41 resultados para Neoplasias de la vulva


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This paper will focus on how Christos Tsiolkas the author of The Slap (2008) invites us to view the complex range of private lives of his male characters living in suburban Melbourne through their daily routines, conversations and innermost thoughts. On the surface most appear to be participating in and achieving a certain level of success in their lives. However, this novel reveals when we agitate and dig below the “practices of everyday life” there is often a disquiet simmering away under the facade of family harmony, male bravado and contentment. This paper will argue that as a result of dissatisfaction with the established order of their lives, each man has managed to create another level of meaning for himself, his own form of la perruque (De Certeau 2011: 29),the concept of living proposed by Michel De Certeau. A treatment of the characters in this article draws on, and is used to illustrate the paradigm.

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There is debate as to whether percutaneous coronary intervention (PCI) with drug-eluting stents or coronary artery bypass surgery (CABG) is the best procedure for subjects with type 2 diabetes and coronary artery disease requiring revascularization. There is some evidence that following these procedures there is less further revascularization with CABG than PCI in subjects with diabetes. Two recent studies; the FREEDOM (Future Revascularization Evaluation in patients with Diabetes mellitus: Optimal Management of Multivessel Disease) trial, and a trial using a real world diabetic population from a Registry, have shown that the benefits of CABG over PCI in subjects with type 2 diabetes extends to lower rates of death and myocardial infarct, in addition to lower rates of revascularization. However, the rates of stroke may be higher with CABG than PCI with drug-eluting stents in this population. Thus, if CABG is going to be preferred to PCI in subjects with type 2 diabetes and multivessel coronary disease, consideration should be given to how to reduce the rates of stroke with CABG.

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La creación del término resiliencia en salud es un paso importante hacia la construcción de comunidades más resilientes para afrontar mejor los desastres futuros. Hasta la fecha, sin embargo, parece que hay poca literatura sobre cómo el concepto de resiliencia en salud debe ser definido. Este artículo tiene como objetivo construir un enfoque de gestión de desastres de salud integral guiado por el concepto de resiliencia. Se realizaron busquedas en bases de datos electrónicas de salud para recuperar publicaciones críticas que pueden haber contribuido a los fines y objetivos de la investigación. Un total de 61 publicaciones se incluyeron en el análisis final de este documento, que se centraron en aquéllas que proporcionan una descripción completa de las teorías y definiciones de resiliencia ante los desastres y las que proponen una definición y un marco conceptual para la capacidad de resiliencia en salud. La resiliencia es una capacidad inherente de adaptación para hacer frente a la incertidumbre del futuro. Esto implica el uso de múltiples estrategias, un enfoque de riesgos máximos y tratar de lograr un resultado positivo a través de la vinculación y cooperación entre los distintos elementos de la comunidad. Resiliencia en salud puede definirse como la capacidad de las organizaciones de salud para resistir, absorber, y responder al impacto de los desastres, mientras mantiene las funciones esenciales y se recupera a su estado original o se adapta a un nuevo estado. Puede evaluarse por criterios como la robustez, la redundancia, el ingenio y la rapidez e incluye las dimensiones clave de la vulnerabilidad y la seguridad, los recursos y la preparación para casos de desastre, la continuidad de los servicios esenciales de salud, la recuperación y la adaptación. Este nuevo concepto define las capacidades en gestión de desastres de las organizaciones sanitarias, las tareas de gestión, actividades y resultados de desastres juntos en una visión de conjunto integral, y utiliza un enfoque integrado y con un objetivo alcanzable. Se necesita urgentemente investigación futura de su medición

