Comparative Evaluation of Tumor-Infiltrating Lymphocytes in Companion Animals: Immuno-Oncology as a Relevant Translational Model for Cancer Therapy.

Despite the important role of preclinical experiments to characterize tumor biology and molecular pathways, there are ongoing challenges to model the tumor microenvironment, specifically the dynamic interactions between tumor cells and immune infiltrates. Comprehensive models of host-tumor immune interactions will enhance the development of emerging treatment strategies, such as immunotherapies. Although in vitro and murine models are important for the early modelling of cancer and treatment-response mechanisms, comparative research studies involving veterinary oncology may bridge the translational pathway to human studies. The natural progression of several malignancies in animals exhibits similar pathogenesis to human cancers, and previous studies have shown a relevant and evaluable immune system. Veterinary oncologists working alongside oncologists and cancer researchers have the potential to advance discovery. Understanding the host-tumor-immune interactions can accelerate drug and biomarker discovery in a clinically relevant setting. This review presents discoveries in comparative immuno-oncology and implications to cancer therapy.

Las narrativas del cuidador: temas, tramas y concurrencias del relato asociados a la sobrecarga / The Caregiver's Narratives: Themes, Plots and Concurrences of the Story Associated with Burden

Resumen Este artículo deriva de la dificultad de trabajar con cuidadores y del interés por comprender mejor las dificultades propias del rol de 51 cuidadores adultos usuarios de Cifel IPS inscritos en el Programa de Prevención del Síndrome del Cuidador. El estudio planteó como objetivo identificar las estructuras narrativas asociadas a la sobrecarga, se realizó una caracterización de los participantes, se aplicó la Escala de Zarit (EZ) y se desarrollaron los talleres en los que se recolectaron los relatos de los participantes, que posteriormente se consignaron en una matriz de análisis. En los resultados, se muestra que el 31 % de los participantes tienen una sobrecarga intensa, mientras que en los relatos se encontraron temas recurrentes de cansancio, hiperexigencia y protección; ramas dominantes en un binomio éxito-fracaso y una perpetuación trágica del rol; y concurrencias redundantes relacionadas con cuidadores secundarios y relaciones fallidas. Se concluye que la estructura del relato del cuidador se basa en la abnegación de su rol, de modo que en la narrativa el cuidador no contempla cambios radicales en su vida, además, el rol y las funciones de cuidador tienen una fuerte presencia en la narrativa identitaria de la persona, lo que se relaciona con la sensación subjetiva de imposibilidad de cambio. Ello implica reconsiderar el tratamiento integral del paciente, en la medida en que la salud mental del cuidador se relaciona con la forma como el cuidador relata su rol.

Abstract This research work derives from the difficulty of working with caregivers and the interest in better understanding the difficulties inherent in the role of 51 adult caregivers using CIFEL IPS enrolled in the caregiver syndrome prevention program. The objective of the study was to identify the narrative structures associated with the burden; a characterization of the participants was carried out, the Zarit Scale (EZ) was applied, and followed by workshops where the participants' stories were collected, which were subsequently recorded in an analysis matrix. The results show that 31% of the participants have an intense burden, while in the accounts a) Recurrent themes of fatigue, hyperdemand and protection were found; b) Dominant plots in a success/failure binomial and a tragic perpetuation of the role; c) Redundant concurrences related to secondary caregivers and failed relationships. It is concluded that the structure of the caregiver story is based on the abnegation of his role, so that in the narrative the caregiver does not contemplate radical changes in his life, in addition, the role and functions of caregiver has a strong presence in the narrative identity of the person, which is related to the subjective feeling of impossibility of change. This implies reconsidering the comprehensive treatment of the patient, insofar as the mental health of the caregiver is related to the way in which the caregiver relates to his/her role.

Complications and local relapse after intraoperative low-voltage X-ray radiotherapy in breast cancer.

