Reusable composite membranes for highly efficient chromium removal from real water matrixes.

Natural or industrial hexavalent chromium water pollution continues to be a worldwide unresolved threat. Today, there is intense research on new active and cost-effective sorbents for Cr(VI), but most still exhibit a critical limitation: their powdered nature makes their recovery from water cost and energy consuming. In this work, Al(OH)3, MIL-88-B(Fe), and UiO-66-NH2 Cr(VI) sorbents were immobilized into a poly (vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) polymeric substrate to develop an easily reactivable and reusable water filtering technology. The immobilization of the sorbents into the PVDF-HFP porous matrix modified the macro and meso-porous structure of the polymeric matrix, tuning in parallel its wettability. Although a partial blocking of the Cr(VI) adsorptive capacity was observed for of Al(OH)3 and MIL-88-B(Fe) when immobilized into composite membranes, PVDF-HFP/UiO-66-NH2 filter (i) exceeded the full capacity of the non-immobilized sorbent to trap Cr(VI), (ii) could be reactivated and reusable, and (iii) it was fully functional when applied in real water effluents.

Multifunctional hybrid membranes for photocatalytic and adsorptive removal of water contaminants of emerging concern.

This work focuses on the combination of multifunctional photocatalytic and adsorbent materials in a unique polymeric membrane. For this purpose, Au/TiO2 and Y2(CO3)3 nanoparticles were immobilised onto a poly (vinylidene fluoride-hexafluoropropylene), (PVDF-HFP) membrane, and the physical-chemical characterisation of these materials was performed, as well as pollutant removal efficiency. An efficient TiO2 functionalisation with gold nanoparticles was achieved, endowing these particles with the capability to absorb visible radiation absorption. A favourable porous structure was obtained for the membranes, with an average pore size of 4 µm, and the nanoparticles immobilisation did not alter the chemical properties of the polymeric membrane. The produced hybrid materials, including both the Au/TiO2 and Y2(CO3)3 nanoparticles, presented an efficiency of 57% in the degradation of norfloxacin (5 mg/L) under ultraviolet radiation for 120 min, 80% under visible radiation for 300 min, and 58% in arsenic adsorption for 240 min. These membranes represent a new multifunctional platform for removing several pollutants, which may allow their incorporation in more efficient and less energy-consuming water treatment processes favouring its application, even in low energy resources countries.

Crystal morphology control of synthetic giniite for enhanced photo-Fenton activity against the emerging pollutant metronidazole.

Metronidazole (MNZ) is a recalcitrant antibiotic with toxic and carcinogenic effects in aquatic environments. In this work, Fe5(PO4)4(OH)3·2H2O (giniite) particles were synthesised with three different alkaline cations (Li+, Na+ and K+) and used as Fenton catalysts for MNZ removal. It is shown that the addition of different cations during the hydrothermal synthesis process promote different morphologies from asterisk-like to flower-like and branches-like, maintaining the crystalline structure of pure giniite. The photo-Fenton activity of these particles was then evaluated through the degradation of MNZ under sunlight radiation for 9 h. The results indicate that the alkaline cation has a predominant role in the photo-Fenton efficiency, as demonstrated by the superior degradation efficiencies of Na@giniite particles (91.2% and 72.5% with giniite concentration of 0.2 g L-1 and 0.07 g L-1, respectively), related with its high surface area (10.7 m2 g-1). Thus, it is demonstrated the suitability of Na@giniite particles as Fenton catalyst for MNZ removal from water.

Photocatalytic and antimicrobial multifunctional nanocomposite membranes for emerging pollutants water treatment applications.

Emerging pollutants represent a new global problem for water quality. As these compounds get into the environment, they cause severe threats to aquatic environments and human health and are typically resistant to conventional wastewater treatments. In this work, TiO2 nanoparticles surface was functionalized with silver (Ag) nanoparticles, and solvent cast and electrospun membranes of poly (vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) were prepared with different concentrations of TiO2 and Ag-TiO2 to produce a multifunctional material. The photocatalytic activity of the nanocomposites was evaluated through the degradation of norfloxacin under ultraviolet (UV) and visible radiation. It is shown that nanocomposites with Ag-TiO2 show the highest degradation efficiencies: 64.2% under UV and 80.7% under visible radiation, for 90 and 300 min, respectively. Furthermore, the recyclability of the membranes has also been demonstrated. Finally, it is shown the antimicrobial activity of the nanocomposite membranes, demonstrating the suitability of the Ag-TiO2/PVDF-HFP nanocomposites as multifunctional photocatalytic and antimicrobial membranes for water remediation applications.

