TGFB1 mRNA expression and frequency of the + 869T>C and + 915G>C genetic variants: impact on risk for systemic sclerosis.

Systemic Sclerosis (SSc) is a chronic autoimmune disease characterized by immune disorder, microvascular damage, and fibrosis. TGFB1 gene encodes for the transforming growth factor isoform 1 (TGF-ß1), one of the most important pro-fibrotic cytokines. Therefore, variants in TGFB1 and changes in its expression could be associated with the pathogenesis of SSc. We aimed to evaluate the association of TGFB1 variants (+ 869T>C [rs1982073] and + 915G > C [rs1800471]) with the TGFB1 mRNA expression and SSc risk in the Southern Mexican population. We included 56 SSc patients and 112 control subjects (CS). The genetic variants were determined by the PCR-RFLP method. The TGFB1 mRNA expression was determined by qPCR. For the + 869T>C variant, the C allele was associated with SSc risk (OR = 1.733; CI = 1.087-2.762; p = 0.020). The C allele for the + 915G>C variant was also associated with SSc risk (OR = 11.168; CI = 1.289-96.754; p = 0.023). The relative expression of TGFB1 mRNA was 1.77-fold lower in SSc patients than in CS. Carriers of polymorphic alleles (TC or CC genotypes) for the + 869T>C variant showed 3.7-fold lower mRNA expression than the TT genotype in patients and 4.81-fold lower in CS. For the + 915G>C variant, patients with GA genotype had 1.78-fold lower mRNA expression than GG genotype carriers. In conclusion, the present study showed that + 869T>C and + 915G>C variants could be SSc risk factors for patients from Southern Mexico, and these genetic variants could induce lower mRNA expression of TGFB1.

Diagnóstico y tratamiento multidisciplinario de melanoma temprano y localmente avanzado. Consenso de expertos. Asociación Colombiana de Hematología y Oncología (ACHO) / Diagnosis and multidisciplinary treatment of early-stage and locally advanced melanoma: Expert consensus, Colombian Association of Hemato-Oncology (ACHO)

Resumen Introducción: El melanoma ocasiona el 75% de las muertes por cáncer de piel. Según GLOBOCAN, en 2018 se presentaron 287.723 casos nuevos de melanoma, con una mortalidad de 60.712 casos, que equivale al 20% del total de los casos incidentes. Las alternativas para el tratamiento del melanoma se fundamentan en la estatificación de la enfermedad, y en las características moleculares de la enfermedad. Objetivo: Consensuar, por común acuerdo de expertos, sugerencias para el diagnóstico y manejo de melanoma temprano basadas en la evidencia y ajustadas al contexto colombiano. Métodos: Se llevó a cabo un consenso de expertos multidisciplinario, constituido por 19 oncólogos clínicos, 2 cirujanos de mama y tejidos blandos, 2 dermatólogos, 2 patólogos y 2 radioterapeutas, miembros activos de la Asociación Colombiana de Hemato Oncología (ACHO). Este consenso se realizó en 4 etapas: 1. Estructuración de 29 preguntas, que se calificaron de 1 a 9. 2. Reenvío de las preguntas no consensuadas. 3. Análisis y discusión de las respuestas. 4. Las respuestas no consensuadas se llevaron a un consenso nominal. Resultados: Se discutieron 29 preguntas relacionadas con el diagnóstico y tratamiento de melanoma temprano, se construyeron sugerencias basadas en evidencia utilizada por los expertos y en guías de manejo de oncología reconocidas internacionalmente, adaptadas al contexto y realidad colombianos. Conclusiones: Se presentan sugerencias multidisciplinarias para el diagnóstico y tratamiento de melanoma temprano, las cuales debe considerarse para orientar la toma de decisiones y homogenizar la práctica clínica de acuerdo al contexto colombiano y a las características propias del sistema de salud del país. Este es un documento académico y no regulatorio.

