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Rectal cancer is a common malignancy of the gastrointestinal tract. Extramural vascular invasion (EMVI) is a key indicator of risk stratification for rectal cancer and an important reference factor in determining individualised treatment options, so it is important to accurately assess whether extramural vessels are infiltrated by the tumour before surgery. The main imaging methods for rectal cancer include magnetic resonance imaging (MRI), computed tomography (CT) and transrectal ultrasound (TRUS). This article focuses on the performance and diagnostic efficacy of these imaging methods in the diagnosis of EMVI in rectal cancer, and provides clinical reference.
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Objective:To explore the relationship between weight change and metabolic control of type 2 diabetic patients after 1 year treatment under the standardized metabolic disease management model.Methods:From November 2017 to November 2021, 950 patients with T2DM in the Standardized Metabolic Management Center of Suzhou Municipal Hospital were recruited in this research, who were divided into normal(BMI 18.5-23.9 kg/m 2), overweight(BMI 24.0-27.9 kg/m 2), and obese(BMI≥28 kg/m 2)groups according to baseline BMI. The metabolic indicators and control rates were compared. The overweight and obese 599 patients were divided into weight reduction(<-3 kg), maintenance(-3-1 kg) and gain(>1 kg)groups according to weight changes by one year, and metabolic indicators and control rates were compared to analyze the influence of weight change on metabolic control of overweight and obese patients. Results:(1) The overweight and obese groups had worse metabolic control at baseline and the obese group was younger. After 1 year, the metabolic indicators of three groups were significantly improved. (2) After 1 year, the metabolic control was better in weight reduction group and worse in weight gain group. The control rates were increased in weight reduction and maintenance groups. (3) For every 1 kg reduction in body weight of overweight and obese patients, blood glucose, blood lipids, blood pressure and comprehensive control rate increased by 1.206, 1.046, 1.069 and 1.107 times, respectively. There was a positive linear relationship between weight reduction and metabolic improvement.Conclusion:Standardized metabolic disease management model promotes metabolic control in type 2 diabetic patients, especially in overweight and obese patients who actively lose weight. In the future we should strengthen the management of overweight and obese patients, enhance self-management ability, and manage body weight scientifically and effectively.
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Development of extramural health care for chronic wounds is still in its infancy in China, and thus it is urgent and vital to establish a correct concept and practicable principles. The authors reviewed recent domestic and international literature and summarized the following treatment procedures and principles for extramural health care of chronic wounds. (1) The patient needs to do self-assessment of the wound by using available simple methods; (2) The patient consults with professional physicians or nurses on wound care to define the severity and etiology of the non-healing wound; (3) Professionals evaluate the existing treatment strategies; (4) Etiological treatments are given by professionals; (5) Patients buy needed dressings via the more convenient ways from pharmacies, e-commerce platform or others; (6) Professionals provide a standardized and reasonable therapeutic plan based on the patient's wound conditions; (7) Both professionals and the patient pay attention to complications to prevent adverse outcomes; (8) Professionals strengthen the public education on wound care and integrated rehabilitation. This review expected to provide new perspectives on the therapeutic strategies for chronic wounds in an extramural setting.
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Humans , Wound Healing , Health Facilities , Delivery of Health Care , China , Wounds and Injuries/therapyABSTRACT
Objetivo: Descrever a experiência de um estágio acadêmico vivenciado por universitários da área da saúde em um município do Baixo Solimões. Síntese dos dados:Trata-se do relato descritivo de um estágio acadêmico extramuro realizado em Manacapuru, Amazonas, ocorrido no período de outubro de 2019 a fevereiro de 2020. A realização da atividade teve a participação de acadêmicos de Medicina, Enfermagem e Odontologia e contou com a aplicação de práticas em saúde direcionadas à atuação individual e coletiva. Tendo como público-alvo os pacientes atendidos por uma Unidade Básica de Saúde (UBS), os universitários auxiliaram na realização de atendimentos eletivos em suas respectivas áreas de atuação e conduziram atividades de educação em saúde como rodas de conversa, gincanas educativas, palestras interativas e educação continuada à equipe da UBS. Conclusão: As práticas e ações em saúde realizadas no período do estágio extramuro proporcionaram uma integração interdisciplinar satisfatória entre os acadêmicos, possibilitando aos mesmos uma vivência apropriada na atenção básica do Sistema Único de Saúde (SUS).
