La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biol��gica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

Inmunoterapia en pacientes con cáncer de pulmón de células no pequeñas versus terapia convencional. Revisión sistemática

RESUMEN Antecedentes y Justificación: El cáncer de pulmón es la principal causa de muerte relacionada con Cáncer en el mundo. El cáncer pulmonar de células no pequeñas (Non-Small-cell lung cancer NSCLC) representa el 85% de todos los cánceres de pulmón y en un 40% es diagnosticado tardíamente y con los tratamientos disponibles actualmente (cirugía, radioterapia y quimioterapia) presenta una supervivencia a 5 años entre el 10 y el 15%. En los últimos años han surgido nuevos tratamientos basados en la inmunoterapia que prometen mejorar la supervivencia de estos pacientes. Objetivo: Determinar la eficacia de la inmunoterapia en el tratamiento del cáncer de pulmón de células no pequeñas (NSCLC) con el fin de integrar la información disponible para su posterior uso en la cl��nica. Metodología: Se realizó búsqueda exhaustiva de la literatura disponible del 1 de Enero de 2003 al 31 de Diciembre de 2013. Se examinaron las siguientes bases de datos: Pubmed, Scielo, Medline, Lilacs, EMBASE, Bandolier, peDRO y Cochrane. Se utilizaron los términos MeSH de búsqueda: immunotherapy, NSCLC, clinical trials. Resultados: de 163 referencias identificadas en las bases de datos, 12 fueron seleccionadas para la revisión. Se identificaron 11 estrategias inmunoterapéuticas que fueron complementarias al uso de quimioterapia, radioterapia o ambas. No se encontró diferencia significativa entre la supervivencia global de los grupos de intervención y controles con excepción de 1 artículo. La mayoría de efectos secundarios fueron de leves a moderados y no hubo diferencias significativas entre los grupos. Discusión: no se evidenció un aumento significativo de la supervivencia global con la utilización de inmunoterapias, a excepción de la que emplea células asesinas inducidas por citocinas junto a células dendríticas. Sin embargo es necesario esperar resultados de estudios fase III en curso.

Análisis bibliométrico de depresión infantil

El objetivo de este estudio fue identificar las tendencias en la investigación de la depresión infantil mediante un análisis bibliométrico de artículos publicados entre enero de 2010 y enero de 2015, en las bases de datos EBSCO, Scopus y Scielo. Se incluyeron 146 artículos, escritos en ingl��s, español y portugués. En el trabajo se identifican los autores más productivos y las tendencias de los autores con respecto al sexo, profesión y producción; así como los países, instituciones y revistas que más publicaron sobre dicho trastorno. La edad y la ansiedad son las variables que con más frecuencia se asocian al tema; de igual forma, se identificó el Children Depression Inventory (CDI) como el instrumento más común para medir la depresión infantil. En este periodo de tiempo destacan los artículos centrados en investigaciones sobre poblaciones con diferentes estados de salud, diseños correlacionales, de corte transversal y escritos por múltiples autores. Al analizar los resultados obtenidos se observa un creciente interés y preocupación de los investigadores por conocer la frecuencia de los trastornos del estado de ánimo y más específicamente de la depresión en niños, y la asociación e influencia que esta puede tener para su desarrollo.

Comparación de cambios cl��nicos y hemodinámicos en pacientes con insuficiencia venosa mixta según tipo de manejo.

Existen varias causas de la insuficiencia venosa profunda, la insuficiencia venosa superficial es una de ellas; por tal motivo, una intervención activa de la insuficiencia superficial ya sea cirugía convencional, esclerosis o radiofrecuencia mejora el reflujo del sistema venoso profundo. En nuestro medio no se acostumbra a intervenir los pacientes con insuficiencia venosa mixta bajo la creencia de exacerbar la enfermedad o generar complicaciones. Se pretende documentar los cambios cl��nicos y hemodinámicos en pacientes con insuficiencia venosa mixta según tipo de manejo, médico vs quirúrgico

Estado situacional de los algoritmos genéticos en los negocios internacionales

La computación evolutiva y muy especialmente los algoritmos genéticos son cada vez más empleados en las organizaciones para resolver sus problemas de gestión y toma de decisiones (Apoteker & Barthelemy, 2000). La literatura al respecto es creciente y algunos estados del arte han sido publicados. A pesar de esto, no hay un trabajo expl��cito que eval��e de forma sistemática el uso de los algoritmos genéticos en problemas específicos de los negocios internacionales (ejemplos de ello son la logística internacional, el comercio internacional, el mercadeo internacional, las finanzas internacionales o estrategia internacional). El propósito de este trabajo de grado es, por lo tanto, realizar un estado situacional de las aplicaciones de los algoritmos genéticos en los negocios internacionales.

