Pediatric Case of Li-Fraumeni Syndrome in Honduras.

Li-Fraumeni syndrome is an inherited, autosomal dominant disease. It is categorized as a rare disease caused by mutations of the TP53 gene, which causes increased susceptibility of the patients and their children to many types of cancer. Choroid plexus tumor is rare, which occurs in 0.3 cases per 1,000,000 people, of which 40% turn out to be carcinomas. We present a 12-year-old boy with a history of worsening headaches of more than one month, gait disturbance, projectile vomiting, and right hemiparesis. An intraventricular tumor was identified in the occipital of the left lateral ventricle, which turned out to be a TP53-mutant choroidal plexus carcinoma.

Changes in steroid hormone profile and tumour progression after genistein treatment of canine inflammatory mammary cancer xenotransplanted mice.

Isoflavones, such as genistein, have been proposed to have beneficial effects on health, including preventive or therapeutic actions in carcinogenesis. Their structural similarity to oestrogens allows them to bind at the cellular level with oestrogen receptors. Therefore, this study attempted to determine the antitumoural effects of genistein administered in a canine inflammatory mammary cancer xenograft model, in terms of tumour proliferation, appearance of metastases and steroid hormone regulation. Using histology and immunohistochemical analyses as well as the EIA technique for hormonal determinations, the antitumoural effects of genistein on an inflammatory mammary cancer xenograft model were assessed for 3 weeks. Mice treated with genistein showed higher Ki-67 levels than the control group. There were significantly more distant metastases in the genistein-treated xenografts versus the control group. Intratumoural and serum progesterone, androstenedione and oestrogen levels in treated mice were elevated, whereas intratumoural testosterone levels were decreased compared to the control group. These results revealed that genistein ingestion promotes tumour proliferation and elevates metastatic rates by increasing intratumoural and circulating oestrogen levels in a mammary cancer xenograft model.

Calidad de vida en pacientes tratados con metadona: el WHOQOL-BREF, estudio psicométrico y resultados de aplicación / Quality of life in patients treated with methadone: The WHOQOLBREF, psychometric study and application results

Objetivo. De entre los muchos instrumentos propuestos para medir la calidad de vida de los pacientes con adicción a opiáceos tratados con metadona el WHOQOL-BREF, propuesto por la World Health Organization, es el que más se utiliza en la actualidad. Este trabajo pretende estudiar la fiabilidad y la validez de constructo de la prueba, aplicada a una muestra amplia y representativa de pacientes, y comparar los resultados con los datos disponibles para población general en España. Se reclutó una muestra de 523 sujetos que se encontraban en tratamiento con metadona, en Madrid y Extremadura. Se efectuó un análisis factorial confirmatorio para probar la estructura teóricamente propuesta y, seguidamente, un análisis paralelo optimizado para conocer el número más adecuado de componentes de la prueba. Los resultados muestran que la prueba presenta sólidos valores de consistencia interna, tanto a nivel del ítem como de las escalas. La estructura tetradimensional teórica se confirma en la muestra con adecuados indicadores de ajuste, aunque también se obtienen serios argumentos para considerar su unidimensionalidad. Se estudió la relación estructural entre los cuatro dominios. El WHOQOL-BREF se muestra como una prueba fiable y válida para su uso en pacientes tratados con metadona, proporcionando una medida multidimensional de la calidad de vida percibida, que incluye factores sociales y ambientales ausentes en otros instrumentos, que son de enorme importancia en el tratamiento de los problemas adictivos

The most commonly instrument used to measure quality of life in patients with addictive behaviors is the WHOQOL-BREF, developed by the World Health Organization. No studies have been found to explore the psychometric properties in Spanish clinical samples. This paper aims to study their reliability as well as the construct validity in a representative sample of patients and comparing the results to the data available for the general population in Spain. A sample was recruited comprised of 523 subjects who were undergoing treatment with methadone in Madrid and Extremadura. A confirmatory factor analysis was completed to test the theoretically proposed structure and then an optimized-parallel analysis was done to establish the most adequate number of components. The result offers solid values for internal consistency both as concerns the items and the scales. The theoretical tetra-dimensional structure is confirmed in the sample although serious arguments are also found for considering its onedimensionality. The structural relationship between the four domains was studied. The WHOQOL-BREF proves to be a reliable and valid test for use on patients treated with methadone, providing a multi-dimensional measure of perceived quality of life that includes social and environmental factors of great importance in treating addiction problems

In vitro and in vivo effect of flutamide on steroid hormone secretion in canine and human inflammatory breast cancer cell lines.