PURPOSE: To study those factors that influence the occurrence of surgical complications and local relapse in patients intervened for breast cancer and receiving intraoperative radiotherapy. METHODS: Observational study on patients intervened for breast cancer with conservative surgery and intraoperative radiotherapy with low-voltage X-ray energy source (INTRABEAM), from 2015 to 2017 with 24 months minimum follow-up. Variables possibly associated to the occurrence of postoperative complications were analyzed with the Student t-test and the Fisher exact test; P < 0.05 considered significant. Subsequently, the construction of multiple multivariate analysis models began, thus building a logistic regression analysis using the IBM SPSS Statistics ver. 23 software. Local relapse was described. RESULTS: The study included 102 patients, mean age of 61.2 years; mean global size of tumor, 12.2 mm. Complications occurred in 29.4%. Fibrosis was the most frequently observed complication, followed by postoperative seroma. Using a 45 mm or larger applicator were significantly associated with the occurrence of complications. Tumor size 2 cm or larger and reintervention showed borderline significant association. Only one case of local relapse was observed. CONCLUSION: Certain factors may increase the risk of complication after the use of intraoperative radiotherapy. Using external complementary radiotherapy does not seem to increase the rate of complications. Select patients and the involvement of a multidisciplinary team are essential for achieving good results.

Enfermedad persistente y recaída en el carcinoma medular de tiroides. Serie de casos / Persistent disease and recurrence in medullary thyroid carcinoma: A case series

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Inverse radiotherapy planning in reconstructive surgery for breast cancer.

BACKGROUND: Post-mastectomy radiotherapy reduces the risk of local-regional relapse and distant disease, and increases global survival in women with axillary involvement. With the new reconstruction techniques and increasing use of directed external radiotherapy, immediate reconstruction can be performed with good cosmetic results and low complication rates. MATERIALS AND METHODS: Observational study with consecutive sampling conducted in patients undergoing reconstructive surgery for breast cancer, between 2010 and 2016, with a 12-months minimum follow-up period. A group of patients radiated after receiving an expander (RT-Expander) were compared with a control group of non-radiated patients (Non-RT), who had been treated with the same surgical technique. We compare general complications, reconstruction failure, aesthetic results and satisfaction degree with software IBM® SPSS® Statistics v. 21 and BREAST-Q scores. RESULTS: Reconstruction failure was observed in 15.6% of patients in a similar proportion in both groups. External radiotherapy was not an independent significant factor influencing the occurrence of general complications, capsular contracture grade ≥3 or reconstruction failure. The Kaplan-Meyer curve showed no differences in reconstruction survival between groups. Aesthetic results were excellent-very good in 78.1% of patients. Absence of a contralateral procedure for symmetrization, occurrence of general complications, occurrence of capsular contracture grade ≥3 and reconstruction failure were significantly associated to fair-poor cosmetic results. The satisfaction degree of operated patients was similar in both groups. CONCLUSIONS: The evolution of external radiotherapy towards more directed techniques, which modulate the dose administered to the mammary tissue and adjacent structures, allowed us to make immediate reconstruction a reality for most patients, with complication rates, cosmetic results and satisfaction degrees similar to those of non-radiated patients.

Factors predicting local relapse and survival in patients treated with surgery for breast cancer.

BACKGROUND: Assessment of local relapse in patients treated with surgery for breast cancer. MATERIALS AND METHODS: This observational study included 673 patients treated with surgery for breast cancer between 2005 and 2010, who were monitored for a 7-year minimum follow-up period. The study was concluded on 2017 and yielded a total of 31 cases of local relapse. RESULTS: 4.6% of patients presented local relapse, most of them during the first 3 years of follow-up; 45% of patients with local relapse subsequently presented the disease at distant points. The association between the occurrence of local relapse and later onset of the disease at distant points was significant. The Kaplan-Meier survival analysis revealed that negative results for the presence of progesterone receptors, the use of neoadjuvant chemotherapy and the presence of the disease at distant points were factors that significantly influenced patient survival. CONCLUSIONS: Almost half of the patients suffering relapse subsequently present the disease at distant points. Certain factors increase the aggressiveness of the disease, predict higher risk of relapse and determine its prognosis.

