Assuntos
COVID-19 , Melanoma , Estudos de Coortes , Humanos , Melanoma/diagnóstico , Melanoma/epidemiologia , Pandemias , SARS-CoV-2RESUMO
Resumen Introducción: La duodeno pancreatectomía cefálica es una operación compleja cuyos resultados a corto plazo son multifactoriales. Objetivo: Evaluar el impacto de la curva de aprendizaje en los resultados a corto plazo de la duodenopancreatectomía cefálica en un hospital de nivel II. Materiales y Método: Se analizaron los datos obtenidos a partir de una base de datos mantenida prospectivamente desde 2005. Se definieron dos periodos de tiempo: de 2005 a 2011 y de 2012 a 2017. Se compararon la morbilidad, mortalidad y estancia postoperatoria de ambos períodos. Resultados: Durante el período de tiempo estudiado se hicieron 126 duodenopancreatectomías cefálicas, 61 durante la primera etapa y 65 durante la segunda. La tasa de transfusión intraoperatoria se redujo de 33% a 15% (p = 0,011). La tasa de transfusión postoperatoria se redujo de 39 a 23% (p = 0,021). No hubo diferencias significativas con respecto a la incidencia global de complicaciones postoperatorias (59% y 52,3%). La incidencia de abscesos intraabdominales fue significativamente menor en el segundo período (18% y 4,6%, respectivamente; p = 0,038). La tasa de reintervenciones se redujo significativamente, de 22% a 9% (p = 0,049). También se redujo significativamente la tasa de mortalidad, de 6,56% a 0% (p = 0,032). La estancia media postoperatoria disminuyó significativamente en el segundo período, pasando de 19,6 a 15,8 días (p = 0,001), con una mayor proporción de pacientes dados de alta en los 8 primeros días de postoperatorio (11,5% y 38,5%, respectivamente; p = 0,001). Conclusión: La curva de aprendizaje es un factor que permite mejorar los resultados de la duodenopancreatectomía cefálica, en un hospital de nivel II, hasta alcanzar valores similares a los de un hospital de nivel III.
Introduction: The duodenum pancreatectomy cephalic is a complex operation whose short-term results are multifactorial. Aim: To assess the impact of the learning curve on the short-term outcomes of cephalic duodenopancreatectomy at a level II hospital. Materials Method: We analyze the data obtained from a database maintained prospectively since 2005. Two time periods were defined: from 2005 to 2011 and from 2012 to 2017. The morbidity, mortality and postoperative stay of both periods were compared. Results: 126 cephalic duodenopancreatectomies were performed, 61 during the first period and 65 during the second. The intraoperative transfusion rate was reduced from 33% to 15% (p = 0.011). The postoperative transfusion rate was reduced from 39 to 23% (p = 0.021). There were no significant differences with respect to the overall incidence of postoperative complications (59% and 52.3%, respectively). However, the incidence of intra-abdominal abscesses was significantly lower in the second period (18% and 4.6%, respectively, p = 0.038). The rate of reoperations was significantly reduced, from 22% to 9% (p = 0.049). The mortality rate was also significantly reduced, from 6.56% to 0% (p = 0.032). The mean postoperative stay decreased significantly in the second period, from 19.6 to 15.8 days (p = 0.001), with a higher proportion of patients discharged in the first 8 postoperative days (11.5% and 38.5%, respectively, p = 0.001). Conclusion: The learning curve is a factor allows improving the results of cephalic pancreaticoduodenectomy, in a level II hospital, until reaching values similar to those of a level III hospital.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/complicações , Pancreaticoduodenectomia/efeitos adversos , Curva de Aprendizado , Período Pós-Operatório , Pancreaticoduodenectomia/educação , Pancreaticoduodenectomia/métodos , Pancreaticoduodenectomia/mortalidadeRESUMO
Variations in the mRNA expression of hepatic and muscle genes that are related to calcium signaling were analyzed by real-time qPCR in farmed Atlantic salmon (Salmo salar L. 1758) to determine changes in expression between parr and smolt stages. These organs were selected due to their close relationship with calcium signaling and metabolism (e.g., glycolysis, oxidative phosphorylation, muscle contraction). Differential expression between smolt and parr specimens and between organs was observed. Compared to parr specimens, smolts exhibited upregulated expression of the calcitonin receptor precursor, calcitonin receptor, calcitonin isoform, parathyroid hormone, and calmodulin in the liver. This pattern was inverse in muscle, with the exception of calmodulin, which was significantly upregulated in smolts compared to parr. Additionally, plasma calcium was decreased in the smolt condition. This study is the first to characterize the expression pattern of calcium signaling-related genes in the liver and muscle of parr and smolt S. salar. However, further functional studies are required to obtain a wider understanding about the physiological changes that accompany the productive conditions during smoltification.
