Valor pronóstico de la densidad microvascular y de la expresión del VEGF, EGFR y HIF-1 en pacientes con cáncer de cérvix localmente avanzado tratados con quimioradiación

Introducción: Colombia cuenta con poca información sobre el comportamiento del cáncer, no obstante, el carcinoma de cuello uterino representa la segunda causa de muerte por la enfermedad entre las mujeres de nuestro entorno. El patrón epidemiológico de la enfermedad es preocupante porque los estados localmente avanzados constituyen el estado más frecuente al momento del diagnóstico y la mortalidad siendo bastante alta a pesar de la presencia de un programa de cribado organizado. Objetivo: Describir el valor pronóstico de la densidad microvascular (DMV) y de la expresión proteica de varios genes relacionados con la supervivencia y proliferación del cáncer de cérvix localmente avanzado en un grupo de mujeres tratadas con quimioradiación y braquiterapia intracavitaria. Se estimaron la tasa de respuesta global (TRG), la supervivencia libre de progresión (SLP) y la supervivencia global (SG). Resultados: Se incluyeron 61 mujeres con una edad media de 52 ± 10 años; todas tenían diagnóstico de cáncer de cérvix localmente avanzado (IIA 2.3%/IIB 47.5%/IIIA 4.9%/IIIB 37.7%/IVA 3.3%/no definido 3.3%), con un volumen tumoral promedio de 6.4cm (DE ± 1.8cm) e infección por VPH en 46% de los casos; 58 sujetos (95%) tenían un patrón escamoso, dos fueron adenocarcinomas y &50% presentaba neoplasias moderada o pobremente diferenciadas. Todas fueron tratadas con quimioradiación (interrupción transitoria en teleterapia por toxicidad y otras causas en 19% y 21.4%, respectivamente/media de ciclos de platino concomitante 4.8 series ± 1.0) y braquiterapia (77% completaron el tratamiento intracavitario). La mediana para la SLP y global fue de 6.6 meses (r, 4.0-9.1) y 30 meses (r, 11-48), respectivamente. Ninguna de las variables tuvo un efecto positivo sobre la SLP, mientras el análisis multivariado demostró que los niveles de expresión del VEGF (P=0.026), EGFR (P=0.030), y el volumen tumoral menor de 6 cm (P=0.02) influyeron positivamente sobre éste desenlace. Conclusión: Existe una influencia positiva sobre el pronóstico, de la tipificación en el cáncer de cérvix localmente avanzado tratado con quimioradiación basada en platino.

LittleProc 2.0. : l'evolució als 16 bits, amb arquitectura superescalar i amb pipeline

Aquest projecte consisteix en evolucionar el LittleProc 1.0, un processador simple dissenyat per ser destinat al món de la docència per tres professors de la UAB. Aquestes evolucions consisteixen en aplicar diversos mètodes i arquitectures diferents per tal d’obtenir un millor rendiment del processador, arribant a executar programes amb la meitat de temps que tardava el LittleProc 1.0. Un cop implementades les diferents arquitectures per tal de millorar el rendiment, es realitzarà un estudi de quin tant per cent de millora ha sigut aquest rendiment.

Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarters 1 to 3 2009/10

Hospitals and care homes are making use of new measures designed to protect people unable to give consent for their care.The Mental Capacity Act Deprivation of Liberty Safeguards were introduced by law on 1 April 2009 to provide a legal framework for depriving someone of their liberty where they are unable to give informed consent regarding their care. The statistics presented here provide the first official information about authorisations to legally detain a person using the legislation.The safeguards apply to people aged 18 and above who suffer from a mental disorder of the mind (such as dementia or a profound learning disability) and who lack capacity to give consent to the arrangements made for their care and / or treatment. The safeguards cover people in all hospitals and care homes in the statutory, independent and voluntary sectors.A rigorous, standardised assessment and authorisation process is used to ensure only appropriate use is made of the safeguards.Key facts?The number of authorisation requests were: 1,772 in quarter 1 1,681 in quarter 2 and, 1,869 in quarter 3. ?Of the total assessments completed in each quarter, a higher proportion were for females than for males ?For each quarter, around three out of four assessments were made by local authorities while the remaining ones were made by primary care trusts. ?The percentage of authorisations granted leading to someone being deprived of their liberty varied between 33.5 per cent and 50.7 per cent across quarters 1 to 3. ?At 31 December 2009 1,074 people were subject to such authorisations.Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 1 (0.31MB)Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 2 (0.31MB)Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 3 (0.31MB)Have your say - give us your comments on this publication��

F+0 renography in neonates and infants younger than 6 months: an accurate method to diagnose severe obstructive uropathy.

