An Erythroid Differentiation Signature Predicts Response to Lenalidomide in Myelodysplastic Syndrome

Background: Lenalidomide is an effective new agent for the treatment of patients with myelodysplastic syndrome (MDS), an acquired hematopoietic disorder characterized by ineffective blood cell production and a predisposition to the development of leukemia. Patients with an interstitial deletion of Chromosome 5q have a high rate of response to lenalidomide, but most MDS patients lack this deletion. Approximately 25% of patients without 5q deletions also benefit from lenalidomide therapy, but response in these patients cannot be predicted by any currently available diagnostic assays. The aim of this study was to develop a method to predict lenalidomide response in order to avoid unnecessary toxicity in patients unlikely to benefit from treatment. Methods and Findings: Using gene expression profiling, we identified a molecular signature that predicts lenalidomide response. The signature was defined in a set of 16 pretreatment bone marrow aspirates from MDS patients without 5q deletions, and validated in an independent set of 26 samples. The response signature consisted of a cohesive set of erythroid-specific genes with decreased expression in responders, suggesting that a defect in erythroid differentiation underlies lenalidomide response. Consistent with this observation, treatment with lenalidomide promoted erythroid differentiation of primary hematopoietic progenitor cells grown in vitro. Conclusions: These studies indicate that lenalidomide-responsive patients have a defect in erythroid differentiation, and suggest a strategy for a clinical test to predict patients most likely to respond to the drug. The experiments further suggest that the efficacy of lenalidomide, whose mechanism of action in MDS is unknown, may be due to its ability to induce erythroid differentiation

Bleeding and Hysteroscopy in Uterine Myomatosis

Uterine leiomyomas are one of the most common diseases in women. However, there is still much about them we do not know. These tumours, also known as fibroids or myomas, affect women mainly during their reproductive years, and they are diagnosed in up to 70% to 80% of women during their lives. The most relevant part of this disease is the profound impact in the quality of life of women, in the provision of health services, and on the costs all around the world. Even though, the majority of women with fibroids are asymptomatic, approximately 30% of them will present severe symptoms, with a broad range of problems such as: abnormal uterine bleeding, infertility, and obstetric complications. There are multiple factors involved in the biology of fibroids: genetic, epigenetic, hormonal, proinflammatory, angiogenic and growth factors, growth factors that are capable of inducing and promoting de development of fibroids. The leiomyoma is surrounded by a pseudocapsule generated by compression and ischaemia of the tumour towards the myometrium and is composed by multiple elements that that promote healing and tissue repair of the myometrium after myomectomy. Therefore, its conservation in the myometrium is essential, regardless of the surgical technique used. Resection by hysteroscopy can be performed in an office or in an operating room, depending on the characteristics of the fibroid, it is required a good diagnosis and experience

A Sustainable Campus for the Future: Proposals for Sarah Lawrence College

The combined version of A Sustainable Campus for the Future: Proposals for Sarah Lawrence College comes from a joint project between the students in Economics of the Ecological Crisis and Global Change Biology in Spring 2016, taught by Nicholas Reksten and Michelle Hersh, respectively.https://digitalcommons.slc.edu/undergrad_sustainproject/1009/thumbnail.jp

Guía de práctica clínica para el manejo de la nutrición enteral en el recién nacido prematuro con muy bajo peso al nacer en el Seguro Social del Perú (EsSalud)

