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San Juan, Argentina

Darlow B.A.,University of Otago | Gilbert C.E.,London School of Hygiene and Tropical Medicine | Quiroga A.M.,Austral University
Clinics in Perinatology | Year: 2013

Retinopathy of prematurity (ROP) programs require collaboration between neonatologists, ophthalmologists, nurses, and allied health personnel, together with parents. The concept of a ROP program will vary according to the setting. However, in every situation there should be 2 main aspects: primary prevention of ROP through better overall care, and secondary prevention through case detection (often called screening), treatment, and follow-up. ROP programs will have different content and emphasis according to whether the setting is in an economically advanced or developing country. © 2013 Elsevier Inc.

Chronic kidney disease is frequently present among patients in high cardiovascular risk that are assisted by clinicians and cardiologists. The prevalence of chronic kidney disease among patients with type 2 diabetes mellitus, high blood pressure, or coronary or cardiovascular disease ranges between 25 to 40%. Its presence contributes significantly to increasing cardiovascular risk, to such an extent that the relative importance of other risk factors becomes minimal. As it is asymptomatic until its advanced stages, it hinders its diagnosis. This is based on the systematic screening, during the initial medical consultations of patients with diabetes mellitus, high blood pressure, multiple risk factors or with cardiovascular disease, over 60 years old or those who have family members with chronic kidney disease. The responsibility for the screening also includes cardiologists. The presumptive diagnosis of chronic kidney disease is based on two simple and routinely laboratory tests: 1) common urine test or dipstick in a spot urine sample to search proteinuria; 2) measurement of serum creatinine levels, and renal function assessment by estimation formula (MDRD or CKD-EPI) using the calculators that are available. The diagnosis of chronic renal disease confirms the existence of a very high risk patient, and at this point, renal function and proteinuria, if it exists, should periodically be reevaluated. Renal function reduction may determine that several of the drugs that we frequently use can require dose adjustment, or need careful use and even interruption of treatment. Moreover, proteinuria evolution is an important point in the follow-up of the treatment results. Additionally, these laboratory results are essential to decide a consultation with a nephrologist timely and not late, as it usually happens. © 2016, Federacion Argentina de Cardiologia. All rights reserved.

Surgical resection is the only curative option for patients with gastrointestinal carcinomas. Unfortunately, the majority of patients are diagnosed in advanced stages when surgery is not possible. Moreover, the incidence and mortality for certain type of tumors such as hepatocellular carcinoma or pancreatic cancer are steadily increasing worldwide. In spite of the advances in the development of molecular targeted therapies for cancer, the impact on patient survival has been rather limited. It is unlikely that individual agents would be ultimately successful as monotherapy. There is a growing area of research focused on the combination of classical chemotherapy (e.g. cyclophosphamide, gemcitabine, paclitaxel and doxorubicin) with radiotherapy and/or gene therapy strategies. Combined approaches seem to be required due to multiple resistance mechanisms that tumors utilize to limit the activity of chemotherapeutic agents (e.g. the occurrence of multidrug resistance or epigenetic alterations), evade immune responses (e.g. induction of regulatory T cells or myeloid-derived suppressor cells) and to generate resistance against anti-angiogenesis or to radiotherapy by, for example, the induction of hypoxia-inducible factor 1. In addition, new studies suggest that combination of low dose of conventional chemotherapy and gene therapy could allow the development of synergic mechanisms able to achieve significant therapeutic effects against diverse tumors. Although cancer gene therapy is not yet available in clinical practice, advances being recently made look promising, especially when it was applied in combination with standard chemo- or radiotherapy protocols.

Ferder M.,University of Buenos Aires | Inserra F.,Austral University | Manucha W.,National University of Cuyo | Ferder L.,Ponce School of Medicine & Health Sciences
American Journal of Physiology - Cell Physiology | Year: 2013

This review attempts to show that there may be a relationship between inflamma-tory processes induced by chronic overstimulation of the renin-angiotensin system (RAS) and the worldwide deficiency of vitamin D (VitD) and that both disorders are probably associated with environmental factors. Low VitD levels represent a risk factor for several apparently different diseases, such as infectious, autoimmune, neu-rodegenerative, and cardiovascular diseases, as well as diabetes, osteoporosis, and cancer. Moreover, VitD insufficiency seems to predispose to hypertension, metabolic syndrome, left ventricular hypertrophy, heart failure, and chronic vascular inflamma-tion. On the other hand, inappropriate stimulation of the RAS has also been associated with the pathogenesis of hypertension, heart attack, stroke, and hypertrophy of the left ventricle and vascular smooth muscle cells. Because VitD receptors (VDRs) and RAS receptors are almost distributed in the same tissues, a possible link between VitD and the RAS is even more plausible. Furthermore, from an evolutionary point of view, both systems were developed simultaneously, actively participating in the regulation of inflammatory and immunological mechanisms. Changes in RAS activity and activation of the VDR seem to be inversely related; thus any changes in one of these systems would have a completely opposite effect on the other, making it possible to speculate that the two systems could have a feedback relationship. In fact, the pandemic of VitD deficiency could be the other face of increased RAS activity, which probably causes lower activity or lower levels of VitD. Finally, from a therapeutic point of view, the combination of RAS blockade and VDR stimulation appears to be more effective than either RAS blockade or VDR stimulation individually. © 2013 the American Physiological Society.

BACKGROUND: Triatoma infestans is the main vector of Chagas'disease in Southern Cone countries. In triatomines, symptoms suggesting neurotoxicity were observed after treatment with Jaburetox (Jbtx), the entomotoxic peptide obtained from jackbean urease. Here, we study its effect in the central nervous system (CNS) of this species.METHODS: Immunohistochemistry, Western blots, immunoprecipitation, two-dimensional electrophoresis, tandem mass spectrometry and enzymatic assays were performed.RESULTS: Anti-Jbtx antibody labeled somata of the antennal lobe only in Jbtx-treated insects. Western blot assays of nervous tissue using the same antibody reacted with a 61kDa protein band only in peptide-injected insects. Combination of immunoprecipitation, two-dimensional electrophoresis and tandem mass spectrometry identified UDP-N-acetylglucosamine pyrophosphorylase (UDP-GlcNAcP) as a molecular target for Jbtx. The activity of UDP-GlcNAcP increased significantly in the CNS of Jbtx-treated insects. The effect of Jbtx on the activity of nitric oxide synthase (NOS) and NO production was investigated as NO is a recognized messenger molecule in the CNS of T. infestans. NOS activity and NO levels decreased significantly in CNS homogenates of Jbtx-treated insects.CONCLUSIONS: UDP-GlcNAcP is a molecular target of Jbtx. Jbtx impaired the activity of T. infestans nitrergic system, which may be related with early behavioral effects.GENERAL SIGNIFICANCE: We report that the CNS of Triatoma infestans is a target for the entomotoxic peptide and propose that a specific area of the brain is involved. Besides potentially providing tools for control strategies of Chagas' disease vectors our data may be relevant in various fields of research as insect physiology, neurobiology and protein function. Copyright © 2014 Elsevier B.V. All rights reserved.

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