We studied the response to F+0 renography and the relative and absolute individual kidney function in neonates and < 6-mo-old infants before and after surgery for unilateral ureteropelvic junction obstruction (UJO). METHODS: The results obtained at diagnosis and after pyeloplasty for 9 children (8 boys, 1 girl; age range, 0.8-5.9 mo; mean age +/- SD, 2.4 +/- 1.5 mo) with proven unilateral UJO (i.e., affected kidney [AK]) and an unremarkable contralateral kidney (i.e., normal kidney [NK]) were evaluated and compared with a control group of 10 children (6 boys, 4 girls; age range, 0.8-2.8 mo; mean age, 1.5 +/- 0.7 mo) selected because of symmetric renal function, absence of vesicoureteral reflux or infection, and an initially dilated but not obstructed renal pelvis as proven by follow-up. Renography was performed for 20 min after injection of (123)I-hippuran (OIH) (0.5-1.0 MBq/kg) immediately followed by furosemide (1 mg/kg). The relative and absolute renal functions and the response to furosemide were measured on background-subtracted and depth-corrected renograms. The response to furosemide was quantified by an elimination index (EI), defined as the ratio of the 3- to 20-min activities: An EI > or = 3 was considered definitively normal and an EI < or = 1 definitively abnormal. If EI was equivocal (1 < EI < 3), the response to gravity-assisted drainage was used to differentiate AKs from NKs. Absolute separate renal function was measured by an accumulation index (AI), defined as the percentage of (123)I-OIH (%ID) extracted by the kidney 30-90 s after maximal cardiac activity. RESULTS: All AKs had definitively abnormal EIs at diagnosis (mean, 0.56 +/- 0.12) and were significantly lower than the EIs of the NKs (mean, 3.24 +/- 1.88) and of the 20 control kidneys (mean, 3.81 +/- 1.97; P < 0.001). The EIs of the AKs significantly improved (mean, 2.81 +/- 0.64; P < 0.05) after pyeloplasty. At diagnosis, the AIs of the AKs were significantly lower (mean, 6.31 +/- 2.33 %ID) than the AIs of the NKs (mean, 9.43 +/- 1.12 %ID) and of the control kidneys (mean, 9.05 +/- 1.17 %ID; P < 0.05). The AIs of the AKs increased at follow-up (mean, 7.81 +/- 2.23 %ID) but remained lower than those of the NKs (mean, 10.75 +/- 1.35 %ID; P < 0.05). CONCLUSION: In neonates and infants younger than 6 mo, (123)I-OIH renography with early furosemide injection (F+0) allowed us to reliably diagnose AKs and to determine if parenchymal function was normal or impaired and if it improved after surgery.

Disease activity in rheumatoid arthritis patients at initiation of biologic agents and 1 year of treatment: results from the Swiss SCQM registry.

OBJECTIVE: In Switzerland, the prescription of biologic antirheumatic agents in rheumatoid arthritis (RA) patients is not limited by stringent requirements from health authorities. The goals of this study were to: determine the characteristics of the Swiss patients at the initiation of biologics, compare them with other countries and evaluate whether different disease activity levels at initiation of therapy, resulting from distinct access to these treatment, influence their effectiveness. METHODS: This is a retrospective cohort study of RA patients followed in the Swiss register (SCQM-RA). Two thousand and sixty patients treated with biologics were retrieved. We present the disease characteristics and the patients' demographic data, at initiation and some effectiveness data after 1 year of treatment. RESULTS: Two thousand and sixty patients treated with biologics were retrieved. At initiation of treatment, the mean disease activity DAS (SD): 4.4 (1.4), number of previous antirheumatic treatments: 1.1, functional status HAQ: 1.1 (0.7) and median duration of illness: 5.5 years were significantly lower than in other published registries. The mean DAS: 3.3 (1.4) 1 year after initiation of therapy also appears lower than in other countries. Additionally, patients treated more recently (after 2005) had a significantly higher improvement in mean DAS. CONCLUSIONS: Data from the Swiss RA registry demonstrate that biologics are prescribed at a lower level of disease activity and after fewer prior DMARD failures than in most other countries, a practice that seems to correlate with overall lower absolute levels of disease activity and better patient outcomes after 1 year of treatment.