Objective: To describe the experience of an academic internship completed by university students in the health field in a municipality in Baixo Solimões. Data synthesis: This is a descriptive report of an extramural academic internship carried out in Manacapuru, Amazonas, from October 2019 to February 2020. The activity was carried out with the participation of medical, nursing and dentistry students and included the application of health practices aimed at individual and collective action. Having as a target audience the patients assisted by a Primary Health Care (PHC) center, the university students helped in carrying out elective care in their respective fields and conducted health education activities such as conversation circles, educational scavenger hunts, interactive lectures and continuing education for the PHC center team. Conclusion: The health practices and actions carried out during the extramural internship enabled a satisfactory interdisciplinary integration among the students and allowed them to have an appropriate experience in primary care in the Unified Health System (Sistema Único de Saúde SUS).
Objetivo: Describir la experiencia de una pasantía académica vivida por universitarios del área de la salud en un municipio del Baixo Solimões. Síntesis de los datos: Se refiere al informe descriptivo de una pasantía académica extramuros realizado en Manacapuru, Amazonas, ocurrido entre octubre de 2019 y febrero de 2020. La realización de la actividad tuvo la participación de académicos de medicina, enfermería y odontología y contó con la aplicación de prácticas en salud direccionadas a la actuación individual y colectiva. Teniendo como público meta los pacientes atendidos por una Unidad Básica de Salud (UBS), los universitarios ayudaron en la realización de atendimientos electivos en sus respectivas áreas de actuación y condujeron actividades de educación y en salud como charlas, juegos educativos, conferencias interactivas y educación continuada para el equipo de la UBS. Conclusión: Las prácticas y acciones en salud realizadas en el período de la pasantía extramuros proporcionaron una integración interdisciplinar satisfactoria entre los académicos, posibilitando a los mismos una experiencia apropiada en la atención básica del Sistema Único de Salud (SUS).
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Objective:To evaluate the value of transrectal ultrasound(TRUS)in diagnosing extramural venous invasion(EMVI) of rectal cancer.Methods:Clinical data of 81 rectal cancer patients were retrospectively analyzed in the People′s Hospital of Inner Mongolia Autonomous Region from January 2015 to December 2021. The extramural vascular sonographic features in these patients were summarized. Based on the postoperative pathology and compared with MRI examination, the efficacy of TRUS for the diagnosis of EMVI in rectal cancer was investigated.Results:①According to the sonographic presentation, extramural vessels of rectal cancer can be divided into the following four types: typeⅠshowed that the mass broke through the muscularis propria of the intestinal wall, and no peripheral vascular shadow was observed; typeⅡshowed that the mass broke through the muscularis propria, surrounded by extraneous vessels with normal diameter, running and blood flow; type Ⅲ showed that the mass broke through the intrinsic muscle layer of the intestinal wall and was surrounded by extramural vessels with abnormally thickened diameters, and blood flow filling defects; type Ⅳ showed a mass that broke through the intrinsic muscular layer, with irregularly dilated vessels outside the peritumoral wall and no blood flow signal in the lumen. ②With type Ⅲ and type Ⅳ as positive signs of EMVI, the diagnosis compliance rate of TRUS was 90.1% (Kappa=0.580, P<0.001), sensitivity was 58.3%, specificity was 95.7%, positive predictive value was 70.0%, negative predictive value was 93.0%, and area under the ROC curve(AUC) was 0.770. The diagnosis compliance rate of MRI was 86.4% (Kappa=0.541, P<0.001), sensitivity was 75.0%, specificity was 88.4%, positive predictive value was 52.9%, negative predictive value was 95.3%, and the AUC was 0.817. The differences in sensitivity and specificity between TRUS and MRI for the diagnosis of rectal cancer EMVI were not statistically significant ( P>0.05), and the differences in the AUC were not statistically significant ( Z=0.447, P=0.655). Conclusions:TRUS is valuable in assessing the extramural vascular status of rectal cancer and is expected to be an effective imaging method for preoperative diagnosis of EMVI.