Quantitative and functional analysis of CD69(+) NKG2D(+) T regulatory cells in healthy subjects.

T regulatory (Treg) cells have a key role in immune homeostasis and the pathogenesis of chronic inflammatory and autoimmune diseases. CD69 is an early leukocyte activation molecule that under steady state conditions is detected in a small proportion of lymphocytes in peripheral blood and lymphoid tissues. Although it has been reported that a subset of CD69(+) T cells behaves as Treg lymphocytes, the possible relationship between CD69(+) Treg cells and CD4(+)NKG2D(+) T lymphocytes, which also exert immunosuppressive activity, has not been explored. In this study, we analyzed the expression of CD69 and NKG2D by T lymphocytes from the peripheral blood of twenty-five healthy subjects by multi-parametric flow cytometry analysis, and their suppressive activity by an assay of inhibition of lymphocyte activation (CD40L expression) and proliferation (carboxyfluorescein partition assay). We found a very small percentage of CD4(+)CD69(+)NKG2D(+) T cells (median 0.002%, Q1-Q3, 0.001-0.004%), which also expressed TGF-ß (Latency Associated Peptide or LAP) and IL-10, in all samples analyzed. These cells exerted an important in vitro suppressive effect on both activation and proliferation of T effector cells. Our data suggest that at very small numbers, CD4(+)CD69(+)NKG2D(+) lymphocytes seem to exert a relevant functional immune-regulatory role in healthy subjects.

Analysis of expression and function of the co-stimulatory receptor SLAMF1 in immune cells from patients with systemic lupus erythematosus (SLE).

The signaling lymphocytic activation molecule SLAMF1 (CD150) is a co-stimulatory molecule that is expressed by most immune cells, including T regulatory (Treg) lymphocytes. Since different abnormalities have been reported regarding the number and function of Foxp3+ Treg cells in patients with systemic lupus erythematosus (SLE), we decided to analyze the expression and function of CD150 in these regulatory lymphocytes in this condition. We isolated peripheral blood mononuclear cells from 20 patients with SLE, and 20 healthy controls. The expression of SLAMF1 was determined by multi-parametric flow cytometry and the suppressive function of CD4+CD25+ lymphocytes, upon engagement or not of CD150 with an agonistic monoclonal antibody, was analyzed by an assay of inhibition of cell proliferation. We observed a significantly increased expression of SLAMF1 by CD3+CD4+ helper T cells and CD19+ B cells in patients with SLE and active disease. However, similar levels of SLAMF1 expression were detected in Foxp3+ Treg cells from patients and controls. In contrast, a higher proportion of SLE patients increased their suppressive function of Treg cells upon CD150 engagement compared to healthy controls. Our data suggest that SLAMF1 is another significant piece in the intricate defective immune-regulatory function of patients with SLE.

Proportions of several types of plasma and urine microparticles are increased in patients with rheumatoid arthritis with active disease.

We analysed the proportions of different microparticles (MPs) in plasma from patients with rheumatoid arthritis (RA), and assessed their relationship with disease activity/therapy and their in-vitro effect on proinflammatory cytokine release. Blood and urine samples were obtained from 55 patients with RA (24 untreated and 31 under conventional therapy) and 20 healthy subjects. Fourteen patients with systemic lupus erythematosus (SLE) were also studied. The proportions of CD3(+) , CD14(+) , CD19(+) , CD41(+) and CD62E(+) MPs were determined by flow cytometry analysis. The in-vitro effect of plasma MPs on the release of interleukin (IL)-1, IL-6, IL-17 and tumour necrosis factor (TNF)-α was also analysed. We detected that the proportions of different types of annexin-V(+) MPs were enhanced in plasma (CD3(+) , CD14(+) , CD19(+) , CD41(+) and CD62E(+) MPs) and urine (CD14(+) , CD3(+) and CD19(+) MPs) from RA patients with high disease activity (DAS28 index > 5·1). Accordingly, a significant positive correlation was observed between the levels of MPs and DAS28 score, and these levels diminished significantly at week 4 of immunosuppressive therapy. Finally, MPs isolated from patients with high disease activity induced, in vitro, an enhanced release of IL-1, IL-17 and TNF-α. In SLE, enhanced levels of different types of plasma MPs were also detected, with a tight correlation with disease activity. Our data further support that MPs have a relevant role in the pathogenesis of RA and suggest that the analysis of the proportions of these microvesicles in plasma could be useful to monitor disease activity and therapy response in patients with RA.

