How to become a Multinational Association of Supportive Care in Cancer-designated center of excellence in supportive care in cancer

Purpose of reviewAim of this review is to encourage and involve more doctors to take care of supportive care in cancer patients and to become centers of excellence.Recent findingsIn 2019, MASCC initiated a certification program to recognize oncology centers that demonstrate best practices in supportive cancer care but literature on how to become MASCC-designated center of Excellence in Supportive Care in Cancer is scarce and will be bulleted.Becoming centers of excellence means not only the recognition of the clinical and managerial requirements to provide good supportive care but also the creation of a network of centers to participate in multicenter scientific projects and thus improve knowledge in the field of supportive care in cancer patients

Avaliação do Programa Coordenador de Pais no Espírito Santo

Resumo A literatura mostra que a participação das famílias na vida escolar dos seus filhos pode ter efeitos importantes sobre os resultados dos alunos. No entanto, ainda há poucas evidências deste efeito em países em desenvolvimento. No Brasil, uma iniciativa recente para aumentar a participação dos pais no ambiente escolar e vida escolar dos filhos foi o programa Coordenador de Pais (CP), implementado entre 2012 e 2013. Este artigo avalia os impactos do programa CP adotado no Espírito Santo sobre o desempenho, a frequência e a evasão utilizando um painel de alunos do 9º ano do Ensino Fundamental ao 3º ano do Ensino Médio e dados administrativos únicos de 2011 a 2014. A partir de uma estratégia de diferenças-em-diferenças, os resultados indicam que o programa aumentou o comparecimento nas aulas e a retenção dos alunos na escola

Acute oxaliplatin-induced thrombotic thrombocytopenic purpura: A case report and results from a cytoflourimetric assay of platelet fibrinogen receptor

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Participación del glutamato en la adaptación osmótica de Pseudomonas aeruginosas

In this work is intended to evaluate the action of the glutamate as exogenous osmoprotectant in Pseudomonas aeruginosa grown under osmotic stress conditions. The addition of exogenous glutamate, starting from a concentration 0,1mM, confers osmotic tolerance when this bacterium grows in presence of NaCl, with glucose and ammonium as carbon and nitrogen sources, respectively. The effect shows for the decrease significatively the lag period of growth, without variations in the time of generation. Contrary to the observed behavior with glutamate, the addition the choline like external osmoprotectant, it diminishes both parameters of growth. If glutamate and choline are simultaneously present in growth medium can be observed a synergist effect, P.aeruginosa incorporates both compounds with decrease of the lag period growth and the time of generation. It demonstrates that these osmoprotectants is not excluded mutually. In P. aeruginosa the glutamate uptake responds to a hyper-osmotic upshock, being dependent of the energetic state of the cell and of the synthesis of new proteins. The study of intracellular metabolites obtained after incubating the cells under conditions hyperosmotic in presence of glutamate, it showed that, once incorporate, this metabolite doesn't accumulate as itself. The analysis of the intracellular contained for HPLC and 13C-NMR reveals the presence of N-Acetylglutaminylglutamine amide (NAGGA) and it confirms that the exogenous glutamate acts as precursor of this dipeptide. The identification for 13C-NMR of the accumulated compatible solutes in stressed cells of P. aeruginosa grows until logarithmic phase under hiperosmotic conditions with the addition of 1 mM glutamate; it showed the presence of glutamate, NAGGA and trehalose. According to these results is possible to attribute the glutamate a double function: to act as a chemical mediator and as a genuine osmolite.En este trabajo se propuso evaluar la acción del glutamato como osmoprotector exógeno en cultivos de Pseudomonas aeruginosa crecidos en condiciones hiperosmolares. La adición de glutamato exógeno, a partir de una concentración 0,1mM, confiere osmoprotección cuando esta bacteria crece en presencia de NaCl, con glucosa y amonio como fuentes de carbono y nitrógeno, respectivamente. El efecto se pone de manifiesto por la disminución del tiempo de latencia, sin variaciones en el tiempo de generación. A diferencia del comportamiento observado con glutamato, la adición de colina como osmoprotector externo, disminuye ambos parámetros de crecimiento. Si glutamato y colina se suplementan simultáneamente a cultivos hiperosmolares, P.aeruginosa incorpora ambos compuestos y se observa un efecto sinérgico, con disminución del tiempo de latencia y el tiempo de generación. Ello demuestra que estos osmoprotectores no se excluyen mutuamente. En P. aeruginosa el transporte de glutamato responde a la alta fuerza osmótica, siendo dependiente del estado energético de la célula y de la síntesis de nuevas proteínas. El estudio de metabolitos intracelulares obtenidos luego de incubar las células en condiciones hiperosmolares en presencia de glutamato, mostró que, una vez incorporado, este metabolito no se acumula como tal. El análisis del contenido intracelular por HPLC y 13C-NMR revela la presencia de N-acetilglutaminil-glutamina amida (NAGGA) y confirma que el glutamato adicionado exógenamente actúa como precursor de este dipéptido. La identificación por 13C-NMR de los solutos compatibles acumulados cuando P. aeruginosa crece hasta fase logarítmica en condiciones hiperosmolares con glutamato 1 mM, mostró la presencia de glutamato, NAGGA y trealosa. En base a estos resultados es posible atribuir al glutamato una doble función: actuar como un mediador químico y como un osmolito genuino

Dynamic of Mutational Events in Variable Number Tandem Repeats of Escherichia coli O157:H7