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Background A feature of epithelial to mesenchymal transition (EMT) relevant to tumour dissemination is the reorganization of actin cytoskeleton/focal contacts, influencing cellular ECM adherence and motility. This is coupled with the transcriptional repression of E-cadherin, often mediated by Snail1, Snail2 and Zeb1/δEF1. These genes, overexpressed in breast carcinomas, are known targets of growth factor-initiated pathways, however it is less clear how alterations in ECM attachment cross-modulate to regulate these pathways. EGF induces EMT in the breast cancer cell line PMC42-LA and the kinase inhibitor staurosporine (ST) induces EMT in embryonic neural epithelial cells, with F-actin de-bundling and disruption of cell-cell adhesion, via inhibition of aPKC. Methods PMC42-LA cells were treated for 72 h with 10 ng/ml EGF, 40 nM ST, or both, and assessed for expression of E-cadherin repressor genes (Snail1, Snail2, Zeb1/δEF1) and EMT-related genes by QRT-PCR, multiplex tandem PCR (MT-PCR) and immunofluorescence +/- cycloheximide. Actin and focal contacts (paxillin) were visualized by confocal microscopy. A public database of human breast cancers was assessed for expression of Snail1 and Snail2 in relation to outcome. Results When PMC42-LA were treated with EGF, Snail2 was the principal E-cadherin repressor induced. With ST or ST+EGF this shifted to Snail1, with more extreme EMT and Zeb1/δEF1 induction seen with ST+EGF. ST reduced stress fibres and focal contact size rapidly and independently of gene transcription. Gene expression analysis by MT-PCR indicated that ST repressed many genes which were induced by EGF (EGFR, CAV1, CTGF, CYR61, CD44, S100A4) and induced genes which alter the actin cytoskeleton (NLF1, NLF2, EPHB4). Examination of the public database of breast cancers revealed tumours exhibiting higher Snail1 expression have an increased risk of disease-recurrence. This was not seen for Snail2, and Zeb1/δEF1 showed a reverse correlation with lower expression values being predictive of increased risk. Conclusion ST in combination with EGF directed a greater EMT via actin depolymerisation and focal contact size reduction, resulting in a loosening of cell-ECM attachment along with Snail1-Zeb1/δEF1 induction. This appeared fundamentally different to the EGF-induced EMT, highlighting the multiple pathways which can regulate EMT. Our findings add support for a functional role for Snail1 in invasive breast cancer.

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Background Breast carcinoma is accompanied by changes in the acellular and cellular components of the microenvironment, the latter typified by a switch from fibroblasts to myofibroblasts. Methods: We utilised conditioned media cultures, Western blot analysis and immunocytochemistry to investigate the differential effects of normal mammary fibroblasts (NMFs) and mammary cancer-associated fibroblasts (CAFs) on the phenotype and behaviour of PMC42-LA breast cancer cells. NMFs were obtained from a mammary gland at reduction mammoplasty, and CAFs from a mammary carcinoma after resection. Results We found greater expression of myofibroblastic markers in CAFs than in NMFs. Medium from both CAFs and NMFs induced novel expression of α-smooth muscle actin and cytokeratin-14 in PMC42-LA organoids. However, although conditioned media from NMFs resulted in distribution of vimentin-positive cells to the periphery of PMC42-LA organoids, this was not seen with CAF-conditioned medium. Upregulation of vimentin was accompanied by a mis-localization of E-cadherin, suggesting a loss of adhesive function. This was confirmed by visualizing the change in active β-catenin, localized to the cell junctions in control cells/ cells in NMF-conditioned medium, to inactive β-catenin, localized to nuclei and cytoplasm in cells in CAF-conditioned medium. Conclusion We found no significant difference between the influences of NMFs and CAFs on PMC42-LA cell proliferation, viability, or apoptosis; significantly, we demonstrated a role for CAFs, but not for NMFs, in increasing the migratory ability of PMC42-LA cells. By concentrating NMF-conditioned media, we demonstrated the presence of factor(s) that induce epithelial-mesenchymal transition in NMF-conditioned media that are present at higher levels in CAF-conditioned media. Our in vitro results are consistent with observations in vivo showing that alterations in stroma influence the phenotype and behaviour of surrounding cells and provide evidence for a role for CAFs in stimulating cancer progression via an epithelial-mesenchymal transition. These findings have implications for our understanding of the roles of signalling between epithelial and stromal cells in the development and progression of mammary carcinoma.

