Mortalidad por cáncer de mama en Colombia y Bogotá 1995 y 2009. Análisis edad – periodo – cohorte

El cáncer de mama es la neoplasia más frecuente en mujeres en el mundo y en Colombia. Este artículo describe las tendencias de mortalidad por cáncer de mama en Bogotá y Colombia entre 1995 y 2009. Metodología: Estudio descriptivo de análisis de tendencias de las tasas de mortalidad a través del modelo estadístico de Edad – Periodo – Cohorte. Los casos se tomaron de los certificados de defunción por cáncer de mama registrados en el Departamento Nacional de Estadística entre 1995 y 2009. Se evaluaron diferentes modelos: periodo, periodo-drift (cambio lineal en el tiempo), periodo-edad, periodo-cohorte, periodo-edad-cohorte por el método funciones estimables. Resultados: La tasa de mortalidad por cáncer de mama en Colombia fue 6.78 por 100.000 con comportamiento constante en los tres periodos. Mientras en Bogotá fue de 7.78 por 100.000 con tendencia a la disminución entre 40 y 69 años, en el último periodo estudiado. En este estudio el efecto periodo + cohorte es el que mejor describe el comportamiento de las tasas de mortalidad por cáncer de mama en ambos escenarios (Bogotá AIC: 13.8 p=0,314; Colombia: AIC=27.4 p=0,238). Conclusiones: Existe una tendencia a la disminución en la mortalidad por cáncer de mama en ciertos grupos etáreos en Bogotá en el periodo 2005-2009, diversas hipótesis explicarían dicho fenómeno, entre estas el acceso a métodos de tamizaje, aunque no hay estudios al respecto. Se recomienda reforzar los métodos de tamizaje y diagnóstico temprano en el resto del país.

Measuring root traits in barley (Hordeum vulgare ssp vulgare and ssp spontaneum) seedlings using gel chambers, soil sacs and X-ray microtomography

Root characteristics of seedlings of five different barley genotypes were analysed in 2D using gel chambers, and in 3D using soil sacs that were destructively harvested and pots of soil that were assessed non-invasively using X-ray microtomography. After 5 days, Chime produced the greatest number of root axes (similar to 6) and Mehola significantly less (similar to 4) in all growing methods. Total root length was longest in GSH01915 and shortest in Mehola for all methods, but both total length and average root diameter were significantly larger for plants grown in gel chambers than those grown in soil. The ranking of particular growth traits (root number, root angular spread) of plants grown in gel plates, soil sacs and X-ray pots was similar, but plants grown in the gel chambers had a different order of ranking for root length to the soil-grown plants. Analysis of angles in soil-grown plants showed that Tadmore had the most even spread of individual roots and Chime had a propensity for non-uniform distribution and root clumping. The roots of Mehola were less well spread than the barley cultivars supporting the suggestion that wild and landrace barleys tend to have a narrower angular spread than modern cultivars. The three dimensional analysis of root systems carried out in this study provides insights into the limitations of screening methods for root traits and useful data for modelling root architecture.

Deriving a sea surface temperature record suitable for climate change research from the along-track scanning radiometers

We describe the approach to be adopted for a major new initiative to derive a homogeneous record of sea surface temperature for 1991–2007 from the observations of the series of three along-track scanning radiometers (ATSRs). This initiative is called (A)RC: (Advanced) ATSR Re-analysis for Climate. The main objectives are to reduce regional biases in retrieved sea surface temperature (SST) to less than 0.1 K for all global oceans, while creating a very homogenous record that is stable in time to within 0.05 K decade−1, with maximum independence of the record from existing analyses of SST used in climate change research. If these stringent targets are achieved, this record will enable significantly improved estimates of surface temperature trends and variability of sufficient quality to advance questions of climate change attribution, climate sensitivity and historical reconstruction of surface temperature changes. The approach includes development of new, consistent estimators for SST for each of the ATSRs, and detailed analysis of overlap periods. Novel aspects of the approach include generation of multiple versions of the record using alternative channel sets and cloud detection techniques, to assess for the first time the effect of such choices. There will be extensive effort in quality control, validation and analysis of the impact on climate SST data sets. Evidence for the plausibility of the 0.1 K target for systematic error is reviewed, as is the need for alternative cloud screening methods in this context.