Characterization of the enzyme involved in the processing of big endothelin-1 in human lung epithelial cells.

Biosynthesis of active endothelin-1 (ET-1) implies an enzymatic processing of the inactive precursor Big ET-1 (1-39) into the mature, 21 amino acid peptide. The aim of this study was to characterize in airway and alveolar epithelial cells the enzymes responsible for this activation. BEAS-2B and A549 cells, which both produce ET-1, were studied in vitro as models for bronchiolar and alveolar cells, respectively. Both cell lines were able to convert exogenously added Big ET-1 (0.1 microM) into ET-1, suggesting a cell surface or an extracellular processing. The conversion was inhibited by phosphoramidon in both cell lines with an IC50 approximately 1 microM, but not by thiorphan, a specific inhibitor of neutral endopeptidase 24.11 (NEP). The endogenous production of serum-stimulated BEAS-2B and A549 cells was not inhibited by thiorphan, and phosphoramidon showed inhibition only at high concentration (>100 microM). Western blotting following electrophoresis in reducing conditions demonstrated a protein of MR 110 corresponding to the ECE-1 monomer in both BEAS-2B and A549 cells, as well as in whole lung extracts. By RT-PCR we revealed the mRNA encoding for the ECE-1b and/or -1c subtype, but not ECE-1a, in both cell lines. We conclude that BEAS-2B and A549 cells are able to process either endogenous or exogenous Big ET-1 by ECE-1 and that isoforms 1b and 1c could be involved in this processing with no significant role of NEP.

Higher CNS penetration-effectiveness of long-term combination antiretroviral therapy is associated with better HIV-1 viral suppression in cerebrospinal fluid.

OBJECTIVES: To determine HIV-1 RNA in cerebrospinal fluid (CSF) of successfully treated patients and to evaluate if combination antiretroviral treatments with higher central nervous system penetration-effectiveness (CPE) achieve better CSF viral suppression. METHODS: Viral loads (VLs) and drug concentrations of lopinavir, atazanavir, and efavirenz were measured in plasma and CSF. The CPE was calculated using 2 different methods. RESULTS: The authors analyzed 87 CSF samples of 60 patients. In 4 CSF samples, HIV-1 RNA was detectable with 43-82 copies per milliliter. Median CPE in patients with detectable CSF VL was significantly lower compared with individuals with undetectable VL: CPE of 1.0 (range, 1.0-1.5) versus 2.3 (range, 1.0-3.5) using the method of 2008 (P = 0.011) and CPE of 6 (range, 6-8) versus 8 (range, 5-12) using the method of 2010 (P = 0.022). The extrapolated CSF trough levels for atazanavir (n = 12) were clearly above the 50% inhibitory concentration (IC50) in only 25% of samples; both patients on atazanavir/ritonavir with detectable CSF HIV-1 RNA had trough levels in the range of the presumed IC50. The extrapolated CSF trough level for lopinavir (n = 42) and efavirenz (n = 18) were above the IC50 in 98% and 78%, respectively, of samples, including the patients with detectable CSF HIV-1 RNA. CONCLUSIONS: This study suggests that treatment regimens with high intracerebral efficacy reflected by a high CPE score are essential to achieve CSF HIV-1 RNA suppression. The CPE score including all drug components was a better predictor for treatment failure in the CSF than the sole concentrations of protease inhibitor or nonnucleoside reverse transcriptase inhibitor in plasma or CSF.

Transmission of HIV-1 drug resistance in Switzerland: a 10-year molecular epidemiology survey.