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of enteral nutrition in premature newborns with very low birth weight in the Social Security of Peru (EsSalud). Objective: Provide evidence-based clinical recommendations for the management of premature newborns with very low birth weight in EsSalud. Methods: A guideline development group (GDG) was formed that included medical specialists and methodologists. The GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches were carried out for systematic reviews and – when considered relevant – primary studies in Medline and CENTRAL during 2021. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, good clinical practice points, and the management flowchart. Finally, the CPG was approved with Resolution No. 071–IETSI-ESSALUD-2022. Results: This CPG addressed 5 clinical questions, all referring to the management of enteral nutrition in premature newborns with very low birth weight. Based on these questions, 5 recommendations were formulated (1 strong recommendation and 4 conditional recommendations), 5 GCP, and 1 flow chart. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of enteral nutrition in premature newborns with very low birth weight in EsSalud.Introducción: El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la nutrición enteral en el recién nacido prematuro con muy bajo peso al nacer en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo del recién nacido prematuro con muy bajo peso al nacer en EsSalud. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 5 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en Medline y CENTRAL durante el 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de manejo. Finalmente, la GPC fue aprobada con Resolución N° 071–IETSI-ESSALUD-2022. Resultados: La presente GPC abordó 5 preguntas clínicas, todas referidas al manejo de la nutrición enteral en el recién nacido prematuro con muy bajo peso al nacer. En base a dichas preguntas se formularon 5 recomendaciones (1 recomendación fuerte y 4 recomendaciones condicionales), 5 BPC, y 1 flujograma. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el manejo de la nutrición enteral en el recién nacido prematuro con muy bajo peso al nacer en EsSalud

Zoonosis, cambio climático y sociedad

La sociedad contemporánea se enfrenta a uno de los retos más grandes de la historia humana, el calentamiento global, mismo que acarrea enormes consecuencias, tales como los disturbios climáticos, así como los patrones de las enfermedades de origen animal transmisibles al hombre. Precisamente ante este escenario las instituciones educativas de nivel superior deben dar cumplimiento a su responsabilidad y ser las generadoras de alternativas de solución mediante el trabajo especializado de investigación; y para ello, la pesquisa científica es la mejor de las alternativas a nuestro alcance para comprender y encarar estos desafíos.Universidad Autónoma del Estado de México y Ediciones y Gráficos Eón, S.A. de C.V

Relación de las alteraciones del sueño con el desarrollo de diabetes mellitus gestacional

Sleeping is a fundamental activity for health, and when alterations occur, they increase the risk of metabolic, cardiovascular, endocrine and neurological disorders. Anatomical changes and in respiratory physiology of pregnancy affect the normal course of sleep, which in turn affects the health of the pregnant woman so that alterations in sleep during gestation associate with a greater risk of obstetric complications, such as gestational diabetes mellitus (GDM). GDM affects from 4 to 30% of pregnancies in Mexico, and is associated with short and long term complications for both mother and offspring. A series of recent studies has offered evidence of a relation between sleep disorder and the development of GDM, and proposes oxidative stress, inflammation, activation of the sympathetic nervous system and hormonal deregulation as underlying mechanisms for said relation. This underscores the importance of sleep alteration as a modifiable factor in sight for reduction of the frequency of GDM. The objective of this manuscript is to carry out a descriptive review about different studies published from 2013 to 2022, that have addressed the relationship between sleep disorders and the development of GDM with emphasis on the proposed mechanisms. The databases used were PubMed Central and Scielo, using the keywords: sleep disorders and gestational diabetes mellitus.Dormir es una actividad fundamental para la salud, por lo que cuando ocurren alteraciones del sueño aumenta el riesgo de trastornos metabólicos, cardiovasculares, endocrinos y neurológicos. Los cambios anatómicos y la fisiología respiratoria del embarazo afectan el curso normal del sueño, impactando en la salud de la mujer embarazada a tal grado que las alteraciones del sueño durante la gestación se asocian con un mayor riesgo de complicaciones obstétricas como la diabetes mellitus gestacional (DMG). La DMG afecta del 4 al 30% de los embarazos en México y se asocia con complicaciones a corto y largo plazo tanto en la madre como en el neonato. Una serie de estudios recientes proporcionan evidencia de una relación entre la alteración del sueño con el desarrollo de DMG y proponen al estrés oxidativo, la inflamación, la activación del sistema nervioso simpático y la desregulación hormonal como mecanismos subyacentes de dicha relación. Ésto pone de relieve la importancia de la alteración del sueño como un factor modificable dirigido a una disminución de la frecuencia de DMG. El objetivo de este trabajo es realizar una revisión descriptiva de los diferentes estudios publicados desde el año 2013 al 2022, que han abordado la relación entre la alteración del sueño con el desarrollo de DMG con énfasis en los mecanismos propuestos. Las bases de datos utilizadas fueron PubMed Central y Scielo, utilizando las palabras clave: trastornos del sueño y diabetes gestaciona