Prospecção de genes de interesse biotecnológico : uma abordagem metagenômica

The total number of prokaryotic cells on Earth has been estimated at 4 to 6x1030 and only about 1% of microorganisms present in the environment can be cultivated by standard techniques of cultivation and plating. Therefore, it is a huge biological and genetic pool that can be exploited, for the identification and characterization of genes with biotechnological potential. Within this perspective, the metagenomics approach was applied in this work. Functional screening methods were performed aiming to identify new genes related to DNA repair and / or oxidative stress resistance, hydrocarbon degradation and hydrolytic activities (lipase, amylase and protease). Metagenomic libraries were built utilizing DNA extracted from soil samples collected in João Câmara RN. The libraries were analyzed functionally using specific substrate containing solid medium (hydrolytic activity), supplemented with H2O2 (DNA repair and / or resistance to oxidative stress) and liquid medium supplemented with light Arabian oil (activity, degradation of hydrocarbons). After confirmation of activity and exclusion of false-positive results, 49 clones were obtained, being 2 positive for amylase activity, 22 resistant to oxidative stress generated by H2O2 and 25 clones active for hydrocarbons degradation. Analysis of the sequences showed hypothetical proteins, dienelactona hydrolase, DNA polymerase, acetyltransferase, phosphotransferase, methyltransferase, endonucleases, among other proteins. The sequence data obtained matched with the functions tested, highlighting the success of metagenomics approaches combined with functional screening methods, leading to very promising results

Kinetic and affinity analysis of hybridization reactions between PNA probes and DNA targets using surface plasmon field-enhanced fluorescence spectroscopy (SPFS)

Sequenz spezifische biomolekulare Analyseverfahren erweisen sich gerade im Hinblick auf das Humane Genom Projekt als äußerst nützlich in der Detektion von einzelnen Nukleotid Polymorphismen (SNPs) und zur Identifizierung von Genen. Auf Grund der hohen Anzahl von Basenpaaren, die zu analysieren sind, werden sensitive und effiziente Rastermethoden benötigt, welche dazu fähig sind, DNA-Proben in einer geeigneten Art und Weise zu bearbeiten. Die meisten Detektionsarten berücksichtigen die Interaktion einer verankerten Probe und des korrespondierenden Targets mit den Oberflächen. Die Analyse des kinetischen Verhaltens der Oligonukleotide auf der Sensoroberfläche ist infolgedessen von höchster Wichtigkeit für die Verbesserung bereits bekannter Detektions - Schemata. In letzter Zeit wurde die Oberflächen Plasmonen feld-verstärkte Fluoreszenz Spektroskopie (SPFS) entwickelt. Sie stellt eine kinetische Analyse - und Detektions - Methode dar, die mit doppelter Aufzeichnung, d.h. der Änderung der Reflektivität und des Fluoreszenzsignals, für das Interphasen Phänomen operiert. Durch die Verwendung von SPFS können Kinetikmessungen für die Hybridisierung zwischen Peptid Nukleinsäure (PNA), welche eine synthetisierte Nukleinsäure DNA imitiert und eine stabilere Doppelhelix formt, und DNA auf der Sensoroberfläche ausgeführt werden. Mittels einzel-, umfassend-, und titrations- Experimenten sowohl mit einer komplementär zusammenpassenden Sequenz als auch einer mismatch Sequenz können basierend auf dem Langmuir Modell die Geschwindigkeitskonstanten für die Bindungsreaktion des oligomer DNA Targets bzw. des PCR Targets zur PNA ermittelt werden. Darüber hinaus wurden die Einflüsse der Ionenstärke und der Temperatur für die PNA/DNA Hybridisierung in einer kinetischen Analyse aufgezeigt.