Correlación entre el Puntaje Obtenido en la Prueba "Timed up and go" y Momentos Articulares del Miembro Inferior Registrados Durante la Transferencia de Sedente a Bípedo en Adultos Mayores con Antecedentes de Caídas Frecuentes / Correlation between the Scores of "Timed up and go" Test and Registered Joint Moments of Lower Limb During the Sit-to-Stand Transfer in Elderly with Antecedents of Frequent Falls

Los cambios producidos durante el envejecimiento predisponen al adulto mayor a las caídas frecuentes, en el ambiente clínico el riesgo de caída es valorado mediante pruebas clínicas que muchas veces carecen de poder analítico, por lo cual es necesario describir cual de dichas pruebas puede tener mayor relación con parámetros biomecánicos analíticos con la finalidad de conferirle a dichas pruebas funcionales tales características. El objetivo de este trabajo fue describir la existencia de correlación entre los puntajes obtenidos en la prueba funcional "Timed up and go" (TUG) y momentos articulares del miembro inferior obtenidos durante la ejecución de la transferencia de sedente a bípedo (TSB) en sujetos adultos mayores con antecedentes de caídas frecuentes. Se obtuvo una muestra de 30 voluntarios, todos adultos mayores con antecedentes de caídas frecuentes, los que fueron evaluados con la prueba funcional de TUG. También se evaluó mediante un sistema de análisis de movimiento la TSB donde se registraron los parámetros biomecánicos necesarios para determinar los momentos articulares del miembro inferior. Existió una correlación significativa (r=-0,39; p=0,03) entre el puntaje obtenido en el TUG y el momento articular máximo de rodilla. Para la muestra evaluada, el tiempo de ejecución de la prueba "Timed up and go" fue indicador de la capacidad de generar momento articular por parte de los músculos flexo-extensores de rodilla en sujetos con antecedentes de caídas frecuentes.

The changes that take place during aging predispose the elder adult to frequent falls. In clinical practice fall risk is assessed by clinical tests that many times lack analytical power, therefore making it necessary to describe which of the clinical tests are related to the analytical biomechanical parameters in order to assign such characteristics to these functional tests. The objective of this work was to describe the existence of a correlation between the score of the functional test "Timed up and go" (TUG) and the joint moments of lower limb obtained during the execution of the sit to stand (STS) transfer in elderly subjects with a history of frequent falls. A sample of 30 volunteers was obtained; all were elders with a history of frequent falls. They were assessed with the functional test of TUG. Also assessed were the joint moments of the lower limb with motion analysis system. There is significant correlation (r=0.39; p=0.03) between the score obtained in the TUG and the maximum joint moment of the knee. For the sample assessed, the time of execution of the test "Timed up and go" was indicative of the capacity to generate a joint moment by the flexion-extensor muscles of the knee in subjects with a history of frequent falls.

Haemophilusinfluenzae type b conjugate vaccine for preventing pneumonia in infants hospitalized for bronchiolitis: a case-control study.

BACKGROUND: Haemophilus influenzae type b (Hib) conjugate vaccine reduces the risk of pneumonia in infants. OBJECTIVE: To determine the effect of Hib conjugate vaccine (HibCV) on the prevention of pneumonia as a complication among infants hospitalized for bronchiolitis. METHODS: This record-based case-control study was conducted at The Children's Hospital "Dr. Ovidio Aliaga U" in La Paz, Bolivia during 2003 and 2004. Cases were infants hospitalized for bronchiolitis under 1 year of age who developed radiological pneumonia during hospitalization. Controls were patients who had good clinical progress without the use of antibiotics. Pneumonia was defined by alveolar consolidation on chest X-ray that justified the use of antibiotics. RESULTS: Eighty patients were studied (16 cases and 64 controls). Their median age was 4.5 months. Demographic and clinical features were similar in both groups, except for a higher proportion of vomiting (56.3% vs. 28.1%; p<0.05) in the case group. The percentage of unvaccinated infants was significantly higher in cases (68.8% vs. 26.6%; p<0.05) and the length of hospital stay longer (8.5+/-5.4 vs. 3.1+/-2.2 days; p<0.05). There was a strong association between unvaccinated infants and the occurrence of pneumonia as a complication (odds ratio 6.1, 95% confidence interval 1.8-20.1; p<0.01). CONCLUSIONS: Unvaccinated infants admitted for bronchiolitis have a higher risk of radiologically confirmed pneumonia. Larger studies are needed to validate these results and reconsider the burden of Hib infection among infants in less developed countries.

