La lectura en el ámbito universitario. Estrategias para intentar resolver un conflicto.

En el siguiente artículo desarrollaremos una reflexión y se propondrán algunas estrategias de resolución vinculadas con una problemática que afecta a la comunidad universitaria: el proceso de lectura académica y la comprensión de los textos. Pensamos en la comprensión de la lectura de un texto académico como la recuperación de su significado a partir de la consideración de ciertas pistas contenidas en el mismo texto. La mencionada recuperación se lleva a cabo –indudablemente- mediante la ejecución de operaciones mentales que pone en funcionamiento el lector con la finalidad de darle sentido a las pistas halladas. Referimos a un proceso dinámico que desarrolla el que lee, a medida que establece conexiones coherentes entre la información que posee en sus estructuras cognitivas y la nueva información que le provee el texto. Partiendo de estos postulados teóricos desarrollaremos nuestra propuesta a través de los siguientes tópicos: el proceso de lectura; las fases de la lectura; principales conflictos; y posibles estrategias de resolución

Enfermedad de Paget en un grupo de pacientes hospitalarias

Se revisa la presentación de 9 (nueve) pacientes con enfermedad de Paget sobre un total de 278 pacientes con cáncer de mama (3,23 %), en un Servicio Hospitalario, durante un período de 5 (cinco) años. (Estudio restrospectivo randomizado). La Enfermedad de Paget es una rara variedad (hasta un 4% del total) de cáncer de mama que reside en el complejo teloareolar y que debe diferenciarse clínicamente del eczema, prurito o grieta del pezón, patologías benignas cuya signosintomatología es similar: prurito, edema, eczema, derrame serosanguinolento por el pezón, eritema y eventualmente, nodulo subareolar.Las pacientes fueron diagnosticadas clínica e histológicamente por biopsia incisional tridimensional (corte que incluye piel, tejido mamario y grasa). La estadificación es estándar para cáncer de mama. Una (1) de las pacientes se presentó en un estadio I de la clasificación TNM de la Organización Mundial contra el Cáncer (UICC), cinco (5) de las mismas correspondieron a un estadio lia y 3 (tres) presentaron un estadio III a y b. Todas las pacientes fueron tratadas de acuerdo a los protocolos oncológicos correspondientes al estadio. Dos pacientes fallecieron durante el seguimiento, pertenecientes al estadio III. Debe enfatizarse el diagnóstico diferencial de esta variedad de cáncer de  mama con patologías benignas de la aréola-pezón, a fin de tratar estas pacientes de acuerdo a las pautas de tratamiento del cáncer, evitando falsos negativos.

Tipificación del Virus del Papiloma Humano en Neoplasias Epiteliales Malignas de Cavidad Bucal

El objetivo de la presente investigación fue detectar y tipificar el virus del papiloma humano en neoplasias epiteliales malignas de cavidad bucal, y comparar los tipos hallados con los de mayor incidencia y más vinculados con neoplasias malignas de mucosa genital.Se analizaron dos tipos de muestras: las primeras obtenidas a través de hisopados bucales de pacientes con diagnóstico presuntivo o confirmado de neoplasias epiteliales malignas de cavidad bucal, que concurrieron al Servicio de Cabeza y Cuello del Instituto de Oncología “Ángel Roffo” Buenos Aires y las segundas, obtenidas de biopsias incluidas en tacos de parafina, de pacientes diagnostica­dos en el Servicio de Patología y Citodiagnóstico del Hospital “J. R. Vidal” , Corrientes. Para ello se aplicaron técnicas de reacción en cadena de la polimerasa (PCR) y PCR -  RFLP.Los resultados obtenidos indicaron que existe un 38% de infección por HPV en las muestras analizadas, de las cuales la mayoría presentaban baja carga viral, y sólo 6 casos pudieron ser tipificados, dando patrones indeterminados

Bispecific PSMA antibodies and CAR-T in metastatic castration-resistant prostate cancer.