Abstract Introduction: Melanoma causes 75% of deaths from skin cancer. In 2018, according to GLOBOCAN, 287,723 new melanoma cases were registered, with a mortality of 60,712 cases, which is equivalent to 20% of all incident cases. Alternatives for the treatment of melanoma are based on disease staging and the molecular characteristics of the disease. Objective: To establish a consensus by common agreement of experts and construct suggestions for the diagnosis and management of early-stage melanoma based on evidence and adjusted to the Colombian context. Methods: A multidisciplinary expert consensus was established, wth the participation of 19 clinical oncologists, 2 soft tissue surgeons, 2 dermatologists, 2 pathologists, and 2 radiotherapists, active members of the Colombian Association of Hemato-Oncology (ACHO). This consensus was carried out in four stages: 1) Structuring of 29 questions, which were scored from 1 to 9; 2) Resubmission of non-consensual questions; 3) Analysis and discussion of responses; and 4) Validation of non-consensual responses by nominal consensus. Results: Twenty-nine questions related to the diagnosis and treatment of early-stage melanoma were discussed in order to construct suggestions based on evidence proven by experts, as well as on internationally recognized oncology management guidelines adapted to the Colombian context and reality. Conclusions: Multidisciplinary suggestions are offered for the diagnosis and treatment of early-stage melanoma, which should be considered in order to guide decision-making and homogenize clinical practice according to the Colombian context and the characteristics of the Colombian health care system. This is an academic and non-regulatory document.

Optimizing the treatment of metastatic castration-resistant prostate cancer: a Latin America perspective.

Prostate cancer is a significant burden and cause of mortality in Latin America. This article reviews the treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC) and provides consensus recommendations to assist Latin American prostate cancer specialists with clinical decision making. A multidisciplinary expert panel from Latin America reviewed the available data and their individual experience to develop clinical consensus opinions for the use of life-prolonging agents in mCRPC, with consideration given to factors influencing patient selection and treatment monitoring. There is a lack of level 1 evidence for the best treatment sequence or combinations in mCRPC. In this context, consensus recommendations were provided for the use of taxane-based chemotherapies, androgen receptor axis-targeted agents and targeted alpha therapy, for patients in Latin America. Prostate-specific antigen (PSA) changes alone, during treatment, should be treated with caution; PSA may not be a suitable biomarker for radium-223. Bone scans and computed tomography are the standard imaging modalities in Latin America. Imaging should be prompted during treatment where symptomatic decline and/or significant worsening of laboratory evaluations are reported, or where a course of therapy has been completed and another antineoplastic agent is under consideration. Recommendations and guidance for treatment options in Latin America are provided in the context of country-level variable access to approved agents and technologies for treatment monitoring. Patients should be treated with the purpose of prolonging overall survival and preserving quality of life through increasing the opportunity to administer all available life-prolonging therapies when appropriate.

Atención Selectiva y sostenida de trabajadores en dos jornadas del día / Selective and sustained attention of workers of two different shifts in the day

Resumen Aun cuando se ha reconocido la importancia del proceso psicológico de la atención por contribuir a la capacidad productiva y la consecución de resultados eficientes y eficaces durante el desarrollo de diversas tareas cotidianas, no ha sido suficientemente estudiado en trabajadores de empresas u organizaciones. Esta investigación buscó identificar cómo es la atención selectiva y sostenida de los trabajadores en dos jornadas diferentes del día (mañana y tarde); adicionalmente, se exploró si variables como la edad, escolaridad y género afectan el desempeño. Se aplicó el programa computarizado Vienna Test System subprueba cognitron forma S1 a 184 trabajadores de una universidad. Los datos fueron analizados mediante un modelo de regresión y prueba t para muestras independientes. Los hallazgos mostraron que la atención selectiva es mayor en horas de la mañana, mientras que la atención sostenida se mantiene a lo largo del día. En cuanto a las otras variables analizadas, se evidenció que la edad fue la única predictora del rendimiento, por cuanto a menor edad mejores desempeños. Estos resultados aportan para la planeación de actividades en el ámbito laboral y complementa los estudios en el área de los procesos psicológicos básicos.

Abstract Although the importance of the psychological process of attention and how it to contributes productive capacity and achieving efficient and effective results during the development of daily tasks has been recognized, it has not been sufficiently studied in workers of companies or organizations. This research sought to identify what selective and sustained attention is like in the workers to two different shifts in the day (morning and afternoon); Additional variables such as age, schooling and gender were investigated to see if they affected performance. We applied the computer program Vienna Test System sub-test cognition form S1 to 184 university workers. Data was analyzed using a regression model and t-test for independent samples. The findings showed that selective attention is greater in the morning, while sustained attention is maintained throughout the day. As for the other variables analyzed, it was evidenced that age was the only predictor of performance, as workers of a younger age performed better. These results contribute to the planning of activities in the workplace and complements the studies in the area of the basic psychological processes.