El canal TRPV1 como diana para tratar el dolor / The TRPVI Chanel as a target for the treatment of pain

Resumen. Introducción. El dolor es resultado del procesamiento de una gran cantidad de señales producidas a diferentes niveles del sistema nervioso central y periférico, que se generan en respuesta a estímulos provenientes del medio ambiente o del organismo mismo. Una de las estrategias para generar nuevos analgésicos consiste en el estudio de las bases moleculares que subyacen en la detección de los estímulos dolorosos, es decir, los receptores. Un receptor de gran importancia para la fisiología sensorial y del dolor es el TRPV1, encargado de la detección de estímulos mecánicos, químicos y térmicos. Objetivo. Discutir los aspectos estructurales y funcionales del canal TRPV1, además de su participación en algunos procesos patológicos y las posibles perspectivas de investigación clínica. Desarrollo. La activación del TRPV1 en neuronas sensitivas genera señalesque llegan al sistema nervioso central, donde se interpretan como dolor, además de provocar la liberación periférica de sustancias proinflamatorias que sensibilizan a otras neuronas a estímulos subsecuentes. El TRPV1 es un receptor estructuralmente similar a otros canales iónicos dependientes de voltaje, con la capacidad de detectar e integrar diversos estímulos del medio ambiente, como temperaturas elevadas nocivas o agentes irritantes. Además, la actividad de este canal se acopla a diversas cadenas de señalización relacionadas con procesos de inflamación. Conclusión. La participación central del TRPV1en la fisiología del dolor resulta alentadora para el desarrollo de fármacos dirigidos a este receptor que puedan utilizarse en el tratamiento de diversos tipos de dolor (AU)

Summary. Introduction. Pain results from the processing of a large number of signals produced at different levels of the central and peripheral nervous system, which are generated in response to stimuli from the environment or from the organism itself. One of the strategies for generating new analgesics consists in studying the molecular bases that underlie the detection of painful stimuli, that is to say, the receptors. One receptor that plays a very important role in sensory and pain physiology is TRPV1, which is responsible for detecting mechanical, chemical and thermal stimuli. Aims. The aim of this study is to discuss the structural and functional aspects of the TRPV1 channel, as well as its participation in certain pathological processes and the possible perspectives for clinical research. Development. TRPV1 activation in sensory neurons generates signals that reach the central nervous system, where they are interpreted as pain, as well as triggering the peripheral release of proinflammatory substances that make other neurons sensitive to subsequent stimuli. TRPV1 is a receptor that is structurally similar to other voltage-dependent ion channels, with the capacity to detect and integrate several different stimuli from the environment, such as dangerously high temperatures or irritants. Furthermore, the activity of this channel is linked to several signalling chains related with inflammatory processes. Conclusions. The central role of TRPV1 in the physiology of pain will surely encourage the development of drugs aimed at this receptor which can be used in the treatment of several types of pain (AU)

[The TRPV1 channel as a target for the treatment of pain]. / El canal TRPV1 como diana para tratar el dolor.

INTRODUCTION: Pain results from the processing of a large number of signals produced at different levels of the central and peripheral nervous system, which are generated in response to stimuli from the environment or from the organism itself. One of the strategies for generating new analgesics consists in studying the molecular bases that underlie the detection of painful stimuli, that is to say, the receptors. One receptor that plays a very important role in sensory and pain physiology is TRPV1, which is responsible for detecting mechanical, chemical and thermal stimuli. AIMS. The aim of this study is to discuss the structural and functional aspects of the TRPV1 channel, as well as its participation in certain pathological processes and the possible perspectives for clinical research. DEVELOPMENT: TRPV1 activation in sensory neurons generates signals that reach the central nervous system, where they are interpreted as pain, as well as triggering the peripheral release of pro-inflammatory substances that make other neurons sensitive to subsequent stimuli. TRPV1 is a receptor that is structurally similar to other voltage-dependent ion channels, with the capacity to detect and integrate several different stimuli from the environment, such as dangerously high temperatures or irritants. Furthermore, the activity of this channel is linked to several signalling chains related with inflammatory processes. CONCLUSIONS: The central role of TRPV1 in the physiology of pain will surely encourage the development of drugs aimed at this receptor which can be used in the treatment of several types of pain.

