Factores asociados a sobrevida a un año en pacientes postoperados de glioblastoma.

OBJECTIVE: To identify factors associated with one-year survival in postoperative glioblastoma patients at a hospital in northeastern Mexico. MATERIAL AND METHODS: Nested case-control study. Patients operated on for glioblastoma between 2016-2019 were included. Information about clinical and surgical factors was obtained, survival was calculated by Kaplan-Meier analysis. Descriptive analysis was performed with medians and ranges, and inferential analysis with χ2, Fisher and Student t test, odds ratio and 95% confidence interval. A value of p < 0.05 was considered significant. RESULTS: Sixty-two patients with glioblastoma were included, 27 (43.5%) women and 35 (56.5%) men, median age 56 years (range: 6-83). Median survival was 3.6 months (1-52), 45 (72.6%) survived less than 12 months. The factors associated with a higher survival were administration of adjuvant treatment (p < 0.001), better functional status (p = 0.001), and absence of post-surgical complications (p = 0.034). CONCLUSIONS: Most patients with glioblastoma survive less than 12 months and the factors most strongly associated with longer survival are administration of adjuvant treatment, better functional status of the patient and absence of post-surgical complications.

OBJETIVO: Identificar los factores asociados a la sobrevida a un año en pacientes postoperados de glioblastoma en un hospital del noreste de México. MATERIAL Y MÉTODOS: Estudio de casos y controles anidado en una cohorte. Se incluyeron pacientes operados de glioblastoma entre 2016 y 2019. Se obtuvo la información sobre factores clínicos y quirúrgicos, se calculó la sobrevida mediante análisis de Kaplan-Meier. El análisis descriptivo se realizó con medianas y rangos, y el inferencial con prueba de χ2, Fisher, t de Student, razón de momios e intervalo de confianza al 95%. Se consideró significativo un valor de p < 0.05. RESULTADOS: Se incluyeron 62 pacientes con glioblastoma, 27 (43.5%) mujeres y 35 (56.5%) hombres, mediana de edad de 56 años (rango: 6-83). La mediana de sobrevida fue de 3.6 meses (1-52), 45 (72.6%) sobrevivieron menos de 12 meses. Los factores asociados a mayor sobrevida fueron: administración de tratamiento adyuvante (p < 0.001), mejor estado funcional (p = 0.001) y ausencia de complicaciones posquirúrgicas (p = 0.034). CONCLUSIONES: La mayoría de los pacientes con glioblastoma sobreviven menos de 12 meses y los factores más fuertemente asociados a mayor sobrevida son administración de tratamiento adyuvante, mejor estado funcional del paciente y ausencia de complicaciones posquirúrgicas.

Ideación autolesiva y sùicida: aspectos psicológicos / Self-injurious and sucicidal ideation: psychological aspects

Las ideas y actos autoagresivos tienen carácter multifactorial y complejo. Hacemos a continuación una revisión bibliográfica, todo lo exhaustiva y crítica posible respecto a los pensamientos autolesivos y suicidas, con o sin psicopatología concomitante. Material y método: Desde una perspectiva principalmente psicologista se ha buscado la mejor información publicada científica de calidad, más reciente y recogida en las principales bases bibliográficas internacionales sobre: 1) La prevención de las autoagresiones; 2) Los factores emocionales y sexuales influyentes; 3) La morbilidad psicopatológica asociada con más frecuencia; y 4) Las estrategias de intervención de eficacia probada. El conjunto, limitado por el autor, de publicaciones relevantes seleccionadas es n= 75. Resultados: En los últimos años han surgido distintos indicadores médicos y psicológicos prometedores al respecto. La ideación autolesiva es frecuente en la adolescencia y se asocia con mayor malestar subjetivo y problemas emocionales o conductuales. En la vejez el suicidio es un asunto relevante de salud pública. Probablemente más de un tercio de las personas que manifiestan ideas suicidas y más de la mitad de las que intentan suicidarse hayan recibido tratamiento psiquiátrico. La calidad de las evidencias que apoyan el beneficio de las intervenciones psicoterapéuticas específicas adicionadas al tratamiento psiquiátrico habitual, empero, son de calidad moderada o baja. Conclusiones: Las variables psicológicas influyentes son importantes, aunque no determinantes. Resulta evidente la responsabilidad profesional, deontológica y legal para la mejor prevención suicida en las personas que puedan, sean, o deban ser identificadas sanitariamente como más vulnerables