Estudio Transversal: Prescripción, Consumo y Automedicación de Inhibidores de Bomba de Protones en Pacientes de Atención Primaria del Azuay, 2016 / Cross-Sectional Research: Prescription, Consumption and Self-Medication of Proton Pump Inhibitors in Primary Care Patients from Azuay, 2016

OBJETIVO: El objetivo del presente estudio fue determinar la frecuencia de prescripción, consumo y prevalencia de automedicación de los inhibidores de la bomba de protones en pacientes atendidos en los Centros de Salud de Ludo y Cuchil, pertenecientes al cantón Sigsig ­ Azuay ­ Ecuador, durante el año 2016. MÉTODO: Estudio descriptivo transversal realizado con todos los pacientes quienes a la fecha de la consulta médica se encontraban consumiendo o tuvieron prescripción de inhibidores de la bomba de protones (IBPs). Se estudiaron las características socio-demográficas de la población, fármaco utilizado, indicaciones para su prescripción, prevalencia de automedicación y su relación con el género, edad, escolaridad y auto identificación étnica. RESULTADOS: Se revisaron 4758 pacientes, 228 pacientes ingresaron al estudio (4.79 %). La edad media fue de 48 ±20 años, las mujeres representaron el 73.25 %. El Omeprazol fue utilizado en el 96 % de los casos. La prevención de lesiones por AINES fue la principal indicación para el uso del medicamento. La prevalencia de automedicación fue de 31.58 %, existiendo relación con la edad mayor a 60 años (RP: 4.13; IC-95 %: 2.68-6.38) y la escolaridad primaria o inferior (RP: 4.87; IC-95 %: 2.22-10.68). CONCLUSIÓN: La frecuencia de prescripción y consumo de inhibidores de la bomba de protones fue de alrededor del 5 % de los pacientes estudiados. El Omeprazol fue el IPB de uso más frecuente. Existe una relación de riesgo y asociación entre la edad superior a 60 años y el nivel de escolaridad (primario o inferior) con la frecuencia de automedicación.(au)

OBJECTIVE: To determine the frequency of prescription, consumption and prevalence of self-medication of proton pump inhibitors in patients who attended to Ludo and Cuchil Health Centers during 2016. METHOD: A cross-sectional descriptive study performed with all the patients who were consuming or had a proton pump inhibitors (PPIs) prescription at the time of the medical attention. Socio-demographic characteristics of the population, used drug, prescription indications, self-medication prevalence and its relation with gender, age, schooling and ethnic self-identification were studied. RESULTS: Were reviewed 4758 patients, and 228 patients entered in this study (4.79 %). Average age was 48 ±20 years, 73.25 % of patients were female. Omeprazole was used in 96 % of the cases. Prevention of NSAID lesions was the main indication to use the drug. Self-medication prevalence reached 31.58 % and had a relation with age over 60 years (PR: 4.13; 95 %-CI: 2.68-6.38) and primary or lower scholarship (RP: 4.87; 95 %-CI: 2.22-10.68). CONCLUSION: Frequency of prescription and consumption of PPIs was around 5 % of students patients. Omeprazole was the most used PPI. There is an association and a risk relation between self-medication frequency and age over 60 years and lower scholarship level.(au)

Evaluación de la actividad antioxidante de suplementos dietéticos utilizados para mejorar la fertilidad masculina / Assessment of the antioxidant activity of commercial dietary supplements used to improve male fertility

Objetivo: Evaluar la actividad antioxidante de cinco suplementos dietéticos comerciales (AndroMÁS®, Androferti®, Aquilea Fértil®, GestaDha®, Seidiferty®) utilizados para mejorar la fertilidad masculina. Material y Métodos: La actividad antioxidante se determinó mediante dos técnicas estandarizadas en la literatura para suplementos dietéticos: ensayo ORAC (Oxygen Radical Absorbance Capacity) y el ensayo de captación de radical DPPH (diphenylpicryl-hydrazyl). Se analizaron dos lotes de cada suplemento (n=5/lote). Resultados: Los suplementos AndroMÁS y Seidiferty mostraron actividad antioxidante significativa (p<0,05) en el ensayo ORAC con índices ORAC de 0,25 y 0,24 μmol Trolox/mg suplemento, respectivamente, valores comprendidos en el rango descrito en la literatura para suplementos dietéticos antioxidantes (0,0018-3,18 μmol Trolox/mg suplemento). AndroMÁS, Androferti y Seidifertymostraron una significativa actividad captadora de radical DPPH (p<0,05) con valores de inhibición de 97,2 %, 93,0 % y 60,5 %, respectivamente a una concentración de 0,5 mg/ml. Conclusiones: Este estudio sugiere que las propiedades antioxidantes mostradas por AndroMÁS y Seidiferty pueden contribuir a la eficacia terapéutica demostrada en infertilidad masculina (AU)

