Anti-epidermal-growth-factor-receptor (EGFR) therapies in combination with radiotherapy are being studied on de-escalation clinical trials for HPV-related oropharyngeal cancer (OPC) patients. The ...HPV16-E5 oncoprotein increases recycling of activated EGFR to the cell surface, enhancing factor signal transduction. Our aim was to evaluate viral HPV16-
oncogene expression as well as EGFR and phosphorylated-EGFR (pEGFR), protein levels as biomarkers for clinical outcome in a retrospective cohort of OPC patients.
Formalin-fixed-paraffin-embedded OPCs were collected from 1990 to 2013. OPC samples containing HPV-DNA were subject to viral
mRNA detection and p16
immunohistochemistry (IHC). HPV16-positive cases were evaluated for HPV16-
(RT-PCR) and EGFR/pEGFR (IHC). A stratified and matched random sample of HPV-negative samples was used as control and evaluated for EGFR/pEGFR. Overall survival (OS) and disease free survival (DFS) estimates were assessed for locally advanced OPC patients (stage III, IVa,b 7th edition).
Among 788 OPC patient samples, 53 were double positive for HPV16-DNA/p16
. HPV16-
expression was found in 41 of 53 samples (77.4%). EGFR expression was observed in 37.7
70.8% of HPV16-positive
HPV-negative samples, respectively; (adjusted OR = 0.15) 5% CI = 0.04-0.56). Expression of pEGFR followed an inverse pattern with 39.6 and 24.9% detection in HPV16-positive and HPV-negative samples; (adjusted OR = 1.58 95% CI = 0.48-5.17). Within HPV16-positive cases, no association between HPV16-
/EGFR nor pEGFR was observed. With a median follow-up of 39.36 months (min = 0.03 - max = 272.07), the combination of HPV status and EGFR or pEGFR expression were predictors of better OS (
< 0.001, for both) and DFS (
< 0.001 for EGFR and
= 0.003 for pEGFR).
HPV16-
is highly expressed on HPV16-positive OPCs. Interestingly, HPV16-positive cases expressed significantly more pEGFR while HPV-negative cases expressed more EGFR. The combinations of HPV status and EGFR or pEGFR may be useful biomarkers for evaluating prognosis outcome in OPC patients.
El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la pancreatitis aguda en el Seguro Social del Perú (EsSalud). Su objetivo es proveer recomendaciones clínicas basadas ...en evidencia para el manejo de la pancreatitis aguda en EsSalud. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 7 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en PubMed durante el 2022. 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 flujogramas correspondientes. Finalmente, la GPC fue aprobada con Resolución N° 105-IETSI-ESSALUD-2022. La presente GPC abordó 7 preguntas clínicas sobre fluidoterapia, momento de inicio de nutrición enteral, analgesia, tipo de nutrición, tratamiento antibiótico y quirúrgico. En base a dichas preguntas se formularon 8 recomendaciones (1 fuerte y 7 condicionales), 13 BPC, y 1 flujograma. El pres as en evidencia de la GPC para el manejo de la pancreatitis aguda en EsSalud.
La Educación en Derechos Humanos (EDH) ha sido comprendida y relacionada desde varios factores del desarrollo humano. Además, en Estados en vías de pacificación es clave para la construcción de ...nuevas ciudadanías. Con el objetivo de realizar un ejercicio investigativo centrado en el análisis de los aportes de la Educación en Derechos Humanos para lograr Escenarios de Paz, presentamos observaciones del último Acuerdo de Paz suscrito por el Gobierno colombiano, atendiendo a sus características de retornar lecciones aprendidas para la construcción de Paz. Se analiza cómo la EDH contribuye a la promoción, garantía y respeto de los Derechos Humanos, declarados universalmente, y cuáles son los contextos del Conflicto armado que se ven trastocados. Por esta razón, el propósito primordial del escrito es la visión desde lo que se denomina Paz Imperfecta frente a la comprensión de consensos que se materializan a través de la EDH, con una mirada especial a la agenda establecida en La Habana (Cuba) y su desarrollo en la mesa de conversación. Las conclusiones encontradas evidencian la relación de los Modelos de Educación en Derechos Humanos, de cara al alcance de lo que se establece en el Acuerdo Final para la terminación del Conflicto y la construcción de una Paz Estable y Duradera. Otra mirada a las conclusiones vislumbra cómo los modelos de EDH son flexibles frente a las exigencias necesarias de los diversos grupos focales, con condiciones y características propias de la sociedad en las que se han desarrollado a consecuencia del Conflicto sociopolítico vivido.