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Rectal cancer is one of the most common malignant tumors of digestive system. Accurate preoperative diagnosis plays an important role in surgeons′ decision on treatment plan. Extramural venous invasion (EMVI), as an important prognostic factor for predicting lymph node metastasis, distant metastasis and overall survival time of rectal cancer, has been paid more attention in recent years. It may even be used as a new staging system for guiding clinical treatment and formulate accurate preoperative staging. Preoperative MRI(mrEMVI) and postoperative pathology (pEMVI) is equal in the accuracy of assessment of EMVI. mrEMVI can be used as an important item for preoperative multi disciplinary team or clinicians to evaluate the patient stage and formulate individual treatment plan, and can also be used as an important evaluation for whether to perform surgery after preoperative chemoradiotherapy (CRT) and whether to prolong postoperative chemoradiotherapy time. EMVI should be taken as one of the necessary preoperative examinations for all the rectal cancer patients.
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Extramural vascular invasion (EMVI) is a prognostic factor in rectal cancer. The previous evaluation of EMVI relies on the analysis of postoperative pathological results. With the development of MRI, MRI can accurately assess the status of EMVI (mrEMVI). MrEMVI has become the important prognostic indicator for rectal cancer. The risk of local recurrence and distant metastasis in mrEMVI-positive patients will be significantly increased. The aim of this article is to review the diagnostic features, clinical significance, and impact on treatment patterns of EMVI, and project its future development trend of EMVI.
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Background: In India presently around 8 million LBW infant are born each year. India accounts for 24% of global neonatal mortality. Improving NMR is an essential component of reducing U-5MR. The aim of this study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods:' This study was conducted at SNCU of Kamala Raja Hospital, Gwalior providing level III neonatal care. This is a retrospective hospital based observational study. Data from SNCU online database were taken for a period of 3 year from March 2016 to March 2019. Data obtained included sex, birth weight, Gestation age, morbidity profile, Diagnosis, and Mortality profile, Duration of stay and outcome. Categorical variables were tabulated and Statistical analysis was done.Results:' A total of 12,027 neonates were recruited, 63.07% were males and 36.92% were females. 54.87% were extramural, while 45.13% were intramural neonates. Prematurity was the most common morbidity 56.98% in the admitted neonates. Major contributors to the neonatal morbidity were Birth asphyxia (24.61%), others (21.60%), Respiratory Distress(14.06%), Sepsis(13.77%). The mortality rate in the present study is 25.45%. Major contributors for neonatal mortality includes Respiratory distress (37.76%), Birth Asphyxia (26.75%), Sepsis(13.91%). Mortality was more in out born babies 33.03% compared to inborn babies 22.03%.'Conclusions:' Improving antenatal care, more deliveries at institutions with SNCU facility, improved access to health facility, early identification of danger signs,'' timely referral of high risk cases, capacity building, can reduce neonatal mortality and its complications.
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Background: The present study was planned to determine the influence of maternal, obstetric and fetal risk factors on the outcome of intramurally (born at a tertiary care centre) and extramurally (born at a peripheral centre, home or a private facility) born asphyxiated neonates.Methods: It was an observational clinical research with a prospective design and was conducted in Neonatal Intensive Care Unit (NICU), Paediatric Neurology Clinic attached to Department of Paediatrics and Department of Obstetrics and Gynecology, Dr S N Medical College Jodhpur, Rajasthan. A total of 160 asphyxiated neonates (80 intramural and 80 extramural) were included in the study. A detailed antenatal and perinatal history with obstetrical interventions were recorded. The progress or deterioration in the clinical status of child was noted in hours. Outcome was evaluated in terms of survival, severest Hypoxic Ischaemic Encephalopathy (HIE) stage, time taken to reach non encephalopathic state, requirement of vasopressors and anticonvulsants, ventilator support, hemodynamic stability, time period to attain full enteral feeding, neurological examination at time of discharge and time taken for discharge.Results: Significant difference was observed in the antenatal and perinatal profile, perinatal management and resuscitation, postnatal management, morbidity, mortality and neurodevelopment outcome of extramurally delivered neonates in a peripheral health centre or at home as compared to intramurally delivered neonates in a tertiary institute.Conclusions: It is of paramount importance to have an early referral of asphyxiated neonates to a well equipped NICU using an appropriate well equipped transport unit/ chain so as to improve their outcome.