Objective: To evaluate the antioxidant activity of five commercially available dietary supplements (AndroMÁS ®, Androferti®, Aquilea Fértil®, GestaDha®, Seidiferty®) used to improve male fertility. Material and Methods: Antioxidant activities were determined using two analytical methods standardized in the literature for dietary supplements namely Oxygen Radical Absorbance Capacity (ORAC) and diphenylpicryl-hydrazyl (DPPH) scavenging radical assays. Two batches of each supplement were analyzed. Results: AndroMÁS and Seidiferty showed significant antioxidant properties (p<0.05) as measured by the ORAC assay, with ORAC values of 0.25 and 0.24 μmol Trolox/mg supplement, within the range reported in the literature for dietary antioxidant supplements (0.018- 3.18 μmol of Trolox equivalent/mg of supplement). The DPPH radical scavenging activity was highest in AndroMÁS, Androferti and Seidiferty (97.2%, 93.0% and 60.5%, respectively) at a concentration of 0.5 mg/ml. Conclusions: This study suggests that the antioxidant properties showed by AndroMÁS and Seidiferty could contribute to the therapeutic efficacy on male infertility (AU)

La promoción de salud dirigida a reducir los factores de riesgo de cáncer cérvico uterino / Health promotion aimed to reducing uterine cervical cancer risk factors

La primera Conferencia Internacional sobre la Promoción de la Salud celebrada en Ottawa, el 21 de noviembre de 1986, definió la promoción de la salud como “el proceso de permitir a la gente aumentar su control sobre su salud y por lo tanto mejorarla”. Se reconoce claramente que la promoción de la salud va más allá de los estilos de vida, en la cual la educación para la salud constituye, junto a la comunicación y a la participación social, herramientas necesarias para su instrumentación en el primer nivel de atención. En la práctica cotidiana se desconoce de forma reiterada el valor que tiene el reconocimiento adecuado de las dimensiones de la promoción de salud, desde una perspectiva holística, dirigidas a reducir los factores de riesgo de cáncer cérvico uterino. El propósito del estudio fue realizar una contribución teórica a la promoción de salud para contribuir al fortalecimiento del Programa Nacional de Diagnóstico Precoz del Cáncer Cérvico Uterino. Al considerar el valor de esta disciplina desde sus dimensiones, el profesional de la salud dispone de una base teórica que guíe las acciones dirigidas a la reducción de factores de riesgos de este tipo de cáncer en la población femenina.

The first International Conference on Health Promotion celebrated in Ottawa on November 21st, 1986, defined health promotion as “the process allowing people to increase the control on their health and therefore to improve it”. It is clearly understood that health promotion goes beyond life styles, and also includes education for health, communication and social participation, necessary tools for its instrumentation in the first health care level. In every day practice it is continually not recognized the value of the adequate acknowledgement of health promotion dimensions, from a holistic perspective, aimed to reducing the uterine cervical cancer risk factors. The purpose of the research was theoretically contributing to the strengthening of the National Program of Uterine Cervical Cancer Precocious Diagnosis. When considering the value of this discipline in all its dimensions, the health care professional has a theoretical base to guide the actions aimed to reducing the risk factors of this kind of cancer among the female population.

Conjunctival metastasis from Kaposi's sarcoma: a case report.

We present one case of Kaposi's sarcoma with conjunctive metastasis. The case describes a 71-years-old white male, who was admitted at hospital by malaise, slight pain on the left eyelid, nodular lesion of the left leg, and enlarge lymph nodes in inguinal regions. The conjunctive neoplasms are rare, and we most frequently can see the pigment ones followed by squamous epithelials and lymphomas. The primary Kaposi's sarcoma (KS) from conjunctiva is a rare tumor and it has increased by AIDS emergence and immunosuppression. The appearance of conjunctival metastasis from KS is a stand out event.

Single center experience with percutaneous endovascular repair of superior vena cava syndrome.