Assuntos
Sinalização do Cálcio/genética , Regulação da Expressão Gênica no Desenvolvimento , Salmo salar/crescimento & desenvolvimento , Salmo salar/genética , AnimaisRESUMO
OBJECTIVE: The aim of this study was to assess the association of overweight and obesity with insulin resistance, hypertension, and hyperlipidemic among 12 to 15 year olds from private and public schools in Chiapas. METHODS: This was a cross-sectional study with a random selection of 259, 12 to 15 year old teenagers from private and public middle schools. Conventional methods were used to measure body weight, height and blood pressure. After a 14-hour fasting period, a blood sample was taken for glucose, total lipids, total cholesterol, LDL-cholesterol, triglycerides and insulin levels. HDL-cholesterol and HOMA-IR were estimated. Weight-for-age, height-for-age and BMI-for-age were calculated using the CDC tables for growth. To assess the difference between overweight and obesity by gender and type of school a X2 and t-test was performed in order to evaluate the mean difference between biochemical indicators of normal and overweight adolescents. The Mann-Whitney test was conducted to assess differences in blood pressure. RESULTS: Observations included high prevalence of overweight (19%) and obesity (13%) with no difference between type of school, gender, or group of age (Table 2). High prevalence of hipercholesterolemia (26%), LDLcholesterol (7%), HDL hypolipoproteinemia (3%), triglycerides (10%), systolic blood pressure (6%), and metabolic syndrome (1.6%) were also observed. The BMI was associated to total lipid, total cholesterol, insulin, and HOMA-IR levels. The Overweight and obese had higher levels of insulin, HOMA-IR, triglycerides, and blood pressure and lower levels of HDL-cholesterol.
Assuntos
Resistência à Insulina , Sobrepeso/metabolismo , Adolescente , Criança , Feminino , Humanos , Hiperlipidemias/complicações , Hipertensão/complicações , Masculino , México , Obesidade/complicações , Obesidade/metabolismo , Sobrepeso/complicaçõesRESUMO
Neisseria meningitidis isolates are conventionally classified by serosubtyping, which characterizes the reactivities of the PorA outer membrane protein variable-region epitopes with monoclonal antibodies (MAbs). New murine hybridomas, secreting specific MAbs against PorA of N. meningitidis serogroup B, were generated using conventional hybridoma procedures. Using outer membrane protein as antigen, we obtained two positive clones, and one of them we characterized. This MAb reacted, on whole-cell enzyme-linked immunosorbent assay (ELISA) and immunoblotting, only with strain subtype P1.15 and its IgG2b isotype. This MAb demonstrated bactericidal activity against the homologous strain in the presence of human complement.
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Anticorpos Monoclonais/metabolismo , Vacinas Bacterianas/imunologia , Neisseria meningitidis/imunologia , Porinas/imunologia , Animais , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais/química , Feminino , Hibridomas , Camundongos , Camundongos Endogâmicos BALB CRESUMO
Magnolia dealbata Zucc. is considered to have tranquilizer and anticonvulsant properties in Mexican traditional medicine. In the present study we report the effects of a crude extract of Magnolia dealbata (30, 100 and 300 mg/kg) on mouse central nervous system (CNS). Pharmacological effects were tested on ambulatory activity, anti-anxiety response, sodium pentobarbital-induced hypnosis and pentylenetetrazole (PTZ)-induced seizures in comparison to honokiol, buspirone, ethosuximide and diazepam as corresponding reference drugs. No changes in spontaneous locomotor activity were produced posterior to Magnolia dealbata administration; however, a significant and dose-dependent diminution in the anxiety response was observed in experimental models such as plus-maze, head-dipping and exploratory rearing tests. Magnolia dealbata not only prolonged the time of sodium pentobarbital-induced hypnosis and delayed the onset of PTZ-induced mioclonus and clonus, but also hindered the presence of tonic seizures and avoided mortality. The hypnotic, anxiolytic and anticonvulsant effects obtained in these experiments support the hypothesis that Magnolia dealbata possesses CNS activity and reinforces the popular use in Mexican traditional medicine.