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RESUMEN El propósito del presente escrito es hacer una reseña histórica del impacto e importancia que tienen los Programas Extramuros de la Especialidad de Prótesis Maxilofacial y para que exista un precedente narrativo documentado; así como resaltar la importancia de la atención médica que está encaminada a la rehabilitación física e incremento de la calidad de vida de los pacientes, lo cual figura en las declaraciones universales de salud pero que, debido a su alto costo, no hay una cobertura adecuada para los sistemas de salud gubernamentales; sin embargo, cuando se conjugan esfuerzos, voluntades y capacidades de diversas instituciones participantes, se puede lograr trascender y acercarse a una medicina de alto nivel.
ABSTRACT The goal of this document is to give an historical account of the importance and impact of the extramural program carried out by the UNAM Faculty of Dentistry Specialty of Maxillofacial Prosthetics to set a narrative precedent. The right of healthcare directed toward the physical rehabilitation and hence increased quality of life of patients is contained in the Article 25 of the Universal Declaration of Human Rights. However, the high cost of this type of care complicates its coverage on the part of Government health systems. But when the effort, the determination, and the capacity of various participating institutions blend, high-level medicine can reach to the most disadvantaged populations.
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Objective@#The study aims to assess the effectiveness of mobile medical App in the management of outpatients with type 2 diabetes(T2DM). @*Methods@#A total of 114 patients with T2DM were randomly divided into mobile medical group (trial group) and traditional face-to-face follow-up group (control group).Every patient received an electronic blood glucose meter, an electronic sphygmomanometer and an electronic weight scale.Patients in the trial group were treated with a telemedicine system and patients in the control group with a conventional outpatient follow-up model.The study was conducted for 6 months.@*Results@#A total of 114 patients were eligible for inclusion and participated in the study voluntarily.At the end of the study, with 1 patient lost and 3 patients withdrawing from the study, 53 patients completed the study in the trial group, while there were 2 patients lost and 55 patients completing the study in the control group. At the end of the study (6 months), the ratio of HbA1c < 7.0% in the trial group was higher than that in the control group (45% vs 29%, P < 0.001), and the difference in HbA1c levels between the two groups was obvious(P=0.032).Compared with the control group, the trial group had better control of BMI, SBP, TG and ALT (P=0.026, P=0.043, P=0.001, P=0.048).Other clinical indicators had no significant difference. The numbers of self-monitoring blood glucose, blood pressure and body weight were higher in the trial group than those in the control group (P=0.009, P=0.033, P=0.045).In terms of safety, the numbers of hypoglycemia in the trial group was lower than those in the control group (2.0% vs 6.4%, P=0.044). A lower number of specialist visits was reported in the telemedicine group (53 vs 87, P=0.031), while the number of emergency and hospitalizations did not show significant differences between the two groups.@*Conclusion@#This study confirms that telemedicine systems can improve the awareness of self-management in patients with T2DM and enhances the communication between doctors and patients.
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OBJECTIVE: To explore the clinical application value of artificial intelligence image aided diagnosis platformbased on Faster R-CNN in identifying EMVI of rectal cancer.METHODS: In the multicenter retrospective study,500 patients with rectal cancer who underwent high-resolution MRI examination between July 2016 and February 2019 wereselected from seven hospitals in China. They were divided into 174 positive and 326 negative patients. Patients wererandomized to a training group(400 patients,including 133 positive and 267 negative) and a validation group(100 patients,including 41 positive and 59 negative) using a random number method. Using the Faster R-CNN to learn and train 20 430 high-resolution MRI images of thetraining group,an artificial intelligence image-aided diagnosis platform was established. The5107 high-resolution MRI images of thevalidation group were clinically validated.Receiver operating characteristic(ROC) curveand area under the curve(AUC) were used tocompare the diagnostic results of the artificialintelligence image-aided diagnosis platform andthe senior image expert.RESULTS: The accuracy,sensitivity,specificity,positive predictive valueand negative predictive value of EMVI forartificial intelligence image-aided diagnosis platform were 93.4%, 97.3%, 89.5%, 0.90 and 0.97,respectively. The area under the receiver operating characteristiccurve(AUC) was 0.98. The time required to automatically recognize a single image was 0.2 seconds,which had clearadvantages compared to radiologists(estimated to be about 10 seconds).CONCLUSION: The artificial intelligence image-assisted diagnosis platform based on Faster R-CNN has high efficiency and feasibility for identifying rectal cancerEMVI,and can assist imaging diagnosis.