A Mobile Agent Based Spam Filter System

A new distributed spam filter system based on mobile agent is proposed in this paper. We introduce the application of mobile agent technology to the spam filter system. The system architecture, the work process, the pivotal technology of the distributed spam filter system based on mobile agent, and the Naive Bayesian filter method are described in detail. The experiment results indicate that the system can prevent spam emails effectively.

Species-specific responses of Late Quaternary megafauna to climate and humans

Despite decades of research, the roles of climate and humans in driving the dramatic extinctions of large-bodied mammals during the Late Quaternary period remain contentious. Here we use ancient DNA, species distribution models and the human fossil record to elucidate how climate and humans shaped the demographic history of woolly rhinoceros, woolly mammoth, wild horse, reindeer, bison and musk ox. We show that climate has been a major driver of population change over the past 50,000 years. However, each species responds differently to the effects of climatic shifts, habitat redistribution and human encroachment. Although climate change alone can explain the extinction of some species, such as Eurasian musk ox and woolly rhinoceros, a combination of climatic and anthropogenic effects appears to be responsible for the extinction of others, including Eurasian steppe bison and wild horse. We find no genetic signature or any distinctive range dynamics distinguishing extinct from surviving species, emphasizing the challenges associated with predicting future responses of extant mammals to climate and human-mediated habitat change.

Updated empirical model of genetically-modified maize grain production practices to achieve European Union labeling thresholds

An updated empirical approach is proposed for specifying coexistence requirements for genetically modified (GM) maize (Zea mays L.) production to ensure compliance with the 0.9% labeling threshold for food and feed in the European Union. The model improves on a previously published (Gustafson et al., 2006) empirical model by adding recent data sources to supplement the original database and including the following additional cases: (i) more than one GM maize source field adjacent to the conventional or organic field, (ii) the possibility of so-called “stacked” varieties with more than one GM trait, and (iii) lower pollen shed in the non-GM receptor field. These additional factors lead to the possibility for somewhat wider combinations of isolation distance and border rows than required in the original version of the empirical model. For instance, in the very conservative case of a 1-ha square non-GM maize field surrounded on all four sides by homozygous GM maize with 12 m isolation (the effective isolation distance for a single GM field), non-GM border rows of 12 m are required to be 95% confident of gene flow less than 0.9% in the non-GM field (with adventitious presence of 0.3%). Stacked traits of higher GM mass fraction and receptor fields of lower pollen shed would require a greater number of border rows to comply with the 0.9% threshold, and an updated extension to the model is provided to quantify these effects.

Sociodemographic determinants of diet quality of the EU elderly: a comparative analysis in four countries

Objective: To investigate the sociodemographic determinants of diet quality of the elderly in four EU countries. Design: Cross-sectional study. For each country, a regression was performed of a multidimensional index of dietary quality v. sociodemographic variables. Setting In Finland, Finnish Household Budget Survey (1998 and 2006); in Sweden, SNAC-K (2001–2004); in the UK, Expenditure & Food Survey (2006–07); in Italy, Multi-purpose Survey of Daily Life (2009). Subjects: One- and two-person households of over-50s (Finland, n 2994; UK, n 4749); over-50 s living alone or in two-person households (Italy, n 7564); over-60 s (Sweden, n 2023). Results: Diet quality among the EU elderly is both low on average and heterogeneous across individuals. The regression models explained a small but significant part of the observed heterogeneity in diet quality. Resource availability was associated with diet quality either negatively (Finland and UK) or in a non-linear or non-statistically significant manner (Italy and Sweden), as was the preference for food parameter. Education, not living alone and female gender were characteristics positively associated with diet quality with consistency across the four countries, unlike socio-professional status, age and seasonality. Regional differences within countries persisted even after controlling for the other sociodemographic variables. Conclusions: Poor dietary choices among the EU elderly were not caused by insufficient resources and informational measures could be successful in promoting healthy eating for healthy ageing. On the other hand, food habits appeared largely set in the latter part of life, with age and retirement having little influence on the healthiness of dietary choices.

