ABSTRACT
The different pathologies of the prostate, involve the presence of a new microenvironment where inflammatory cells are actively recruited. This research explores the presence of mast cells and eosinophils associated with age and the evaluation of prostate cancer progress (Gleason Index). Forty two biopsies of anonymized patients, with confirmed prostate cancer, were used for histological analysis for eosinophils and mast cells and subsequent determination of Gleason index according to age. The results of the histological analyzes show the presence of eosinophils and mast cells in prostate biopsies with confirmed cancer. In the multiple correlation studies, a high correlation was observed between the presence of lymphocytes and the age of the patient diagnosed with prostate cancer, same correlation was observed between the patient's age and higher Gleason Index (Pearson and Spearman p< 0.05). It is concluded that in prostate biopsies from Chilean patients with confirmed cancer, eosinophilia and tissue mastocytosis were observed. Correlation analyzes show a direct correlation between older patients, higher Gleason index and presence of mast cell. Regarding eosinophilia, only a correlation between age and Gleason index was observed Further studies are suggested to determine that the presence of eosinophils and mast cells can be used as early bioindicators of prostate cancer.
Las diferentes patologías de próstata, involucran la presencia de un nuevo microambiente donde las células inflamatorias son activamente reclutadas. La presente investigación explora la presencia de mastocitos y eosinófilos asociadas a la edad y la evaluación del progreso del cáncer de próstata según índice de Gleason. Cuarenta y dos biopsias de pacientes anonimizados, con cáncer prostático confirmados, fueron utilizadas para su análisis histológico para eosinófilos y mastocitos y posterior determinación del índice de Gleason según edad. Los resultados de los análisis histológicos, muestran la presencia de eosinófilos y mastocitos en biopsias de próstata con cáncer confirmado. En los estudios de correlación múltiple, se observó una alta correlación entre la presencia de linfocitos, mastocitos y la edad del paciente diagnosticado con cáncer prostático, igual correlación se observó entre la edad del paciente y mayor índice de Gleason (Pearson y Spearman p<0,05). Se concluyó que en las biopsias de próstata de pacientes chilenos con cáncer confirmado, se observó eosinofilia y mastocitosis tisular. Los análisis de correlación muestran una correlación directa entre pacientes de mayor edad, índice de Gleason más alto y la presencia de mastocitos. Con respecto a la eosinofilia, solo se observó una correlación entre la edad y el índice de Gleason. Se sugieren estudios adicionales para determinar que la presencia de eosinófilos y mastocitos puede usarse como bioindicadores tempranos del cáncer de próstata.
Subject(s)
Humans , Male , Prostatic Neoplasms/pathology , Prostate/pathology , Prostatic Neoplasms/diagnosis , Biopsy , Mastocytosis/pathology , Biomarkers, Tumor/analysis , Chile , Age Factors , Eosinophilia/pathology , Early Detection of Cancer , Neoplasm GradingABSTRACT
OBJETIVO: Encuestar a cirujanos de rodilla en Chile, sobre su conducta en contaminaciones accidentales del injerto, en reconstrucciones de ligamento cruzado anterior (LCA). MÉTODOS: Se realizó una encuesta anónima en relación a la incidencia, tratamiento y resultados clínicos de los injertos de LCA contaminados, a todos los médicos pertenecientes al área de traumatología y ortopedia asistentes al congreso Ateneo de rodilla 2015. RESULTADOS: Se encuestaron 54 médicos, 33 (61%) especialistas en cirugía de rodilla y 21 (39%) médicos en formación. De los cirujanos de rodilla, 15 (45%) reportaron al menos un caso de contaminación, de los cuales 12 (80%) informaron un único evento, 3 (20%) indicaron la eventualidad en 2, 3 y 5 ocasiones respectivamente, para un total de 22 injertos contaminados. De los cirujanos que reportaron injertos contaminados, 11 (73%) realizan 50 o más reconstrucciones al año. La decisión tomada en los casos de contaminación fue en 13 oportunidades (59%), lavar el injerto y utilizarlo de acuerdo al plan inicial; en 6 casos (27%), utilizar aloinjerto; en 2 ocasiones (9%), utilizar autoinjerto alternativo; y en 1 oportunidad (5%); triplicar el semitendinoso. Ninguno de los casos de contaminación reportó infecciones. CONCLUSIONES: En casos de una contaminación accidental, la mayoría de los cirujanos encuestados prefieren optar por la descontaminación del injerto y su utilización en la reconstrucción de acuerdo al plan inicial; para lo cual la clorhexidina y antibióticos sería la solución a usar de preferencia. NIVEL DE EVIDENCIA: Nivel V, opinión de experto.