The aim was to study the effects of flutamide on cell proliferation, in vivo tumour growth and steroid production in canine and human IBC cell lines. IPC-366 and SUM149 cell cultures were exposed to flutamide concentrations for 72 hours. Additionally, IPC-366 and SUM149 xenotransplanted mice were treated subcutaneously with flutamide 3 times a week for 2 weeks. Steroid hormones determination in culture media, serum and tumour homogenates (pregnenolone, progesterone, androstenedione, testosterone, dihydrotestosterone, 17ß-oestradiol and oestrone sulphate) were assayed by EIA. in vitro cell proliferation percentages showed a decrease in all flutamide dosages in IPC-366 and SUM149. in vivo flutamide reduced tumour size by 55% to 65%, and metastasis rates decreased. In treated groups, androgen levels in culture media, serum and tumour homogenates were increased as oestrogen levels decreased. These results suggest that flutamide treatment inhibits cell proliferation and promotes tumour reduction by increasing androgen levels and also support future therapy approaches.

Canine cell line, IPC-366, as a good model for the study of inflammatory breast cancer.

Inflammatory breast cancer (IBC) is an aggressive type of cancer with poor survival in women. Inflammatory mammary cancer (IMC) in dogs is very similar to human IBC and it has been proposed as a good surrogate model for study the human disease. The aim was to determine if IPC-366 shared characteristics with the IBC cell line SUM149. The comparison was conducted in terms of ability to grow (adherent and nonadherent conditions), stem cell markers expression using flow cytometry, protein production using western blot and tumorigenic capacity. Our results revealed that both are capable of forming long-term mammospheres with a grape-like morphology. Adherent and nonadherent cultures exhibited fast growth in vivo. Stem cell markers expressions showed that IPC-366 and SUM149 in adherent and nonadherent conditions has mesenchymal-like characteristics, E-cadherin and N-cadherin, was higher in adherent than in nonadherent cultures. Therefore, this study determines that both cell lines are similar and IPC-366 is a good model for the human and canine disease.

Profile of Steroid Receptors and Increased Aromatase Immunoexpression in Canine Inflammatory Mammary Cancer as a Potential Therapeutic Target.

Canine inflammatory mammary cancer (IMC) has been proposed as a model for the study of human inflammatory breast cancer (IBC). The aims of this study were to compare the immunohistochemical expression of aromatase (Arom) and several hormone receptors [estrogen receptor α (ERα), estrogen receptor ß (ERß), progesterone receptor (PR) and androgen receptor (AR)], in 21 IMC cases vs 19 non-IMC; and to study the possible effect of letrozole on canine IMC and human inflammatory breast cancer (IBC) in vitro using IPC-366 and SUM-149 cell lines. Significant elevations of the means of Arom Total Score (TS), ERß TS and PR TS were found in the IMC group (p = 0.025, p = 0.038 and p = 0.037, respectively). Secondary IMC tumours expressed higher levels of Arom than primary IMC (p = 0.029). Non-IMC PR- tumours contained higher levels of Arom than non-IMC PR+ tumours (p = 0.007). After the addition of letrozole, the number of IMC and IBC cells dropped drastically. The overexpression of Arom found and the results obtained in vitro further support canine IMC as a model for the study of IBC and future approaches to the treatment of dogs with mammary cancer, and especially IMC, using Arom inhibitors.