Self-aggressive ideas and acts have a complex and multifactorial character. In this work, we make a bibliographic review (as critical and exhaustive as possible) regarding self-injurious and suicidal thoughts, either with or without concomitant psychopathology. Material and method: From a mainly psychologistic perspective, we havesearched for the best, most recent, high quality published scientific information that is gathered up in the main international bibliographic databases about: 1) prevention of self-aggressions; 2) emotional and sexual influencing factors; 3) psychopathological morbidity which is most frequently associated; and 4) proven-effectiveness intervention strategies. The amount of relevant publications limited and selected by the author was n= 75. Results: Several promising psychological and medical indicators in that regard have appeared in the last years. Self-injurious ideation is frequent in adolescence and is associated with greater subjective unease and emotional or behavioural problems. In old age, suicide is a relevant public health issue. More than one third of people manifesting suicidal ideas and more than the half of people attempting suicide have probably received psychiatric treatment. Nevertheless, the quality of evidence supporting the benefit of specific psychotherapeutic interventions added to habitual psychiatric treatment are of poor or moderate quality. Conclusions: Influencing psychological variables are important, although they are not determining. Legal, deontological and professional responsibility for the best suicide prevention in those people who are, may be or must be sanitary identified as more vulnerable is clear (AU)

Neuro-psicopatología y procrastinación

Introducción: La procrastinación es un fenómeno omnipresente, polifacético y problemático. Abordaremos el mejor conocimiento científico publicado al respecto, que es limitado y de calidad más bien reducida. Método: Para este estudio original de revisión, se han examinado de forma no sistemática varias importantes bases de datos bibliométricas, sin pretensiones de exhaustividad. La metodología en muchas de las investigaciones consultadas es deficiente. Se ha pretendido que el resultado obtenido de las fuentes primarias fuera sintético, y se han evitado las más especulativas. Resultados: En relación con la clínica neuro-psicopatológica, internalizar la conducta se relaciona con el neuroticismo, y externalizarla con la impulsividad. La procrastinación aumenta con la afectividad negativa y, a menudo, ocurre en ciertos trastornos mentales en los que suele constituir una forma permanente de comportamiento. Pocos estudios han investigado los correlatos neurales de la procrastinación. Esta puede ser, además de voluntaria, consecuencia indirecta de rasgos perfeccionistas de la personalidad, entre otros. En general, la mejora de las habilidades para regular las emociones probablemente sea muy eficaz para reducir el comportamiento procrastinador. En relación con el sueño nocturno, su postergación habitual parece relacionada también con las características de la personalidad. Conclusiones: Se plantea por el autor la hipótesis de que cualquier intervención específica, sea o no sanitaria, que mejore la concienciación de la propia tendencia pasiva procrastinadora propiciará su reducción. Pero si se buscara influir específicamente sobre la salud mental del sujeto, la intervención tendrá que practicarse exclusiva o preferentemente por facultativos clínicos adecuados.

Introduction: Procrastination is a ubiquitous, multifaceted and problematic phenomenon. This paper will address the best scientific understanding published on this subject, although it is limited and of poor quality. Method: For this original revision study, we have examined various relevant bibliometric databases in a non-systematic way and with no claim to being comprehensive. The methodology used in much of the research consulted is quite deficient. Our objective has been to provide synthetic results from primary sources and have therefore avoided the most speculative ones. Results: With regard to the neuropsychopathological clinical features of procrastination, internalizing this behaviour is related to neuroticism, and externalizing it is linked to impulsivity. Procrastination increases with negative affectivity, and it often occurs in certain mental disorders, where it tends to constitute a permanent behaviour. Few studies have researched the neural correlations of procrastination. It can be can be voluntary and also an indirect consequence of perfectionist traits of personality, among others. In general, improving one's ability to regulate emotions might be very effective in reducing procrastinating behaviour. In relation to bedtime, its continued postponement seems to also be tied to personality traits. Conclusions: The author proposes the hypothesis that any specific intervention, whether medical or not, that improves awareness of one's own passive tendency to procrastinate will favour its reduction. However, if the intention is to influence somebody's mental health specifically, then the intervention should be conducted exclusively or preferably by properly qualified physicians.

Redox post-translational modifications and their interplay in plant abiotic stress tolerance.