Correlación en grado de gleason entre biopsia prostática por punción y biopsia diferida luego de prostatectomía radical: ¿es confiable la información de la biopsia por punción para la toma de decisiones? / Gleason grade correloation between preoperatory prostate biopsy and final pathology. Is it trustable the information provided by primary biopsy?

La biopsia prostática es el método mediante el cual se confirma la sospecha de un cáncer de la próstata. Múltiples estudios han centrado su interés en perfeccionar esta técnica con la finalidad de mejorar ensensibilidad y especificidad. Surge la pregunta si el grado de malignidad informado por el patólogo es fidedigno respecto a la información de la biopsia diferida. Esta pregunta cobra especial relevancia cuando esta primera informaciónen relevante para definir el tratamiento a ofrecer y establecer un pronóstico inicial. Este trabajo intenta mostrar el grado de correlación entre la biopsia por punción versus la diferida de la pieza operatoria, identificado en qué grupos se produciría mayor error. Se revisa en forma retrospectiva el caso de 64 pacientes que fueron a prostatectomía radical entre enero de2003 y diciembre de 2005, constatando Gleason al minuto del diagnóstico y de biopsia diferida de pieza operatoria, definiendo correlación en base a sobreestimación, subestimación e igualdad en el Score de Gleason. Se operan 64 pacientes en los cuales la biopsia por punción sobreestimó la diferida en 6 (9,37 por ciento). Subestimó 25casos (39,06 por ciento) y fue igual en 33 (51,56 por ciento). El mayor número de casos de subestimación en la biopsia por punción se concentra en Gleason informados como bajos en ésta última de 3+4 hacia los grados menores(95 por ciento de los casos descritos) encontrándose la mitad de los casos en el Gleason informado a la punción como 3+3=6. Al hacer el análisis de los Gleason de las biopsias definitivas, el 98,7 por ciento de los Gleason 7 (3+/- 4, 52por ciento;4+3, 46,7 por ciento) fueron subestimados en la biopsia por punción. El Gleason más frecuentemente diagnosticado en biopsia por punción es 3+3=6 (43,8 por ciento), en biopsia diferida el Gleason 3+4=7 (39,1 por ciento). En nuestra serie se evidencia una subestimación en la biopsia por punción en un 37,5 por ciento de los casos, básicamente en los valores de Gleason...

Prostatic biopsy (PB) constitutes the primary objective diagnose for prostate carcinoma. Several studies have attempted to improve its results in terms of sensitivity and specificity. As the information provided by the biopsy defines initial prognosis and surgical treatment, the correlation between PC and final pathologyis of utmost importance. Our aim was to define the correlation and identified groups with higher differences. A retrospective analysis of 64 cases of radical prostatectomy performed between January 2003 - December2005 was performed. Results of PB and final pathology were evaluated to define correlation. Gleason grade from PB was higher than final pathology in 6 patients (9.37 percent). In 25 patients PB was lower than final pathology and gleason grade was equal in both PB and final pathology in 33 patients (51.5 percent). The highest number of cases with underestimation in PB corresponded to patients with Gleason 3+4. On final pathology it was verified that 98,7 percent of patients with Gleson 7 were initially underestimated. We could verify a high percentage of underestimation in our series (37, 5 percent), especially in patients with low gleason grades. In the setting of prognosis and decision making; pathologic underestimation is an important fact in therapeutical planning.

Sling bulbouretral para la incontinencia urinaria de esfuerzo masculina post cirugía prostática / Bulbourethral sling for the treatment of urinary stress incontinence secondary to radical prostatectomy