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This paper sets out to contribute to the literature on the design and the implementation of management control systems. To this end, we question what is discussed when a management control system is to be chosen and on what decision-making eventually rests. This study rests upon an ethnomethodology of the Salvation Army’s French branch. Operating in the dual capacity of a researcher and a counsellor to management, between 2000 and 2007, we have unrestricted access to internal data revealing the backstage of management control: discussions and interactions surrounding the choosing of control devices. We contribute to understanding the arising of a need for control, the steps and process followed to decide upon a management control system, and controls in nonprofits. [Cet article vise à contribuer à la littérature sur la mise en place des systèmes de contrôle de gestion. À cette fin, nous questionnons ce qui est discuté lors du choix d’un système de contrôle et sur quoi repose in fine la décision. Cet article est fondé sur une approche ethnométhodologique de l’Armée du Salut en France permise par notre double qualité de chercheurs mais également de conseiller auprès de la direction de l’organisation entre 2000 et 2007. Un accès illimité à des données internes nous permet ainsi de mettre en lumière les aspects méconnus et invisibles du contrôle de gestion : les discussions et interactions entourant le choix d’outils. Nous contribuons à la compréhension de l’émergence du besoin de contrôle, des étapes et du processus de choix d’outils et enfin du contrôle de gestion dans une organisation à but non lucratif.]

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Whilst native French speakers oftentimes collapse accountability to account giving, this paper outlines the shape of an accountability ala française. Reading Tocqueville’s (1835) work highlights that accountability as practiced in Anglo-Saxonc countries has been an offspring of American democracy. An accountability a la française would be characterised by conformance to a set or universal values, the submission of minorities to choices made by the majority, a means obligation as well as the rejection of transparency. [Alors que le francophone réduit généralement l’accountability à la reddition de comptes, cet article esquisse les contours d’une véritable accountability à la française. La lecture de Tocqueville (1835) révèle que l’accountability pratiquée dans les pays anglo-saxons trouve ses origines dans les fondements de la démocratie américaine. En France, l’accountability serait caractérisée par le respect d’un ensemble de valeurs universelles, l’adhésion des minorités aux choix majoritaires, l’absence de discriminations, une obligation de moyens et un rejet de la transparence.]

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The microenvironment plays a key role in the cellular differentiation of the two main cell lineages of the human breast, luminal epithelial, and myoepithelial. It is not clear, however, how the components of the microenvironment control the development of these cell lineages. To investigate how lineage development is regulated by 3-D culture and microenvironment components, we used the PMC42-LA human breast carcinoma cell line, which possesses stem cell characteristics. When cultured on a two-dimensional glass substrate, PMC42-LA cells formed a monolayer and expressed predominantly luminal epithelial markers, including cytokeratins 8, 18, and 19; E-cadherin; and sialomucin. The key myoepithelial-specific proteins α-smooth muscle actin and cytokeratin 14 were not expressed. When cultured within Engelbreth-Holm- Swarm sarcoma-derived basement membrane matrix (EHS matrix), PMC42-LA cells formed organoids in which the expression of luminal markers was reduced and the expression of other myoepithelial-specific markers (cytokeratin 17 and P-cadherin) was promoted. The presence of primary human mammary gland fibroblasts within the EHS matrix induced expression of the key myoepithelial-specific markers, α-smooth muscle actin and cytokeratin 14. Immortalized human skin fibroblasts were less effective in inducing expression of these key myoepithelial-specific markers. Confocal dual-labeling showed that individual cells expressed luminal or myoepithelial proteins, but not both. Conditioned medium from the mammary fibroblasts was equally effective in inducing myoepithelial marker expression. The results indicate that the myoepithelial lineage is promoted by the extracellular matrix, in conjunction with products secreted by breast-specific fibroblasts. Our results demonstrate a key role for the breast microenvironment in the regulation of breast lineage development.