The impact of climate change entails a progressive and inexorable modification of the Earth's climate and events such as salinity, drought, extreme temperatures, high luminous intensity and ultraviolet radiation tend to be more numerous and prolonged in time. Plants face their exposure to these abiotic stresses or their combination through multiple physiological, metabolic and molecular mechanisms, to achieve the long-awaited acclimatization to these extreme conditions, and to thereby increase their survival rate. In recent decades, the increase in the intensity and duration of these climatological events have intensified research into the mechanisms behind plant tolerance to them, with great advances in this field. Among these mechanisms, the overproduction of molecular reactive species stands out, mainly reactive oxygen, nitrogen and sulfur species. These molecules have a dual activity, as they participate in signaling processes under physiological conditions, but, under stress conditions, their production increases, interacting with each other and modifying and-or damaging the main cellular components: lipids, carbohydrates, nucleic acids and proteins. The latter have amino acids in their sequence that are susceptible to post-translational modifications, both reversible and irreversible, through the different reactive species generated by abiotic stresses (redox-based PTMs). Some research suggests that this process does not occur randomly, but that the modification of critical residues in enzymes modulates their biological activity, being able to enhance or inhibit complete metabolic pathways in the process of acclimatization and tolerance to the exposure to the different abiotic stresses. Given the importance of these PTMs-based regulation mechanisms in the acclimatization processes of plants, the present review gathers the knowledge generated in recent years on this subject, delving into the PTMs of the redox-regulated enzymes of plant metabolism, and those that participate in the main stress-related pathways, such as oxidative metabolism, primary metabolism, cell signaling events, and photosynthetic metabolism. The aim is to unify the existing information thus far obtained to shed light on possible fields of future research in the search for the resilience of plants to climate change.

Interaction between Melatonin and NO: Action Mechanisms, Main Targets, and Putative Roles of the Emerging Molecule NOmela.

Melatonin (MEL), a ubiquitous indolamine molecule, has gained interest in the last few decades due to its regulatory role in plant metabolism. Likewise, nitric oxide (NO), a gasotransmitter, can also affect plant molecular pathways due to its function as a signaling molecule. Both MEL and NO can interact at multiple levels under abiotic stress, starting with their own biosynthetic pathways and inducing a particular signaling response in plants. Moreover, their interaction can result in the formation of NOmela, a very recently discovered nitrosated form of MEL with promising roles in plant physiology. This review summarizes the role of NO and MEL molecules during plant development and fruit ripening, as well as their interactions. Due to the impact of climate-change-related abiotic stresses on agriculture, this review also focuses on the role of these molecules in mediating abiotic stress tolerance and the main mechanisms by which they operate, from the upregulation of the entire antioxidant defense system to the post-translational modifications (PTMs) of important molecules. Their individual interaction and crosstalk with phytohormones and H2S are also discussed. Finally, we introduce and summarize the little information available about NOmela, an emerging and still very unknown molecule, but that seems to have a stronger potential than MEL and NO separately in mediating plant stress response.

[Prevalencia y genotipos del virus del papiloma humano en muestras de tejido laríngeo de pacientes con cáncer de laringe del noreste de México]. / Prevalence and genotypes of the human papillomavirus in laryngeal tissue samples of patients with laryngeal cancer from Northeastern Mexico.

ANTECEDENTES: El cáncer de laringe representa el 21.7% de las neoplasias malignas de vías aerodigestivas superiores. La prevalencia del virus del papiloma humano (VPH) en el cáncer de laringe oscila entre el 0 y el 80%. MÉTODO: Se incluyeron 112 muestras de tejido laríngeo de pacientes con cáncer de laringe. Se amplificó el ADN y se analizó la presencia y el genotipo del VPH mediante hibridación reversa (INNO-LiPA®). Se realizaron pruebas de ji cuadrada, Fisher y t de Student no pareada. RESULTADOS: Se incluyeron muestras de 107 hombres (95.5%) y 5 mujeres (4.5%), con una edad de 65.3 ± 10.1 años, con antecedente de tabaquismo 108 (96.4%), alcoholismo 9 (8.0%) y carcinoma epidermoide moderadamente diferenciado queratinizante 96 (85.7%). Se identificó VPH en 60 (53.5%), VPH-11 en 51 (45.5%), VPH-52 en 27 (24.1%), VPH-16 en 9 (8.0%), VPH-45 en 3 (2.6%) y coinfección por más de un genotipo en 31 (27.6%). No hubo diferencia entre pacientes con y sin infección por VPH en cuanto a edad, sexo, localización, diagnóstico histopatológico, tabaquismo ni alcoholismo (p > 0.05). CONCLUSIONES: La prevalencia de infección por VPH en el cáncer de laringe fue del 53.5%, con coinfección por más de un genotipo en el 27.6%. El genotipo más frecuente fue el VPH-11, tipo de bajo riesgo, seguido por el VPH-52, de alto riesgo oncogénico. BACKGROUND: Laryngeal cancer represents 21.7% of malignancies of the upper aerodigestive tract. The prevalence of the Human Papillomavirus (HPV) in laryngeal cancer ranges 0 to 80%. METHODS: We included 112 laryngeal tissue samples obtained from patients with laryngeal cancer. DNA was extracted and amplified by PCR. HPV presence and genotype were analyzed by the reverse hybridization INNO-LiPA® assay. Chi-square, Fisher's and unpaired Student t tests were used. RESULTS: Samples from 107 male (95.5%) and 5 female patients (4.5%) were evaluated, aged 65.3±10.1 years, 108 with smoking history (96.4%), 9 with alcoholism history (8.0%), and in 96 the histological diagnosis was moderately differentiated keratinizing squamous cell carcinoma (85.7%). HPV was detected in 60 samples (53.5%), HPV-11 in 51 (45.5%), HPV-52 in 27 (24.1%), HPV-16 in 9 (8.0%), HPV-45 in 3 (2.6%), and coinfection by more than one genotype in 31 (27.6%). There was no difference between patients with and without HPV infection with respect to age, sex, tumor location and histology, smoking and alcoholism history (p>0.05). CONCLUSIONS: The prevalence of HPV infection in laryngeal cancer was 53.5% with coinfection with more than one genotype in 27.6%. The most frequent genotype was HPV-11, an oncogenic low-risk genotype, followed by HPV-52, a high-risk genotype.