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Objective@#To evaluate the value of preoperative diagnosis of extramural vascular invasion (EMVI) of rectal cancer with 3.0T high-resolution magnetic resonance imaging (MRI) and the MRI-related factors of EMVI in rectal cancer.@*Methods@#The clinical and imaging data of 40 patients with rectal cancer were retrospectively analyzed. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficacy of preoperative diagnosis of EMVI of rectal cancer by high-resolution MRI, and to analyze the relationship between the EMVI and clinical and MRI features.@*Results@#Of the 40 patients, 19 cases were diagnosed as positive EMVI and 21 were negative by MRI. Pathological diagnosis of EMVI was positive in 10 cases and negative in 30 cases. The sensitivity, specificity and accuracy of MRI in the diagnosis of EMVI were 100%, 70.0% and 77.5%, respectively. Preoperative MRI and postoperative pathology were moderately consistent in the diagnosis of EMVI in rectal cancer (Kappa=0.538, P<0.001). Pathological EMVI positivity were related to tumor size under MRI examination (P=0.028), degree of differentiation (P<0.001), depth of invasion (P=0.002), lymph node metastasis (P=0.001), liver metastasis (P=0.011), tumor apparent diffusion coefficient (ADC) value (P=0.010) and exponential apparent diffusion coefficient (eADC) value (P=0.003). It also related to extramural nerve invasion by pathological examination (P=0.005).@*Conclusion@#According to the EMVI imaging score of rectal cancer, preoperative MRI has a high value in the diagnosis of EMVI of rectal cancer.
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The present study aimed to establish a methodology capable to cause intestinal ischemia and reperfusion injuries, to perform clamping of the jejunal segment of the extramural peri-intestinal marginal artery branch. For this, 37, 10-week-old male New Zealand breed rabbits were used. One rabbit was used to establish the anatomic references for the procedure and was not part of the six experimental groups; the rest were allocated into six experimental groups: Sham group, negative control, subjected only to midline celiotomy; group I1H undergoing vascular occlusion for an hour; group I2H submitted to vascular occlusion for two hours; group I1H/R2H undergoing vascular occlusion for one hour followed by two hours of reperfusion; group I2H/R1H undergoing vascular occlusion for two hours, followed by reperfusion for one hour, and group I2H/R5H undergoing vascular occlusion for two hours followed by reperfusion for five hours. The rabbits were evaluated for the macroscopic aspects (color and peristalsis) of the jejunal segment, as well as the histological aspect, checking for presence or absence of mucosal destruction, edema, hemorrhaging, lymphatic vessel dilatation, and the presence of polymorphonuclear cells. It was observed that the macroscopic and histopathological lesions accentuated in larger employed ischemia and reperfusion times. Rabbits subjected to ischemia for two hours followed by reperfusion for five hours (I2H/R5H) made up the experimental group which was easily reproducible and showed moderate intestinal injury, different from the other groups.(AU)
O presente estudo objetivou estabelecer uma metodologia capaz de causar lesões de isquemia e reperfusão intestinal, realizando clipagem de um ramo de artéria marginal peri-intestinal extramural em segmento jejunal. Para tal foram utilizados 37 coelhos da raça Nova Zelândia, machos, de 10 semanas de idade, alocados em seis grupos experimentais: grupo Sham, controle negativo, submetido apenas a celiotomia mediana; grupo I1H submetido à oclusão vascular por uma hora; grupo I2H submetido a oclusão vascular por duas horas; grupo I1H/R2H submetido a oclusão vascular por uma hora, seguida de reperfusão por duas horas; grupo I2H/R1H submetido a oclusão vascular por duas horas, seguida de reperfusão por uma hora e grupo I2H/R5H submetido a oclusão vascular por duas horas seguida de reperfusão por cincos horas. Os animais foram avaliados quanto o aspecto macroscópico (coloração e peristaltismo) do segmento jejunal e quanto ao aspecto histopatológico, verificando presença ou ausência de destruição de mucosa, edema, hemorragia, dilatação de vasos linfáticos e presença de polimorfonucleares. Observou-se que as lesões macroscópicas e histopatológicas se acentuaram nos maiores tempos de isquemia e reperfusão empregados. Os animais submetidos à isquemia durante duas horas, seguida de reperfusão por cinco horas (I2H/R5H) compuseram o grupo experimental de fácil reprodução e foram os que apresentaram uma lesão intestinal moderada, diferentes dos demais grupos.(AU)
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Animals , Rabbits , Rabbits/injuries , Reperfusion Injury/veterinary , Ischemia/diagnosisABSTRACT
The present study aimed to evaluate the efficacy of mesenchymal stem cell (MSC) infusion, derived from adipose tissue, on reduction of local and remote tissue damage caused by the event of experimental intestinal I/R in New Zealand breed rabbits. For obtaining, characterization, and cultivation of MSC derived from adipose tissue (MSC-Adp), 3 juvenile animals (four months old) were used. The cells were considered to be viable for therapy after the fourth passage (in vitro phase). For the in vivo stage, 24 young adult animals (six months old) were used, weighing approximately 3.5 kg, in which were randomly divided into two groups, called: IR treated with MSC (I2H/R5H MSC 3D; I2H/R5H MSC 7D); IR treated with PBS (I2H/R5H PBS 3D; I2H/R5H PBS 7D). The animals were anesthetized and submitted to pre-retro-umbilical midline celiotomy. The extramural peri-intestinal marginal artery was located and clamped (predetermined and standardized region) with the aid of a vascular clip, promoting a 2 hour blood flow interruption. After this period, blood flow was reestablished, inhalatory anesthesia was suspended, and the animals awaken. After 5 hours of reperfusion, the treatments were performed by intravenous infusion according to the experimental groups. The animals were evaluated 72 hours and seven days after the treatment as for the macroscopic appearance (color and peristaltism) of the jejunal segment, and by histological evaluation of the ischemic segment for the presence or absence of destruction of the intestinal mucosa, edema, bleeding, dilation of lymph vessels, and presence of polymorphonuclear inflammatory cells, both in the mucosa and submucosa. The observed results revealed that the groups treated with MSC-Adp obtained smaller mucosal and submucosal lesions when compared to the groups treated with PBS. Also, MSC-Adp treated groups obtained controlled inflammatory response and higher mitotic rate, outcomes related to the therapeutic potential of MSC. Infusion of stem cells attenuated the lesions caused by intestinal I/R in both MSC groups when compared to the group treated with PBS.(AU)
O presente estudo teve como principal objetivo avaliar a eficácia da infusão células tronco mesenquimais (CTM) derivada de tecido adiposo sobre diminuição das lesões teciduais locais e remotas, causadas pelo evento de I/R intestinal experimental, em coelhos da raça Nova Zelândia. Para obtenção, cultivo e caracterização das CTM provenientes de tecido adiposo (ADCTM) foram utilizados 3 animais jovens. As células foram consideradas viáveis para terapia a partir da quarta passagem (fase in vitro). Para etapa in vivo foram utilizados 24 animais, adulto-jovens, pesando aproximadamente 3,5kg, divididos aleatoriamente em dois grupos experimentais, denominados IR Tratado com CTM (I2H/R5H CTM 3D; I2H/R5H CTM 7D); IR Tratado PBS (I2H/R5H PBS 3D; I2H/R5H PBS 7D). Os animais foram anestesiados e submetidos à celiotomia mediana pré-retroumbilical. A artéria marginal peri-intestinal extramural foi localizada e clampeada (região predeterminada e padronizada) com auxílio de um clipe vascular, promovendo uma interrupção do fluxo sanguíneo durante 2 horas. Após esse período, o fluxo sanguíneo foi restabelecido, a anestesia inalatória suspendida e os animais despertados. Após 5 horas de reperfusão realizou-se os tratamentos por infusão endovenosa, conforme grupos experimentais. Os animais foram avaliados 72 horas e sete dias após o tratamento quanto ao aspecto macroscópico (coloração e peristaltismo) do segmento jejunal e por meio de avaliação histológica do segmento isquemiado quanto à presença ou ausência de destruição de mucosa intestinal, edema, hemorragia, dilatação de vasos linfáticos e presença de células inflamatórias polimorfornucleares, tanto em mucosa quanto submucosa. Os resultados observados revelaram que os grupos tratados com ADCTM obtiveram menores lesões em mucosa e submucosa quando comprados aos grupos tratados com PBS. Ainda os grupos tratados com ADCTM obtiveram resposta inflamatória controlada e maior taxa mitótica, resultados relacionados ao potencial terapêutico das CTM.(AU)
Subject(s)
Animals , Rabbits , Rabbits/anatomy & histology , Rabbits/genetics , Rabbits/injuries , Infusions, Intravenous/veterinary , Mesenchymal Stem Cell Transplantation/statistics & numerical data , Ischemia/veterinaryABSTRACT
Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI)in diagnosis of extramural vascular invasion (EMVI)of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings (k=0.324,P=0.039).The accuracy rate of MRI in diagnosis of EMVI was 66.7% (22/33).The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both (r=0.546).The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both (r=0.469). ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI (AUC=0.757).Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.
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Extramural vascular invasion(EMVI)was defined as the presence of tumor cells within an endotheliumlined vessel beyond the muscularis propria.High-resolution MRI had 100％sensitivity and 89％specificity in identification of large(caliber greater than 3 mm)EMVI with histopathology as reference.EMVI detected by both histopathology and MRI was significantly associated with local recurrence,distance metastasis and tumor-related death in rectal cancer,which was also identified as an independent prognostic factor for 3-year tumor-free survival and overall survival.EMVI could be used as one of the risk factors,which would allow stratification of patients with rectal cancer to receive neoadjuvant chemoradiotherapy(neoCRT).Moreover,EMVI detected by high-resolution MRI was identified as an independent predictor for response to neoCRT.Tumor regression grading scale defined by high-resolution MRI could be used to evaluate EMVI regression after neoCRT.
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Se muestran las principales experiencias del trabajo de extensión universitaria realizado con la participación de profesores y estudiantes de la Facultad de Biología de la Universidad de La Habana, para incrementar el conocimiento sobre la prevención de la tuberculosis, sus síntomas y transmisión y promover la participación social comunitaria entorno a la comprensión de esta enfermedad. El trabajo involucró a niños, jóvenes, adultos y ancianos, mediante acciones que integraron las funciones sustantivas de la educación superior como una estrategia de extensión universitaria. En su consecución se desarrollaron charlas, video debates, cursos, talleres, eventos, conferencias, encuestas y actividades recreativas, que permitieron realizar un trabajo sistemático desde diferentes perspectivas y con la inclusión de métodos formales como la docencia y la investigación. Participaron 2 575 personas entre vecinos, obreros y la población en general, lo que generó un compromiso social de los implicados. Atendiendo a que la tuberculosis es una enfermedad prevenible, este es un esfuerzo que aprovecha las diversas potencialidades del trabajo de extensión universitaria en la divulgación de los aspectos de prevención y control de la tuberculosis, de gran utilidad para la atención nacional de esta enfermedad infecciosa y cuyos resultados servirán de orientación para la continuidad de este trabajo
The main pieces of experience in the university extramural activities carried out by professors and students of the School of Biology of Havana University in order to raise the level of knowledge of the population on the prevention, symptoms and transmission of tuberculosis as well as to promote the social involvement of community in understanding this disease were presented in this paper. These activities involved children, young people, adults and the elderly through actions integrating the fundamental functions of higher education into an extramural university strategy. Talks, video debates, courses, workshops, events, lectures, surveys and recreational activities were held to support systematic work from different perspectives, and to include formal methods such as teaching and research. The involved people amounted to 2 575 including neighbors, simple workers and population at large, which fostered social engagement of the participants. Taking into account that tuberculosis is a preventable disease, this is a sort of effort that makes good use of the various potentialities of the university extramural activities for the dissemination of tuberculosis prevention and control informative aspects; they are also very useful for the national care of this infectious disease and for further orientation to carry on these activities
Subject(s)
Health Promotion , Tuberculosis/prevention & controlABSTRACT
PURPOSE: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. MATERIALS AND METHODS: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients' clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. RESULTS: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. CONCLUSIONS: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes.
Subject(s)
Humans , Constriction, Pathologic , Cystectomy , Dialysis , Follow-Up Studies , Physical Examination , Pyelonephritis , Recurrence , Ureter , Urinary Bladder , Urinary Bladder NeoplasmsABSTRACT
Este trabalho pretende oferecer caminhos de compreensão para as potencialidades contidas em algumas experiências de extensão, desenvolvidas na UERJ e cadastradas na Sub-reitoria de Extensão e Cultura, ou seja, suas características agregadoras e emancipadoras, seu papel na formação dos alunos, que se quer emancipador, e o posicionamento da equipe frente às políticas públicas da área de atuação dos projetos. Atualmente, as universidades vivenciam múltiplos desafios colocados tanto pela sociedade, que questiona sua existência, quanto por parte do Estado, que restringe o financiamento de suas atividades. As crises por que passa a Universidade dizem respeito também ao questionamento da sua hegemonia e da sua legitimidade. Neste sentido, mais que uma análise sobre sua estrutura e/ou conjuntura, é preciso refletir sobre o seu fazer cotidiano, procurando germes de mudanças, experiências que tragam para o debate uma maneira de se fazer formação que não seja aquela centrada no modo moderno de conhecer onde a razão se separa dos sentimentos, onde as relações são quantificáveis e onde a experiência foi silenciada. Esta reflexão se ancora no conceito de Boaventura Santos o qual considera emancipador o conhecimento que pensa as conseqüências dos seus atos, nos quais a relação sujeito-objeto é substituída pela reciprocidade entre os sujeitos e onde a solidariedade e a participação estão presentes. Através da análise documental dos proJetos e das entrevistas realizadas com coordenadores, alunos e usuários pudemos perceber que a contribuição das atividades para a formação do aluno se dá em dois níveis: a formação técnica e aquela mais voltada para a qualidade das relações, baseadas no respeito e no afeto. Foi igualmente possível observar que a concepção de saúde presente nas propostas não reduzem o homem às suas doenças, que a indissociabilidade ensinopesquisa4:lxtensão ainda não se concretizou de forma mais ampliada e que o conhecimento produzido é menos disciplinar e mais contextualizado, concretizandose na articulação com outras formas de conhecimento e com outros atores. (AU)
This work tries to help understand the potentíalities of some extra-mural activíties carried out at UERJ and registered at the Vice-Chancellorship for Extra-Mural projects and Culture - that ís, theír congregating and emancípating characteristícs, their emancipating role in the student's formatíon, and the staffs posítian towards public policies ín the fields comprised by the projects. At present, universíties face many obstacles placed either by the society, which questions their existence, or by the State, which restricts financial support. The university's crises also have to do with questions on its hegemony and legitimacy. ln this sense, more than analysing its structure and/or sítuatíon, we ought to think about the university's daily work, looking for changes, experiences that discuss a kind of formation other than the one based on modem knowledge, in which reason is apart from feelings, where relations are quantifíed and experience has become silent. This reflection is based on concepts stated by Boaventura Santos, for whom emancipating is the knowledge that thinks about the consequences of its acts, where the relation subject/object is replaced by reciprocity among subjects, and solidarity and participation are present. Through documental analysis of projects and interviews with coordinators, students and users, we could notice that the activities contribution to the student's formation occurs on two leveis: technical formation, and one concerned with the quality of relations, based on respect and affection. lt was also possible to notice that the proposal's health concepts do not reduce man to his diseases, that teaching, research and extra-mural activies are not completely apart yet, and that knowledge, less disciplinary and more contextualized, is materia!ízed in articulation with other forms of knowledge and with other actors. (AU)