OBJECTIVES: Representative prevalence data of transmitted drug-resistant HIV-1 are essential to establish accurate guidelines addressing resistance testing and first-line treatments. METHODS: Systematic resistance testing was carried out in individuals in Switzerland with documented HIV-1 seroconversion during 1996-2005 and available samples with RNA > 1000 copies/ml obtained within 1 year of estimated seroconversion. Resistance interpretation used the Stanford list of mutations for surveillance of transmitted drug resistance and the French National Agency for AIDS Research algorithm. RESULTS: Viral sequences from 822 individuals were available. Risk groups were men having sex with men (42%), heterosexual contacts (32%) and intravenous drug users (20%); 30% were infected with non-B subtype viruses. Overall, prevalence of transmitted resistance was 7.7% [95% confidence interval (CI), 5.9-9.5] for any drug, 5.5% (95% CI, 3.9-7.1) for nucleoside reverse transcriptase inhibitors, 1.9% (95% CI, 1.0-2.8) for non-nucleoside reverse transcriptase inhibitors and 2.7% (95% CI, 1.6-3.8) for protease inhibitors. Dual- or triple-class resistance was observed in 2% (95% CI, 0.8-2.5). No significant trend in prevalence of transmitted resistance was observed over years. There were no differences according to ethnicity, risk groups or gender, but prevalence of transmitted resistance was highest among individuals infected with subtype B virus. CONCLUSIONS: The transmission rate of drug-resistant HIV-1 has been stable since 1996, with very rare transmission of dual- or triple-class resistance. These data suggest that transmission of drug resistance in the setting of easy access to antiretroviral treatment can remain stable and be kept at a low level.

L'accessibilitat dels webs de les universitats catalanes

L'estudi vol detectar quin és el grau d'accessibilitat dels webs de les universitats catalanes. Els indicadors utilitzats són els presents en el nivell de prioritat 1 de les Pautes d'accessibilitat al contingut del web, versió 1.0 -WCAG- del World-Wide WebConsortium, acompanyats per altres de complementaris. Com a principal resultat s¿obté que només una de les 43 pàgines analitzades compleix els llindars d'accessibilitat.

Nivel de accesibilidad de las sedes web de las universidades españolas

El estudio presenta un análisis del nivel de accesibilidad de las webs de las universidades españolas según los indicadores de prioridad 1 de las Pautas de accesibilidad al contenido de la web, versión 1.0WCAG dentro de la Iniciativa WAI del World-Wide Web Consortium, y otros indicadores complementarios. Los resultados obtenidos nos indican que ninguna web universitaria española cumple en su totalidad este primer nivel y que queda pendiente una gran tarea de adaptación. [eng] This report presents an analysis of the accessibility level of websites in the Spanish universities considering level"A" of Web Contents Accessibility Guidelines 1.0 WCAG issued by the Web Accessibility Initiative working group in the Worlwide Web Consortium, and some additional criteria. The conclusions show that no Spanish university web reaches completely this first level and that there is still a hard work to do redesigning websites.

Métodos de concentração de minerais 2:1 secundários na fração argila visando sua identificação por difratometria de raios x

