Toxicities of Immunosuppressive Treatment of Autoimmune Neurologic Diseases

In parallel to our better understanding of the role of the immune system in neurologic diseases, there has been an increased availability in therapeutic options for autoimmune neurologic diseases such as multiple sclerosis, myasthenia gravis, polyneuropathies, central nervous system vasculitides and neurosarcoidosis. In many cases, the purported benefits of this class of therapy are anecdotal and not the result of good controlled clinical trials. Nonetheless, their potential efficacy is better known than their adverse event profile. A rationale therapeutic decision by the clinician will depend on a comprehensive understanding of the ratio between efficacy and toxicity. In this review, we outline the most commonly used immune suppressive medications in neurologic disease: cytotoxic chemotherapy, nucleoside analogues, calcineurin inhibitors, monoclonal antibodies and miscellaneous immune suppressants. A discussion of their mechanisms of action and related toxicity is highlighted, with the goal that the reader will be able to recognize the most commonly associated toxicities and identify strategies to prevent and manage problems that are expected to arise with their use

Influencia del nivel educacional en la respuesta sexual femenina

Rosario Fadul C. (biografía): Fue profesora de enfermería pasiquiátrica en la Universidad Autónoma de Santo Domingo. Realizó un posgrado en terapia marital y sexual en el Instituto APEC de Educación Sexual (INSAPEC). Actualmente dirigie el Instituto de Sexualidad Humana de la UASD y es coordinadora de su programa de maestría en terapia familiar. Junto con el Dr. Rafael García Álvarez escribió el libro "Lo que quiero saber sobre el sexo: guía de respuestas a las inquietudes privadas de tu intimidad". Otras obras suyas son: "Conducta sexual del adolescente dominicano" (en coautoría con Rafael García, Antonio de Moya, Elizabeth Gómez y Edward Herold) y "Sosúa Sanky-Pankies and Female Sex Workers" (en coautoría con Antonio de Moya, Rafael García y Edward Herold)............./.............Rafael García Álvarez (biografía): Médico psiquiatra de nacionalidad dominicana. Como docente, ha enseñado epidemiología, psiquiatría y terapia sexual en la Universidad Autónoma de Santo Domingo (UASD) y en la Universidad Nacional Pedro Henríquez Ureña (UNPHU). Además, dirigió la maestría en salud pública de la UASD y fundó, en 1985, el Instituto de Sexualidad Humana de ese centro universitario. En el Instituto APEC de Educación Sexual, tuvo a su cargo la maestría en terapia marital y sexual. Entre sus trabajos publicadas están: "Lo que quiero saber sobre el sexo: guía de respuestas a las inquietudes privadas de tu intimidad" (en coautoría con Rosario Fadul), "Conducta sexual del adolescente dominicano" (en coautoría con Rosario Fadul, Antonio de Moya, Elizabeth Gómez y Edward Herold), "Sosúa Sanky-Pankies and Female Sex Workers" (en coautoría con Antonio de Moya, Rosario Fadul y Edward Herold), "Infantofilia, Pedofilia y Hebefilia: hallazgos recientes" (en coautoría con E. Antonio de Moya)........../...........Aida María Freites (biografía): Psicóloga, realizó un posgrado en terapia marital y sexual en el Instituto APEC de Educación Sexual (INSAPEC)........./........Laura Erickson: Es psicóloga.Se presenta aquí una investigación sobre la sexualidad femenina. La hipótesis, comprobada por los resultados, sostiene que el nivel educacional de la mujer incide en su respuesta sexual. Limitándose a mujeres dominicanas de clase alta y entre los 20 y los 45 años de edad, el estudio asociativo comparó las diferencias que se dan, en el ámbito de la respuesta sexual, y particularmente en el logro del orgasmo, entre quienes solo son bachilleras y quienes tienen estudios universitarios. También se consideraron las variables del nivel educativo de los progenitores, el nivel de satisfacción de la primera relación sexual y la actitud del compañero, todas las cuales mostraron incidir positivamente en el fenómeno estudiado. Estos resultados son contestes con la comprobación hecha por la psicología y la sexología de que la conducta sexual humana no solo es el producto de factores biológicos, sino también de factores psicológicos, ambientales y culturales

Análise da correção atmosférica de imagens Landsat em estudo multitemporal na região de Mata Atlântica, Estado do Rio de Janeiro.

