Cáncer pulmonar: prevención y pesquisa precoz

ResumenEl cáncer pulmonar es el más mortal de todos los cánceres. Debido a que la gran mayoría de los cánceres pulmonares son causados por el hábito de fumar, su erradicación es la mejor estrategia de prevención primaria. El diagnóstico del cáncer pulmonar en etapas tempranas mejora significativamente su pronóstico, por lo que ésta es la mejor estrategia de prevención secundaria. Recientemente se ha reportado que un programa de pesquisa de cáncer pulmonar con escáner de tórax (TAC) reduce la mortalidad por cáncer. El objetivo de esta revisión es, en primer lugar, apelar a la evidencia en cuanto al rendimiento de los programas de pesquisa de cáncer pulmonar en poblaciones de alto riesgo, y en segundo lugar, analizar las distintas estrategias que tiene un médico cuando se enfrenta a un paciente a quien se le ha encontrado incidentalmente un nódulo pulmonar.SummaryLung cancer is a deadly disease. Since this cancer is closely related to tobacco smoke, the best way to avoid this disease is smoking prevention. Unfortunately smoking is a worldwide epidemic and in Chile its prevalence is not decreasing. The second best strategy is an early detection. For the first time there is a report showing that screening with the use of low-dose CT reduces mortality from lung cancer. The prognosis is much better in early stages. The purpose of this publication is to review the evidence about screening of lung cancer, and to analyze the different strategies to deal, in the general practice, with a finding of a lung nodule

Osteogenic parameters surrounding trabecular tantalum metal implants in osteotomies prepared via osseodensification drilling

Surgical fixation of implants into bone for the correction of bone deformities or defects is a traditional approach for skeletal stabilization. Important measures of efficacy of implants include implant stability and osseointegration?the direct interaction between living bone and an implant. Osseointegration depends on successful implant placement and subsequent bone remodeling. This study utilized osseodensification drilling (OD) in a low bone density model using trabecular metal (TM) implants. Three osteotomy sites, Regular, OD-CW (clockwise), and OD-CCW (counterclockwise), were prepared in each ilium of three female sheep. Drilling was performed at 1100rpm with saline irrigation. Trabecular metal (TM) (Zimmer®, Parsippany, NJ, USA) implants measuring 3.7mm in diameter x 10mm length were placed into respective osteotomies. A three-week period post-surgery was given to allow for healing to take place after which all three sheep were euthanized and the ilia were collected. Samples were prepared, qualitatively and quantitatively analyzed using histology micrographs and image analysis software (ImageJ, NIH, Bethesda, MD). Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were quantified to evaluate the osseointegration parameters. All implants exhibit successful bone formation in the peri-implant environment as well as within the open spaces of the trabecular network. Osseointegration within the TM (quantified by %BIC) as a function of drilling technique was more pronounced in OD samples(p>0.05). The %BAFO however shows a significant difference (p=0.036) between the CCW and R samples. Greater bone volume and frequency of bone chips are observed in OD samples. The utilization of OD as a design for improved fixation of hardware was supported by increased levels of stability, both primary and secondary. Histological data with OD provided notably different results from those of the regular drilling method

Geochemistry of the Late Cretaceous Pandan Formation in Cebu Island, Central Philippines: Sediment Contributions From the Australian Plate Margin During the Mesozoic

The Late Cretaceous Pandan Formation in Cebu Island is one of the oldest sedimentary units in the Central Philippines. The inconsistencies in geological descriptions and interpretation of the depositional environment of the Pandan Formation complicated efforts to determine the origin and tectonic history of the basement of Cebu Island. This study therefore looks into the petrological and geochemical characteristics of the Pandan Formation and their implications for the tectonic development of the Philippine Arc during the late Mesozoic. Petrographic analyses indicate significant contribution from mafic sources with additional inputs from felsic rocks, siliciclastics and metamorphic sources. Enrichment of detrital quartz from felsic volcanic and plutonic rocks, as well as from siliciclastic and metamorphic sources, has shifted the SiO2 composition of the Pandan clastics from a mafic to a more intermediate source. Whole-rock geochemical analyses revealed low SiO2/Al2O3 = 4.21, low K2O/Na2O = 1.16, low Th/Sc = 0.13, low Th/U = 2.78, high La/Th = 4.51, significantly low REEs = ca 76.45 ppm and low LaN/YbN = 4.28. A slight negative chondrite-normalized Eu/Eu* (0.91) anomaly and significantly high PAAS-normalized positive Eu/Eu* (1.39) values are consistent with derivation from a young undissected magmatic arc terrane. Tectonic discrimination diagrams suggest formation in an oceanic island arc to active margin/collision zone modelled to be located at the oceanic leading edge of Australia. Rapid uplift and erosion of the magmatic arc and older allochthonous blocks gave way to the rapid deposition of the Pandan Formation in the Late Cretaceous at the subequatorial region

Identification and Functional Characterization of Two Intronic NIPBL Mutations in Two Patients with Cornelia de Lange Syndrome