Identifizierung und Charakterisierung neuer Proteine des Abwehrsystems der Porifera - ein Apoptoseregulator und ein antimikrobielles Protein aus dem Schwamm Suberites domuncula

Aufgrund ihrer Lebensweise und -umgebung sind effiziente Strategien zur Abwehr bedrohender Einflüsse essentiell für die Porifera. Eine dieser Strategien stellen die Apoptose in höheren Metazoen, sowie ein effizientes Immunsystem dar. Diese sichern sowohl das Überleben des Organismus als auch die Entfernung beschädigter, infizierter oder redundanter Zellen. Bei Untersuchungen der Porifera auf Moleküle, die an diesen Prozessen beteiligt sind, konnten in den letzten Jahren beachtliche Erfolge erzielt werden. So konnten das in der Apoptose involvierte Protein GCDD2 (proapoptotisch), die antiapoptotischen GCBHP1 und GCBHP2 Proteine (Wiens et al., 2001), sowie ein LPS induzierbarer TNF (Wiens et al., 2007) und zwei Caspasen (Wiens et al., 2003) in Schwämmen identifiziert werden. Um diese essentiellen Mechanismen besser verstehen zu können, sollte ein möglicher Tumor-Nekrose-Faktor-Rezeptor identifiziert werden. Hierzu wurde die SpongeBase Datenbank nach Proteinen mit Todesdomänen durchsucht und diese unter Anwendung von PCR- und Screening-Techniken in einer cDNA-Bank des marinen Schwammes S. domuncula komplettiert. Im Anschluss an ihre Sequenzierung wurde ein Klon ausgewählt, dessen Todesdomäne größte Homologie zu einem TNFR zeigte. Dieser Klon SD_TNFR-like (Suberites domuncula TNFR-homologes Protein) wurde anschließend diversen Sequenz- und Strukturanalysen unterzogen. Diese offenbarten die Existenz zweier funktional bedeutsamer Domänen (Ubiquitin-like und Todesdomäne). Vor allem die Todesdomäne impliziert eine Beteiligung des Proteins an apoptotischen Prozessen. Über einen „Yeast Two Hybrid Screen“ sollten Proteine identifiziert werden, welche mit dem Ausgangsprotein interagieren. Hierbei wurde ein Protein identifiziert, das Ähnlichkeit mit einem antimikrobiellen Peptid aufweist. Dieses Protein kann analog zu einer Gruppe von antimikrobiellen Peptiden, den α-helikalen kationischen Peptiden, in drei Teile gespalten werden. Das Signalpeptid sowie ein anionisches Propeptid werden abgespalten und es entsteht ein kationisches, antimykotisch wirksames Peptid. Beide Proteine sollten, sofern sie in die Abwehrreaktionen involviert sind, durch Inkubation mit mikrobiellen Strukturen vermehrt exprimiert werden. Eine Überprüfung der Transkription mittels Northern Blot Analysen bestätigte dies für das SD_TNFR-like nach Inkubation mit LPS und TNF- α sowie für SD_Brevinin-like nach Inkubation mit LPS, PAM und Hefe. Mit der Herstellung eines rekombinanten SD_TNFR-like-Proteins wurde die Immunisierung von Kaninchen und die folgende Gewinnung eines polyklonalen SD_TNFR-like-Antikörpers ermöglicht. Dieser gestattete den Nachweis der SD_TNFR-like -Expression mittels Western Blot-Analysen sowie die stressinduzierte erhöhte Expression mittels Dot Blot-Analysen auch auf Proteinebene. Um die Funktion des SD_TNFR-like Proteins zu charakterisierten, wurde ein Test mit RAW-Blue™-Zellen durchgeführt. Die Ergebnisse implizieren, dass das Protein Teil der Immunreaktion analog der der TLR- bzw. NLR- Reaktion ist. Auch die Interaktion mit einem antimikrobiellen Protein, welches für das Überleben des Organismus und die Bekämpfung der Mikroorganismen sorgt, deutet auf eine solche Beteiligung hin. Zusätzlich wird diese These durch ein Ergebnis der Strukturanalysen unterstützt, nämlich die Identifizierung einer TRAF2 Bindestelle. TRAF2 ist ein Adapterprotein der TNFR und aktiviert Überlebensfaktoren über den NF - B-Weg. Immunohistochemische Analysen zeigten, dass das SD_TNFR-like Protein im Organismus vor allem um die Bakteriozysten, um verschiedene Mikroorganismen und am Rand des Schwammes exprimiert wird, was ebenfalls für eine immunologische Funktionsweise spricht. Auch im restlichen Gewebe wird es kontinuierlich, auch ohne vorherige LPS Inkubation exprimiert. Diese Akkumulation zeigt deutlich, dass das Protein in einen Schutzmechanismus gegen äußere Bedrohungen involviert ist. Es scheint dabei direkt an den eindringenden Mikroorganismen zu wirken. Das SD_TNFR-like ist demnach ein potentieller Bestandteil der Immunantwort des Schwammes, welches Apoptose verhindern und Überlebensmechanismen aktivieren kann. Das SD_Brevinin-like Protein besitzt antimykotische Aktivität, wie in einem antimikrobiellen Test gezeigt werden konnte. Weiterhin scheint es für das SD_TNFR-like Protein als positiver bzw. negativer Regulator von Bedeutung zu sein, der eine Reaktion entweder beendet oder die Expression von Überlebensfaktoren verstärkt. Die in dieser Arbeit präsentierten Ergebnisse und Schlussfolgerungen demonstrieren somit die Identifizierung eines neuen Schwammproteins, welches eine Rolle in der Immunantwort spielt, sowie eines neuen antimikrobiellen Peptids, welches die Wirkung des TNFR-like moduliert. Es müssen jedoch noch weitere Funktionsanalysen folgen, um den Mechanismus des SD_TNFR-like Proteins und seine Regulation genauer charakterisieren zu können

