shown that human papillomavirus presence is a necessary condition for the development of cervical cancer. However, it is not sufficient and only a small number of exposed women will progress to cervical neoplasia. Proposed cofactors include other sexually transmitted infections, smoking habit, hormones, nutritional deficiencies, obesity and host genetic/immunologic responses. Chlamydia trachomatis is the most common bacterial sexually transmitted infection and it has been associated with the development of cervical cancer in many case-controlled and population based studies. However, it is still necessary to elucidate some aspects of cause/effect relationship between Chlamydia trachomatis infection, human papillomavirus persistence and progression to cervical cancer. This article aims to review the current scientific literature upon the role of Chlamydia trachomatis as a cofactor in the development of invasive cervical cancer and HPV establishment. Prophylaxis against Chlamydia trachomatis could be important in reducing the incidence of cervical cancer, mainly in young women.