Cannabis Medicinal: Afrontando los avances de la investigación científica / Medicinal Cannabis: Facing the advances of scientific research

El consumo de cannabis es una realidad con la que el profesional de salud debe estar familiarizado. En la actualidad, son muchos los pacientes que declaran un uso medicinal de la sustancia, y es importante conocer cuáles son los aspectos científicos que avalan estos efectos terapéuticos. En este artículo se exponen algunas generalidades sobre el sistema endocannabinoide, la investigación científica y clínica que se ha desarrollado en el área de la medicina cannabinoide, y algunas consideraciones básicas sobre los riesgos asociados al consumo perjudicial.

Cannabis consumption is a reality to which the health care provider must be familiarized with. At the moment, many patients declare a medicinal use of the substance, and it is important to know the scientific aspects that support these therapeutic effects. In this article, we present an overview about the endocannabinoid system, the scientific and clinical investigations that have been developed in cannabinoid medicine, as well as a few basic considerations about the associated risks with risky cannabis consumption.

Isoflavones and their effects on the onset of puberty in male Wistar rats.

This study was performed to determine how two of the most important isoflavones, genistein and daidzein, affect the gonadal axis in male prepuberal rats. One hundred and seventy-five prepuberal male Wistar rats were allocated into seven groups: one control group and six experimental groups that were orally administered a high or low dose of genistein, daidzein or a mixture of both. Testosterone determination was assayed by EIA. The testes and body weights were measured, and the histology of the epididymis with the sperm content and epididymal sperm count were evaluated. In the control group, we observed an increase in the serum testosterone levels (>2.5 ng ml(-1) ) at the third week (52 days), which corresponded to the onset of puberty in these rats. The same increase in serum testosterone levels was observed at the fourth week in rats that received low doses of isoflavones; therefore, we concluded that the onset of puberty was delayed. At high doses, there was no significant increase in testosterone levels, which could be related to the fact that these male rats did not reach puberty. These findings were supported by the results obtained from the analysis of the epididymal content as well as the testes/body weight ratio.

The effects of isoflavones on androgens and glucocorticoids during puberty on male Wistar rats.

Isoflavones are the most common phytoestrogens found in human diets. However, it is still not clear whether isoflavones have effects on the reproductive and the endocrine systems under normal dietary intake and overdose. The aim of this study was to determine how the most important isoflavones, genistein and daidzein, affect androgen and glucorticoid levels on male prepuberal rats. A hundred and seventy-five 30-day-old male Wistar rats were dosed orally by stomach tube every day for 35 days, with saline solution, low and high doses of genistein, daidzein and a mixture of both. Serum samples were analysed by an enzyme immunoassay for hormone determinations. In control group, there was a peak of testosterone (T) and dihydrotestosterone levels associated to the onset of puberty, at the third week. However, in low-dose groups, the same peak was found at the fourth week (p < 0.05), indicating a delay in the onset of puberty in these groups. Moreover, high doses groups serum androgen levels were significantly lower (p < 0.05) than the control group from the first week until fifth week. This fact was supported by a epididymal histological analysis that indicate in low doses there were several content of spermatozoa at fourth week and in high doses there were few content of spermatozoa. Besides, corticosterone levels followed the same pattern of androgens in all groups. We can conclude that oral administration of isoflavones in male rats decreased the secretion of androgens and glucocorticoids causing a delay in the onset of puberty and may cause physiological and developmental problems.

Accidente cerebrovascular isquémico como manifestación inicial de endocarditis infecciosa / Stroke as an initial manifestation of infectious endocarditis

Las manifestaciones neurológicas en pacientes con endocarditis infecciosa pueden ser muy frecuentes. Presentamos un caso clínico cuya manifestación cardinal fue un accidente cerebrovascular isquémico, y revisamos la epidemiología de este fenómeno, así como algunos aspectos terapéuticos y diagnósticos a considerar en este tipo de pacientes. Se otorga énfasis a la controversia en torno a la indicación de anticoagulación, la evaluación precoz con neuroimagen en pacientes asintomáticos, y la decisión de intervención quirúrgica precoz para pacientes seleccionados...