VNTRs regions have been successfully used for bacterial subtyping; however, the hypervariability in VNTR loci is problematic when trying to predict the relationships among isolates. Since few studies have examined the mutation rate of these markers, our aim was to estimate mutation rates of VNTRs specific for verotoxigenic E. coli O157:H7. The knowledge of VNTR mutational rates and the factors affecting them would make MLVA more effective for epidemiological or microbial forensic investigations. For this purpose, we analyzed nine loci performing parallel, serial passage experiments (PSPEs) on 9 O157:H7 strains. The combined 9 PSPE population rates for the 8 mutating loci ranged from 4.4 × 10−05 to 1.8 × 10−03 mutations/generation, and the combined 8-loci mutation rate was of 2.5 × 10−03 mutations/generation. Mutations involved complete repeat units, with only one point mutation detected. A similar proportion between single and multiple repeat changes was detected. Of the 56 repeat mutations, 59% were insertions and 41% were deletions, and 72% of the mutation events corresponded to O157-10 locus. For alleles with up to 13 UR, a constant and low mutation rate was observed; meanwhile longer alleles were associated with higher and variable mutation rates. Our results are useful to interpret data from microevolution and population epidemiology studies and particularly point out that the inclusion or not of O157-10 locus or, alternatively, a differential weighting data according to the mutation rates of loci must be evaluated in relation with the objectives of the proposed study.Fil: Bustamante, Ana Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Sanso, Andrea Mariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Segura, D. O.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Parma, Alberto Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Lucchesi, Paula Maria Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; Argentin

Atypical presentations of thrombotic thrombocytopenic purpura in middle-aged women with recurrent cerebral macrovascular thrombosis: a case report

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Separate episodes of capillary leak syndrome and pulmonary hypertension after adjuvant gemcitabine and three years later after nab-paclitaxel for metastatic disease

Background: Systemic capillary leak syndrome is a rare disease with a high mortality rate. This syndrome is characterised by generalised edema, hypotension, hemoconcentration, and hypoproteinemia. The cause is the sudden onset of capillary hyperpermeability with extravasations of plasma from the intravascular to the extravascular compartment. We present the case of a patient who experienced two episodes of systemic capillary leak syndrome and pulmonary hypertension; the first after gemcitabine in an adjuvant setting and the second three years later after treatment with nab-paclitaxel for metastatic disease.Case presentation: A 65-year-old patient underwent a pancreatectomy in January 2010 for ductal carcinoma (pT3 N0 M0, stage IIa), followed by adjuvant chemotherapy. Seven days after the last cycle, she developed dyspnea associated with orthopnea and cough. A transthoracic cardiac ecocolordoppler was performed, with evidence of pulmonary hypertension (58 mmHg). Blood tests showed an increase in creatinine, pro-BNP and D-Dimer. She began high-dose diuretic therapy combined with cortisone. After a month, the patient was eupneic and the anasarca had resolved. We decided gradually to reduce the steroid and diuretic therapy. After ten days of the reduction, the patient began to re-present the same symptoms after treatment with gemcitabine. Corticosteroid therapy was restored with rapid clinical benefit and decreased pro-BNP after a week of treatment. After two years, the disease returned. As a first line treatment, it was decided to use nab-paclitaxel 100 mg/m2 weekly. After two doses, followed by approximately 14 days of treatment, the patient developed acute respiratory distress syndrome. The clinical suspicion was a relapse of capillary leak syndrome and treatment with a high-dose diuretic (furosemide 250 mg daily) was started combined with cortisone (40 mg methylprednisolone). The patient showed a progressive clinical benefit.Conclusions: In patients treated with gemcitabine and nab-paclitaxel who experience a sudden onset of diffuse edema with respiratory distress, capillary leak syndrome should be suspected. Immediate treatment with corticosteroids may be life-saving. © 2013 Casadei Gardini et al.; licensee BioMed Central Ltd

Characterization of Shiga toxin-producing Escherichia coli O130:H11 and O178:H19 isolated from dairy cows

Shiga toxin-producing E. coli (STEC) are isolated from human patients with bloody diarrhea, hemorrhagic colitis (HC), and hemolytic uremic syndrome (HUS). In the last years, the infections with non-O157 serotypes are increasing their frequency of association with human disease. STEC produce Shiga toxin (Stx) and other virulence factors that could contribute to human pathogenesis. Cattle are the main reservoir and the transmission to humans is through the consumption of undercooked meat, non-pasteurized dairy products, and vegetables or water contaminated with feces. We have previously determined that O130:H11 and O178:H19 serotypes were the most prevalent in dairy cows from Argentina. In the present study, 37 and 25 STEC isolates from dairy cows belonging to O130:H11 and O178:H19 serotypes, respectively, were characterized regarding to their cytotoxicity on Vero cells, stx subtypes, presence of saband typing by multiple-locus variable-number tandem repeat analysis (MLVA). All strains demonstrated a cytotoxic effect, and in O130:H11 isolates, stx2EDL933 was the predominant subtype. In O178:H19 isolates the main stx2 subtype was stx2vha. The sab gene was detected in 65 and 24% of the isolates belonging to O130:H11 and O178:H19, respectively. Only one MLVA profile was identified among the O130:H11 isolates meanwhile 10 MLVA profiles were detected among the O178:H19 isolates which were grouped in two main clusters. In conclusion, our data show that O130:H11 and O178:H19 STEC isolates encode virulence factors associated with severe human disease and both serotypes should be considered for routinely testing. Our subtyping experiments showed that isolates could be distinguished based on the stx2 subtype and the presence/absence of sabgene, and for isolates belonging to O178:H19, also when the MLVA type was considered. However, MLVA subtyping of O130:H11 isolates will require the development of more specific markers.Fil: Fernandez, Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Krüger, Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Polifroni, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Bustamante, Ana Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Sanso, Andrea Mariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Etcheverría, Analía Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Lucchesi, Paula Maria Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Parma, Alberto Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; ArgentinaFil: Padola, Nora Lía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Tandil. Centro de Investigacion Veterinaria de Tandil; Argentin