Bioanalysis of new designer drugs

Since the late 1990s the illicit drug market has undergone considerable change: along with the traditional drugs of abuse that still dominate, more than 100 psychotropic substances designed to bypass controlled substances legislation have appeared and led to intoxications and fatalities. Starting from the huge class of phenylalkylamines, containing many subgroups, the spectrum of structures has grown from tryptamines, piperazines, phenylcyclohexyl derivates and pyrrolidinophenones to synthetic cannabinoids and the first synthetic cocaine. Due to the small prevalence and high number of unknown substances, the detection of new designer drugs is a challenge for clinical and forensic toxicologists. Standard screening procedures might fail because a recently discovered or yet unknown substance has not been incorporated in the library used. Nevertheless, many metabolism studies, case reports, screening methods and substance-profiling papers concentrating on single compounds have been published. This review provides an overview of the developed bioanalytical and analytical methods, the matrices used, sample-preparation procedures, concentration of analytes in case of intoxication and also gives a résumé of immunoassay experiences. Additionally, six screening methods for biological matrices with a larger spectrum of analytes are described in more detail.

Detection of exon deletions within an entire gene (CFTR) by relative quantification on the LightCycler

BACKGROUND: Cystic fibrosis (CF) is associated with at least 1 pathogen point sequence variant on each CFTR allele. Some symptomatic patients, however, have only 1 detectable pathogen sequence variant and carry, on the other allele, a large deletion that is not detected by conventional screening methods. METHODS: For relative quantitative real-time PCR detection of large deletions in the CFTR gene, we designed DNA-specific primers for each exon of the gene and primers for a reference gene (beta2-microglobulin). For PCR we used a LightCycler system (Roche) and calculated the gene-dosage ratio of CFTR to beta2-microglobulin. We tested the method by screening all 27 exons in 3 healthy individuals and 2 patients with only 1 pathogen sequence variant. We then performed specific deletion screenings in 10 CF patients with known large deletions and a blinded analysis in which we screened 24 individuals for large deletions by testing 8 of 27 exons. RESULTS: None of the ratios for control samples were false positive (for deletions or duplications); moreover, for all samples from patients with known large deletions, the calculated ratios for deleted exons were close to 0.5. In addition, the results from the blinded analysis demonstrated that our method can also be used for the screening of single individuals. CONCLUSIONS: The LightCycler assay allows reliable and rapid screening for large deletions in the CFTR gene and detects the copy number of all 27 exons.