[Multicenter study of satisfaction with fast-dissolving ebastine, 20 mg/ day, in Mexican patients with allergic rhinitis]. / Estudio multicéntrico de satisfacción con ebastina de disolución rápida 20 mg/día en pacientes mexicanos con rinitis alérgica.

BACKGROUND: Allergic rhinitis is an inflammatory disease of the nasal mucosa, with common symptoms, which is essentially characterized by nasal itching, nasal congestion, sneezing, hyaline rhinorrhea and repetitive sneezing. The disease is very common, 15% of the population worldwide suffers it. Among many treatments that have been used to relieve the symptoms of this disease there is a selective inhibitor of H1 receptors, ebastine. OBJECTIVE: To evaluate patient satisfaction using the scale of Treatment Satisfaction Questionnaire for Medication (TSQM). MATERIAL AND METHODS: A multicentric, retrospective, observational study performed in 250 Mexican patients with the diagnosis of intermittent allergic rhinitis (IAR) or persistent allergic rhinitis (PER), confirmed by prick test, specific IgE, or both, treated with lyophilised ebastine in fast-dissolving (FDT) 20 mg at any time in the last two months, prescribed for at least two weeks by their doctor to relieve the symptoms of intermittent allergic rhinitis or persistent allergic rhinitis. We used a validated questionnaire assessment scales, TSQM. RESULTS: The presentation of ebastine fast-dissolving (FDT) is effective and has good tolerability, over 80% of patients reported comfort and satisfaction using it. CONCLUSIONS: Assessment of overall satisfaction, efficacy, tolerability and comfort showed that ebastine in fast-dissolving is an antihistamine with clear benefits to encourage compliance.

Tissue engineered testicular prostheses with prolonged testosterone release.

PURPOSE: Bilateral anorchia, either congenital or acquired, often requires testicular prostheses placement and testosterone supplementation. Several types of testosterone compounds and various modes of hormone delivery are currently used clinically, however, their pharmacokinetic properties are not ideal. In this study, we explored the possibility of creating hormone releasing testicular prostheses that could continuously supply and maintain physiologic levels of testosterone in vivo over time. METHODS: Chondrocytes, harvested from bovine articular cartilage, were seeded on testicular shaped polymer scaffolds at a concentration of 100 x 10(6) ml(-1). The scaffolds were maintained in a bioreactor for 4 weeks to form cartilage tissue. Subsequently, testosterone enanthate (100 microg) was injected into the central hollow space of each testicular prosthesis, and maintained for 40 weeks in culture. A sample of the medium was collected every 2 days for testosterone assays. Another group of ex vivo engineered testicular prostheses was implanted into the scrotal space of castrated athymic mice (n = 10). Intratesticular injection of testosterone enanthate was made into each prosthesis at a concentration of 100 microg. Control groups consisted of animals with castration only (n = 8) and sham operations (n = 5). Testosterone levels were measured prior and 2 weeks after castration, 1 day after testosterone administration, and weekly up to 14 weeks. The engineered testicular prostheses were retrieved at sacrifice for histomorphological and immunocytochemical analyses. RESULTS: Milky white cartilage testicular protheses were formed by 4 weeks. The ex vivo prostheses showed an initial burst effect of testosterone followed by a broad plateau for 16 weeks (>500 ng/dl) and a decreased level of testosterone until 40 weeks. The testosterone levels were physiologic throughout 40 weeks and the entire testosterone released was calculated as 60% of the injected volume. The circulating testosterone levels in the protheses implanted animals demonstrated a maximum peak on day 1 and a continued physiologic range during the entire study period. Histologically, the retrieved testicular implants showed mature chondrocytes with a hollow center in each prosthesis. CONCLUSION: This study demonstrates that engineered cartilage testis can be created in bioreactors, can be implanted in vivo, and can release testosterone for a prolonged period. Furthermore, the levels of testosterone release can be maintained within the physiologic range. Periodic reinjection may potentially provide permanent physiologic hormonal replacement. This novel technology may be beneficial for patients who require testicular prostheses and chronic hormone supplementation.