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Este proyecto se desarrollo por iniciativa de las autoras y con el apoyo de un grupo interdisciplinario, con el interés común de desarrollar una investigación académica cuyo resultado sea de utilidad para el desarrollo del sector productivo artesanal Peruano. El proceso de investigación nace a partir de una observación de campo acerca de la problemática del producto artesanal Peruana y enfocada en los aspectos comerciales, de diseño y producción. Esta observación se centro en Cajamarca (por ser el departamento menos intervenido por otras investigaciones en este tema) en la zona de Aylambo y Cruz Blanca, en los talleres artesanales que desarrollan productos cerámicos. A partir de un análisis de tipo FODA de los productos y de su contexto de desarrollo, encontramos que los artesanos que trabajan con los empresarios exportadores, requieren un tipo de capacitación que les permita desarrollar su trabajo mediante un proceso orientado a cumplir con exigencias técnicas y de diseño para el desarrollo de productos validos como oferta exportable. Como punto de partida se recurrió a las instituciones no gubernamentales y del gobierno, que promueven el sector artesanal Peruano (Prompex, Adex, Proyecto PARA, IMPART) para conocer su opinión respecto a los mercados objetivos de este sector, y para adoptar como parte del proyecto, lo vigente respecto a las políticas y planes de comercialización. Para entender la contraparte comercial de este sector artesanal recurrimos a empresas privadas exportadoras con muchos años de experiencia, para ello contamos con la colaboración de empresas como Allpa, Manos Amigas, Novica. A partir de la observación de campo preliminar y de la información recogida de los expertos consultados, se realizo un diagnostico de la situación productiva en este sector. En base a la definición del problema, se establecieron las estrategias y metodologías para el diseño de la investigación, siendo parte de estas estrategias, la realización de un taller de desarrollo de productos en Cajamarca. Las estrategias tuvieron como enfoque principal la definición de metodologías de trabajo, cuya aplicación sea posible en el marco del contexto económico, político y cultural en el que se desarrolla este sector en la realidad inmediata del país. El proyecto culmina con la presentación de una propuesta que mas allá de abarcar únicamente lo metodológico en el área del diseño, presenta también ‘modelos’ de trabajo entre los diferentes actores que intervienen en el sector, de manera que a través de estrategias colaborativas se pueda potenciar el crecimiento del sector y beneficiar el desarrollo del artesano.

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"The major La Niña climate event responsible for record flooding in Queensland  - and the largest ever cyclone to hit Australia in Yasi  —  is not over yet according to a senior climatologist at Britain’s Met office."

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Photographic documentation of sculpture produces significant consequences for the way in which sculptural space is conceived. When viewed as discrete mediums the interaction of the photograph and its sculptural subject is always framed by notions of loss. However, when taken as a composite system, the sculpture-photograph proposes a new ontology of space. In place of the fixity of medium, we can observe a topology at play: a theory drawn from mathematics in which space is understood not as a static field but in terms of properties of connectedness, movement and differentiation. Refracted through the photographic medium, sculpture becomes not a field of fixed points in space, but rather as a fluid set of relations - a continuous sequence of multiple ‘surfaces’, a network of shifting views. This paper will develop a topological account of studio practice through an examination of the work of the contemporary Belgian sculptor Didier Vermeiren (b. 1951). Since the 1980s, Vermeiren has made extensive use of photography in his sculptural practice. By analysing a series of iterations of his work Cariatide à la Pierre (1997-1998), this paper proposes that Vermeiren’s use of photography reveals patterns of connection that expand and complicate the language of sculpture, while also emphasising the broader topology of the artist’s practice as a network of ‘backward glances’ to previous works from the artist’s oeuvre and the art-historical canon. In this context, photography is not simply a method of documentation, but rather a means of revealing the intrinsic condition of sculpture as medium shaped by dynamic patterns of connection and change. In Vermeiren’s work the sculpture-photograph, has a composite identity that exceeds straightforward categories of medium. In their place, we can observe a practice based upon the complex interactions of objects whose ontology is always underpinned by a certain contingency. It is in this fundamental mobility, that the topology of Vermeiren’s practice can be said to rest.