Prostate cancer is the most common cancer among men and the second leading cause of cancer-related deaths in men in the United States. The treatment paradigm for prostate cancer has evolved with the emergence of a variety of novel therapies which have improved survival; however, treatment-related toxicities are abundant and durable responses remain rare. Immune checkpoint inhibitors have shown modest activity in a small subset of patients with prostate cancer and have not had an impact on most men with advanced disease. The discovery of prostate-specific membrane antigen (PSMA) and the understanding of its specificity to prostate cancer has identified it as an ideal tumor-associated antigen and has revived the enthusiasm for immunotherapeutics in prostate cancer. T-cell immunotherapy in the form of bispecific T-cell engagers (BiTEs) and chimeric antigen receptor (CAR) T-cell therapy have shown exceptional success in treating various hematologic malignancies, and are now being tested in patients with prostate cancer with drug design centered on various target ligands including not just PSMA, but others as well including six-transmembrane epithelial antigen of the prostate 1 (STEAP1) and prostate stem cell antigen (PSCA). This summative review will focus on the data surrounding PSMA-targeting T-cell therapies. Early clinical studies with both classes of T-cell redirecting therapies have demonstrated antitumor activity; however, there are multiple challenges with this class of agents, including dose-limiting toxicity, \u27on-target, off-tumor\u27 immune-related toxicity, and difficulty in maintaining sustained immune responses within a complex and overtly immunosuppressive tumor microenvironment. Reflecting on experiences from recent trials has been key toward understanding mechanisms of immune escape and limitations in developing these drugs in prostate cancer. Newer generation BiTE and CAR T-cell constructs, either alone or as part of combination therapy, are currently under investigation with modifications in drug design to overcome these barriers. Ongoing innovation in drug development will likely foster successful implementation of T-cell immunotherapy bringing transformational change to the treatment of prostate cancer

Phase 1, open-label, dose-escalation study on the safety, pharmacokinetics, and preliminary efficacy of intravenous Coxsackievirus A21 (V937), with or without pembrolizumab, in patients with advanced solid tumors

Background Oncolytic virus V937 showed activity and safety with intratumoral administration. This phase 1 study evaluated intravenous V937±pembrolizumab in patients with advanced solid tumors. Methods Patients had advanced non-small cell lung cancer (NSCLC), urothelial cancer, metastatic castration-resistant prostate cancer, or melanoma in part A (V937 monotherapy), and metastatic NSCLC or urothelial cancer in part B (V937+pembrolizumab). Prior immunotherapy was permitted >28 days before study treatment. Patients received intravenous V937 on days 1, 3, and 5 (also on day 8 in part B) of the first 21-day cycle and on day 1 of subsequent cycles for eight cycles. Three ascending dose-escalation cohorts were studied. Dose-escalation proceeded if no dose-limiting toxicities (DLTs) occurred in cycle 1 of the previous cohort. In part B, patients also received pembrolizumab 200 mg every 3 weeks from day 8 for 2 years; dose-expansion occurred at the highest-dose cohort. Serial biopsies were performed. Results No DLTs occurred in parts A (n=18) or B (n=85). Grade 3–5 treatment-related adverse events (AEs) were not observed in part A and were experienced by 10 (12%) patients in part B. The most frequent treatment-related AEs (any grade) in part B were fatigue (36%), pruritus (18%), myalgia (14%), diarrhea (13%), pyrexia (13%), influenza-like illness (12%), and nausea (12%). At the highest tested dose, median intratumoral V937 concentrations were 117,631 copies/mL on day 8, cycle 1 in part A (n=6) and below the detection limit for most patients (86% (19/22)) on day 15, cycle 1 in part B. Objective response rates were 6% (part A), 9% in the NSCLC dose-expansion cohort (n=43), and 20% in the urothelial cancer dose-expansion cohort (n=35). Conclusions Intravenous V937+pembrolizumab had a manageable safety profile. Although V937 was detected in tumor tissue, in NSCLC and urothelial cancer, efficacy was not greater than that observed in previous studies with pembrolizumab monotherapy. Trial registration number NCT02043665

Approved checkpoint inhibitors in bladder cancer: which drug should be used when?

The treatment of advanced metastatic urothelial carcinoma has recently evolved with the approval of five checkpoint inhibitors. In the second-line setting, in patients who have progressed on cisplatin-based chemotherapy, pembrolizumab, atezolizumab, durvalumab, nivolumab and avelumab are United States Food and Drug Administration (FDA) approved. In cisplatin-ineligible patients, atezolizumab and pembrolizumab are the FDA-approved checkpoint inhibitors. Here we describe the updated clinical efficacy of these checkpoint inhibitors in the treatment of advanced urothelial carcinoma and then suggest how they can be sequenced in the context of available chemotherapeutic options. For cisplatin-eligible patients, platinum-based chemotherapy remains the standard first-line treatment. For patients progressing on platinum-based therapy, phase III trials have been performed comparing pembrolizumab and atezolizumab separately with standard chemotherapy, and results favor the use of pembrolizumab

Additional file 1: of Autoimmune inner ear disease in a melanoma patient treated with pembrolizumab

Original audiogram report showing pure tone and speech audiometry. Caption/Description of data: After a series of intratympanic dexamethasone injections, hearing thresholds improved significantly in both ears in the 250 – 2000 Hz range. Left: Pre and post injection audiometry tracings. Black line denotes pre-injection hearing thresholds and red line denotes post-injection thresholds. Right: Word recognition scores. Right ear word recognition improved from 48 to 88 %, and left ear WR improved from 44 to 84 %. (JPG 1002 kb