Cornelia de Lange syndrome (CdLS) is a rare genetically heterogeneous disorder with a high phenotypic variability including mental retardation, developmental delay, and limb malformations. The genetic causes in about 30% of patients with CdLS are still unknown. We report on the functional characterization of two intronic NIPBL mutations in two patients with CdLS that do not affect a conserved splice-donor or acceptor site. Interestingly, mRNA analyses showed aberrantly spliced transcripts missing exon 28 or 37, suggesting the loss of the branch site by the c.5329-15A>G transition and a disruption of the polypyrimidine by the c.6344del(-13)-(-8) deletion. While the loss of exon 28 retains the reading frame of the NIBPL transcript resulting in a shortened protein, the loss of exon 37 shifts the reading frame with the consequence of a premature stop of translation. Subsequent quantitative PCR analysis demonstrated a 30% decrease of the total NIPBL mRNA levels associated with the frameshift transcript. Consistent with our results, this patient shows a more severe phenotype compared to the patient with the aberrant transcript that retains its reading frame. Thus, intronic variants identified by sequencing analysis in CdLS diagnostics should carefully be examined before excluding them as nonrelevant to disease

CARMA Survey Toward Infrared-bright Nearby Galaxies (STING): Molecular Gas Star Formation Law in NGC4254

This study explores the effects of different assumptions and systematics on the determination of the local, spatially resolved star formation law. Using four star formation rate (SFR) tracers (H\alpha with azimuthally averaged extinction correction, mid-infrared 24 micron, combined H\alpha and mid-infrared 24 micron, and combined far-ultraviolet and mid-infrared 24 micron), several fitting procedures, and different sampling strategies we probe the relation between SFR and molecular gas at various spatial resolutions and surface densities within the central 6.5 kpc in the disk of NGC4254. We find that in the high surface brightness regions of NGC4254 the form of the molecular gas star formation law is robustly determined and approximately linear and independent of the assumed fraction of diffuse emission and the SFR tracer employed. When the low surface brightness regions are included, the slope of the star formation law depends primarily on the assumed fraction of diffuse emission. In such case, results range from linear when the fraction of diffuse emission in the SFR tracer is ~30% or less (or when diffuse emission is removed in both the star formation and the molecular gas tracer), to super-linear when the diffuse fraction is ~50% and above. We find that the tightness of the correlation between gas and star formation varies with the choice of star formation tracer. The 24 micron SFR tracer by itself shows the tightest correlation with the molecular gas surface density, whereas the H\alpha corrected for extinction using an azimuthally-averaged correction shows the highest dispersion. We find that for R<0.5R_25 the local star formation efficiency is constant and similar to that observed in other large spirals, with a molecular gas depletion time ~2 Gyr.Comment: accepted for publication in ApJ, vol 729, March 10 2011 issue; 30 pages; 14 figures; revised version includes referee's comments; results unchange

Long-term immune response accompanies clinical outcomes in severe asthmatics treated with anti-IL-5/IL-5R biologics

This work was supported by ISCIII - Instituto de Salud Carlos III, FIS (Fondo de Investigación Sanitaria - Spanish Health Research Fund) grants PI21/00896 and FI19/00067; Ciber de Enfermedades Respiratorias (CIBERES); SEAIC grants 22A07; BASEAS STUDY (Basophils in EosinophilicAsthma) Study Code ESR-20-20764 AstraZeneca International; Comunidad de Madrid grant PEJ2021-AI_BMD-22320 and FEDER funds (Fondo Europeo de Desarrollo Regiona

Gender-dependent differences in plasma matrix metalloproteinase-8 elevated in pulmonary tuberculosis.

Tuberculosis (TB) remains a global health pandemic and greater understanding of underlying pathogenesis is required to develop novel therapeutic and diagnostic approaches. Matrix metalloproteinases (MMPs) are emerging as key effectors of tissue destruction in TB but have not been comprehensively studied in plasma, nor have gender differences been investigated. We measured the plasma concentrations of MMPs in a carefully characterised, prospectively recruited clinical cohort of 380 individuals. The collagenases, MMP-1 and MMP-8, were elevated in plasma of patients with pulmonary TB relative to healthy controls, and MMP-7 (matrilysin) and MMP-9 (gelatinase B) were also increased. MMP-8 was TB-specific (p<0.001), not being elevated in symptomatic controls (symptoms suspicious of TB but active disease excluded). Plasma MMP-8 concentrations inversely correlated with body mass index. Plasma MMP-8 concentration was 1.51-fold higher in males than females with TB (p<0.05) and this difference was not due to greater disease severity in men. Gender-specific analysis of MMPs demonstrated consistent increase in MMP-1 and -8 in TB, but MMP-8 was a better discriminator for TB in men. Plasma collagenases are elevated in pulmonary TB and differ between men and women. Gender must be considered in investigation of TB immunopathology and development of novel diagnostic markers