RESUMO
BACKGROUND: The length of conventional single-use cholangioscopes poses a challenge for percutaneous or laparoscopic approaches for direct visualization of the biliary tract. The aim of this retrospective observational clinical study was to assess the use of a dedicated percutaneous short single-operator cholangioscope (PSSOC) for diagnosis and treatment of benign or malignant biliary diseases. METHODS: Retrospective analysis of a prospectively maintained database including all consecutive patients undergoing percutaneous transhepatic cholangioscopy with the PSSOC between 06/2021 and 01/2023. RESULTS: Forty patients were included (22F/18 M, age 58.7 ± 16.7 years). The diagnostic and therapeutic management plan was based on procedural findings. Indications were bile duct obstruction associated with complex anatomy (n = 13), choledocholithiasis (n = 11), suspected malignant stenosis of the biliary tract (n = 11), biliary stent placement (n = 2) and removal (n = 1), and failed endoscopic retrograde cholangiopancreatography (n = 2). The cholangioscopies were diagnostic (n = 5), therapeutic (n = 20) or both simultaneously (n = 15). The most frequent procedures were electrohydraulic lithotripsy (n = 25) and biopsy sampling (n = 12). Complications occurred in 7 cases (17.5%), including cholangitis (n = 4, B2), pleural perforation (n = 1, B2), portal bleeding (n = 1, B3), and Tako-Tsubo syndrome (n = 1, B3), classified according to the Society of Interventional Radiology classification. Intraprocedural visual diagnosis was confirmed by the histopathologic result in 11/12 patients in which biopsies were performed (91.7%). PSSOC was relevant to avoid surgery in 2 patients (5%) with indeterminate strictures, allowing to rule out malignancy and treat the lithiasis. CONCLUSIONS: Direct visualization of the biliary tract enabled targeted biopsies for histopathological diagnosis. The visual and histopathological diagnoses were concordant in all but one case. Percutaneous cholangioscopy with a dedicated PSSOC allows to optimize identification and treatment of complex biliary disease including biliary lithiasis while assessing bile duct patency. The clinical use of the novel PSSOC system was safe and effective and could prevent surgical exploration in select patients.
Assuntos
Neoplasias dos Ductos Biliares , Doenças da Vesícula Biliar , Laparoscopia , Litíase , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Litíase/patologia , Estudos Retrospectivos , Endoscopia do Sistema Digestório/métodos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Ductos Biliares/patologia , Doenças da Vesícula Biliar/patologia , Neoplasias dos Ductos Biliares/patologiaRESUMO
BACKGROUND: Lactoferrin (LTF) is an iron-binding glycoprotein found in milk and other exocrine secretion with antibacterial activity proposed as an alternative to mastitis treatment or prevention. LTF has been proposed as a candidate gene for mastitis resistance selection. The aim of this paper was to assess LTF promotor to explore variations with potential association to mastitis resistance in dairy cows from Honduras. METHODS: A resequencing of promotor and Exon I of LTF gene in extreme mastitis susceptibility cows (126 Holstein and Holstein crossbred) was performed. RESULTS: Eight polymorphisms were found in promotor region, four of them were novel variations. Two were important by frequency among extreme groups, but a polymorphism in - 421 A/T position was significantly (P = 0.0188) associated to mastitis susceptibility. CONCLUSION: Results support the key role of regulatory region of LTF gene. Some candidate genes are proposed in association with mastitis traits and implications are discussed.
Assuntos
Lactoferrina , Mastite Bovina , Feminino , Bovinos/genética , Animais , Humanos , Lactoferrina/genética , Genótipo , Polimorfismo Genético , Leite , Mastite Bovina/genética , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
The relationship between HIV knowledge and testing behavior is poorly understood among young Chinese-, Korean-, and Vietnamese-American women. This study assesses: (1) levels of HIV/AIDS knowledge, (2) lifetime and annual prevalence of HIV testing, and (3) whether higher levels of HIV knowledge were associated with increased likelihood of testing after controlling for HIV risk behaviors. Fifty-one percent reported lifetime HIV testing (n=117); among those tested, 53% were tested within the past year. A significant and positive association between scores on the HIV Knowledge Questionnaire (HIV KQ-45) and HIV testing was identified. This association was no longer statistically significant after controlling for sexual risk behaviors. Participants were most knowledgeable about HIV symptoms (88.6%) and least knowledgeable about treatment options (56.8%). Future studies should further characterize cultural factors affecting these women's sexual practices, as well develop culturally adapted HIV educational interventions to increase HIV knowledge and testing rates.
RESUMO
Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.