La incontinencia de orina de esfuerzo masculina (IOEM) puede resultar tanto de una complicación de la cirugía de la próstata como ser una manifestación de insuficiencia esfinteriana neurogénica. El tratamiento quirúrgico de la IOE post-prostatectomía incluye las inyecciones transuretrales, el esfínter urinario artificial y las operaciones de Sling bulbouretral (SBU). Este trabajo intenta mostrar nuestra experiencia inicial en el manejo de la IOEM con la instalación de Sling bulbouretral respecto a eficacia y seguridad. A cuatro pacientes del incontinentes post prostatectomía radical (PR) y post adenomectomía transvesical (ASPTV) se les realiza cirugía correctora de la incontinencia con Sling ARGUS®, entre junio de 2004 y mayo de 2005, evaluando su evolución con uroflujometría postoperatoria, cistoscopia y análisis clínico registrando: tiempo de evolución de IOEM y magnitud, procedimientos previos, eficacia, seguridad eimpacto en la calidad de vida. Técnica estandarizada descrita, realizando estudio prospectivo comparativo observacional longitudinal aplicando cuestionarios IIQ-7, UDI-6, IPSS, calidad de vida (QoL) relacionada con problemas urinarios e índice de impacto en la vida diaria (IVD) respecto a estado preoperatorio y postoperatorio.De los 4 pacientes, uno fue operado de ASPTV, 3 de PR de los cuales uno recibió RT. El tiempo de evolución de la IOEM fue de 20 a 137 meses con un promedio de 74,5 meses. La magnitud de la IOM fue de Severa en 3 casos y de Moderada en 1 (ASPTV), este último recibió inyecciones de Defluc en 2 oportunidades, recidivando al corto plazo. Todos los pacientes fueron enviados a Kinesioterapia. Promedio: IIQ-7 preop: 21,5 y postop: 0 (0-28); UDI-6 preop: 9 y postop: 1,5 (0-18); IPSS preop: 3 y postop 1,5 (0-13); QoL preop: 1 y postop: 9,5 (0-10), IVD preop 9,25 y postop 1,75 (0-13).Los cuatro a la fecha están secos y sin obstrucción. Las complicaciones presentadas fue una erosión que requirió retiro del...

Stress urinary incontinence (SUI) is usually associated with radical prostatectomy (RP), however it canal so be a symptom of neurogenic sphincter insufficiency. Treatment options include transurethral injections, artificial sphincter, and sling procedures. We report our initial experience with the bulbourethral sling. In a one-year period, four patients with a history of SUI secondary to RP and transvesical adenomectomy underwent correction with the ARGUS sling. Outcomes were measured with flow meter, cystoscopy and clinical scores and validated questionnaires (IIQ-7, UDI-6, IPSS, QoL, IVD). Out of the 4 patients, 3 were secondary to RP of which 1 had radiotherapy. Mean follow up was 74,5 months (range 20 to 137 months).SUI was severe in 3 cases and moderate in 1, this last case was unsuccessfully treated with transurethral injections in 2 opportunities. The rest of the cases were treated with sling. All patients received rehabilitation. All four patients are currently without SUI. One patient presented urethral erosion and the sling had to be removed and reinstalled one year later. Bulbourethral sling is a safe and effective technique for the management o SUI secondary to prostatic surgery with good results.

Cuidadores familiares de ancianos: quienes son y como asumen este rol / Relatives as caregivers of the elderly: who they are and how they assume their role

Objetivo: caracterizar el perfil sociodemográfico de cuidadores familiares de ancianos con dependencia funcional y describir cómo asumen su rol. Materiales y métodos: estudio descriptivo de corte transversal; 39 cuidadores familiares de ancianos con dependencia funcional, con seis o más meses como cuidadores, sin retribución económica, que viven en Envigado. Muestreo por conveniencia. Resultados: 100 por ciento mujeres, edad promedio 53,9 años, 64,1 por ciento hijas de quien cuidan; 89,7 por ciento comparten vivienda con el anciano; 38,5 por ciento solteras y 38,5 por ciento casadas, 51,3 por ciento tienen hijos. Baja escolaridad: 28,1 por ciento primaria incompleta. Situación socioeconómica así: ingreso familiar promedio del 89,7 por ciento es menor de dos salarios mínimos legales mensuales. El 79,5 por ciento comparten el papel de cuidadora con otro; 64,1 por ciento sin actividad remunerada previamente. Con referencia al cuidado: 30,8 por ciento lleva entre 3 y 6 años, 12,9 por ciento más de 12 años; 76,9 por ciento dedica más de ocho horas día; 56,3 por ciento reciben apoyo fundamentalmente de familiares y, del sistema formal, el 7,7 por ciento . Conclusiones: en Colombia es incipiente el reconocimiento del cuidado familiar; hay similitud del perfil de cuidadores con otros países; la situación del perfil de las cuidadoras se acentúa por el escaso tiempo para enriquecimiento personal y poco apoyo sistemático; se percibe ausencia de políticas de salud para fortalecer el cuidado familiar y los cuidadores.

Immune effects of therapy with Adalimumab in patients with rheumatoid arthritis.