The neurological manifestations of patients with infectious endocarditis can be very common. We present a case report in which the cardinal manifestation was a stroke, and we review the epidemiology of this phenomenon, as well as some diagnostic and therapeutic aspects to consider in this type of patients. We put emphasis on the controversy around the anticoagulation therapy, initial evaluation with neuroimaging in asymptomatic patients, and the decision of surgical intervention in selected patients...

Establishment and characterization of a canine xenograft model of inflammatory mammary carcinoma.

Canine inflammatory mammary cancer (IMC) and human inflammatory breast cancer (IBC) are the most aggressive form of mammary/breast cancer. Both species naturally develop it, sharing epidemiological, clinical and histological characteristics. Thus, IMC has been suggested as a model to study the human disease. We have developed the first IMC xenograft model in SCID mice. Xenografts reproduced the histological features from the primary tumor, were highly aggressive and showed dermal tumor emboli, distinctive hallmarks of IMC/IBC. This model was hormone receptors positive and HER2 negative. Our findings showed that estrogens and androgens are locally produced in tissues. Factors related to tumor vascularization showed positive expression and xenografts with the highest expression of all analyzed vascular factors had the highest rate of tumor proliferation. The role of steroid hormones and the angio/lymphangiogenic properties found in this model, provide additional knowledge for future interventions in the diagnosis, treatment and prevention of the disease.

Blood mRNA biomarkers for detection of treatment response in acute pulmonary exacerbations of cystic fibrosis.

BACKGROUND: Acute pulmonary exacerbations accelerate pulmonary decline in cystic fibrosis (CF). There is a critical need for better predictors of treatment response. OBJECTIVE: To test whether expression of a panel of leucocyte genes directly measured from whole blood predicts reductions in sputum bacterial density. METHODS: A previously validated 10-gene peripheral blood mononuclear cell (PBMC) signature was prospectively tested in PBMC and whole blood leucocyte RNA isolated from adult subjects with CF at the beginning and end of treatment for an acute pulmonary exacerbation. Gene expression was simultaneously quantified from PBMCs and whole blood RNA using real-time PCR amplification. Test characteristics including sensitivity, specificity, positive and negative predictive values were calculated and receiver operating characteristic curves determined the best cut-off to diagnose a microbiological response. The findings were then validated in a smaller independent sample. RESULTS: Whole blood transcript measurements are more accurate than forced expiratory volume in 1 s (FEV(1)) or C reactive protein (CRP) alone in identifying reduction of airway infection. When added to FEV(1), the whole blood gene panel improved diagnostic accuracy from 64% to 82%. The specificity of the test to detect reduced infection was 88% and the positive predictive value for the presence of persistent infection was 86%. The area under the curve for detecting treatment response was 0.81. Six genes were the most significant predictors for identifying reduction in airway bacterial load beyond FEV(1) or CRP alone. The high specificity of the test was replicated in the validation cohort. CONCLUSIONS: The addition of blood leucocyte gene expression to FEV(1) and CRP enhances specificity in predicting reduced pulmonary infection and may bolster the assessment of CF treatment outcomes.

Relación entre las nuevas tecnologías y la preferencia en la comunicación en estudiantes de segundo año de la educación media / Relationship between new technologies and communication preference in students of second year of secondary education

Se llevó a cabo un análisis correlacional entre el conocimiento y uso de las nuevas tecnologías y la preferencia en la comunicación de estudiantes de segundo año de la Educación Media del Colegio Público seleccionado. La muestra fue intencional y autoseleccionada, conformada por 277 estudiantes de segundo año de la Educación Media. Se aplicó un diseño descriptivo, exploratorio y correlacional. Los instrumentos utilizados fueron los siguientes cuestionarios: "Conocimiento y Uso de las Nuevas Tecnologías de la Información y la Comunicación (NTIC's)" y "Preferencias de los jóvenes en su Comunicación Cotidiana". Los resultados reportan que existe correlación entre el conocimiento y uso y la preferencia de comunicación en los estudiantes de segundo año de la Educación Media.

