Incidencia y evolución de lesiones epiteliales cervicouterinas en mujeres menores de 25 años

Introducción: las mujeres menores de 25 años constituyen un grupo de riesgo para las lesiones cervicales uterinas y hay que conocer la incidencia, la tendencia temporal y la evolución histológica de las mismas.  Objetivo: evaluar la incidencia, tendencia, factores de riesgo y evolución histológica de lesiones cervicales en mujeres pinareñas menores de 25 años (2003 y 2014, 12 años).  Método: estudio con componentes descriptivos y analíticos. Población: la pinareña de esos grupos de edades.  Muestra: Aquellas con diagnóstico histopatológico.  Se emplearon frecuencias y tasas, coeficiente de correlación de Pearson, X2 y OR e IC al 95 % para la búsqueda de asociación entre variables.  Resultados: incrementó el número de mujeres con neoplasias intraepiteliales cervicales: tasa global de 19.3 (2003) vs 573.0/100000 mujeres (2014). La tasa promedio anual fue de 200.1 lesiones/100 000 mujeres. Se encontró asociación entre la edad de la primera relación sexual, el número de parejas sexuales y la presencia del virus del papiloma humano con la presencia de neoplasias intraepiteliales cervicales  (p<0,05).    Fueron Viñales, Pinar del Río y Sandino los municipios de mayor incidencia anual.  Sólo aproximadamente 4 % regresaron y 8 % evolucionaron a grados superiores de neoplasias intraepiteliales cervicales   después de 2 años de seguimiento.  El cáncer invasor fue escaso.  Conclusiones: Las neoplasias intraepiteliales cervicales  son las lesiones cervicales más frecuentes, y su estabilidad en el tiempo es una prueba de que no se deben incluir a estas mujeres en programas masivos de pesquisaje

Inter-sector participatory strategy in Cuba using an ecosystem approach to prevent dengue transmission at the local level

Cuba está ubicada en una zona de países con alta incidencia de dengue. En los últimos 10 años ha sido afectada por varias epidemias, es por ello que se diseñó, implementó y evaluó una estrategia participativa, basada en el enfoque de ecosalud, la cual estuvo dirigida a propiciar acciones intersectoriales en la gestión del ecosistema para disminuir las poblaciones del mosquito Aedes aegypti y prevenir la transmisión de dengue en el municipio Cotorro de Ciudad de La Habana, Cuba. Para el desarrollo de este trabajo se utilizó la metodología de investigación acción participativa. Como resultado del proceso se pudo describir una estrategia que garantiza la participación activa de la comunidad, los sectores y el gobierno en la producción de ecosistemas saludables, se desarrollaron acciones de prevención y control oportunas e integrados que disminuyeron los riesgos para la proliferación del vector y la transmisión local de la enfermedad. Este enfoque permitió el análisis holístico de los problemas, su priorización y la gestión de sus soluciones; la estrategia se sostiene dos años después de concluido el procesoCuba is located among a group of countries with high dengue incidence. Following several epidemics in the last 10 years, the country designed, implemented, and evaluated a participatory strategy based on the Ecohealth approach. The aim was to promote inter-sector ecosystem management to decrease Aedes aegypti infestation and prevent dengue transmission in the municipality of Cotorro, in Havana city. The study adopted a participatory research methodology. The strategy ensured active participation by the community, diverse sectors, and government in the production of healthy ecosystems. Timely and integrated measures for prevention and control were developed, thereby decreasing the risk of vector proliferation and local dengue transmission. The approach allowed holistic problem analysis, priority setting, and administration of solutions. The strategy has been sustained two years after concluding the process

Caracterización electroencefalográfica en los pacientes de tres a 18 años de edad con diagnóstico de trastorno por déficit de atención e hiperactividad