OBJECTIVE: To survey knee surgeons who perform anterior cruciate ligament (ACL) reconstruction in Chile, about the management when ACL graft contamination occurs. METHODS: An anonymous survey was conducted to all physicians belonging to the area of traumatology and orthopedics who attended the 2015 annual Chilean Knee Society meeting. The survey questioned the incidence, treatment, and outcomes of ACL graft contaminations. RESULTS: Fifty-four physicians were surveyed, of which 33 (61%) where knee surgeons and 21 (39%) physicians in training. Of the 33 knee surgeons, 15 (45%) reported at least one contamination during their career. Of those 15, 12 (80%) had one event, and three surgeons (20%) informed having 2, 3, and 5 episodes respectively, for a total of 22 reported contaminated grafts. Of the surgeons who reported a contaminated graft, 11 (73%) performed 50 or more ACL reconstructions annually. In 13 opportunities (59%) the management for a contaminated graft was cleansing the graft and proceeding as planned. In 6 cases (27%) an allograft was used, in 2 occasions (9%) a different graft was harvested, and in 1 opportunity (5%) a semitendinosus graft triplication was performed. No infections in any of the contaminated grafts were reported. CONCLUSIONS: In case of accidental graft contamination during an ACL reconstruction, knee surgeons most often preferred disinfecting the graft and using it as the initial plan. LEVEL OF EVIDENCE: Level V, expert opinion.
Subject(s)
Humans , Accidents , Equipment Contamination/statistics & numerical data , Transplants/microbiology , Anterior Cruciate Ligament Reconstruction/methods , Orthopedic Surgeons/psychology , Chlorhexidine/administration & dosage , Sterilization/methods , Decontamination , Equipment Contamination/prevention & control , Surveys and Questionnaires , Disinfectants/administration & dosage , Allografts/microbiology , Autografts/microbiology , Anti-Bacterial AgentsABSTRACT
Background: A tight glycemic control of hospitalized patients increases the risk of hypoglycemia, whose management is not always optimal. Aim: To assess the hypoglycemia management competences of a multidisciplinary team in a clinical hospital. Material and Methods: An anonymous questionnaire about hypoglycemia management was answered by 11 staff physicians, 42 residents and 28 nurses of the department of medicine and critical care unit ofa university hospital. Results: Respondents had a mean of 60 percent of correct answers, without significant differences between groups. The capillary blood glucose level that defines hypoglycemia was known by most of the respondents, but the value that defines severe episodes was known only by 60 percent. The initial management and follow up was well known only for severe episodes. Less than 50 percento knew the blood glucose value that required continuing with treatment. Conclusions: Although most professionals are able to recognize hypoglycemia, the knowledge about is management if insufficient.
Subject(s)
Female , Humans , Male , Clinical Competence/statistics & numerical data , Disease Management , Hypoglycemia/diagnosis , Medical Staff, Hospital/standards , Nursing Staff, Hospital/standards , Patient Care Team/standards , Attitude of Health Personnel , Blood Glucose/analysis , Cross-Sectional Studies , Glycemic Index , Hospitals, University , Hypoglycemia/therapy , Surveys and Questionnaires , Severity of Illness IndexABSTRACT
Background: Carotid intima media thickness (CIMT) is a marker of cardiovascular damage that can be modified by traditional risk factors. Aim: To determine attributable risk factors for a high CIMT among healthy adults. Material ana Methods: A sample of 1270 individuáis (636 males and 634 femóles) aged 44 ±11 years, was studied. Blood pressure, weight, height, lipidprofile and blood glucose were measured in all. CIMT and thepresence of atheroscleroticplaques were determined by carotid ultrasound. Standard criteria were used to define hypertension, dyslipidemia and diabetes. Results: Mean CIMT in the sample studied was 0.62 ± 0.01 mm and percentile 75 was 0.67. The most important risk factor for a CIMT over percentile 75 and thepresence of atherosclerotic plaques was hypertension with attributable risks of 54 and 57 percent, respectively. Conclusions: In this sample, the main risk factor for a high CIMT was hypertension.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Arteriosclerosis/pathology , Carotid Artery Diseases/pathology , Carotid Intima-Media Thickness , Arteriosclerosis , Carotid Artery Diseases , Cross-Sectional Studies , Risk Factors , Socioeconomic FactorsABSTRACT
Background: Waist to height ratio and ultrasensitive C-reactive protein are predictors of the presence of the metabolic syndrome in children. Aim: To determine the proportional risk of metabolic syndrome component clustering in children, using waist to height ratio and ultrasensitive C-reactive protein. Material and Methods: Anthropometric measures, blood pressure, fasting serum lipid profle, blood glucose and ultrasensitive C-reactive protein were determined in 209 children aged 11.5 ± 2 years (50 percent females). The presence of the metabolic syndrome as a function of waist to height ratio and C-reactive protein was modeled using logistic regression equations. The risk of clustering one, two or more components of the metabolic syndrome was calculated. Results: Metabolic syndrome was present in 5 percent of all children and 18 percent of those that were obese. The cut off points for waist to hip ratio and ultrasensitive C-reactive protein were 0.55 and 0.61 mg/L, respectively. For each 0.01 increment in waist to height ratio, the odds ratio of increasing one component of the metabolic syndrome was 1.2 (1.15-1.25) or 15 to 25 percent. The odds ratio for log-transformed ultrasensitive C-reactive protein was 1.62 (1.26-2.09). Excluding waist circumference, the odds ratio of adding one or more components of the metabolic syndrome was 1.05 (1.01-1.09) per 0.01 increment in waist to height ratio, but the odds ratio for C-reactive protein was no longer significant. Conclusions: Waist to height ratio and ultrasensitive C-reactive protein predict the risk of clustering components of the metabolic syndrome in these children.