OBJECTIVES: To demonstrate short-term effectiveness and long-term efficacy of percutaneous transluminal angioplasty (PTA) with or without adjunctive therapy in treatment of superior vena cava syndrome (SVCS). BACKGROUND: Recently, PTA with or without adjunctive therapy has evolved as first-line therapy for SVCS. Despite growing evidence for PTA with or without adjunctive therapy, there are little data reflecting its short- and long-term outcomes. METHODS: We retrospectively reviewed 14 consecutive patients undergoing PTA with or without adjunctive therapy for SVCS, between July 2001 and September 2009. RESULTS: A total of 14 patients (nine women; mean age, 49 ± 15 years) with SVCS underwent attempted PTA with or without adjunctive therapy. Causes of SVCS were indwelling catheters or pacemaker wires (n = 5), idiopathic (n = 5), thoracic outlet syndrome (n = 2), and cancer-related thrombosis (n = 2). Obstruction of the SVC involved inflow branches in 86% of patients (n = 12). PTA with or without adjunctive therapy was attempted in all 14 patients and was angiographically successful in 93% (n = 13). PTA and stenting was performed in eight (57%) patients; three (21%) patients had PTA with thrombectomy/thrombolysis; one (7%) patient had PTA alone; and one (7%) patient had thrombectomy/thrombolysis alone. Symptom relief was seen in 86% (n = 12), and initial patency was 90%. There were no procedural complications. Mean follow-up was 12 months, and no deaths were reported. In the 11 (79%) patients with follow-up imaging, nine (82%) patients showed patency and two (18%) had residual symptoms, with one patient undergoing surgery. CONCLUSIONS: PTA with adjunctive endovascular stent therapy for SVCS is safe and effective at giving both rapid and sustained symptom relief.

La promoción de salud dirigida a reducir los factores de riesgo de cáncer cérvico uterino / Health promotion aimed to reducing uterine cervical cancer risk factors

La primera Conferencia Internacional sobre la Promoción de la Salud celebrada en Ottawa, el 21 de noviembre de 1986, definió la promoción de la salud como el proceso de permitir a la gente aumentar su control sobre su salud y por lo tanto mejorarla. Se reconoce claramente que la promoción de la salud va más allá de los estilos de vida, en la cual la educación para la salud constituye, junto a la comunicación y a la participación social, herramientas necesarias para su instrumentación en el primer nivel de atención. En la práctica cotidiana se desconoce de forma reiterada el valor que tiene el reconocimiento adecuado de las dimensiones de la promoción de salud, desde una perspectiva holística, dirigidas a reducir los factores de riesgo de cáncer cérvico uterino. El propósito del estudio fue realizar una contribución teórica a la promoción de salud para contribuir al fortalecimiento del Programa Nacional de Diagnóstico Precoz del Cáncer Cérvico Uterino. Al considerar el valor de esta disciplina desde sus dimensiones, el profesional de la salud dispone de una base teórica que guíe las acciones dirigidas a la reducción de factores de riesgos de este tipo de cáncer en la población femenina(AU)

The first International Conference on Health Promotion celebrated in Ottawa on November 21st, 1986, defined health promotion as the process allowing people to increase the control on their health and therefore to improve it. It is clearly understood that health promotion goes beyond life styles, and also includes education for health, communication and social participation, necessary tools for its instrumentation in the first health care level. In every day practice it is continually not recognized the value of the adequate acknowledgement of health promotion dimensions, from a holistic perspective, aimed to reducing the uterine cervical cancer risk factors. The purpose of the research was theoretically contributing to the strengthening of the National Program of Uterine Cervical Cancer Precocious Diagnosis. When considering the value of this discipline in all its dimensions, the health care professional has a theoretical base to guide the actions aimed to reducing the risk factors of this kind of cancer among the female population(AU)

Refinement of rhinoplasty with lipoinjection.