Introduction: Attention deficit hyperactivity disorder is defined as a persistent pattern of symptoms of inattention, hyperactivity and impulsivity. It is the most common neurodevelopmental disorder of childhood, of genetic and multifactorial origin, with a neurobiological substrate that mainly affects the frontal lobe and its connections with the basal ganglia. The electroencephalogram provides a direct measure of brain function and has been considered an appropriate tool to evaluate this disorder.Objective: to characterize electroencephalographically patients from 3 to 18 years old with ADHD diagnosis in our province Pinar del Río in the period from January to December 2019.Methods: an electroencephalogram was performed using a 19-channel digital electroencephalograph (Fénix 5) of wakefulness or sleep (depending on age), to patients coming from the child psychiatry service with a diagnosis of attention deficit disorder with hyperactivity and quantitative variables such as age, sex, types of paroxysms, topographic distribution were studied.Results: 77 patients were studied, of which 63 presented altered results. Paroxysmal activity was the most frequent alteration identified and slow spikes with frontocentral bisynchronous focal distribution were the most frequent type of paroxysmal activity.Conclusions: the results obtained allowed characterizing the electroencephalographic alterations presented by these patients with attention deficit hyperactivity disorder.Introducción: el trastorno por déficit de atención con hiperactividad es definido como un patrón persistente de síntomas de inatención, hiperactividad e impulsividad. Es el trastorno del neurodesarrollo más común de la infancia, de origen genético y multifactorial, con un sustrato neurobiológico que afecta principalmente al lóbulo frontal y sus conexiones con los ganglios basales. El electroencefalograma provee de una manera directa una medida del funcionamiento cerebral y se ha considerado como una herramienta apropiada para evaluar este trastorno.Objetivo: caracterizar electroencefalográficamente a los pacientes de tres a 18 años de edad con diagnóstico de TDAH en la provincia Pinar del Río en el período comprendido entre enero a diciembre de 2019.Métodos: se les realizó un electroencefalograma con la utilización de un electroencefalógrafo digital de 19 canales (Fénix 5) de vigilia o sueño (según la edad), a los pacientes procedentes del servicio de psiquiatría infantil con diagnóstico de trastorno por déficit de atención con hiperactividad y se estudiaron variables cuantitativas como edad, sexo, tipos de paroxismos, distribución topográfica.Resultados: se estudiaron 77 pacientes, de los cuales 63 presentaron resultados alterados. La actividad paroxística fue la alteración más frecuente identificada y fueron las puntas lentas con distribución focal bisincrónica frontocentral el tipo de actividad paroxística más frecuente.Conclusiones: los resultados obtenidos permitieron caracterizar las alteraciones electroencefalográficas que presentan estos pacientes con trastorno por déficit de atención e hiperactividad

E-Cadherin gene expression in oral cancer : clinical and prospective data

Low protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. Objective: The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression

Transcriptome and Proteome Response of Rhipicephalus annulatus Tick Vector to Babesia bigemina Infection

A system biology approach was used to gain insight into tick biology and interactions between vector and pathogen. Rhipicephalus annulatus is one of the main vectors of Babesia bigemina which has a massive impact on animal health. It is vital to obtain more information about this relationship, to better understand tick and pathogen biology, pathogen transmission dynamics, and new potential control approaches. In ticks, salivary glands (SGs) play a key role during pathogen infection and transmission. RNA sequencing obtained from uninfected and B. bigemina infected SGs obtained from fed female ticks resulted in 6823 and 6475 unigenes, respectively. From these, 360 unigenes were found to be differentially expressed (p &lt; 0.05). Reversed phase liquid chromatography–mass spectrometry identified a total of 3679 tick proteins. Among them 406 were differently represented in response to Babesia infection. The omics data obtained suggested that Babesia infection lead to a reduction in the levels of mRNA and proteins (n = 237 transcripts, n = 212 proteins) when compared to uninfected controls. Integrated transcriptomics and proteomics datasets suggested a key role for stress response and apoptosis pathways in response to infection. Thus, six genes coding for GP80, death-associated protein kinase (DAPK-1), bax inhibitor-1 related (BI-1), heat shock protein (HSP), heat shock transcription factor (PHSTF), and queuine trna-ribosyltransferase (QtRibosyl) were selected and RNA interference (RNAi) performed. Gene silencing was obtained for all genes except phstf. Knockdown of gp80, dapk-1, and bi-1 led to a significant increase in Babesia infection levels while hsp and QtRibosyl knockdown resulted in a non-significant decrease of infection levels when compared to the respective controls. Gene knockdown did not affect tick survival, but engorged female weight and egg production were affected in the gp80, dapk-1, and QtRibosyl-silenced groups in comparison to controls. These results advanced our understanding of tick–Babesia molecular interactions, and suggested new tick antigens as putative targets for vaccination to control tick infestations and pathogen infection/transmission

Anaplasma phagocytophilum MSP4 and HSP70 proteins are involved in interactions with host cells during pathogen infection.

Anaplasma phagocytophilum transmembrane and surface proteins play a role during infection and multiplication in host neutrophils and tick vector cells. Recently, A. phagocytophilum Major surface protein 4 (MSP4) and Heat shock protein 70 (HSP70) were shown to be localized on the bacterial membrane, with a possible role during pathogen infection in ticks. In this study, we hypothesized that A. phagocytophilum MSP4 and HSP70 have similar functions in tick-pathogen and host-pathogen interactions. To address this hypothesis, herein we characterized the role of these bacterial proteins in interaction and infection of vertebrate host cells. The results showed that A. phagocytophilum MSP4 and HSP70 are involved in host-pathogen interactions, with a role for HSP70 during pathogen infection. The analysis of the potential protective capacity of MSP4 and MSP4-HSP70 antigens in immunized sheep showed that MSP4- HSP70 was only partially protective against pathogen infection. This limited protection may be associated with several factors, including the recognition of non-protective epitopes by IgG in immunized lambs. Nevertheless, these antigens may be combined with other candidate protective antigens for the development of vaccines for the control of human and animal granulocytic anaplasmosis. Focusing on the characterization of host protective immune mechanisms and protein-protein interactions at the host-pathogen interface may lead to the discovery and design of new effective protective antigens