Serum markers for predicting pre-eclampsia

Pre-eclampsia, a pregnancy-specific disorder, contributes substantially to perinatal morbidity and mortality of both, mother and newborn. An increasing number of biochemical agents were evaluated as markers for predicting pre-eclampsia. None of them has been proved to be of clinical value yet. Much effort has been put into assessing novel potential markers and their combination with other screening methods such as Doppler sonography. The purpose of this review is to reflect the current knowledge of serum markers for predicting pre-eclampsia. So far, the most promising serum markers are placental protein 13 (PP-13), as well as soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PIGF) and soluble endoglin (sEng). These markers allow screening at a relatively early stage and, most importantly, show relatively high predictive values and improved diagnostic performance if combined with first trimester Doppler sonography. Large-scale prospective studies, assessing these markers, are important to justify their clinical use in view of early intervention to prevent pre-eclampsia in the future.

Large deletions in the CFTR gene: clinics and genetics in Swiss patients with CF

Cystic fibrosis (CF) is the most common life-shortening autosomal recessive disorder in Caucasians, and is associated with at least one mutation on each CF transmembrane conductance regulator (CFTR) allele. Some patients, however, with only one identifiable point mutation carry on the other allele, a large deletion that is not detected by conventional screening methods. The overall frequency of large deletions in patients with CF is estimated to be 1-3%. Using the CFTR Multiplex Ligation dependent Probe Amplification Kit (MRC-Holland, Amsterdam, Netherlands) that allows the exact detection of copy numbers from all 27 exons in the CFTR gene, we screened 50 patients with only one identified mutation for large deletions in the CFTR gene. Each detected deletion was confirmed using our real-time polymerase chain reaction (PCR) assay and deletion-specific PCR reactions using junction fragment primers. We detected large deletions in eight patients (16%). These eight CF alleles belong to four different deletion types (CFTRindel2, CFTRdele14b-17b, CFTRdele17a-17b and CFTRdele 2-9) whereof the last is novel. Comparing detailed clinical data of all these patients with CF and the molecular genetic findings, we were able to elaborate criteria for deletion screenings and possible genotype-phenotype associations. In conclusion, we agree with other authors that deletion screenings should be implemented in routine genetic diagnostics of CF.

Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging

OBJECTIVES: To study the validity of both rheumatological and orthodontic examinations and ultrasound (US) as screening methods for early diagnosis of TMJ arthritis against the gold standard MRI. METHODS: Thirty consecutive juvenile idiopathic arthritis (JIA) patients were included in this pilot study. Rheumatological and orthodontic examinations as well as US were performed within 1 month of the MRI in a blinded fashion. Joint effusion and/or increased contrast enhancement of synovium or bone were considered signs of active arthritis on MRI. RESULTS: A total of 19/30 (63%) patients and 33/60 (55%) joints had signs of TMJ involvement on MRI. This was associated with condylar deformity in 9/19 (47%) patients and 15/33 (45%) joints. Rheumatological, orthodontic and US examinations correctly diagnosed 11 (58%), 9 (47%) and 6 (33%) patients, respectively, with active TMJ arthritis, but misdiagnosed 8 (42%), 10 (53%) and 12 (67%) patients, respectively, as having no signs of inflammation. The best predictor for active arthritis on MRI was a reduced maximum mouth opening. CONCLUSION: None of the methods tested was able to reliably predict the presence or absence of MRI-proven inflammation in the TMJ in our cohort of JIA patients. US was the least useful of all methods tested to exclude active TMJ arthritis.

Evidence based check-up: the general medical point of view

Check-up is a frequent motivation for patients to see their general practitioner. The challenge lies in the choice of screening tools to accomplish an efficient, individual and age-adapted approach. In this article we review evidence-based screening methods, whose efficacy has been demonstrated by randomized clinical trials, as well as their application in clinical practice. While cardiovascular check-up has a high grade of evidence for nearly all patients, counselling to lifestyle change except for smoking cessation has been proved with lower evidence. In contrast, relatively new is the fact that ultrasound to screen for an abdominal aortic aneurysm is useful among men smokers or past smokers between 65 and 75 years old.

Human Trafficking: What is the Role of the Health Care Provider?

