Histone H2A variant H2A.B is enriched in transcriptionally active and replicating HSV-1 lytic chromatin.

Herpes simplex virus 1 (HSV-1) transcription is restricted in latently infected neurons and the genomes are in mostly silenced chromatin, whereas all viral genes are transcribed in lytically infected cells, in which the genomes are dynamically chromatinized. Epigenetic regulation modulates HSV-1 transcription during lytic, latent, and reactivating infections but the precise mechanisms are not fully defined. Nucleosomes are dynamic: they slide, breathe, assemble, and disassemble. We and others have proposed that the most dynamic HSV-1 chromatin is transcriptionally competent, whereas the least dynamic is silenced. However, the mechanisms yielding the unusually dynamic viral chromatin remain unknown. Histone variants affect nucleosome dynamics. The dynamics of H2A, H2A.X, and macroH2A were enhanced in infected cells, whereas those of H2A.B were uniquely decreased. We constructed stably transduced cells expressing tagged histone H2A, H2A.B, macroH2A, or H2B, which assembles the H2A/H2B nucleosome dimers with all H2A variants. All H2A variants, as well as ectopic and endogenous H2B were assembled into HSV-1 chromatin evenly throughout the genome but canonical H2A was relatively depleted whereas H2A.B was enriched, particularly in the most dynamic viral chromatin. When viral transcription and DNA replication were restricted, H2A.B became as depleted from the viral chromatin through the entire genome as H2A. We propose that lytic HSV-1 nucleosomes are enriched in the dynamic variant H2A.B/H2B dimers to promote HSV-1 chromatin dynamics and transcriptional competency and conclude that the dynamics of HSV-1 chromatin are determined in part by the H2A variants. IMPORTANCE: Herpes simplex virus 1 (HSV-1) transcription is epigenetically regulated during latent and lytic infections, and epigenetic inhibitors have been proposed as potential antiviral drugs to modulate latency and reactivation. However, the detailed epigenetic mechanisms of regulation of HSV-1 transcription have not been fully characterized and may differ from those regulating cellular transcription. Whereas lytic HSV-1 chromatin is unusually dynamic, latent silenced HSV-1 chromatin is not. The mechanisms resulting in the unique dynamics of the lytic chromatin remain unknown. Here we identify the enrichment of the highly dynamic histone 2A variant H2A in the most dynamic viral chromatin, which provides a mechanistic understanding of its unique dynamics. Future work to identify the mechanisms of enrichment in H2A.B on the viral chromatin may identify novel druggable epigenetic regulators that modulate HSV-1 latency and reactivation.

Modeling hydro, nuclear, and renewable electricity generation in India: An atom search optimization-based EEMD-DBSCAN framework and explainable AI.

Background and objective: Tracking clean electricity generation in developing economies is highly challenging owing to the influence of turbulent external factors. Clean electricity is a significant enabler of striving toward environmental sustainability. In this research, we aim to model hydro, nuclear, and renewable electricity generation in India through applied predictive modeling. We also strive to uncover the influence of the critical determinants responsible for clean electricity growth. Methodology: We propose a granular predictive framework comprising ensemble empirical mode decomposition, clustering applications in spatial data based on density, including noise, and atom search optimization-based novel optimization methodology to predict absolute figures of clean energy generation. The framework uses a series of socio-economic factors reflecting household demand and industrial growth in India as explanatory variables. Results: The rigorous scrutiny of the predictive framework specifies hydro electricity generation is relatively more predictable during the time horizon influenced by the COVID-19 pandemic. The deployment of dedicated explainable artificial intelligence (AI) tools suggests an increased adoption of clean electricity in selected industrial sectors in India, which broadly governs the evolutionary pattern. Conclusion: The underlying research is the first of its kind to fathom the daily temporal dynamics of clean electricity generation in the Indian context. Consideration of three distinct clean electricity sources during highly volatile time regimes underscores the contribution of the work. The predictive framework survives a stringent performance check, which justifies the robustness of the same. Demand in different industrial sectors in India profoundly influences the growth toward clean electricity.

On the causes and consequences of the free-roaming dog problem in southern Chile.