Palaeovegetation of China: a pollen data-based synthesis for the mid-Holocene and last glacial maximum.

Pollen data from China for 6000 and 18,000 14C yr bp were compiled and used to reconstruct palaeovegetation patterns, using complete taxon lists where possible and a biomization procedure that entailed the assignment of 645 pollen taxa to plant functional types. A set of 658 modern pollen samples spanning all biomes and regions provided a comprehensive test for this procedure and showed convincing agreement between reconstructed biomes and present natural vegetation types, both geographically and in terms of the elevation gradients in mountain regions of north-eastern and south-western China. The 6000 14C yr bp map confirms earlier studies in showing that the forest biomes in eastern China were systematically shifted northwards and extended westwards during the mid-Holocene. Tropical rain forest occurred on mainland China at sites characterized today by either tropical seasonal or broadleaved evergreen/warm mixed forest. Broadleaved evergreen/warm mixed forest occurred further north than today, and at higher elevation sites within the modern latitudinal range of this biome. The northern limit of temperate deciduous forest was shifted c. 800 km north relative to today. The 18,000 14C yr bp map shows that steppe and even desert vegetation extended to the modern coast of eastern China at the last glacial maximum, replacing today’s temperate deciduous forest. Tropical forests were excluded from China and broadleaved evergreen/warm mixed forest had retreated to tropical latitudes, while taiga extended southwards to c. 43°N.

Probing the Large Magellanic Cloud age gap at intermediate cluster masses

The Large Magellanic Cloud (LMC) has a rich star cluster system spanning a wide range of ages and masses. One striking feature of the LMC cluster system is the existence of an age gap between 3 and 10 Gyr. But this feature is not clearly seen among field stars. Three LMC fields containing relatively poor and sparse clusters whose integrated colours are consistent with those of intermediate-age simple stellar populations have been imaged in BVI with the Optical Imager (SOI) at the Southern Telescope for Astrophysical Research (SOAR). A total of six clusters, five of them with estimated initial masses M < 104 M(circle dot), were studied in these fields. Photometry was performed and colour-magnitude diagrams (CMDs) were built using standard point spread function fitting methods. The faintest stars measured reach V similar to 23. The CMD was cleaned from field contamination by making use of the three-dimensional colour and magnitude space available in order to select stars in excess relative to the field. A statistical CMD comparison method was developed for this purpose. The subtraction method has proven to be successful, yielding cleaned CMDs consistent with a simple stellar population. The intermediate-age candidates were found to be the oldest in our sample, with ages between 1 and 2 Gyr. The remaining clusters found in the SOAR/SOI have ages ranging from 100 to 200 Myr. Our analysis has conclusively shown that none of the relatively low-mass clusters studied by us belongs to the LMC age gap.

A emissão das gal��xias esferoidais no infravermelho médio

Propriedades fotométricas no infravermelho médio são apresentadas para uma amostra de 28 gal��xias esferoidais, observadas em 6.75, 9.63 e 15 jlk com o instrumento ISOCAM a bordo do satélite ISO. As distribuições espectrais de energia (DEE) das gal��xias foram derivadas usando dados do infravermelho médio junto com dados do UV, do ótico e do infravermelho próximo, previamente publicados. Estas DEE mostram duas componentes: a poeira quente aquecida até T ~ 260 K dominando a emissão no infravermelho médio e a população estelar com T ~ 4000 K, que domina no ótico. Da emissão no infravermelho médio pode ser visto que a morfologia em 6.75 μm, onde a contribuição estelar é importante, é esferoidal. Em comprimentos de onda mais longos, onde há majoritariamente emissão da poeira, a morfologia é menos suave, mostrando nuvens, filamentos e discos de poeira. Também pode ser inferido que há um gradiente de temperatura da poeira, que cresce em direção ao centro da gal��xia. Os perfis de energia mostram bojos R¼ simples, composição de bojos e discos e perfis irregulares. As luminosidades no infravermelho médio estão na faixa de(3 - 42) x 10 L. As propriedades dos grãos de poeira são inferidos das cores no infravermelho médio. A emissão no infravermelho vem principalmente de grãos muito pequenos, que estão num equil��brio térmico oscilante. As massas para a componente quente da poeira estão na faixa de 10 - 400 M.