BACKGROUND: The most common aesthetic defects after rhinoplasty are small dorsal irregularities observed mainly in patients with thin dorsal nasal skin. Many techniques have been used in attempts to prevent perceptible irregularities and sharp edges of bone and cartilage in these patients. Adipose tissue transplantation has been used widely in aesthetic surgery as a surgical method to correct surface depression or to augment soft tissue. Recently, this tissue has been considered a potential source of stem cells with regenerative capacity and other benefits. The authors present a simple procedure using lipoinjection of microfat grafts over the osseocartilaginous framework of the nasal dorsum as a routine technique in rhinoplasty. METHODS: Open rhinoplasty was performed for all the patients. At the start of the procedure, we aspirated 3 to 5 ml of fat and separated it using the sedimentation method. The fat deposited as sediment (2-3 ml) was injected at the beginning of the procedure, after suture of the incisions and before application of the splint, over the osseocartilaginous framework in the subcutaneous space. The fat acted as a thin layer of soft tissue to thicken the overlying skin and help camouflage minimal imperfections. RESULTS: Between February 2003 and May 2005, 78 rhinoplasties were performed, with injection of autologous fat. Of the 78 patients, 61 were primary rhinoplasties and 17 were secondary rhinoplasties with a follow-up time of 1 to 36 months. No minor irregularities were observed, and the aspect and quality of the skin improved for all the patients. CONCLUSIONS: Fat injection into the nose as a refinement of rhinoplasty is a fast, easy, inexpensive procedure for obtaining regular and smooth contours on the nasal dorsum that lasts over time.

Programa de prevención de conducta agresiva y promoción de conducta prosocial en niños y jóvenes / Agressive behaviour prevention program and psychosocial behaviour promotion in children and youth

Este estudio comparó la efectividad de dos condiciones de intervención para disminuir el comportamiento agresivo y aumentar el comportamiento prosocial, en un grupo de 262 niños y adolescentes de ambos sexos, distribuidos en doce grupos, tres grupos por cada rango de edad, 4-7, 9-13 y 14-17 años y con dos niveles de ajuste-mayor ajuste y menor ajuste- previo a la intervención, entres instituciones educativas de Bogotá. Se utilizó un diseño cuasi-experiemental bloqueado. Seis grupos recibieron el entrenamiento directo compuesto por un taller de doce sesiones aplicado a los niños y jóvenes; la intervención ambiental que consistió en un taller de tres sesiones para padres y profesores, y estrategias visuales (claves y afiches). A otros seis grupos se les aplicó la intervención ambiental. Se tomaron las medidas pre y post del nivel de ajuste y de los comportamientos externalizantes en todos los participantes. Se usaron el autoreporte y el reporte de padres Achenbach & Edelbrock (1991), el PEI (Pupil Evaluation Inventory, 1976) yse observó y registró de manera directa la conducta agresiva, la constrstación de los niveles de desajuste en la medida pre y post muestra un cambio significativo en los puntajes, así como en la comparación entre el pre y post de los registros observacionales del comportamiento agresivo. De otro lado, se encontraron diferencias significativas entre los puntajes de externalización en el grupo experimental. Se observa que no existieron diferencias significativas al comparar el pre y post de los grupos de menos ajuste, sin embargo, sí se presentaron cambios en el nivel de ajuste entre las medidas pre y post en el 73 por ciento de los participantes. Se comprobó el efecto del programa de la disminución de la conducta agresiva de los niños y jóvenes.

Securing nasal tip rotation through suspension suture technique.

BACKGROUND: Multiple techniques have been described to produce tip rotation in rhinoplasty, including the use of sutures, a technique popularized by several authors and shown to be predictable, controllable, and nondestructive. The authors describe a simple procedure for nasal tip rotation with a suture suspension technique through a closed method that allows the nasal tip to be rotated while maintaining its appropriate position. METHODS: In each case, after the authors performed standard rhinoplasty techniques, the osteocartilaginous junction was used as an anchor for their suture suspension technique. This technique requires the use of a guide that positions the sutures across the medial side of both domes of the alar cartilages and osteocartilaginous junction. RESULTS: Between September of 2002 and September of 2004, this technique was used in 30 patients with nasal tip ptosis who requested improvement of this condition. There were 21 primary rhinoplasty and nine secondary rhinoplasty procedures. The results were satisfactory in all of the patients, but four patients had minimal asymmetries of the tip. In the follow-up of these patients, the projection of the nasal tip was maintained long term. CONCLUSION: With this suspension suture technique, the authors were able to maintain the optimal position of the nasal tip, using the osteocartilaginous junction as a pillar to provide long-term stability of the nasal tip.