Além dos baixos teores normalmente encontrados na fração argila dos solos sob clima tropical e subtropical, o tamanho reduzido e a baixa cristalinidade dos minerais 2:1 secundários dificultam sua identificação por difratometria de raios X (DRX). Este estudo objetivou avaliar métodos químicos e físico de concentração de minerais 2:1 secundários na fração argila para facilitar a identificação por DRX, incluindo a natureza dos minerais quanto ao local de formação de cargas permanentes (lâmina tetraedral ou octaedral). Coletaram-se amostras de dois Cambissolos originados de argilito da Formação Guabirotuba na Bacia Sedimentar de Curitiba (PR): horizontes A, Bi, C1 (1,2 a 1,5 m), C2 (2,2 a 2,5 m), C3 (3,2 a 3,5 m) e C4 (4,2 a 4,5 m). Após remoção da matéria orgânica e dispersão da terra fina seca ao ar, a fração argila foi submetida a tratamentos sequenciais com ditionito-citratobicarbonato (DCB) (amostra desferrificada - remoção de óxidos de Fe pedogenéticos) e com soluções de NaOH a quente, em diferentes concentrações (0,5; 1,0; 1,5; 2,5; 3,5; 4,0; 4,5 e 5,0 mol L-1), para extração de gibbsita e caulinita, em diferentes graus. A fração argila desferrificada também foi submetida à separação física (centrifugação) em argila grossa (0,2 a 2 m) e fina (< 0,2 m). Foram realizados tratamentos auxiliares para identificar as espécies minerais 2:1 na fração argila: saturação com Mg e solvatação com etilenoglicol; saturação com K e secagem ao ar e aquecimento a 550 ºC; e saturação com Li (teste de Greene-Kelly). Os resultados mostraram que o método clássico de extração da caulinita, com solução de NaOH 5,0 mol L-1 a quente, não deve ser aplicado para concentração de minerais 2:1 secundários, pois também removeu grande parte desses minerais. O tratamento com DCB e com solução de NaOH 3,5 mol L-1 possibilitou, com maior eficiência, a concentração e identificação de minerais 2:1 secundários por DRX nas amostras dos horizontes A, Bi e C1. Nas amostras tomadas em maiores profundidades (horizontes C2, C3 e C4), devido aos maiores teores desses minerais e ao menor tamanho dos cristais (argila fina), a solução menos concentrada de NaOH (1,5 mol L-1) foi mais eficiente para esse propósito. No horizonte A, os minerais 2:1 concentraram-se na fração argila grossa, compatível com o maior grau de intemperismo desse horizonte. Identificou-se esmectita com hidroxi-Al entrecamadas nos horizontes mais superficiais (A e Bi) e esmectita nas amostras do horizonte C. A saturação com Li permitiu a identificação das esmectitas dioctaedrais montmorilonita e beidelita/nontronita. As adaptações ao métodopadrão (NaOH 5 mol L-1) favoreceram a concentração de minerais 2:1 secundários na fração argila dos solos; a concentração da solução de NaOH deve ser maior para horizontes com menor teor do mineral.

Simultaneous multielement extraction with the Mehlich-1 solution for Southern Brazilian soils determined by ICP-OES and the effects on the nutrients recommendations to crops

The amounts of macro (P, K, Ca and Mg) and micronutrients (Cu and Zn) extracted with the Mehlich-1 (M1) solution, by the 1.0 mol L-1 KCl (KCl) and with the 0.1 mol L-1 HCl (HCl) for representative soil types of the Rio Grande do Sul state (Brazil) were compared with those extracted with the Mehlich-1 solution determined with the inductively coupled plasma optical emission spectroscopy (ICP). The amounts of nutrients extracted by the different methods showed high correlation coefficients. On average, the Mehlich-1 solution extracted similar amounts of P, determined with colorimetric and ICP methods, and, K determined with emission and ICP. The amounts of Ca and Mg extracted with the Mehlich-1 solution, determined by ICP, were similar to those extracted with the KCl solution determined by the atomic absorption spectrophotometry. The amounts of Cu and Zn extracted with the Mehlich-1 solution, determined by the ICP, were higher than those extracted with the 0.1 mol L-1 HCl determined by the atomic absorption spectrophotometry. The results indicate that the Mehlich-1 solution and ICP can be used for simultaneous multielement extraction and determination for Southern Brazilian soils. However, a conversion factor for values interpretation is needed. The use of the conversion factor to determine the K availability index in soils is adequate and does not affect the K recommendations for crops in southern Brazilian soils.

SEQUENTIAL EXTRACTION OF PHOSPHORUS BY MEHLICH-1 AND ION EXCHANGE RESIN FROM B HORIZONS OF FERRIC AND PERFERRIC LATOSOLS (OXISOLS)