It has been made a correlational analysis between knowledge and usage of new technologies and preference in communication of second year of Secondary Education (11th grade) students from a selected public school. The sample was intentional, self-selected and composed of 277 students. A descriptive, exploratory and correlational design was applied. The used instruments were the following questionnaires: "Knowledge and Usage of New Technologies of Information and Communication (NITC's)" and "Young people's Preference in Daily Communication". The results indicated that there is a correlation between knowledge and usage, and the preference of communication in students attending second year of Secondary.

Dynamic synergy of graphitic nanoplatelets and multi-walled carbon nanotubes in polyetherimide nanocomposites.

Hybridizing graphitic nanoplatelets (GNP) with commercially functionalized multi-walled carbon nanotubes (MWCNTs) in a polyetherimide (PEI) composite at a total loading of 0.5 wt% resulted in considerable improvements in electrical conductivity, thermal conductivity and dynamic mechanical properties, compared to solely GNP or solely MWCNT composites at the same total loading. The results reveal a synergistic interaction between the GNPs and MWCNTs based on GNP protection against fragmentation of the MWCNTs during high power sonication, while still allowing full dispersion of both fillers, by providing a shielding mechanism against MWCNT damage during dispersion processing. A new process for molecular level dispersion of exfoliated GNPs in PEI is also reported. Field emission scanning electron microscopy revealed strong interactions between PEI and the flat surfaces of GNPs and effectively intercalated GNP morphology within the matrix. GNPs alone can also produce excellent electrical conductivity improvements: at 1.0 wt% of GNP, electrical conductivity of the composite increased by 11 orders of magnitude and the percolation threshold was determined to be between 0.5 and 1.0 wt% of GNP.

Blame apportioning and the emergence of zoonoses over the last 25 years.

Over the last 25 years zoonoses have emerged and re-emerged worldwide without a specific pattern or trend. The most recent ones (1998-2008) are geographically limited to Southeast Asia, making this salient region the most immediate culprit. The media, experts and politicians have helped shape public perceptions regarding the origin of emerging zoonoses. Assigning blame to certain countries or regions can results in social, political, cultural and economic consequences that turn out to be unjustified, unfair and ultimately detrimental.

[Tailless tenrec (Tenrec ecaudatus): natural maintenance host of leptospires?]. / Le tanrec (Tenrec ecaudatus): réservoir animal de leptospires?

In order to know if the Tailless tenrec (Tenrec ecaudatus), endemic insectivorous mammal of Madagascar and present only on Indian Ocean islands, is a natural maintenance host of leptospires carrier in La Reunion, we conducted a research of anti-leptospire antibodies by microagglutination test in 37 individuals. 81.1% of serums tested were positive, (> 1/50) with the highest titers for the Icteroharmorrhagiae serogroup. So, in la Reunion, the Tailless tenrec can be suspected of being a reservoir of leptospires. A more detailed study should confirm or not this hypothesis and should possibly quantify its importance.

An economic opportunity survey of small dairy farms in Paraguay.

Participatory rural appraisal (PRA) in 15 small farms and an economic opportunity survey (EOS) in 13 were carried out in the Cordillera basin of Paraguay to identify production constraints and the best ways to achieve economic gain. PRA showed farmers' perception was that nutrition was the main constraint. The EOS showed that over 70% of the milk produced was sold in the neighbourhood. The average number of adult cows (lactating and dry cows) per farm ranged from 15 to 120, of which 62.2% to 80% were lactating cows. Milk production per cow on one day ranged from 8.5 to 18.2 litres and average lactation length was more than 300 days. Average age at first calving varied from 31 to 39 months. The highest economic opportunity was observed for increased milk production. Age at first calving and calf production interval were also found to be important constraints. Ultrasonography survey of the ovaries 20 maiden heifers over six months showed inadequate activity. Partially budgeted interventions were instituted to improve nutrition and management of maiden heifers, in-calf cows and those in early lactation. More forages were grown. PRA and EOS were shown to be useful tools in identifying production constraints.

[Clinical nutrition knowledge in health care members of University Hospitals of Paraguay]. / Nivel de conocimiento en nutrición clínica en miembros del Equipo de Salud de Hospitales Universitarios del Paraguay.