Free-roaming dogs are an important concern for public health, livestock production and the environment. Human behaviors-such as allowing pets to roam, abandoning dogs, or feeding stray animals-could influence free-roaming dog abundance and the frequency of occurrence of dog-caused problems. Here we aim to determine patterns of free-roaming dog abundance in urban and rural areas, to reveal spatial variation in human behaviors underlying the free-roaming dog problem, and to test for associations between free-roaming dog abundance and related problems. We conducted our study in Chile, where dogs are a major environmental issue. In Chile, as in many other Global South countries, many people leave their dogs to roam, partly due to norms and to lax enforcement of dog control laws. To address our objectives, we counted dogs in 213 transects in urban and rural areas to model dog abundance using N-mixture models. Then we conducted interviews in 553 properties around the transects to determine people's dog management, their behavior towards free-roaming dogs and the prevalence of dog-caused problems. Dog abundance was higher in transects where a higher number of owned dogs was allowed to roam, as well as in lower-income neighborhoods (based on property tax valuation). Meanwhile, rural citizens were more likely to let their dogs' roam. Dog abandonment was reported more frequently in lower-income urban neighborhoods and rural areas. Not surprisingly, we found that several problems-such as dog bites-were more frequent where we detected more free-roaming dogs. Our results highlight that the owned dog population is a central component of the free-roaming dog problem, and that human behavior is the key driver underlying the problem. Dog management programs should promote responsible dog-ownership, with a strong message focused on keeping dogs inside properties and preventing abandonment.

Role of proliferation COVID-19 media chatter in predicting Indian stock market: Integrated framework of nonlinear feature transformation and advanced AI.

The outbreak of the COVID-19 pandemic has transpired the global media to gallop with reports and news on the novel Coronavirus. The intensity of the news chatter on various aspects of the pandemic, in conjunction with the sentiment of the same, accounts for the uncertainty of investors linked to financial markets. In this research, Artificial Intelligence (AI) driven frameworks have been propounded to gauge the proliferation of COVID-19 news towards Indian stock markets through the lens of predictive modelling. Two hybrid predictive frameworks, UMAP-LSTM and ISOMAP-GBR, have been constructed to accurately forecast the daily stock prices of 10 Indian companies of different industry verticals using several systematic media chatter indices related to the COVID-19 pandemic alongside several orthodox technical indicators and macroeconomic variables. The outcome of the rigorous predictive exercise rationalizes the utility of monitoring relevant media news worldwide and in India. Additional model interpretation using Explainable AI (XAI) methodologies indicates that a high quantum of overall media hype, media coverage, fake news, etc., leads to bearish market regimes.

Chromatin-mediated epigenetic regulation of HSV-1 transcription as a potential target in antiviral therapy.

The ability to establish, and reactivate from, latent infections is central to the biology and pathogenesis of HSV-1. It also poses a strong challenge to antiviral therapy, as latent HSV-1 genomes do not replicate or express any protein to be targeted. Although the processes regulating the establishment and maintenance of, and reactivation from, latency are not fully elucidated, the current general consensus is that epigenetics play a major role. A unifying model postulates that whereas HSV-1 avoids or counteracts chromatin silencing in lytic infections, it becomes silenced during latency, silencing which is somewhat disrupted during reactivation. Many years of work by different groups using a variety of approaches have also shown that the lytic HSV-1 chromatin is distinct and has unique biophysical properties not shared with most cellular chromatin. Nonetheless, the lytic and latent viral chromatins are typically enriched in post translational modifications or histone variants characteristic of active or repressed transcription, respectively. Moreover, a variety of small molecule epigenetic modulators inhibit viral replication and reactivation from latency. Despite these successes in culture and animal models, it is not obvious how epigenetic modulation would be used in antiviral therapy if the same epigenetic mechanisms governed viral and cellular gene expression. Recent work has highlighted several important differences between the viral and cellular chromatins, which appear to be of consequence to their respective epigenetic regulations. In this review, we will discuss the distinctiveness of the viral chromatin, and explore whether it is regulated by mechanisms unique enough to be exploited in antiviral therapy.

Widespread Presence of Domestic Dogs on Sandy Beaches of Southern Chile.

