No es posible predecir la afectación unilateral en pacientes con cáncer de próstata de bajo riesgo

OBJETIVO: Identificar factores predictivos de afectación unilateral en el cáncer de próstata (CaP) de bajo riesgo. MATERIAL Y METODOS: 95 pacientes con CaP de bajo riesgo. Evaluamos la presencia de CaP unilateral en la pieza de prostatectomía. Se realizó análisis uni y multivariante estudiando las variables: edad, PSA, volumen prostático, porcentaje de cilindros afectos y presencia de biopsias previas. RESULTADOS: el 36% presentaron CaP unilateral en la pieza. No se han encontrado diferencias significativas entre el grupo de pacientes con CaP unilateral y el bilateral. CONCLUSION: No hemos identificado ningún factor predictivo de CaP unilateral en pacientes de bajo riesgo.

Assessment of immunological changes in Epstein-Barr virus co-infection in Egyptian chronic HCV patients

Epstein-Barr virus (EBV) plays a major role in liver pathology. Similar to other members of the herpesvirus family, EBV establishes a persistent infection in more than 90% of adults. The aim of this study was to evaluate the impact of EBV and chronic hepatitis C co-infection (HCV) on biochemical and immunological responses in patients. The study was conducted in 62 patients and 33 apparently healthy controls. Patients were divided into three groups: group I, consisting of 31 patients with chronic hepatitis C infection (CHC), group II, consisting of eight patients with EBV infection and without HCV infection and group III, consisting of 23 patients with EBV and chronic HCV. The percentage of CD3+ cells, helper CD4+ cells and CD19+ B-cells was measured by flow cytometry. Human interferon-γ (IFN-γ) and interleukin (IL)-15 levels were measured by an ELISA. The levels of liver alanine aminotransferase and aspartate aminotransferase enzymes were higher in EBV/HCV patients compared to that in EBV and HCV mono-infected patients. EBV/HCV patients had significantly reduced percentages of CD3+ and CD4+ cells compared to EBV patients. Serum IFN-γ levels were significantly reduced in EBV/HCV patients (3.86 pg/mL) compared to CHC patients (6.76 pg/mL) and normal controls (4.69 pg/mL). A significant increase in serum IL-15 levels was observed in EBV/HCV patients (67.7 pg/mL) compared to EBV patients (29.3 pg/mL). Taken together, these observations suggest that HCV and EBV co-infection can potentiate immune response dampening in patients.

Puesta en marcha del cribado de cáncer de Colon en Andalucía

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

Cáncer colorrectal : proceso asistencial integrado. 2ª ed

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Estudio comparativo de la respuesta inflamatoria peritoneal en la gastrectomía por cáncer: abordaje abierto frente abordaje laparoscópico.

Introducción Estudios en colecistectomías y cáncer colorrectal demostraron que la laparoscopia genera menor respuesta inflamatoria sistémica. Escasos trabajos en cáncer gástrico evalúan el impacto inflamatorio en laparoscopia y emplean metodología deficiente. Hipótesis Demostrar mediante el estudio de tejido peritoneal la menor respuesta inflamatoria(protein-arrays) en pacientes gastrectomizados por laparoscopia vs. vía abierta. Material y métodos 26 pacientes: laparoscópica (12) vs. abierta (14); 2010-2012. Resultados Basados en TNF muestran incremento similar de respuesta a la agresión quirúrgica (aunque hubo diferencias en valores finales en ambos abordajes). Conclusiones Resultados preliminares apuntan hacia conclusiones estadísticamente significativas que apoyen nuestra hipótesis: menor respuesta inflamatoria en laparoscopia y correlación con datos clínicos.