The article will address the global and local issue of human trafficking. An estimated 20,000 people are trafficked within the U.S. each year. Trafficked people are forced, defrauded and coerced into labor and sexual service for profit of others. Traffickers use individual vulnerabilities and immigration status, language ability and poor understanding of U.S. laws to identify future victims. One case in 2005 in Texas resulted in 100 victims being identified, none of whom revealed themselves to health care professionals. Health care professionals need contemporary and updated information and resources about health risks, screening methods, and identification of trafficked persons. Readers will learn about common medical problems experienced by individuals who are leaving trafficking situations. Legal and health care intersections will be explored. Implementation of a response protocol to assist those who may currently be enslaved will be introduced. Real case examples from trafficking survivors will be presented and discussed. Participants will learn how to reach out, look beneath the surface, provide assistance, and access resources to help victims, and gain a better understanding of the health challenges faced by trafficked victims.

Serum IL-6: a candidate biomarker for intracranial pressure elevation following isolated traumatic brain injury.

BACKGROUND: Increased intracranial pressure (ICP) is a serious, life-threatening, secondary event following traumatic brain injury (TBI). In many cases, ICP rises in a delayed fashion, reaching a maximal level 48-96 hours after the initial insult. While pressure catheters can be implanted to monitor ICP, there is no clinically proven method for determining a patient's risk for developing this pathology. METHODS: In the present study, we employed antibody array and Luminex-based screening methods to interrogate the levels of inflammatory cytokines in the serum of healthy volunteers and in severe TBI patients (GCS RESULTS: Consistent with previous reports, we observed sustained increases in IL-6 levels in TBI patients irrespective of their ICP status. However, the group of patients who subsequently experienced ICP >or= 25 mm Hg had significantly higher IL-6 levels within the first 17 hours of injury as compared to the patients whose ICP remained 128 pg/ml correctly identified 85% of isolated TBI patients who subsequently developed elevated ICP, and values between these cut-off values correctly identified 75% of all patients whose ICP remained CONCLUSIONS: Our results suggest that serum IL-6 can be used for the differential diagnosis of elevated ICP in isolated TBI.

The influence of HIV/AIDS on the association between genital human papillomavirus and cervical cancer in HIV/AIDS infected women: A literature review

Background: With over 440 million cases of infections worldwide, genital HPV is the most frequent sexually transmitted infection. There are several types including high risk types 16, 18, 58 and 70 among others, which are known to cause cervical cell abnormality and if persistent, can lead to cervical cancer which globally, claims 288,000 lives annually. 33.4 million people worldwide are currently living with HIV/AIDS, with 22.4 million in sub-Saharan Africa where 70% of the female population living with HIV/AIDS is also found. Similar risk factors for HPV, cervical cancer and HIV/AIDS include early age at sexual debut, multiple sexual partners, infrequent condom use, history of STI and immune-suppression. ^ Objectives: To describe the role of HPV in cervical cancer development, to describe the influence of HIV/AIDS on HPV and in the development of cervical cancer and to describe the importance of preventive measures such as screening. ^ Methods: This is a literature review where data were analyzed qualitatively and a descriptive narrative style used to evaluate and present the information. The data came from searches using Pub Med, Cochrane Library, EBSCO Medline databases as well as websites such as the CDC and WHO. Articles selected were published in English over the last 10 years. Keywords used included: 'HPV, cervical cancer and HIV', 'HIV and HPV', 'HPV and cervical cancer', 'HPV infection', 'HPV vaccine', 'genital HPV', 'HIV and cervical cancer', 'prevalence of HIV and cervical cancer' and 'prevalence of cervical cancer'. ^ Results: Women with HIV/AIDS have multiple HPV types, persistent infection, are more likely to present with cervical neoplasia and are at higher risk for cervical cancer. Research also shows that HIV could affect the transmissibility of HPV and that HPV itself could also increase the susceptibility to HIV acquisition. ^ Conclusion: HIV, genital HPV and cervical cancer are all preventable. Need to emphasize programs that aim to increase HIV/AIDS, HPV and cervical cancer awareness. Stress importance of behavior modification such as frequent use of condoms, decreased sexual partners and delayed first intercourse. Facilitate programs for screening and treating HPV, male circumcision, effective management of HAART and HPV vaccination.^