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Increasing pancreatic cancer is not paralleled by pancreaticoduodenectomy volumes in Brazil:A time trend analysis

Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 79-86页

作者： Lucila m Perrotta de Souza jessica pl m.reira Homero S Fogaca José marcus Raso Eulálio Ronir R Luiz Heitor SP de Souza Department of Internal medicine School of Medicine Federal University of Rio de Janeiro Institute of Public Health Studies (IESC) Federal University of Rio de Janeiro Department of Surgery School of Medicine Federal University of Rio de Janeiro D’Or Institute for Research and Education

Background: Currently, surgical resection represents the only curative treatment for pancreatic cancer(PC), however, the majority of tumors are no longer resectable by the time of diagnosis. The aim of this study was to describe time trends and distribution of pancreaticoduodenectomies(PDs) performed for treating PC in Brazil in recent years. methods: Data were retrospectively obtained from Brazilian Health Public System(namely DATASUS) regarding hospitalizations for PC and PD in Brazil from January 2008 to December 2015. PC and PD rates and their mortalities were estimated from DATASUS hospitalizations and analyzed for age, gender and demographic characteristics. Results: A total of 2364 PDs were retrieved. Albeit PC incidence more than doubled, the number of PDs increased only 37%. most PDs were performed in men(52.2%) and patients between 50 and 69 years old(59.5%). Patients not surgically treated and those 70 years or older had the highest in-hospital mortality rates. The most developed regions(Southeast and South) as well as large metropolitan integrated municipalities registered 76.2% and 54.8% of the procedures, respectively. LmIm PD mortality fluctuated, ranging from 13.6% in 2008 to 11.8% in 2015. Conclusions: This study suggests a trend towards regionalization and volume-outcome relationships for PD due to PC, as large metropolitan integrated municipalities registered most of the PDs and more stable mortality rates. The substantial differences between PD and PC increasing rates reveals a limiting step on the health system resoluteness. Reduction in the number of hospital beds and late access to hospitalization, despite improvement in diagnostic methods, could at least in part explain these findings.

关键词： Pancreatic cancer Pancreaticoduodenectomy Time trend analysis Ecological study Hospitalization rates mortality rates

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Commitment of human mesenchymal stromal cells to skeletal lineages is independent of their morphogenetic capacity

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World Journal of Stem Cells 2023年第7期15卷 701-712页

作者： jessica Cristina marín-Llera Damián García-García Estefania Garay-Pacheco Victor Adrian Cortes-morales Juan Jose montesinos-montesinos Jesus Chimal-monroy medicina Genómica y Toxicología Ambiental Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoCoyoacan 04510Mexico Laboratorio de Células Troncales mesenquimales Unidad de Investigación Médica en Enfermedades OncológicasHospital de Oncología Centro Medico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico City 06720Mexico Departamento de medicina Genómica y Toxicología Ambiental Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoCoyoacan 04510Mexico

BACKGROUND mesenchymal stromal cells(mSCs)are multipotent cell populations obtained from fetal and adult *** share some characteristics with limb bud mesodermal cells such as differentiation potential into osteogenic,chondrogenic,and tenogenic lineages and an embryonic mesodermal *** mSCs differentiate into skeletal-related lineages in vitro,they have not been shown to selforganize into complex skeletal structures or connective tissues,as in the *** this work,we demonstrate that the expression of molecular markers to commit mSCs to skeletal lineages is not sufficient to generate skeletal elements in *** To evaluate the potential of mSCs to differentiate into skeletal lineages and generate complex skeletal structures using the recombinant limb(RL)*** We used the experimental system of RLs from dissociated-reaggregated human placenta(pl)and umbilical cord blood(UCB)*** being harvested and reaggregated in a pellet,cultured cells were introduced into an ectodermal cover obtained from an early chicken limb ***,this filled ectoderm was grafted into the back of a donor chick *** these conditions,the cells received and responded to the ectoderm’s embryonic signals in a spatiotemporal manner to differentiate and pattern into skeletal *** response to differentiation and morphogenetic signals was evaluated by quantitative poly-merase chain reaction,histology,immunofluorescence,scanning electron microscopy,and in situ *** We found that human pl-mSCs and UCB-mSCs constituting the RLs expressed chondrogenic,osteogenic,and tenogenic molecular markers while differentially committing into limb lineages but could not generate complex structures in ***-RL from pl or UCB were committed early to chondrogenic ***,the UCB-RL osteogenic commitment was favored,although preferentially to a tenogenic cell *** findings suggest that the commitment of mSCs to differentiate int

关键词： Human mesenchymal stromal cells Recombinant limbs mesenchymal stromal cell morphogene-sis mesenchymal stromal cell in vivo differentiation Skeletal tissues

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