The aim of this study was to assess the effect of Adalimumab on different immune parameters in patients with RA. Adalimumab was administered (40 mg every other week for 26 weeks) to eight patients with RA that were refractory to conventional drug therapy. Peripheral blood samples were obtained at days 0, 15 and 180 of Adalimumab therapy, and the following immune parameters were assessed: Number, phenotype, and function of regulatory T lymphocytes. The induction of apoptosis of immune cells and the in vitro and in vivo reactivity towards M. tuberculosis were also analysed. All patients responded to Adalimumab (ACR response 50-70), and a modest but significant increase in the number and function of regulatory T cells was observed at day 15 of anti-TNF-alpha therapy. In addition, an increased percent of apoptotic cells was detected in the peripheral blood at day 15 of Adalimumab therapy. Unexpectedly, most of these effects were not further observed at day 180. However, two patients showed a persistent and marked reduction in the reactivity to M. tuberculosis. Although we have found that Adalimumab affects the number and function of regulatory T lymphocytes, and the apoptosis of immune cells, these effects are transient and its possible causal relationship with the therapeutic activity of this biological agent remains to be determined. Nevertheless, the down-regulatory effect of Adalimumab on the reactivity to M. tuberculosis could be related to an enhanced risk of tuberculosis reactivation.

Uretrolisis transvaginal / Transvaginal urethrolysis

La incidencia de obstrucción después de cirugía para corregir la incontinencia de orina en la mujer se desconoce. Varía de acuerdo al tipo de pacientes operadas, la técnica utilizada y las patologías asociadas. Se estima entre 2,5 por ciento y 24 por ciento. Material y método: Estudio retrospectivo de las historias clínicas de las pacientes con obstrucción posterior a cirugía de corrección de la incontinencia urinaria con TVT (Johnson & Johnson). Resultados: Durante el período de julio de 2000 a abril de 2004 se realizaron 95 cirugías para corrección de la incontinencia de orina con TVT. Hubo 3 pacientes con sintomatología obstructiva y/o urgeincontinencia de novo. La evaluación de las pacientes incluyó anamnesis, examen físico, cartilla miccional, cistoscopia y urodinamia. La cistoscopia fue normal en todas ellas. Los parámetros urodinámicos fueron concluyentes de obstrucción en 2 de las 3 pacientes. La corrección quirúrgica fue realizada por uretrolisis transvaginal que fue exitosa en todas las pacientes. No hubo complicaciones quirúrgicas intra o postoperatorias. Conclusiones: Hubo 3,2 por ciento de complicación obstructiva en nuestra serie de 95 pacientes, que se encuentra dentro de las series clínicas publicadas. Consideramos que la uretrolisis transvaginal es una técnica adecuada para la corrección de la obstrucción uretral posterior a la cirugía TVT. Es un procedimiento quirúrgico seguro y técnicamente fácil. Nuestra serie clínica no nos permitió identificar factores de riesgo a considerar en las pacientes que van a ser operadas.

Cadherin expression in glandular tumors of the cervix.

BACKGROUND: The cadherins are homotypic adhesion proteins that are important in cell sorting during organogenesis. Classic cadherins include several different types that show tissue specific expression. Specific tissue expression of cadherins often is preserved in neoplastic transformation, and cadherin phenotype can be used to differentiate morphologically similar but histogenetically distinct tumors. METHODS: The authors examined by using immunohistochemistry in paraffin sections the expression of E- (epithelial) and P- (placental) cadherin in 39 patients with glandular tumors of the cervix, including invasive adenocarcinoma, villoglandular adenocarcinoma, adenocarcinoma in situ (AIS), and adenoma malignum. RESULTS: In all cases, E-cadherin was expressed in both normal and malignant glands without appreciable differences. P-cadherin, normally confined to basal epithelial cells and not observed in benign glands, was aberrantly expressed in neoplastic glands in 27 cases, including 96%(23 of 24 cases) of invasive cancers, 40% (2 of 5) of villoglandular carcinomas, 25% (2 of 8) of AIS, and 0% (0 of 2) of adenoma malignum. CONCLUSIONS: The authors' results show that E-cadherin is uniformly expressed in glandular tumors of the cervix with no evidence of decreased expression in these tumors. In addition, P-cadherin is aberrantly expressed in most adenocarcinomas and appears to be preferentially expressed in invasive rather than in situ lesions. Thus, aberrant expression of P-cadherin may be a useful marker of invasive or aggressive clinical behavior in glandular lesions of the cervix.

Nuclear localization of E-cadherin expression in Merkel cell carcinoma.