Intranet del Centro Nacional de Información de Ciencias Médicas-Infomed: un espacio de trabajo en red para el Sistema de Información en Salud de Cuba / Intranet of the National Medical Sciences Information Centre- Infomed: a working space in the network for the health information system in Cuba

Se expone la visión, misión, escenario, valores, factores críticos del éxito y los objetivos del Centro Nacional de Información de Ciencias Médicas-Infomed, como organización líder del Sistema Nacional de Información en Ciencias de la Salud en Cuba. Se aborda la creación de la intranet de la institución, su tecnología, su política y diversos aspectos sobre su utilización. La creación de la intranet del centro es, sin lugar a dudas, desde la perspectiva de la gestión del conocimiento organizacional, una formidable herramienta para el cumplimiento de su misión y objetivos

Genetic background of people in the Dominican Republic with or without obese type 2 diabetes revealed by mitochondrial DNA polymorphism.

People in the Dominican Republic are considered to be genetically heterogeneous owing to the post-Colombian admixture of Native American, African, and European populations. To characterize their genetic background, nucleotide sequences of the D-loop region of human mitochondrial DNA (mtDNA) were examined in 33 healthy women and 50 gender-matched patients with obese type 2 diabetes (OD) from the Dominican Republic. Phylogenetic analysis of 198 mtDNA lineages including Native Americans, Africans, and Europeans enabled us to assess relative genetic contributions of the three ancestral fractions to the two groups in the Dominican Republic. In the OD group, the majority (64.0%) of the mtDNA lineages were from African ancestry, whereas the Native American fraction was predominant (51.5%) in the healthy group, with both showing smallest amounts (14.0% and 9.1%, respectively) of European contribution. This difference in maternal genetic background between the two groups was similarly demonstrated by phylogenetic analysis at the population level based on net nucleotide diversities between populations. These findings may imply ethnic-specific predisposition to OD, a possible association of an unidentified factor from African ancestry with OD in the Dominican Republic population.

Evaluación tratamiento adjuvante con 5-Fluorouracilo en pacientes con carcinoma gástrico / Gastric carcinoma an adyuvant chemotherapy with 5 Fluoruracilo

Como propósito realizamos un estudio retrospectivo descriptivo para determinar la utilidad de la terapia adyuvante con 5-fluorouracilo en pacientes con carcinoma gástrico. Se analizaron 159 historias clínicas correspondientes a los pacientes con diagnóstico de carcinoma gástrico que consultaron al Instituto Nacional de Cancerología de Santafé de Bogotá- Colombia, entre el 1 de Enero al 31 de Diciembre de 1985. Fueron estadificados de acuerdo a la clasificación patológica del American Joint Committee y divididos en dos grupos; aquellos que recibieron terapia adyuvante post quirúrgica con 5-FU y aquellos que sólo recibieron tratamiento quirúrgico. Se estableció la supervivencia a 5 años por estadío patológico para ambos grupos. RESULTADOS: La supervivencia a 5 años del grupo que recibió terapia adyuvante por estadíos patológicos fue:Ib 50 por ciento, II 75 por ciento, IIIa 8,8 por ciento, IIIb 0 por ciento IV 0 por ciento y para el grupo que recibió sólo tratamiento quirúrgico fue: Ia 100 por ciento, Ib 50 por ciento, IIIa 8.8 por ciento, IIIb 0 por ciento, IV 0 por ciento

Porfiria intermitente aguda / Acute intermitted porphyria

La porfiria intermitente aguda es un desorden hereditario caracterizado por la deficiencia del porfobilinógeno deaminasa, enzima necesaria en las biosíntesis del hem. Como resultado una superproducción, acumulación y excreción excesiva de precursores de la porfirina, ác. delta aminolevulínico y porfobilinógeno. Esta enfermedad se caracteriza por exacerbaciones y remisiones. Muchos de los pacientes pasan asintomáticos hasta que uno de los factores precipitantes la activan. Durante el ataque agudo los pacientes experimentan dolores abdominales, naúseas, constipación, dolores musculares y síntomas neurosiquiátricos. El tratamiento se basa en dar una dieta hipercarbohidratada y la administración ev. de hematina. Lo más importante es la prevención de los ataques evitando los factores precipitantes. Esto es importante para el médico clínico, que debe estar en conocimiento de las drogas precipitantes. El paciente debe saber que los ataques agudos de su enfermedad pueden ser evitados. En la casuística presntada predomina el sexo femenino, en una edad que corresponde entre 30 y 40 años. En uno de aparentemente el factor precipitan te fue el embarazo y una sobrecarga hormonal y el último de los casos tenemos como factor precipitantes. Esto es importante para el médico clínico, que debe estaar en conocimiento de las drogas precipitantes. El paciente debe saber que los ataques agudos de su enfermedad pueden ser evitados. En la casuística presentada predomina el sexo femenino, en una edad que ...