Dogs on sandy beaches are a threat to shorebirds. Managing this problem requires understanding the factors that influence the abundance of dogs in these ecosystems. We aimed to determine the proportion of beaches used by dogs and the effects of human presence on dog abundance on sandy beaches of southern Chile. We conducted dog counts and recorded the presence of tracks on 14 beaches. We used zero-inflated generalized linear mixed models to determine if the number of people, number of households, and other covariates were associated with dog abundance. We detected dog tracks on all the beaches, and dog sightings on most of them. Dogs were frequently not supervised (45%) and only 13% of them were leashed. The number of people on the beach and the number of houses near the beach were positively associated with the number of dogs on beaches. Finally, when dogs co-occurred with whimbrels (Numenius phaeopus), the probability of dog harassment was high (59%). Our work reveals that human presence determines the abundance of dogs on sandy beaches. Therefore, our study suggests that any strategy aiming at reducing dog harassment of shorebirds requires changes in those human behaviors that favor the presence of free-ranging dogs at beaches.

Recommendations on the pharmacological treatment of epithelial ovarian cancer in Mexico.

Ovarian cancer is the third most frequent gynaecological malignancy worldwide and in Mexico, with a high mortality rate, due to that in many cases its diagnosis is made in advanced stages. Prognosis is important for determining the subtype and the degree of evolution. During lasts years, the management of ovarian cancer has undergone an important evolution with the incorporation of new therapeutic options, which in turn represent an increase in the survival of these patients. We present recommendations for the management of ovarian cancer developed by an expert panel Mexican based on available evidence so far and the characteristics of health care in the country.

El cáncer de ovario es la tercera neoplasia maligna ginecológica más frecuente globalmente y también en México, con una elevada tasa de mortalidad debido a que en muchos casos su diagnóstico se realiza en etapas avanzadas. Para establecer su pronóstico es importante la determinación del subtipo y del grado de evolución. En los últimos años, el manejo del cáncer de ovario ha sufrido una importante evolución con la incorporación de nuevas opciones terapéuticas, que a su vez representan un incremento en la supervivencia de estas pacientes. Se presentan las recomendaciones para el manejo del cáncer de ovario elaboradas por un panel de expertos mexicanos basadas en la evidencia disponible hasta el momento y en las características de la atención sanitaria del país.

Recomendaciones sobre el tratamiento farmacológico del cáncer de ovario epitelial en México / Recommendations on the pharmacological treatment of epithelial ovarian cancer in Mexico

Resumen El cáncer de ovario es la tercera neoplasia maligna ginecológica más frecuente globalmente y también en México, con una elevada tasa de mortalidad debido a que en muchos casos su diagnóstico se realiza en etapas avanzadas. Para establecer su pronóstico es importante la determinación del subtipo y del grado de evolución. En los últimos años, el manejo del cáncer de ovario ha sufrido una importante evolución con la incorporación de nuevas opciones terapéuticas, que a su vez representan un incremento en la supervivencia de estas pacientes. Se presentan las recomendaciones para el manejo del cáncer de ovario elaboradas por un panel de expertos mexicanos basadas en la evidencia disponible hasta el momento y en las características de la atención sanitaria del país.

Abstract Ovarian cancer is the third most frequent gynaecological malignancy worldwide and in Mexico, with a high mortality rate, due to that in many cases its diagnosis is made in advanced stages. Prognosis is important for determining the subtype and the degree of evolution. During lasts years, the management of ovarian cancer has undergone an important evolution with the incorporation of new therapeutic options, which in turn represent an increase in the survival of these patients. We present recommendations for the management of ovarian cancer developed by an expert panel Mexican based on available evidence so far and the characteristics of health care in the country.

Preservación de la fertilidad: opinión de grupo de expertos en México / Fertility preservation: an expert taskforce opinion

La preservación de la fertilidad es la aplicación de estrategias médicas y de laboratorio para preservar la descendencia genética parental en adultos o niños en riesgo de esterilidad. El cáncer es la principal indicación de preservación de fertilidad en pacientes en edad reproductiva. En las últimas décadas ha incrementado la incidencia de cáncer en adolescentes. Los tratamientos oncológicos también han mejorado significativamente, por lo que hoy es posible la curación en un amplio porcentaje de pacientes. La mayoría de los niños y adolescentes con cáncer se convierten en sobrevivientes a largo plazo, lo que aumenta el interés en los efectos del tratamiento del cáncer sobre la fertilidad. Las condiciones sociales, económicas y culturales también son determinantes para decidir el momento que una pareja busque promover su fertilidad. Además, otras patologías o incluso fármacos para prevención del rechazo de órganos trasplantados pueden afectar la fertilidad y, por tanto, tales pacientes son susceptibles de orientación sobre preservación de la fertilidad. El éxito en los programas de reproducción asistida y en los tratamientos oncológicos brindan alternativas para preservar la fertilidad. En esta primera Opinión de Grupo de Expertos Mexicanos en Preservación de la Fertilidad hemos evaluado pacientes oncológicas que son candidatas a preservación de fertilidad: jóvenes con riesgo de compromiso de su fertilidad por el tratamiento oncológico, pero con reserva ovárica suficiente y pronóstico vital aceptable. También se consideraron casos especiales como la preservación social, en casos de conceptualización sexual diferente, así como los aspectos legales y éticos básicos