CONTEXT: Cadherins are cell-cell adhesion proteins that act as tumor suppressor genes and have a critical role in cell sorting and tissue formation during organogenesis. The pattern of cadherin expression constitutes a useful diagnostic and prognostic tool in the evaluation of tumors and for determining the histogenesis of tumor cells. We have previously characterized the cell types of several tumors based on the expression of individual cadherins. OBJECTIVE: To investigate the expression of cadherins in Merkel cell carcinomas. DESIGN: Paraffin immunohistochemical analysis of the 3 best-studied cadherins was performed on 35 cases of Merkel cell carcinoma. RESULTS: E-cadherin was expressed in 34 (97%) of 35 Merkel cell carcinomas examined, N-cadherin was expressed in 22 (63%) of 35 cases, and P-cadherin was expressed in 15 (43%) of 35 cases. This frequency of cadherin expression was similar to a group of small cell and neuroendocrine tumors from other primary sites. Interestingly, the localization of E-cadherin expression was unique in Merkel cell carcinomas compared with other primary neuroendocrine tumors. Merkel cell carcinomas showed marked preference for nuclear versus membrane localization, whereas small cell tumors from other sites showed fewer cases of nuclear E-cadherin expression. The nuclear localization of E-cadherin did not correlate with cadherin-associated protein beta-catenin nuclear expression. CONCLUSIONS: Our findings show that E-cadherin is the most frequently expressed cadherin in Merkel cell carcinoma, followed in frequency by N-cadherin then P-cadherin. The pattern of nuclear E-cadherin expression is more frequent for Merkel cell carcinoma than small cell tumors of other primary sites. These observations suggest that E-cadherin expression and function are altered in Merkel cell carcinoma, and this finding has potential use in the differential diagnosis of these tumors.

The International Society of Gynecological Pathologists. Its founding and early years.

The International Society of Gynecological Pathologists was founded in 1976 to facilitate an exchange of knowledge about gynecological disease throughout the world. The Society moved quickly to schedule companion meetings with established international and regional pathology and gynecology societies, including the International Academy of Pathology, its United States-Canadian Division, and the International Federation of Gynecology and Obstetrics, and to sponsor smaller meetings within individual countries. In 1981 the Society founded this journal, and in 1983, at the invitation of the World Health Organization, it assumed the responsibility of revising the WHO classifications of tumors of the female genital tract. The foundation of the Society appears to have been solid in view of its present robust health.

P-cadherin expression in breast carcinoma indicates poor survival.

BACKGROUND: The cadherin family of cell-cell adhesion molecules and their associated proteins, the catenins, are essential to embryonic development and the maintenance of adult tissues. During development, the homotypic interaction of a particular cadherin with an identical cadherin expressed on a neighboring cell results in the sorting of cells to form distinctive tissues. Cadherins are believed to be tumor suppressors, and their altered expression and function have been associated with tumor development. METHODS: The authors examined the expression of P-cadherin, E-cadherin, and N-cadherin, and alpha-catenin and beta-catenin in 183 cases of invasive breast carcinoma by immunohistochemistry on paraffin sections using specific antibodies and a steam-based antigen retrieval method. RESULTS: P-cadherin was positive in 95 cases and negative in 88 cases of breast carcinoma. Positive P-cadherin expression in breast carcinoma showed a strong correlation with poor patient prognosis. Five years after surgery, 90% of the patients with P-cadherin negative tumors were alive in contrast to only 59% of patients with P-cadherin positive tumors. The difference in survival reached statistical significance (P = 0.0001) as early as 2 years after surgical treatment. Expression of N-cadherin, alpha-catenin, and beta-catenin did not correlate with patient survival. Multivariable statistical analyses of the data showed that expression of P-cadherin was independent of tumor size and lymph node metastases, but correlated inversely with estrogen/progesterone receptor status. In ductal carcinomas, positive P-cadherin expression correlated with a higher histologic grade. In contrast, expression of E-cadherin was low in high grade ductal carcinomas but negative tumors were uncommon. Negative or low E-cadherin expression did not correlate with poor survival. In lobular carcinomas, E-cadherin expression frequently was negative or low, and P-cadherin always was negative. CONCLUSIONS: Expression of P-cadherin in breast carcinoma is associated strongly with poor survival and constitutes an independent prognostic predictor. P-cadherin expression is a better indicator of clinical outcome than alterations in the expression of E-cadherin, N-cadherin, alpha-catenin, or beta-catenin.