Subject(s)
Child , Female , Humans , Male , C-Reactive Protein/analysis , Metabolic Syndrome/diagnosis , Waist Circumference/physiology , Anthropometry , Biomarkers/blood , Epidemiologic Methods , Metabolic Syndrome/epidemiology , Reference ValuesABSTRACT
Background: A cardiovascular risk score for children, that includes traditional risk factors, obesity, sedentary habits and a family history of cardiovascular disease, has been recently proposed by Spanish researchers. Aim: To apply this score in school age children in Santiago de Chile and correlate its results with markers of subclinical atherosclerotic disease. Material and Methods: Retrospective analysis of data obtained from 209 children, aged 11.5 ± 2 years, studied between 2005 and 2006. Weight, height, blood pressure, ultrasound measurement of carotid intimamedia thickness and fow mediated dilatation of brachial artery and ultrasensible C reactive protein (us PCR) were measured. The Spanish cardiovascular risk score was calculated and correlated with ultrasound parameters and C reactive protein. Results: According to the score, 173 children (83 percent) had a low cardiovascular risk, 28 (13 percent) an intermediate risk and 8 (4 percent) a high risk. There was no association between the cardiovascular risk score and carotid intima-media thickness, fow mediated arterial dilatation and us PCR. Conclusions: No significant association was observed between the proposed cardiovascular risk score and early markers of atherosclerotic disease in this group of children.
Subject(s)
Adolescent , Child , Female , Humans , Male , Atherosclerosis/epidemiology , C-Reactive Protein/analysis , Atherosclerosis/etiology , Atherosclerosis , Biomarkers/analysis , Carotid Arteries , Chile , Retrospective Studies , Risk Assessment/methods , Risk Factors , Tunica IntimaABSTRACT
Las variaciones anatómicas de los elementos musculares de la región axilar son poco frecuentes y, generalmente, se encuentran olvidadas en los textos modernos de anatomía. Sin embargo, cuando existen, presentan un serio escollo para el cirujano, ya que alteran los hitos anatómicos de referencia para el abordaje de los importantes elementos vasculares y neurales de la región. Desde el siglo XIX algunos autores han descrito una variedad de pequeños fascículos musculares originados en el Panniculus carnosus, que se disponen en relación con los elementos neurovasculares de la axila. En esta ocasión presentamos un hallazgo efectuado en un cadáver, de sexo masculino, utilizado con fines docentes en el Departamento de Anatomía de la Escuela de Medicina de la Pontificia Universidad Católica de Chile. En la región axilar derecha, se observa un fascículo muscular que se extiende desde la apófisis coracoides, dispuesto por delante del músculo subescapular y pasando por detrás del paquete neurovascular de la axila. En su trayecto, este fascículo toma íntima relación con el nervio axilar y con la porción distal de la arteria subescapular. El músculo aberrante termina como una expansión aponeurótica, dispuesta ventral al tendón del latísimo del dorso, que se funde con la fascia axilar.
The anatomical variations of the muscular elements of the axillary region are infrequent and, generally, they are forgotten in modern texts of anatomy. Nevertheless, when they exist, they present a serious obstacle for the surgeon, since they alter the anatomical landmarks of reference for the approach to important neural and vascular elements of the region. Since the 19th century some authors have described a variety of small muscular fascicles originated in the "panniculus carnosus", that are arranged in relation to neurovasculares elements of the axila. In this occasion we present a finding performed in a corpse, male sex, dissected in the Department of Anatomy of the School of Medicine of the Pontificia Universidad Católica de Chile. In the right axillary region, a muscular fascicle is observed that extends from the coracoid process, arranged in front of the subscapularis muscle, and passing behind the neurovascular elements of the axila. In its course, this fascicle takes close relation with the axillary nerve and with the distal portion of the subscapular artery. This aberrant fascicle ends as an aponeurotic expansion, arranged ventral to the tendon of the latissimus dorsi muscle, which melts with the axillary fascia.