This paper centers on the identification and evolution of the strategic groups (SG) in the Venezuelan banking sector in the 2008-2010 period. The Box M test showed that there was financial ...instability during that time and, thus, SG behavior was evaluated for each year of the study. Other results had indicated that by applying a statistical procedure it is possible to detect grades in the strategies' implementation or evasion, or in the resource commitment by the SGs, and the use of the statistical procedure led to coincidences with previous studies in which none of the studied SG corresponded exclusively to the main categories of the banking business: corporate, retail, investment, among others, but develop hybrid strategies, well differentiated by the variables employed. This results will allow bank managers to know the SG where they participate, who are their most immediate competitors and what strategies are used by the other SG, as well as how SGs evolve in unstable environments.
Objectives: To analyze the effects of anticipatory fatigue and emotional symptomatology on the physical and cognitive perception of fatigue. The conditional and partial effects of independent ...variables were analyzed by multivariate and univariate analyses in an ex- post-fact and correlational method. Sample was composed of 317 participants (29% come from clinical population). Anticipatory fatigue, and perception of fatigue (by the Chalder et al.´s Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg´s questionnaire, GHQ-28. Anticipatory fatigue and emotional symptoms (mainly depressive symptoms) had significant effects on the cognitive and physical fatigue. The anticipatory fatigue moderated the effects between group (clinical versus general) and cognitive fatigue. Emotional symptoms (mainly depressive symptoms) and anticipatory fatigue made an important contribution to the cognitive and physical fatigue. However, the contribution of the anticipatory fatigue was no longer significant when the emotional symptoms were considered. It suggests the mediational role of the symptoms between anticipatory fatigue and perception of fatigue.
Con el objetivo de brindar algunos hallazgos sobre la recepción de Pierre Bourdieu en el contexto mexicano, se revisaron ocho ediciones del Congreso Nacional de Investigación Educativa (del 2003 al ...2017), lo anterior a través del análisis de las citas y referencias incluidas en las ponencias en donde apareció el autor. El estudio empleó herramientas metodológicas como el análisis de contenido y la estadística descriptiva para examinar las citas y referencias incluidas en las ponencias ya mencionadas. Dentro de los resultados, se pudo identificar que el sociólogo francés es el autor más citado y referenciado, además se pudo reconocer el papel que juega la cita y las obras referenciadas para considerar la popularidad del autor, de igual manera fue posible recuperar algunos indicios sobre la recepción de Bourdieu en México al leer al autor a través de otros, ya sea traductores o difusores. Finalmente, el estudio concluye en que la cita puede entenderse como una medida de consagración, como una condición de validez para un texto académico, como un factor de evaluación, como un objeto de lucha y como un capital cultural.
Objectives: To analyze the effects of anticipatory fatigue and emotional symptomatology on the physical and cognitive perception of fatigue. The conditional and partial effects of independent ...variables were analyzed by multivariate and univariate analyses in an ex- post-fact and correlational method. Sample was composed of 317 participants (29% come from clinical population). Anticipatory fatigue, and perception of fatigue (by the Chalder et al.´s Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg´s questionnaire, GHQ-28. Anticipatory fatigue and emotional symptoms (mainly depressive symptoms) had significant effects on the cognitive and physical fatigue. The anticipatory fatigue moderated the effects between group (clinical versus general) and cognitive fatigue. Emotional symptoms (mainly depressive symptoms) and anticipatory fatigue made an important contribution to the cognitive and physical fatigue. However, the contribution of the anticipatory fatigue was no longer significant when the emotional symptoms were considered. It suggests the mediational role of the symptoms between anticipatory fatigue and perception of fatigue.
This article summarizes the clinical practice guideline (CPG) for the management of acute pancreatitis in the Social Security of Peru (EsSalud), to provide evidence-based clinical recommendations for ...the management of acute pancreatitis in EsSalud. A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant- primary studies were carried out in PubMed during 2022. 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 work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding flow charts. Finally, the CPG was approved with Resolution No. 105-IETSI-ESSALUD-2022. This CPG addressed 7 clinical questions on fluid therapy, start of enteral nutrition, analgesia, type of nutrition, antibiotic, and surgical treatment. Based on these questions, 8 recommendations (1 strong and 7 conditional), 13 BPCs, and 1 flowchart were formulated. This article summarizes the methodology and evidence-based conclusions of the CPG for the management of acute pancreatitis in EsSalud.
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