Fertility preservation is the application of medical and laboratory strategies to preserve parental genetic offspring in adults or children at risk of sterility. Cancer is the main indication of fertility preservation in patients of reproductive age. In recent decades, the incidence of cancer in adolescents has increased. Cancer treatments have also improved significantly, making cure possible today in a large percentage of patients. Most children and adolescents with cancer become long-term survivors, increasing interest in the effects of cancer treatment on fertility. Social, economic and cultural conditions are also decisive in deciding when a couple seeks to promote their fertility. Furthermore, other pathologies or even drugs for the prevention of rejection of transplanted organs can affect fertility and, therefore, such patients are susceptible to guidance on fertility preservation. Success in assisted reproduction programs and cancer treatments provide alternatives to preserve fertility. In this first Opinion of the Group of Mexican Experts on Fertility Preservation, we have evaluated oncological patients who are candidates for fertility preservation: young people at risk of compromising their fertility due to oncological treatment, but with sufficient ovarian reserve and acceptable vital prognosis. Special cases such as social preservation were also considered, in cases of different sexual conceptualization, as well as the basic legal and ethical aspects

STANDARD TREATMENT WITH BEVACIZUMAB AS TARGETED THERAPY IN CERVICAL CANCER.

Metastatic, recurrent, or persistent disease in cervical cancer has a poor prognosis. Historically, this group of patients has had limited treatment options, even with the best cytotoxic treatments (platinum-based chemotherapy [CT] doublets). Therefore, investigating new medications that help improve the patient's quality of life and survival has been essential. Angiogenesis has been shown to play a critical role in tumor cell growth and survival. Bevacizumab is a recombinant humanized monoclonal G1 immunoglobulin targeted against vascular endothelial growth factor. The combination of CT and bevacizumab is associated with an increase in overall survival as well as in progression-free survival and response rates.

Controversies on the treatment of ovarian cancer with dose-dense chemotherapy.

Epithelial ovarian cancer is the most lethal gynaecological malignancy with an estimated 295,414 new cases and 184,799 deaths around the world. Cytoreductive surgery and combination chemotherapy have remained a standard therapy for decades. The majority of women diagnosed with ovarian cancer will receive systemic chemotherapy for recurrent or advanced diseased. In recent years, therapies such as anti-angiogenics, PARP inhibitors, and dose-dense chemotherapy have emerged as novel strategies against ovarian cancer. Dose-dense chemotherapy, usually with a carboplatin and paclitaxel regimen, has been proposed as an alternative to conventional chemotherapy for these patients. However, the results for different trails are inconsistent and dose-dense chemotherapy remains controversial. Results from the JGOG 3016 study showed a progression free survival and overall survival benefit, with increased neurotoxicity and anaemia. While the GOG 262, MITO-7, GOG 252 and ICON8 studies found no benefit on progression free survival, with a recent meta-analysis concluding that three weekly chemotherapy remains the standard of care. Ovarian cancer molecular subtypes and differences in pharmacogenetics between populations may explain the differences in response to dose dense chemotherapy, however our understanding of this factors is still lacking. Here, we reviewed the evidence for and against dose-dense chemotherapy and the possible factors for the different results among trials.

Standard treatment with bevacizumab as targeted therapy in cervical cancer

ABSTRACT Metastatic, recurrent, or persistent disease in cervical cancer has a poor prognosis. Historically, this group of patients has had limited treatment options, even with the best cytotoxic treatments (platinum-based chemotherapy [CT] doublets). Therefore, investigating new medications that help improve the patient's quality of life and survival has been essential. Angiogenesis has been shown to play a critical role in tumor cell growth and survival. Bevacizumab is a recombinant humanized monoclonal G1 immunoglobulin targeted against vascular endothelial growth factor. The combination of CT and bevacizumab is associated with an increase in overall survival as well as in progression-free survival and response rates.