Assuntos
Ansiolíticos/farmacologia , Anticonvulsivantes/farmacologia , Hipnóticos e Sedativos/farmacologia , Magnolia , Extratos Vegetais/farmacologia , Animais , Ansiolíticos/toxicidade , Anticonvulsivantes/toxicidade , Diazepam/farmacologia , Relação Dose-Resposta a Droga , Etanol , Hipnóticos e Sedativos/toxicidade , Dose Letal Mediana , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Pentobarbital , Pentilenotetrazol , Extratos Vegetais/toxicidade , Folhas de Planta , Convulsões/induzido quimicamente , Convulsões/prevenção & controle , Sono/efeitos dos fármacos , Solventes , Fatores de TempoRESUMO
SETTING: In developing countries, tuberculosis is diagnosed by identification of acid-fast bacilli (AFB) on sputum smears. OBJECTIVE: To evaluate the quality of AFB microscopy, the Mexican Secretary of Health National Reference Laboratory implemented proficiency testing for its network of 637 laboratories. DESIGN: A total of 586 (92%) laboratories were inspected and 430 technicians evaluated by proficiency testing consisting of 10 slides with known numbers of AFB. Results were compared with those of slide rechecking and with proficiency testing performed 2 years later. RESULTS: Of the 430 technicians evaluated by proficiency testing in 1998, 196 (46%) scored less than 80% and received intensive training in 1999. From a previous mean score of 65% their results increased to 90% (P < 0.0001). In 2001, they again underwent proficiency testing, and the mean score was 83%. The main factors affecting proficiency testing results were the type of laboratory in which the microscopists worked and the number of low-positive slides (1-9/100) in the test. Laboratories whose work was rechecked had better scores (P = 0.002). Proficiency testing scores and the estimated sensitivity of the microscopist's laboratory were associated (P = 0.01). CONCLUSION: External quality assessment and training improve diagnostic performance. Rechecking and proficiency testing are both viable measures of laboratory performance.
Assuntos
Competência Clínica , Técnicas de Laboratório Clínico , Implementação de Plano de Saúde , Microscopia , Avaliação de Programas e Projetos de Saúde , Garantia da Qualidade dos Cuidados de Saúde , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia , Humanos , México , Mycobacterium tuberculosis/isolamento & purificação , Reprodutibilidade dos Testes , Escarro/citologia , Escarro/microbiologia , Análise de SistemasRESUMO
OBJECTIVE: To present a case of solitary pelvic kidney with congenital absence of the vagina. METHODS: A patient with solitary pelvic kidney and vaginal aplasia is described. Patient evaluation included hematological, hormonal, cytogenetic, laparoscopic and imaging studies. RESULTS: Blood, hormone and cytogenetic studies were normal. Laparoscopy showed absence of the uterus and both tubes and ovaries, which was confirmed by pneumopyelography. IVP showed absence of renal shadows and a solitary pelvic kidney. CONCLUSIONS: Congenital absence of the vagina should be suspected in a patient with a pelvic solitary kidney consulting for primary amenorrhea.
Assuntos
Anormalidades Múltiplas/diagnóstico , Rim/anormalidades , Vagina/anormalidades , Adulto , Feminino , HumanosRESUMO
Prothymosin alpha (PTA) was detected by immunocytological and biochemical methods in oocytes at different stages of oogenesis, and in early embryos of the amphibian Bufo anenarum. In all cases PTA was detected in the nucleus and was absent from the cytoplasm. This indicates that this protein could act at the level of regulating transcription. Western blots were carried out using polyclonal antibodies with extracts of embryos at different stages of development from early fertilisation up to neural tube. With this method PTA was detected in all the samples under study.
Assuntos
Bufo arenarum/metabolismo , Embrião não Mamífero/metabolismo , Oócitos/metabolismo , Precursores de Proteínas/metabolismo , Timosina/análogos & derivados , Animais , Western Blotting , Bufo arenarum/embriologia , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Feminino , Imuno-Histoquímica , Timosina/metabolismoRESUMO
OBJECTIVE: To describe a case of crossed testicular ectopia that was diagnosed in a 52-year-old patient who had consulted for infertility associated with a genital anomaly. METHODS: Patient evaluation included hematological, hormonal, cytogenetic and imaging studies. An exploratory operation was also performed. RESULTS: The hematological, hormonal and cytogenetic studies gave normal results. There were no urinary tract abnormalities in the intravenous urography; retrograde urethrography disclosed a narrow duct behind the urethra that ascended towards the left inguinal duct and divided into two epididymides after reaching the scrotum. Surgical exploration showed two testes in the left scrotal pouch that were biopsied. Histological examination revealed an almost complete hyalinization of the tubular wall with no germ cells within the tubules. CONCLUSIONS: Crossed testicular ectopia is one of the most uncommon testicular anomalies and is often associated with other disorders such as inguinal hernia, hypospadias, pseudohermaphroditism and scrotal abnormalities. Like all dysgenetic testes, progression to malignancy is relatively frequent. The foregoing should be remembered when dealing with these patients.