In general, Latosols have low levels of available P, however, the influence of the parent material seems to be decisive in defining the pool and predominant form of P in these soils. This study evaluated P availability by extraction with Mehlich-1 (M-1) and Ion Exchange Resin (IER), from samples of B horizons of Ferric and Perferric Latosols developed from different parent materials. To this end, in addition to the physical and chemical characterization of soils, 10 sequential extractions were performed with M-1 and IER from samples of B horizons (depth between 0.8 and 1.0 m). Total contents of Ca, P, Fe, Al, and Ti were determined after digestion with nitric, hydrofluoric and perchloric acids. The effects of sequential P extractions on Fe oxides were also evaluated from the analyses of dithionite-citrate-bicarbonate and ammonium acid oxalate. The high similarity between contents of P accumulated after sequential extractions with M-1 and IER in soils developed on tuffite indicated a predominance of P-Ca. Higher contents of P after a single IER extraction show greater efficiency in P removal from highly weathered soils, as from the Latosols studied here. The P contents also show the high sensitivity of extractant M-1 in highly buffered soils. Furthermore, a single extraction with extractant M-1 or IER is not sufficient to estimate the amount of labile P in these soils.

Measurement of immunoreactive angiotensin-(1-7) heptapeptide in human blood.

BACKGROUND: The renal enzyme renin cleaves from the hepatic alpha(2)-globulin angiotensinogen angiotensin-(1-10) decapeptide [Ang-(1-10)], which is further metabolized to smaller peptides that help maintain cardiovascular homeostasis. The Ang-(1-7) heptapeptide has been reported to have several physiological effects, including natriuresis, diuresis, vasodilation, and release of vasopressin and prostaglandins. METHODS: To investigate Ang-(1-7) in clinical settings, we developed a method to measure immunoreactive (ir-) Ang-(1-7) in 2 mL of human blood and to estimate plasma concentrations by correcting for the hematocrit. A sensitive and specific antiserum against Ang-(1-7) was raised in a rabbit. Human blood was collected in the presence of an inhibitor mixture including a renin inhibitor to prevent peptide generation in vitro. Ang-(1-7) was extracted into ethanol and purified on phenylsilylsilica. The peptide was quantified by radioimmunoassay. Increasing doses of Ang-(1-7) were infused into volunteers, and plasma concentrations of the peptide were measured. RESULTS: The detection limit for plasma ir-Ang-(1-7) was 1 pmol/L. CVs for high and low blood concentrations were 4% and 20%, respectively, and between-assay CVs were 8% and 13%, respectively. Reference values for human plasma concentrations of ir-Ang-(1-7) were 1.0-9.5 pmol/L (median, 4.7 pmol/L) and increased linearly during infusion of increasing doses of Ang-(1-7). CONCLUSIONS: Reliable measurement of plasma ir-Ang-(1-7) is achieved with efficient inhibition of enzymes that generate or metabolize Ang-(1-7) after blood sampling, extraction in ethanol, and purification on phenylsilylsilica, and by use of a specific antiserum.

Determination of picogram levels of midazolam, and 1- and 4-hydroxymidazolam in human plasma by gas chromatography-negative chemical ionization-mass spectrometry.

Midazolam is a widely accepted probe for phenotyping cytochrome P4503A. A gas chromatography-mass spectrometry (GC-MS)-negative chemical ionization method is presented which allows measuring very low levels of midazolam (MID), 1-OH midazolam (1OHMID) and 4-OH midazolam (4OHMID), in plasma, after derivatization with the reagent N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide. The standard curves were linear over a working range of 20 pg/ml to 5 ng/ml for the three compounds, with the mean coefficients of correlation of the calibration curves (n = 6) being 0.999 for MID and 1OHMID, and 1.0 for 4OHMID. The mean recoveries measured at 100 pg/ml, 500 pg/ml, and 2 ng/ml, ranged from 76 to 87% for MID, from 76 to 99% for 1OHMID, from 68 to 84% for 4OHMID, and from 82 to 109% for N-ethyloxazepam (internal standard). Intra- (n = 7) and inter-day (n = 8) coefficients of variation determined at three concentrations ranged from 1 to 8% for MID, from 2 to 13% for 1OHMID and from 1 to 14% for 4OHMID. The percent theoretical concentrations (accuracy) were within +/-8% for MID and 1OHMID, within +/-9% for 4OHMID at 500 pg/ml and 2 ng/ml, and within +/-28% for 4OHMID at 100 pg/ml. The limits of quantitation were found to be 10 pg/ml for the three compounds. This method can be used for phenotyping cytochrome P4503A in humans following the administration of a very low oral dose of midazolam (75 microg), without central nervous system side-effects.