Relación de la susceptibilidad genética y de las características anatomopatológicas del cáncer de próstata con los polimorfismos de nucleótido simple

Actualmente no se disponen de marcadores biológicos específicos para la cáncer de próstata produciéndose en muchas ocasiones biopsias prostáticas innecesarias o un sobretratamientos para cánceres indolentes. Existen cada vez más un número mayor de publicaciones sobre cómo los polimorfismos de nucleótido simple (SNP) se relacionan con la susceptibilidad al cáncer de próstata o predecir con mayor precisión qué grado de agresividad adquiere la enfermedad. Se presenta una revisión bibliográfica de las investigaciones publicadas en PubMed desde el año 2000 hasta el 2012 que ponen de manifiesto la relación de los SNP con el riesgo a padecer cáncer de próstata y con sus características anatomopatológicas.

Sobremortalidad por cáncer en El Campo de Gibraltar. El medio social, la piedra clave

Vol. 1 del proyecto de investigación: "La sobremortalidad por cáncer en El Campo de Gibraltar. Mirar el pasado para explicar el presente".

Hormonoterapia primaria en mujeres añosas con cáncer de mama localizado hormonosensible

Se analizó de forma retrospectiva una serie de pacientes con una edad mediana de 79 años con cáncer de mama localizado, con receptor de estrógeno positivo tratadas con hormonoterapia primaria. Tras recibir el tratamiento primario las pacientes candidatas se sometían a cirugía. La respuesta clínica fue de un 63.6%. La mediana de tiempo a progresión fue de 94 meses y la mediana de la supervivencia global no se alcanzó, siendo la media de 123 meses. Se evaluó el impacto del tratamiento quirúrgico en estos resultados, no objetivándose diferencias estadísticamente significativas. La hormonoterapia exclusiva en casos seleccionados es efectiva y segura

Haut potentiel intellectuel et TDA/H: ressemblances, différences, co-existence ?

Si les particularités du haut potentiel intellectuel (HPI) et du trouble déficit d'attention avec/sans hyperactivité (TDA/H) sont largement décrites dans la littérature, les liens entre ces deux profils sont moins connus. Il est pourtant établi que HPI et TDA/H partagent des manifestations communes comme l'agitation, les difficultés scolaires ou les troubles du comportement. Cette similitude sémiologique est responsable de confusions, d'errance diagnostique, voire de choix thérapeutiques discutables. Et la mission du médecin devient même particulièrement délicate lorsqu'il s'agit d'envisager une éventuelle « co-morbidité ». La clinique nous apprend en effet que le HPI et le TDA/H peuvent cohabiter chez le même enfant. Ainsi, les identifier et les prendre en charge devient un exercice complexe mais indispensable, car l'approche et le soutien de ces enfants aux besoins particuliers est très différente selon les cas de figure.

Cohesion, competition and contradiction: INTERREG and Franco-British Cross border co-operation

Aquest article resumeix el desenvolupament del programa INTERREG i la cooperació a la frontera franc-britànica en els últims vint anys. Això és seguit per una anàlisi de la forma transfronterera cooperació pot entendre recorrent a les discussions conceptuals de canviar la governança europea i les relacions de poder entre els diferents nivells de govern. Aquestes idees conceptuals proporcionen un context per a un examen en profunditat de la iniciativa INTERREG IIIA, a la frontera franc-britànica que es destaquen alguns dels principals problemes i les contradiccions de la cooperació transfronterera.

Co-administration of plasmid-encoded granulocyte-macrophage colony-stimulating factor increases human immunodeficiency virus-1 DNA vaccine-induced polyfunctional CD4+ T-cell responses

