ABSTRACT
The participation of civil society is essential for environmental health policies to be accepted. The objective of this study was to know the perceptions of government officials, members of civil society, and academics about environmental health problems and its governance in the Bucaramanga Metropolitan Area, Colombia. In the region, there is a strong citizens movement that defends the moorland ecosystem (páramo) as a source of drinking water for large-scale mining projects. A multi-method study was conducted, including the review of newspaper and scientific articles, a citizens survey, and interviews and focus groups with identified key stakeholders. The findings indicate that government officials prioritize their actions on issues related to air and water pollution and environmental education. In contrast, citizens prioritize water availability from the moorland ecosystem. There are some advances in the management of environmental health, mainly related to greater citizen awareness. Contrary perceptions among government officials, academics, and civil society prevent adequate prioritization of environmental health problems. Participation of civil society is absent in activities related to environmental governance. An ongoing citizens science experience engaging high school students and the academy can be the first meeting point with government officials in the pathway to improve the environmental governance in the territory. The participation of civil society in the environmental health governance must be enforced to broaden the issues of interest and prioritize the activities in short- and long-term policy planning.
Subject(s)
Ecosystem , Environmental Policy , Humans , Conservation of Natural Resources , Colombia , Environmental HealthABSTRACT
Cystic fibrosis (CF) airways feature high extracellular levels of the IL-1 family of proinflammatory mediators. These mediators are cleavage products of caspase-1, the final protease in the inflammasome cascade. Due to the proven chronic presence of reprogrammed neutrophils in the CF airway lumen, understanding inflammasome signaling in these cells is of great importance to understand how disease is perpetuated in this milieu. Here, we hypothesized that CF airway neutrophils contribute to chronic inflammation, in part, via the packaging of inflammasome-inducing signals in extracellular vesicles (EVs). We confirmed that CF airway fluid is enriched in IL-1α, IL-1ß, and IL-18, and that CF airway neutrophils up-regulate the activating receptor IL-1R1. Meanwhile, down-modulatory signals such as IL-1R2 and IL-1RA are unchanged. Active caspase-1 itself is present in CF airway fluid EVs, with neutrophil-derived EVs being most enriched. Using a transmigration model of CF airway inflammation, we show that CF airway fluid EVs are necessary and sufficient to induce primary granule exocytosis by naïve neutrophils (hallmark of reprogramming) and concomitantly activate caspase-1 and IL-1ß production by these cells and that the addition of triple-combination highly effective CFTR modulator therapy does not abrogate these effects. Finally, EVs from activated neutrophils can deliver active caspase-1 to primary tracheal epithelial cells and induce their release of IL-1α. These findings support the existence of a feed-forward inflammatory process by which reprogrammed CF airway neutrophils bypass 2-step control of inflammasome activation in neighboring cells (naïve neutrophils and epithelial cells) via the transfer of bioactive EVs.
Subject(s)
Cystic Fibrosis , Extracellular Vesicles , Caspases , Cystic Fibrosis Transmembrane Conductance Regulator , Humans , Inflammasomes , Inflammation , Interleukin 1 Receptor Antagonist Protein , Interleukin-18 , Neutrophils , Peptide Hydrolases , Receptors, Interleukin-1 Type IIABSTRACT
El objetivo de este proyecto fue determinar la certeza diagnóstica de la biopsia guiada por arpón para las lesiones mamográficas no palpables en la detección del cáncer de mama. Material y Métodos: Se realizó un estudio descriptivo de corte transversal retrospectivo para evaluar las biopsias guiadas por arpón post localización mamográfica de las lesiones no palpables (LNP) de la mama en 51 pacientes que acudieron o fueron referidas al Servicio de Radiología (Mamografía) del Hospital Nacional "Arzobispo Loayza" entre Julio 2007 - Junio 2012. Se incluyeron a pacientes con lesiones no palpables de la mama detectadas por mamografía con informe mamo gráfico interpretado por un médico miembro del staff de radiólogo s del servicio y placas radiográficas. Asimismo, se revisaron las historias clínicas y los informes del Servicio de Anatomía Patológica. Resultados: Los hallazgos mamográficos anormales más frecuentes fueron: microcalcificaciones 56.86 por ciento, la asociación de nódulo o asimetría o distorsión de la arquitectura con microcalcificaciones 19.60 por ciento, nódulo 17.64 (nódulo irregular 11.76 por ciento) y la asimetría focal 5.89 por ciento (p<0.05). En cuanto a la relación entre los hallazgos mamográficos y el cáncer, el nódulo espiculado tuvo el mayor valor predictivo positivo (VPP) del 100 por ciento, seguido de la asimetría focal con VPP del 33.33 por ciento, la asociación de nódulo o asimetría o distorsión de la arquitectura con microcalcificaciones un VPP de 30 por ciento y las microcalcificaciones 20.69 por ciento. Se registraron 11 (21.6 por ciento) carcinomas de mama (carcinoma in situ 63.6 por ciento, carcinoma ductal infiltrante 27.3 por ciento y carcinoma lobulillar infiltrante 9.1 por ciento), 4 (7.8 por ciento) con hiperplasia ductal atípica y 36 (70.6 por ciento) lesiones benignas. Conclusión: En las lesiones no palpables, la certeza diagnóstica para cáncer de mama mediante localización pre-quirúrgica con arpón fue de 21.6 por ciento.