[Group B streptococcal perinatal infection: A Global, Latin American and Mexican Overview]. / Infección perinatal por estreptococo del grupo B: panorama global, en América Latina y en México.

Group B streptococci (Streptococcus agalactiae) cause a number of infections in women during pregnancy and postpartum, such as urinary tract infection, chorioamnionitis and endometritis, consequently may affect the newborn. Group B streptococci is the most common cause of severe infections in newborns in developed countries. Studies on the epidemiology of group B streptococci infections in Latin America are still limited. This information is also unknown in Mexico, but studies carried out in the center of the country have found high rates of vaginal colonization in pregnant women and there are case series and case reports of newborns. Microbiological and molecular epidemiology studies in Mexico have shown that populations of group B streptococci have a clonal distribution and that there are clones with genetic and phenotypic characteristics of high virulence that appear to be responsible for most of perinatal pathology. However, the actual role of group B streptococci in perinatal pathology in Mexico is unknown. Consequently, whether to perform or not the screening for determining the group B streptococci colonization status in pregnant women, and the indication or not for intrapartum antibiotic prophylaxis to prevent neonatal group B streptococci infection in Mexico, are still controversial.

Drug resistance mutations during structured interruptions of HAART in two HIV-1-infected children.

Information concerning structured treatment interruptions (STI) of the Highly Active Antiretroviral Therapy (HAART) and their risk for selecting antiretroviral drug resistance in children is scarce. In this study, we searched for antiretroviral drug resistance mutations at the end of five viral rebounds of two children with HIV and a chronically undetectable viral load (VL) who underwent an STI program. The HAART was interrupted for 4 weeks and then restarted and continued for 12 weeks for three cycles. VL, CD4+/CD8+ lymphocytes, and clinical status were evaluated at the end of each STI and at 6 and 12 weeks after HAART was resumed. Treatment of both the patients based on zidovudine+lamivudine+ritonavir remained identical during the study. The reverse transcriptase (RT)- and protease (PR)-coding regions were sequenced at the end of each viral rebound. One patient experienced progressively lower viral rebounds (269000-31300 at the first and third rebounds, respectively), while the other patient did not experience such a reduction, and the VL of both the patients fell to undetectable levels during therapy. In the five viral rebounds examined, no mutations for resistance to protease inhibitors (PIs) were found and the analysis indicated susceptibility to all PIs currently in clinical use. Although the mutation K103R associated with non-nucleoside reverse transcriptase inhibitor resistance was found in two viral rebounds of one patient, the analysis indicated the absence of resistance to RT inhibitors. As no mutation related to antiretroviral drug resistance was found, our results suggest that the STI program evaluated may have a low risk of selecting antiretroviral drug resistance. Nevertheless, further studies evaluating larger cohorts over longer periods are required before definitive conclusions about the safety of STI of HAART in children may be drawn.

A randomized phase II study of PX-12, an inhibitor of thioredoxin in patients with advanced cancer of the pancreas following progression after a gemcitabine-containing combination.