Assuntos
Tratamento Farmacológico da COVID-19 , Peptídeos , Humanos , Honduras , Estimativa de Kaplan-Meier , Peptídeos/efeitos adversos , Modelos de Riscos ProporcionaisRESUMO
Injuries in the metatarsophalangeal joint complex of the hallux are seen with greater frequency in athletes, their importance lies in the functional limitation it generates. Early diagnosis and treatment can reduce the sequelae, however, the recognition of chronic lesions and with it the implementation of adequate therapeutic management generate improvements in quality of life. This document records a case of inveterate dislocation of the metatarsophalangeal joint of the hallux of more than one year of evolution with involvement of the intersesamoid ligament which was corrected with arthrodesis achieving immediate satisfactory results, in the medium and long term with the subsequent functional recovery and total reduction of pain.
Las lesiones en el complejo articular metatarsofalángico del hallux son vistas con mayor frecuencia en deportistas, su importancia radica en la limitación funcional que genera. El diagnóstico y tratamiento temprano puede disminuir las secuelas; sin embargo, el reconocimiento de lesiones crónicas y con ello la implementación del adecuado manejo terapéutico, generan mejoras en la calidad de vida. Se registra en este documento un caso de luxación inveterada de la articulación metatarsofalángica del hallux de más de un año de evolución con compromiso del ligamento intersesamoideo, la cual fue corregida con artrodesis, se lograron resultados satisfactorios inmediatos, a mediano y largo plazo con la posterior recuperación funcional y disminución total del dolor.
Assuntos
Hallux Valgus , Hallux , Articulação Metatarsofalângica , Artrodese , Humanos , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Qualidade de VidaRESUMO
The tannery is an important trade in various Peruvian regions; however, tannery effluents are a serious local environmental threat due to its highly toxics components and lack of efficient treatment. The untreated effluents produced by tannery factories in Arequipa Rio Seco Industrial Park (PIRS) have formed a lake in the region nearby. In this work, we study the capability of filamentous fungi species found in this effluents lake with potential for chromium (VI) bioremediation. Fourteen species of filamentous fungi were isolated; only two species were identified Penicillium citrinum and Trichoderma viride, and third strain identified as Penicillium sp. The filamentous fungi showed that are fully tolerant to chromium (VI) concentrations up to 100 mg/L. These fungal strains showed significant growth in chromium (VI) concentrations up to 250 mg/L. Tolerant index (TI) analysis revealed that P. citrinum and T. viride began adaptation to chromium (IV) concentrations of 250 and 500 mg/L, after 6 and 12 days, respectively. When exposed to higher Cr (VI) concentrations (1000 mg/L), only T. viride was able to show growth (enhance phase). Interestingly, one of the significant responses from these fungal strains to increasing chromium (VI) concentrations was an increment in secreted laccase enzymes. Our results show tolerance and adaptation to elevated concentrations of chromium (VI) of these fungal strains suggesting their potential as effective agents for bioremediation of tannery effluents.
Assuntos
Biodegradação Ambiental , Cromo/metabolismo , Fungos , Águas Residuárias/microbiologia , Fungos/isolamento & purificação , Fungos/metabolismo , Resíduos Industriais , Lacase/metabolismo , Penicillium/isolamento & purificação , Penicillium/metabolismo , Peru , Trichoderma/isolamento & purificação , Trichoderma/metabolismo , Eliminação de Resíduos LíquidosRESUMO
BACKGROUND: Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. MATERIAL AND METHODS: descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. RESULTS: 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p <0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). CONCLUSIONS: the profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records.
Assuntos
Acidentes de Trânsito , Traumatismos Maxilofaciais , Adolescente , Idoso , Chile , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Retrospectivos , ViolênciaRESUMO
El presente artículo recopila un extracto de las distintas ponencias realizadas por investigadores de diferentes lugares del Ecuador en el marco del Simposio sobre Cáncer Cervical y el virus del papiloma humano ocurrido en el 5° Congresosobre enfermedades infecciosas llevado a cabo en octubre del 2018 en la Pontificia Universidad Católica del Ecuador (Quito). Estas presentaciones presentan un diagnóstico acerca de la situación actual del virus de papiloma humano (VPH) y del cáncer cervical en nuestra región. Estas presentaciones complementan la información presentada en un evento similar realizado hace un par de años en las Jornadas Nacionales de Biología Espol 2016, constituyendo estas memorias en conjunto como uno de los pocos documentos disponibles que recopilan los últimos avances realizados en este campo en el Ecuador en años recientes.
Thisarticle compiles an extract of the different presentations made by researchers from different parts of Ecuador in the framework of the Symposium on Cervical Cancer and the human papillomavirus occurred at the 5th Congress on infectious diseases carried out in October 2018 at the Pontificia Catholic University of Ecuador (Quito). These presentations present a diagnosis about the current situation of human papilloma virus (HPV) and Cervical Cancer in our region. These presentations complement the informationpresented in a similar event held a couple of years ago at the National Conference of Biology Espol2016, constituting these memories together as one of the few documents available that assemble the latest advances made in this field in Ecuador in recent years.