Standard Treatment with Bevacizumab as Targeted Therapy in Cervical Cancer.

Metastatic, recurrent, or persistent disease in cervical cancer has a poor prognosis. Historically, this group of patients has had limited treatment options, even with the best cytotoxic treatments (platinum-based chemotherapy [CT] doublets). Therefore, investigating new medications that help improve the patient's quality of life and survival has been essential. Angiogenesis has been shown to play a critical role in tumor cell growth and survival. Bevacizumab is a recombinant humanized monoclonal G1 immunoglobulin targeted against vascular endothelial growth factor. The combination of CT and bevacizumab is associated with an increase in overall survival as well as in progression-free survival and response rates.

Chromatin dynamics and the transcriptional competence of HSV-1 genomes during lytic infections.

During latent infections with herpes simplex virus 1 (HSV-1), viral transcription is restricted and the genomes are mostly maintained in silenced chromatin, whereas in lytically infected cells all viral genes are transcribed and the genomes are dynamically chromatinized. Histones in the viral chromatin bear markers of silenced chromatin at early times in lytic infection or of active transcription at later times. The virion protein VP16 activates transcription of the immediate-early (IE) genes by recruiting transcription activators and chromatin remodelers to their promoters. Two IE proteins, ICP0 and ICP4 which modulate chromatin epigenetics, then activate transcription of early and late genes. Although chromatin is involved in the mechanism of activation of HSV- transcription, its precise role is not entirely understood. In the cellular genome, chromatin dynamics often modulate transcription competence whereas promoter-specific transcription factors determine transcription activity. Here, biophysical fractionation of serially digested HSV-1 chromatin followed by short-read deep sequencing indicates that nuclear HSV-1 DNA has different biophysical properties than protein-free or encapsidated HSV-1 DNA. The entire HSV-1 genomes in infected cells were equally accessible. The accessibility of transcribed or non-transcribed genes under any given condition did not differ, and each gene was entirely sampled in both the most and least accessible chromatin. However, HSV-1 genomes fractionated differently under conditions of generalized or restricted transcription. Approximately 1/3 of the HSV-1 DNA including fully sampled genes resolved to the most accessible chromatin when HSV-1 transcription was active, but such enrichment was reduced to only 3% under conditions of restricted HSV-1 transcription. Short sequences of restricted accessibility separated genes with different transcription levels. Chromatin dynamics thus provide a first level of regulation on HSV-1 transcription, dictating the transcriptional competency of the genomes during lytic infections, whereas the transcription of individual genes is then most likely activated by specific transcription factors. Moreover, genes transcribed to different levels are separated by short sequences with limited accessibility.

Biopsychosocial Assessment of Pain with Thermal Imaging of Emotional Facial Expression in Breast Cancer Survivors.

Background: Recent research has evaluated psychological and biological characteristics associated with pain in survivors of breast cancer (BC). Few studies consider their relationship with inflammatory activity. Voluntary facial expressions modify the autonomic activity and this may be useful in the hospital environment for clinical biopsychosocial assessment of pain. Methods: This research compared a BC survivors group under integral treatment (Oncology, Psychology, Nutrition) with a control group to assess the intensity of pain, behavioral interference, anxiety, depression, temperament-expression, anger control, social isolation, emotional regulation, and alexithymia and inflammatory activity, with salivary interleukin 6 (IL-6). Then, a psychophysiological evaluation through repeated measures of facial infrared thermal imaging (IRT) and hands in baseline-positive facial expression (joy)-negative facial expression (pain)-relaxation (diaphragmatic breathing). Results: The results showed changes in the IRT (p < 0.05) during the execution of facial expressions in the chin, perinasal, periorbital, frontal, nose, and fingers areas in both groups. No differences were found in the IL-6 level among the aforementioned groups, but an association with baseline nasal temperature (p < 0.001) was observable. The BC group had higher alexithymia score (p < 0.01) but lower social isolation (p < 0.05), in comparison to the control group. Conclusions: In the low- and medium-concentration groups of IL-6, the psychophysiological intervention proposed in this study has a greater effect than on the high concentration group of IL-6. This will be considered in the design of psychological and psychosocial interventions for the treatment of pain.

[National guidelines of diagnosis and treatment of the non-Hodgkin lymphoma]. / Guías nacionales de diagnóstico y tratamiento de linfoma no Hodgkin.

Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.

¿Creen haber cambiado los docentes un año después de un curso de docencia clínica? / Do clinical tutors believe to have changed their teaching practices one year after finishing a faculty development course?

Introducción. Los cursos de formación pedagógica pueden mejorar el desempeño de los docentes clínicos. Diseñamos un curso de diez sesiones para mejorar las competencias docentes de profesionales que tienen responsabilidades como tutores clínicos. En el año 2008 se realizaron tres cursos. Las actividades se programaron una vez a la semana, de 08:30 a 10:00 h de la mañana, para facilitar la asistencia. El curso se componía de tres módulos -currículo, metodología y evaluación- y se diseñó para centrarse en los alumnos. Fueron facilitadores de los cursos docentes clínicos con formación en docencia en ciencias de la salud (con diploma o maestría). Objetivo. Evaluar si los asistentes percibían haber realizado cambios en sus prácticas docentes a un año de haber finalizado el curso. Sujetos y métodos. Se administró de modo anónimo, mediante una plataforma informática, un cuestionario con 13 preguntas cerradas y espacio para comentarios. Se envió por correo electrónico una invitación a responder el cuestionario a los 55 tutores clínicos que fueron alumnos de los tres cursos realizados durante el año 2008. El cuestionario se remitió un año después de haber finalizado el curso respectivo. Resultados. El cuestionario fue respondido por 41 tutores clínicos (74,5%). Las respuestas apuntaron a cambios realizados en todos los aspectos consultados: programas (34%), metodología (83%) y evaluación (71%). Conclusiones. La mayoría de los participantes en estos cursos de formación docente perciben haber hecho cambios positivos en sus prácticas docentes. Actualmente se está dictando el noveno curso de estas características (AU)

Introduction. Faculty development courses can improve the performance of teachers. We designed a ten sessions course aimed to improve the teaching skills of professionals who have responsibilities as tutors in clinical settings. Three courses were given in year 2008. The courses were held in teaching hospitals once a week to make easier for tutors to attend. The courses included curriculum, methodology and evaluation modules. They were student centred, took place in the workplace and employed local teachers with a degree in health sciences education that were clinical tutors themselves. Aim. To assess whether clinical tutors perceived themselves as having made changes in their teaching practices one year after having finished the course. Subjects and methods. An anonymous online survey with thirteen closed questions and space for open comments was administered online. One year after finishing the respective course, an invitation to complete the survey was e-mailed to the fifty-five tutors who completed one of the year 2008 courses. Results. Forty-one tutors answered the survey (74.5%). Changes in teaching practices and in major aspects of the teaching process were declared in all the items consulted in the survey: teaching methodology 83%, assessment of students 71%, programs 34%. Conclusions. Clinical tutors perceive themselves as having made positive changes in their teaching practices after a faculty development course. Currently the ninth similar course is being given (AU)

[Third National Ovarian Consensus. 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"]. / Tercer Consenso Nacional de Cáncer de Ovario 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM".

INTRODUCTION: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. CONCLUSIONS: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.

[The first Mexican consensus of endometrial cancer. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México]. / Primer consenso Mexicano de cancer de endometrio.

INTRODUCTION: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. CONCLUSIONS: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

Detección de resistencia primaria en pacientes chilenos infectados por VIH / Detection of primary antiretroviral resistance in Chilean patients recently infected with human immunodeficiency virus (HIV)

Background: In countries with universal access to antiretroviral therapy a progressive increase in the number of patients that are infected with resistant virus, is observed. Aim To detect the presence of primary resistance to antiretroviral drugs among patients with a recent diagnosis of HIV infection. Material and methods: Twenty five male patients aged 25 to 45 years, with a diagnosis of a recent HIV infection, done between 2004 and 2005, were studied. Genotypic resistance to antiretroviral drugs was studied using the Genetic Resistance Test TRUGENE® from Bayer. Results: Resistance mutations were detected in 10 patients. All had an university title or had university studies. All lived in northeastern Santiago and had risky sexual behaviors while traveling abroad. Seven mutations were detected in reverse transcriptase. Of these, three were associated to a high resistance level and four, to an intermediate or low resistance, were also detected. Conclusions: A high frequency of genotypic resistance was detected in this group of Chilean patients recently infected with HIV. A higher socioeconomic status and lifestyle could have influenced these results.