PURPOSE: This study evaluated PX-12, a novel small molecule inhibitor of the proto-oncogene (Trx-1), in patients with previously treated advanced pancreatic cancer (APC). METHODS: PX-12 (54 or 128 mg/m²) was administered by 3-hour IV infusion daily × 5 days every 21 days (n = 17). Patients were randomized to either 54 or 128 mg/m² and then stratified based on CA 19-9 level (≥ 1,000 vs. < 1,000 U/ml) and SUV values on PET scans (≥ 7.0 vs. <7.0). The primary endpoint was based on a progression-free survival (PFS) at 4 months in ≥ 40% of patients, and required 40 patients in each arm. An amendment required elevated Trx-1 levels (> 18 ng/ml) as an entry criteria after the first 17 patients were accrued. RESULTS: Plasma Trx-1 levels were elevated in 3/28 (11%) patients screened for study. The grade of the expired metabolite odor was higher in the 128 mg/m² arm. Therapy was well tolerated, and Grade ≥ 3 adverse events were uncommon. The best response was stable disease in 2 patients. There was no consistent decrease in SUV, Trx-1 levels or CA 19-9 levels with therapy. No patients had a PFS of >4 months. Median PFS and survival were 0.9 months (95% CI 0.5-1.2) and 3.2 months (95% CI 2.4-4.2), respectively. CONCLUSIONS: Due to the lack of significant antitumor activity and unexpectedly low baseline Trx-1 levels, the study was terminated early. PX-12 does not appear to be active in unselected patients with previously treated APC.

Role of polyamines in arginine-dependent colon carcinogenesis in Apc(Min) (/+) mice.

We evaluated the role of polyamines in arginine-dependent intestinal tumorigenesis in Apc(Min) (/+) mice. Arginine is a substrate for ornithine synthesis and thus can influence polyamine production. Supplementing the diet with arginine increased intestinal and colonic polyamine levels and colonic carcinogenesis. Inhibiting polyamine synthesis with D,L-alpha-diflouromethylornithine (DFMO) decreased small intestinal and colonic polyamine pools. In mice provided basal diet, but not when supplemented with arginine, DFMO decreased small intestinal tumor number and burden, and increased intestinal apoptosis. In mice provided supplemental arginine in the diet, DFMO induced late apoptosis and decreased tumorigenesis in the colon. DFMO slightly reduced tumor incidence, number, and size while significantly decreasing tumor burden and grade. These changes in colon tumorigenesis did not occur in mice not provided supplemental arginine. Our study indicates that polyamines play unique roles in intestinal and colonic carcinogenesis in Apc(Min) (/+) mice. Inhibition of polyamine synthesis suppresses the arginine-dependent risk of colon tumorigenesis, resulting in apoptosis induction and decreased tumorigenesis, in this murine model.

Effects of a high-selenium yeast supplement on celecoxib plasma levels: a randomized phase II trial.

A combination of celecoxib and selenium was used in a randomized double-blind Phase II trial as a preliminary study to a multicenter Phase III colorectal cancer chemoprevention trial using these two agents together. The purpose of this trial was to determine whether high-selenium baker's yeast [(Saccharomyces cerevisiae) 200 microg once daily] in combination with celecoxib (400 mg once daily) altered the steady-state plasma concentration of celecoxib or produced clinically significant toxicities. Seventy-three healthy subjects (ages 40-75 years) were recruited to the 6-week study from the general local population and were randomized to either the celecoxib plus selenized baker's yeast group or the celecoxib plus placebo group after a 2-week run in period of celecoxib only. Blood samples were taken at baseline (to document that there was no evidence of celecoxib intake), after the 2-week run-in period on celecoxib to verify steady-state blood levels of this agent, and at end of study (4 weeks postrandomization). Toxicities were monitored at 2 weeks after initiation of celecoxib, at 4 weeks after initiation, and at the end of the study. Blood level concentrations of celecoxib did not differ between the two groups as determined by high-performance liquid chromatography analysis nor were there significant differences in blood chemistry values between the two groups. Subjects' self-report of general physical toxicities was uncommon and limited to National Cancer Institute toxicity grade 2 or less; however, 2 female participants (3%) were removed from the study medications because of grade 2 edema and significant weight gain after 2 and 2.5 weeks of celecoxib administration. In conclusion, high-selenium yeast and celecoxib can be taken at the described doses with minimum short-term negative effects. In future Phase III chemoprevention trials of celecoxib, weight gain should be carefully monitored, and participants should be made aware of this potential side effect before study entry.