T-cell based vaccines against human immunodeficiency virus (HIV) generate specific responses that may limit both transmission and disease progression by controlling viral load. Broad, polyfunctional, and cytotoxic CD4+T-cell responses have been associated with control of simian immunodeficiency virus/HIV-1 replication, supporting the inclusion of CD4+ T-cell epitopes in vaccine formulations. Plasmid-encoded granulocyte-macrophage colony-stimulating factor (pGM-CSF) co-administration has been shown to induce potent CD4+ T-cell responses and to promote accelerated priming and increased migration of antigen-specific CD4+ T-cells. However, no study has shown whether co-immunisation with pGM-CSF enhances the number of vaccine-induced polyfunctional CD4+ T-cells. Our group has previously developed a DNA vaccine encoding conserved, multiple human leukocyte antigen (HLA)-DR binding HIV-1 subtype B peptides, which elicited broad, polyfunctional and long-lived CD4+ T-cell responses. Here, we show that pGM-CSF co-immunisation improved both magnitude and quality of vaccine-induced T-cell responses, particularly by increasing proliferating CD4+ T-cells that produce simultaneously interferon-γ, tumour necrosis factor-α and interleukin-2. Thus, we believe that the use of pGM-CSF may be helpful for vaccine strategies focused on the activation of anti-HIV CD4+ T-cell immunity.

Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

Geological setting of the Guelb Moghrein Fe oxide-Cu-Au-Co mineralization, Akjoujt area, Mauritania

The Guelb Moghrein Fe oxide-Cu-Au-Co deposit is located at the western boundary of the West African craton in NW Mauritania. The wall rocks to the mineralization represent a meta-volcanosedimentary succession typical of Archaean greenstone belts. Two types of meta-volcanic rocks are distinguished: (1) volcanoclastic rocks of rhyodacite-dacite composition (Sainte Barbe volcanic unit), which form the stratigraphic base; (2) tholeiitic andesites-basalts (Akjoujt meta-basalt unit). The trace element signature of both types is characteristic of a volcanic arc setting. A small meta-pelitic division belongs to the Sainte Barbe volcanic unit. A meta-carbonate body, which contains the mineralization, forms a tectonic lens in the Akjoujt meta-basalt unit. It can be defined by the high X(mg) (=36) of Fe-Mg carbonate, the REE pattern and the delta(13)C values of -18 to -17 parts per thousand as a marine precipitate similar to Archaean banded iron formation (BIF). Additionally, small slices of Fe-Mg clinoamphibole-chlorite schist in the meta-carbonate show characteristics of marine shale. This assemblage, therefore, does not represent an alteration product, but represents an iron formation unit deposited on a continental shelf, which probably belongs to the Lembeitih Formation. The hydrothermal mineralization at 2492 Ma was contemporaneous with regional D(2) thrusting of the Sainte Barbe volcanic unit and imbrications of the meta-carbonate in the upper greenschist facies. This resulted in the formation of an ore breccia in the meta-carbonate, which is enriched in Fe, Ni, Co, Cu, Bi, Mo, As and Au. Massive sulphide ore breccia contains up to 20 wt% Cu. The ore fluid was aqueous-carbonic in nature and either changed its composition from a Mg-rich oxidizing to an Fe-rich reducing fluid or the two fluid types mixed at the trap site. All lithologies at Guelb Moghrein were deformed by D(3) thrusting to the east in the lower greenschist facies. The mobility of REE in the retrogressed rocks explains the formation of a second generation of hydrothermal monazite, which was dated at c. 1742 Ma. Archaean rocks of the West African craton extend to the west to Guelb Moghrein. The active continental margin was deformed and mineralized in the Late Archaean-Early Proterozoic and again reactivated in the Mid-Proterozoic and Westphalian, showing that the western boundary of the craton was reactivated several times.

Assistência à criança com câncer: alguns elementos para a análise do processo de trabalho

Este estudo procura analisar alguns elementos do processo de trabalho na assistência à criança com câncer, fundamentado no Modelo de Organização Tecnológica do Trabalho. Partiu-se do princípio teórico de que a enfermagem é uma prática social e, portanto, historicamente estruturada e socialmente articulada; desta forma a enfermagem é parte do processo coletivo de trabalho em saúde. Apontamos para o fato de que o processo de trabalho da enfermagem na assistência à criança com câncer está em fase de transformação, passando do modelo exclusivamente clínico para outro, que tem como características a ampliação do referencial teórico e nova instrumentalização.