Emprego da citometria de fluxo na avaliação do perfil imunofenotípico de pacientes com leucemia linfocítica crônica

Chronic lymphocytic leukemia (B-CLL) is a clonal proliferation of mature B lymphocytes characterized by indolent clinical course. Biologically this clonallity is characterized by low expression of surface immunoglobulin (sIg) with restriction to a single immunoglobulin light chain associated with high expression of CD5 antigen and positivity to B cell antigens lymphocytes such as CD19, CD20 and CD23 and negativity to FMC7. The immunological profile and morphological analysis of lymphoid cells are the main means for the differential diagnosis of B-CLL from other chronic lymphoproliferative diseases. The aim of this study was to evaluate the expression pattern of a variety of membrane antigens in leukemic cells originating from patients with B-CLL. In this study, peripheral blood samples from 80 patients with B-CLL were analyzed by multiparametric flow cytometry in addition to routine hematologic exams, using a panel of monoclonal antibodies (MoAb): CD45/CD14, CD3/CD19/CD45, CD4/CD8 / CD3, CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7, FMC7/CD23, CD103/CD22/CD20, HLADR/CD38, CD10/CD19, CD1a, CD11b and also IgM/gD, kappa and lambda immunoglobulin light chains for the detection of surface immunoglobulin and clonal restriction for immunoglobulin light chain. The Hematological data were obtained from the hematological analyzer and cytomorphological analysis in blood film stained by Leishmann. The study samples consisted of 45 men and 35 women, ages ranging from 55 to 84 years (mean 65 years). Complete white blood count showed count ranging from 10.0 to 42.0 x 109/l. (mean 50.0 x 109/l) and lymphocytes count greater than 5.0 x 109/l in all cases. The neoplastic cells displayed B-CLL phenotype (CD5+/CD19+/CD20+/HLADR+/CD23+) in the vast majority of the cases, associated to failed to stain for T cell markers (CD1a, CD2, CD4, CD3, CD7, CD8), CD103, CD14 and FMC7. Leukemic cells of most patients also expressed low intensity of IgM and IgD with restricted kappa light chain, in most cases (59,7%). This observation highlights the importance of immunophenotyping for correct diagnosis of chronic lymphoproliferative syndromes and the panel of MoAb used was sufficient for diagnostic confirmation of B-CLL

Caracterização da área foliar de Merremia aegyptia

O conhecimento da área foliar de plantas daninhas pode auxiliar o estudo das relações de interferência entre elas e as culturas agrícolas. O objetivo desta pesquisa foi determinar uma equação matemática que estime a área foliar de Merremia aegyptia, a partir da relação entre as dimensões lineares dos limbos foliares. Folhas da espécie foram coletadas de diferentes locais na Universidade Estadual Paulista, Jaboticabal, Brasil, medindo-se o comprimento (C), a largura máxima (L) e a área foliar de três tipos de fol��olos. Foram estimadas equações lineares (Y = a*X) para cada tipo de fol��olo. A área foliar da espécie pode ser estimada pelo somatório das áreas dos limbos foliares de cada tipo de fol��olo, por meio da equação AFest = 0,547470(X) + 1,145298(Y) + 1,244146(Z), em que X indica C*L do fol��olo principal e Y e Z indicam C*L médios dos fol��olos primário e secundário, respectivamente.

Determination of Merremia cissoides leaf area using the linear measures of the leaflets

O conhecimento da área foliar de plantas daninhas pode auxiliar o estudo das relações de interferência entre elas e as culturas agrícolas. O objetivo desta pesquisa foi determinar uma equação matemática que estime a área foliar de Merremia cissoides, a partir da relação entre as dimensões lineares dos limbos foliares. Folhas da espécie foram coletadas de diferentes locais na Universidade Estadual Paulista, Jaboticabal, Estado de São Paulo, Brasil, medindo-se o comprimento (C), a largura máxima (L) e a área foliar de três tipos de fol��olos. Foram estimadas equações lineares Y = a x (X) para cada tipo de fol��olo. Houve sobreposição dos intervalos de confiança das equações dos fol��olos primário e secundário, por isso considerou-se uma única equação da média desses fol��olos, al��m da equação do fol��olo principal, para caracterização da área foliar de M. cissoides. Assim, a área foliar dessa espécie pode ser estimada pelo somatório das áreas dos limbos foliares dos fol��olos principal e primário + secundário, por meio da equação AFnest = 0,501 x (X) + 2,181 x (Z), em que X indica C x L do fol��olo principal e Z indica C x L médios dos fol��olos primário + secundário, respectivamente.