BACKGROUND: Adequate clinical nutrition care is an integral part of the complete treatment of hospitalised patients, requiring specific knowledge from the health care team. The aim of this study is to assess, in Paraguay, the health care team ability in clinical care nutrition. MATERIALS AND METHODS: A survey was made including 174 people of Paraguay university hospitals (29% physicians, 29% medicine graduating students, 11% pharmaceutics, 24% nurses, 7% dieticians), by answering voluntarily a multiple choice questionnaire of 20 items. RESULTS: The median score of the 20 questions was 6 (0-15). Physicians obtained a median of 6 (2-15), graduating students 7 (2-14), pharmaceutics 7 (0-15), nurses 3 (0-11), and dieticians 9 (4-13). The dieticians obtained a significantly higher score than the other groups (p < 0.005). CONCLUSIONS: The knowledge about clinical nutrition in the health care members from university hospitals is not adequate. The level of education in clinical nutrition is better in the dietician.

Nivel de conocimiento en nutrición clínica en miembros del Equipo de Salud de Hospitales Universitarios del Paraguay / Clinical nutrition knowledge in health care members of university hospitals of Paraguay

Introducción: Cuidados adecuados de nutrición clínica constituyen parte integral del completo tratamiento de los pacientes hospitalizados. Para la práctica correcta de la terapia nutricional, los profesionales del equipo de salud necesitan conocimientos específicos. Es de interés conocer el nivel de estos conocimientos en el Paraguay. Materiales y métodos: A 174 personas de hospitales universitarios del Paraguay (29% médicos, 29% estudiantes de sexto año de Medicina de la Universidad Nacional de Asunción, 11% farmacéuticos, 24% licenciados en enfermería, 7% nutricionistas) se suministró un cuestionario de selección múltiple de 20 puntos para determinar el nivel de conocimiento en nutrición según la calificación obtenida. Resultados: La calificación mediana de un total de 20 puntos fue de 6 (0-15). Los médicos obtuvieron una mediana de 6 (2-15), los estudiantes 7 (2-14), los farmacéuticos 7 (0-15), los licenciados en enfermería 3 (0-11) y las nutricionistas 9 (4-13). El puntaje de las nutricionistas fue significativamente mayor que el de los otros grupos (p < 0,005). Conclusión: La formación en nutrición clínica en el personal de blanco de hospitales universitarios en Paraguay no es completa. El nivel de conocimiento es superior en las nutricionistas (AU)

Background: Adequate clinical nutrition care is an integral part of the complete treatment of hospitalised patients, requiring specific knowledge from the health care team. The aim of this study is to assess, in Paraguay, the health care team ability in clinical care nutrition. Materials and methods: A survey was made including 174 people of Paraguay university hospitals (29% physicians, 29%medicine graduating students, 11% pharmaceutics, 24% nurses, 7% dieticians), by answering voluntarilya multiple choice questionnaire of 20 items. Results: The median score of the 20 questions was 6 (0-15). Physicians obtained a median of 6 (2-15), graduating students 7 (2-14), pharmaceutics 7 (0-15), nurses 3 (0-11), and dieticians 9 (4-13). The dieticians obtained a significantly higher score than the other groups (p <0.005). Conclusions: The knowledge about clinical nutrition in the health care members from university hospitals is not adequate. The level of education in clinical nutrition is better in the dietician (AU)

Regulation of the production of polygalacturonase by Aspergillus niger.

Synthesis of ethylene in static cultures as well as the effect of endogenous and exogenous ethylene on the synthesis of polygalacturonase by Aspergillus niger were determined. This strain produced maximum ethylene amounts when cultured at 30 degrees C for 3 d. The effect of adding ethylene precursors (citrate-cycle intermediates) on ethylene production was investigated. Best intracellular and extracellular polygalacturonase production was obtained with 2-oxoglutaric, pyruvic and fumaric acids, and with glutamic acid too. Addition of ethylene to the culture medium also increased the synthesis of polygalacturonase, although to a lower degree than when glutamic acid was added.