HOPE (SOLTI-1903) breast cancer study: real-world, patient-centric, clinical practice study to assess the impact of genomic data on next treatment decision-choice in patients with locally advanced or metastatic breast cancer

Background Metastatic breast cancer (mBC) causes nearly all BC-related deaths. Next-generation sequencing (NGS) technologies allow for the application of personalized medicine using targeted therapies that could improve patients' outcomes. However, NGS is not routinely used in the clinical practice and its cost induces access-inequity among patients. We hypothesized that promoting active patient participation in the management of their disease offering access to NGS testing and to the subsequent medical interpretation and recommendations provided by a multidisciplinary molecular advisory board (MAB) could contribute to progressively overcome this challenge. We designed HOPE (SOLTI-1903) breast cancer trial, a study where patients voluntarily lead their inclusion through a digital tool (DT). The main objectives of HOPE study are to empower mBC patients, gather real-world data on the use of molecular information in the management of mBC and to generate evidence to assess the clinical utility for healthcare systems.Trial design After self-registration through the DT, the study team validates eligibility criteria and assists patients with mBC in the subsequent steps. Patients get access to the information sheet and sign the informed consent form through an advanced digital signature. Afterwards, they provide the most recent (preferably) metastatic archival tumor sample for DNA-sequencing and a blood sample obtained at the time of disease progression for ctDNA analysis. Paired results are reviewed by the MAB, considering patient's medical history. The MAB provides a further interpretation of molecular results and potential treatment recommendations, including ongoing clinical trials and further (germline) genetic testing. Participants self-document their treatment and disease evolution for the next 2 years. Patients are encouraged to involve their physicians in the study. HOPE also includes a patient empowerment program with educational workshops and videos about mBC and precision medicine in oncology. The primary endpoint of the study was to describe the feasibility of a patient-centric precision oncology program in mBC patients when a comprehensive genomic profile is available to decide on a subsequent line of treatment

Frequency and Characteristics of familial melanoma in Spain: the FAM-GEM-1 Study.

Familial history of melanoma is a well-known risk factor for the disease, and 7% melanoma patients were reported to have a family history of melanoma. Data relating to the frequency and clinical and pathological characteristics of both familial and non-familial melanoma in Spain have been published, but these only include patients from specific areas of Spain and do not represent the data for the whole of Spain. PATIENTS AND METHODS: An observational study conducted by the Spanish Group of Melanoma (GEM) analyzed the family history of patients diagnosed with melanoma between 2011 and 2013 in the dermatology and oncology departments. RESULTS: In all, 1047 patients were analyzed, and 69 (6.6%) fulfilled criteria for classical familial melanoma (two or more first-degree relatives diagnosed with melanoma). Taking into account other risk factors for familial melanoma, such as multiple melanoma, pancreatic cancer in the family or second-degree relatives with melanoma, the number of patients fulfilling the criteria increased to 165 (15.8%). Using a univariate analysis, we determined that a Breslow index of less than 1 mm, negative mitosis, multiple melanoma, and a history of sunburns in childhood were more frequent in familial melanoma patients, but a multivariate analysis revealed no differences in any pathological or clinical factor between the two groups. CONCLUSIONS: Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior

Information and Communication Technologies, as a strategy to promote academic interest in students

Teniendo en cuenta la incidencia de las nuevas tecnologías en la educación de hoy, el propósito de la presente investigación radica en implementar las tecnologías de la información y la comunicación TIC en el aula de clase para fomentar el interés académico en los estudiantes de la IED Fundación. Metodológicamente la investigación se orientó desde una mirada Cualitativa, bajo el paradigma sociocritico; la unidad de análisis estuvo constituida por cuarenta (40) estudiantes del grado octavo entre las edades de catorce (14) quince (15) y dieciséis (16) años; como técnica de recolección de información se utilizó la observación participante, como instrumento de recolección, el diario de campo; a partir de las actividades desarrolladas con la implementación de las TIC en el aula de clase se encontró que los estudiantes presentan mayores niveles de motivación e interés por aprender, mejorando significativamente su promedio de notas cuándo se trabajan los contenidos curriculares articulados con estasTaking into account the incidence of new information and communication technologies in education today, the purpose of research in the implementation of information technology and communication students of the IED Foundation. Methodologically, the research was oriented from a Qualitative perspective, under the socio-critical paradigm; the analysis unit consisted of forty (40) eighth grade students between the ages of fourteen (14) fifteen (15) and sixteen (16) years; as a tool for gathering information, the collection instrument, the field diary; From the activities developed with the implementation of ICT in the classroom, students were found to have higher levels of motivation and interest in learning, significantly improving their grade point average when working with articulated curricular content