Multitemporal, remotely sensed data applied to land use land cover dynamic studies require radiometric correction of images, in addition to geometric correction. This allow the analysis of temporal variation of targets without the influence of others factors such as the atmospheric effects. This study aims to apply the dark-object subtraction technique to correct atmospheric effects and to analyze the results on multitemporal images of rivers Macacu and Caceribu watersheds, in Rio de Janeiro state, in Atlantic Forest region. Images without clouds from sensors TM/Landsat-5 and ETM+/Landsat-7 were selected for analysis of land use land cover dynamic of two periods: 1997 to 2002 and 2002 to 2007. The results indicated that the correction method did not reduce the atmospheric effects in a satisfactory manner. These effects continued to influence in any significant way in the spectral response of the targets. The major differences between the levels of gray of the corrected images were among the images of different sensors, indicating likely influence of the response of the sensors on the final results. o objetivo do presente trabalho é analisar o efeito da correção atmosférica aplicando método de subtração de nível de ci nza em imagens multitemporais da região das bacias hidrográficas dos rios Macacu e Caceribu, no Estado do Rio de Janeiro, em região de Mata Atlântica

Methotrexate Encephalopathy: Two Cases in Adult Cancer Patients, Who Recovered with Pathophysiologically Based Therapy

Background/Objectives: Neurotoxicity is a serious and sometimes fatal adverse effect that can occur following methotrexate treatment. We describe two adult patients with hematological malignancies with methotrexate encephalopathy who recovered with dextromethorphan therapy. Results: Case 1 : A 24-year-old male with acute lymphoblastic leukemia developed the acute onset of bilateral facial weakness and slurred speech after his first treatment with high-dose intravenous methotrexate. The clinical scenario and a head magnetic resonance imaging supported a diagnosis of methotrexate encephalopathy. Treatment with dextromethorphan was coincident with recovery. Case 2 : A 65-year-old female with recurrent diffuse large B-cell lymphoma was treated with high- dose intravenous methotrexate. Two weeks after a cycle, she developed hypoactive delirium, marked lethargy, ocular ataxia, and a right-sided facial weakness. Within 2 days of starting dextromethorphan, there was improvement with clinical recovery. Conclusions: These two cases suggest that N -methyl d -aspartate receptor activation by homocysteine may play an important role in the pathogenesis of methotrexate neurotoxicity

Predictors of duloxetine response in patients with oxaliplatinâ induced painful chemotherapyâ induced peripheral neuropathy (CIPN): a secondary analysis of randomised controlled trial â CALGB/alliance 170601

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136306/1/ecc12421_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136306/2/ecc12421.pd

Ovarian Cancer Progression is Controlled by Phenotypic Changes in Dendritic Cells

We characterized the initiation and evolution of the immune response against a new inducible p53-dependent model of aggressive ovarian carcinoma that recapitulates the leukocyte infiltrates and cytokine milieu of advanced human tumors. Unlike other models that initiate tumors before the development of a mature immune system, we detect measurable antitumor immunity from very early stages, which is driven by infiltrating dendritic cells (DCs) and prevents steady tumor growth for prolonged periods. Coinciding with a phenotypic switch in expanding DC infiltrates, tumors aggressively progress to terminal disease in a comparatively short time. Notably, tumor cells remain immunogenic at advanced stages, but anti-tumor T cells become less responsive, whereas their enduring activity is abrogated by different microenvironmental immunosuppressive DCs. Correspondingly, depleting DCs early in the disease course accelerates tumor expansion, but DC depletion at advanced stages significantly delays aggressive malignant progression. Our results indicate that phenotypically divergent DCs drive both immunosurveillance and accelerated malignant growth. We provide experimental support for the cancer immunoediting hypothesis, but we also show that aggressive cancer progression after a comparatively long latency period is primarily driven by the mobilization of immunosuppressive microenvironmental leukocytes, rather than loss of tumor immunogenicity

Dinâmica de uso e cobertura da terra nas bacias hidrográficas de Guapi-Macacu e Caceribu - RJ.

bitstream/CNPS-2010/14730/1/bpd136-dinamica-guapi-macacu.pd

Addressing and Inspiring Vaccine Confidence in Black, Indigenous, and People of Color During the Coronavirus Disease 2019 Pandemic

During the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than white Americans, and, now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines