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OBJECTIVE: To evaluate the genetic diversity, admixture, genetic relationships, and sex-biased demographic processes in Mexican Mestizo (admixed) populations based on 10 X-chromosome STRs (X-STRs). METHODS: We analyzed the X-STRs Decaplex system in 104 Mexican Native Americans to obtain the ancestral reference needed to complete the demographic analyses above mentioned. We included reported Iberian and Latin American (admixed) populations from Central and South America, as well as datasets from Mexican Mestizos based on Y-linked STRs (Y-STRs), autosomal STRs (A-STRs), and mtDNA. RESULTS: Higher X-linked Native American ancestry was observed among Latin American populations regarding that reported from A-STRs and Y-STRs. The interpopulation differentiation based on ancestry among Mexican Mestizos diminished according to the inheritance pattern: Y-STRs (highest), A-STRs, X-STRs, and mtDNA (lowest). This finding is related to the peculiar admixture process that occurred during and after the Spanish Conquest of Mexico (and most of Latin America), involving a large number of Spanish men (Y-chromosomes) with a lesser proportion of X-chromosomes than autosomes; besides to the limited number of Spanish women (XX) arrived in the Americas in subsequent and shorter periods. Population expansion was detected in Mexican Mestizos from all the country, except those from the southeast region characterized by elevated indigenous ancestry, marginalization, and poorness. CONCLUSIONS: Population growth was detected in most Mexican Mestizos, besides more homogeneous and larger Native American ancestry based on X-linked inheritance than that based on autosomal STRs and Y-STRs.
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OBJECTIVE: This study aimed to compare the insertion torque (IT), flexural strength (FS) and surface alterations between stainless steel (SS-MIs) and titanium alloy (Ti-MIs) orthodontic mini-implants. METHODS: Twenty-four MIs (2 x 10 mm; SS-MIs, n = 12; Ti-MIs, n = 12) were inserted on artificial bone blocks of 20 lb/ft3 (20 PCF) and 40 lb/ft3 (40 PCF) density. The maximum IT was recorded using a digital torque meter. FS was evaluated at 2, 3 and 4 mm-deflection. Surface topography and chemical composition of MIs were assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). General linear and mixed models were used to assess the effect of the MI type, bone density and deflection on the evaluated outcomes. RESULTS: The IT of Ti-MIs was 1.1 Ncm greater than that obtained for the SS-MIs (p= 0.018). The IT for MIs inserted in 40 PCF test blocks was 5.4 Ncm greater than that for those inserted in 20 PCF test blocks (p < 0.001). SS-MIs inserted in higher density bone (40 PCF) had significantly higher flexural strength than the other groups, at 2 mm (98.7 ± 5.1 Ncm), 3 mm (112.0 ± 3.9 Ncm) and 4 mm (120.0 ± 3.4 Ncm) of deflection (p< 0.001). SEM evidenced fractures in the Ti-MIs. EDS revealed incorporation of 18% of C and 2.06% of O in the loaded SS-MIs, and 3.91% of C in the loaded Ti-MIs. CONCLUSIONS: Based on the findings of this in vitro study, it seems that SS-MIs offer sufficient stability and exhibit greater mechanical strength, compared to Ti-MIs when inserted into higher density bone.
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Ligas Dentárias , Implantes Dentários , Resistência à Flexão , Teste de Materiais , Microscopia Eletrônica de Varredura , Procedimentos de Ancoragem Ortodôntica , Aço Inoxidável , Propriedades de Superfície , Titânio , Torque , Titânio/química , Aço Inoxidável/química , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Ligas Dentárias/química , Técnicas In Vitro , Espectrometria por Raios X , Análise do Estresse Dentário , Humanos , Estresse Mecânico , Densidade ÓsseaRESUMO
ABSTRACT Objective: This study aimed to compare the insertion torque (IT), flexural strength (FS) and surface alterations between stainless steel (SS-MIs) and titanium alloy (Ti-MIs) orthodontic mini-implants. Methods: Twenty-four MIs (2 x 10 mm; SS-MIs, n = 12; Ti-MIs, n = 12) were inserted on artificial bone blocks of 20 lb/ft3 (20 PCF) and 40 lb/ft3 (40 PCF) density. The maximum IT was recorded using a digital torque meter. FS was evaluated at 2, 3 and 4 mm-deflection. Surface topography and chemical composition of MIs were assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). General linear and mixed models were used to assess the effect of the MI type, bone density and deflection on the evaluated outcomes. Results: The IT of Ti-MIs was 1.1 Ncm greater than that obtained for the SS-MIs (p= 0.018). The IT for MIs inserted in 40 PCF test blocks was 5.4 Ncm greater than that for those inserted in 20 PCF test blocks (p < 0.001). SS-MIs inserted in higher density bone (40 PCF) had significantly higher flexural strength than the other groups, at 2 mm (98.7 ± 5.1 Ncm), 3 mm (112.0 ± 3.9 Ncm) and 4 mm (120.0 ± 3.4 Ncm) of deflection (p< 0.001). SEM evidenced fractures in the Ti-MIs. EDS revealed incorporation of 18% of C and 2.06% of O in the loaded SS-MIs, and 3.91% of C in the loaded Ti-MIs. Conclusions: Based on the findings of this in vitro study, it seems that SS-MIs offer sufficient stability and exhibit greater mechanical strength, compared to Ti-MIs when inserted into higher density bone.
RESUMO Objetivo: O objetivo deste estudo foi comparar o torque de inserção (TI), a resistência flexural (RF) e as alterações de superfície em mini-implantes ortodônticos de aço inoxidável (MIs-Ai) e de liga de titânio (MIs-Ti). Métodos: Vinte e quatro MIs (2 x 10 mm; MIs-Ai, n = 12; MIs-Ti, n = 12) foram inseridos em blocos de osso artificial de densidades de 20 lb/ft3 (20 PCF) e 40 lb/ft3 (40 PCF). O torque máximo de inserção foi registrado por meio de um torquímetro digital. A resistência flexural foi avaliada nas deflexões de 2, 3 e 4 mm. Topografia de superfície e composição química dos MIs foram avaliadas por Microscopia Eletrônica de Varredura (MEV) e Espectroscopia de Energia Dispersiva de Raios X (EDS). Modelos lineares gerais e mistos foram utilizados para avaliar o efeito do tipo de MI, da densidade óssea e da deflexão nos desfechos avaliados. Resultados: O TI dos MIs-Ti foi 1,1 Ncm maior do que o obtido para os MIs-Ai (P = 0,018). O TI para MIs inseridos em blocos de teste de 40 PCF foi 5,4 Ncm maior do que para aqueles inseridos em blocos de teste 20 PCF (p < 0,001). MIs-Ai inseridos em osso de maior densidade (40 PCF) apresentaram resistência flexural significativamente maior do que outros grupos, em deflexões de 2 mm (98,7 ± 5,1 Ncm), 3 mm (112,0 ± 3,9 Ncm) e 4 mm (120,0 ± 3,4 Ncm) (p < 0,001). A MEV evidenciou fraturas nos MIs-Ti. A EDS revelou incorporação de 18% de C e 2,06% de O nos MIs-Ai e 3,91% de C nos MIs-Ti, ambos submetidos a testes mecânicos. Conclusões: Com base nos resultados desse estudo in vitro, os MIs-Ai aparentam oferecer adequada estabilidade e maior resistência mecânica, em comparação aos MIs-Ti, quando inseridos em osso de maior densidade.
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PURPOSE: Limited information is available on multiple myeloma (MM), chronic lymphocytic leukemia (CLL), and non-Hodgkin lymphoma (NHL) management in Latin America. The primary objective of the Hemato-Oncology Latin America (HOLA) study was to describe patient characteristics and treatment patterns of Latin American patients with MM, CLL, and NHL. METHODS: This study was a multicenter, retrospective, medical chart review of patients with MM, CLL, and NHL in Latin America identified between January 1, 2006, and December 31, 2015. Included were adults with at least 1 year of follow-up (except in cases of death within 1 year of diagnosis) treated at 30 oncology hospitals (Argentina, 5; Brazil, 9; Chile, 1; Colombia, 5; Mexico, 6; Panama/Guatemala, 4). RESULTS: Of 5,140 patients, 2,967 (57.7%) had NHL, 1,518 (29.5%) MM, and 655 (12.7%) CLL. Median follow-up was 2.2 years for MM, 3.0 years for CLL, and 2.2 years for NHL, and approximately 26% died during the study observation period. Most patients had at least one comorbidity at diagnosis. The most frequent induction regimen was thalidomide-based chemotherapy for MM and chlorambucil with or without prednisone for CLL. Most patients with NHL had diffuse large B-cell lymphoma (DLBCL; 49.1%) or follicular lymphoma (FL; 19.5%). The majority of patients with DLBCL or FL received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. CONCLUSION: The HOLA study generated an unprecedented level of high-quality, real-world evidence on characteristics and treatment patterns of patients with hematologic malignancies. Regional disparities in patient characteristics may reflect differences in ethnoracial identity and level of access to care. These data provide needed real-world evidence to understand the disease landscape in Latin America and may be used to inform clinical and health policy decision making.
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Leucemia Linfocítica Crônica de Células B/epidemiologia , Linfoma não Hodgkin/epidemiologia , Mieloma Múltiplo/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , América Latina/epidemiologia , Pessoa de Meia-Idade , Sistema de Registros , Adulto JovemRESUMO
OBJECTIVE: Approximately 40-50% of patients with acute myeloid leukaemia (AML) have been reported to present with a normal karyotype and a variable disease-free period, most likely due to the molecular heterogeneity presented by these patients. A variety of mutations have been identified at the molecular level, such as those in the IDH1/2 gene, which causes a gain of function of the isocitrate dehydrogenase enzyme, generating high levels of the (R)-2-hydroxyglutarate oncometabolite, which competitively inhibits dioxygenase enzymes. Therefore, the objective of this study was to evaluate the incidence of IDH1/2 gene mutations in AML patients and their impact on survival. MATERIALS AND METHODS: A total of 101 patients with a diagnosis of AML were included; mononuclear cells were obtained for DNA extraction and purification. Mutations were detected using TaqMan™ competitive allele-specific probes (castPCR™). Overall survival curves were plotted using IBM SPSS Statistics 23 software. RESULTS: The frequency of IDH gene mutations was 19.8%. For the IDH1 gene, 13.8% of the mutations identified included R132H, V178I, G105G and R132C. The frequency of mutations of the IDH2 gene was 5.9%; the variants included R172K and R140Q. The mean survival time in patients without IDH1 gene mutations was 173.15 days (120.20-226.10), while the mean survival time for patients with mutations was 54.95 days (9.7-100.18), p = 0.001. CONCLUSION: The frequency of IDH1 and IDH2 gene mutations in the sample was similar to that reported in other studies. The analysis of these mutations in AML patients is of great importance as a prognostic factor due to their impact on survival and their use as potential therapeutic targets or as targets of inhibitors of IDH1(Ivosidenib, Tibsovo) and IDH2 (Enasidenib, Idhifa).
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BACKGROUND: The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. AIM: To evaluate the usefulness of imaging studies in patients with prostate cancer. MATERIAL AND METHODS: We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according Damicos classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. RESULTS: We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. CONCLUSIONS: Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups.
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Neoplasias da Próstata/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Medição de RiscoRESUMO
Background: The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. Aim: To evaluate the usefulness of imaging studies in patients with prostate cancer. Material and Methods: We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according Damicos classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. Results: We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. Conclusions: Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups.
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Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Medição de Risco , Estadiamento de Neoplasias/métodosRESUMO
INTRODUCCIÓN: El constante avance de la tecnología y el desarrollo de las técnicas mínimamente invasivas en cirugía robótica han dado mayores opciones de tratamiento quirúrgico a pacientes con Cáncer de Próstata. Debido a la complejidad anatómica y reducido espacio de la pelvis la cirugía robótica facilita realizar la prostatectomía . La superioridad técnica del sistema con robot en cuanto a visión, libertad de movimiento y precisión, permite una cirugía más segura además de mejorar resultados quirúrgicos, oncológicos y funcionales. El objetivo del presente video es demostrar la técnica utilizada en nuestro centro para prostatectomía radical robótica y mostrar una sistematización que simplifica el procedimiento. DESARROLLO: Se exponen las características del instrumento Madajet, así como su carga y armado. Se realiza el aislamiento y superficialización del conducto deferente derecho mediante técnica de tres dedos, en la cual el cirujano coloca sus dedos índice y medio en la cara posterior del escroto, fijando el deferente con el dedo pulgar en la cara anterior de la pared escrotal. Una vez aislado el deferente se realiza la anestesia local mediante del disparo del dispositivo sobre la pared anterior del escroto, repitiendo el proceso sobre el deferente izquierdo. Se realiza vasectomía sin bisturí mediante aislamiento del deferente en el rafe medio escrotal con clamp de anillo Li Brand®, con posterior punción y divulsión de la piel con pinza aguzada Li Brand® . Se efectúa la exteriorización del conducto deferente y posterior separación de éste de los vasos deferenciales, finalizando con la oclusión y sección del deferente. CONCLUSIONES: La vasectomía con técnica sin bisturí sin aguja con dispositivo Madajet es una cirugía sencilla y reproducible que simplifica y disminuye los costos del procedimiento, lo que podría producir una mayor masificación de la vasectomía como método de control de fertilidad.(AU)
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Masculino , Prostatectomia , Filme e Vídeo Educativo , Procedimentos Cirúrgicos RobóticosRESUMO
The different prostate cancer (PCa) cell populations (bulk and cancer stem cells, CSCs) release exosomes that contain miRNAs that could modify the local or premetastatic niche. The analysis of the differential expression of miRNAs in exosomes allows evaluating the differential biological effect of both populations on the niche, and the identification of potential biomarkers and therapeutic targets. Five PCa primary cell cultures were established to originate bulk and CSCs cultures. From them, exosomes were purified by precipitation for miRNAs extraction to perform a comparative profile of miRNAs by next generation sequencing in an Illumina platform. 1839 miRNAs were identified in the exosomes. Of these 990 were known miRNAs, from which only 19 were significantly differentially expressed: 6 were overexpressed in CSCs and 13 in bulk cells exosomes. miR-100-5p and miR-21-5p were the most abundant miRNAs. Bioinformatics analysis indicated that differentially expressed miRNAs are highly related with PCa carcinogenesis, fibroblast proliferation, differentiation and migration, and angiogenesis. Besides, miRNAs from bulk cells affects osteoblast differentiation. Later, their effect was evaluated in normal prostate fibroblasts (WPMY-1) where transfection with miR-100-5p, miR-21-5p and miR-139-5p increased the expression of metalloproteinases (MMPs) -2, -9 and -13 and RANKL and fibroblast migration. The higher effect was achieved with miR21 transfection. As conclusion, miRNAs have a differential pattern between PCa bulk and CSCs exosomes that act collaboratively in PCa progression and metastasis. The most abundant miRNAs in PCa exosomes are interesting potential biomarkers and therapeutic targets.
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Biomarcadores Tumorais/genética , Exossomos/genética , Fibroblastos/metabolismo , MicroRNAs/genética , Células-Tronco Neoplásicas/metabolismo , Próstata/metabolismo , Neoplasias da Próstata/genética , Apoptose , Biomarcadores Tumorais/metabolismo , Western Blotting , Movimento Celular , Proliferação de Células , Biologia Computacional , Progressão da Doença , Fibroblastos/patologia , Regulação Neoplásica da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Células-Tronco Neoplásicas/patologia , Próstata/patologia , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/secundário , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Células Tumorais CultivadasRESUMO
La estenosis pieloureteral (EPU) puede predisponer al desarrollo de nefrolitiasis debido a estasis urinaria. Inicialmente la endopielotomía percutánea fue la alternativa mínimamente invasiva de elección frente a la cirugía abierta para la resolución de los casos de EPU con nefrolitiasis concomitante. Sin embargo, el bajo éxito de la endopielotomía percutánea ha favorecido el uso de la laparoscopía convencional o asistida por robot para el tratamiento de las EPU. Se han reportado casos de pieloplastías laparoscópicas en los cuales se ha introducido un nefroscopio flexible a través de un trócar para resolver la nefrolitiasis por vía transpiélica. Acá reportamos nuestra experiencia en un caso.(AU)
The pelvi-ureter stenosis may predispose to the development of nephrolithiasis due to urinary stasis. Initially, a percutaneous endopyelotomy was minimally invasive alternative of choice versus open surgery for resolving cases of EPU with concomitant nephrolithiasis. However, the low success of percutaneous endopyelotomy has favored the use of conventional laparoscopy or robot-assisted treatment of the pelvi-ureter stenosis. There have been reports of laparoscopic pyeloplasty in which a flexible nephroscope is inserted through a trocar to solve nephrolithiasis by a transpielic via. Here we report our experience in one case.(AU)