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SUMMARY OBJECTIVE: The aim of this study was to determine the role of positron emission tomography/computed tomography in the decision to perform axillary surgery by comparing positron emission tomography/computed tomography findings with pathology consistency after neoadjuvant chemotherapy. METHODS: Patients who were diagnosed for T1-4, cN1/2 breast cancer receiving neoadjuvant chemotherapy in our clinic between January 2016 and February 2021 were evaluated. Clinical and radiological responses, axillary surgery, and histopathological results after neoadjuvant chemotherapy were evaluated. RESULTS: Axillary involvement was not detected in positron emission tomography/computed tomography after neoadjuvant chemotherapy in 140 (60.6%) of 231 node-positive patients. In total, 88 (62.8%) of these patients underwent sentinel lymph node biopsy, and axillary lymph node dissection was performed in 29 (33%) of these patients upon detection of 1 or 2 positive lymph nodes. The other 52 (37.1%) patients underwent direct axillary lymph node dissection, and no metastatic lymph nodes were detected in 33 (63.4%) patients. No metastatic lymph node was found pathologically in a total of 92 patients without involvement in positron emission tomography/computed tomography, and the negative predictive value was calculated as 65.7%. Axillary lymph node dissection was performed in 91 (39.4%) patients with axillary involvement in positron emission tomography/computed tomography after neoadjuvant chemotherapy. Metastatic lymph nodes were found pathologically in 83 of these patients, and the positive predictive value was calculated as 91.2%. CONCLUSION: Positron emission tomography/computed tomography was found to be useful in the evaluation of clinical response, but it was not sufficient enough to predict a complete pathological response. When planning axillary surgery, axillary lymph node dissection should not be decided only with a positive positron emission tomography/computed tomography. Other radiological images should also be evaluated, and a positive sentinel lymph node biopsy should be the determinant of axillary lymph node dissection.
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Aims:The study was carried out to investigate the acute and sub-acute toxicity of Chrysanthemumindicumon albino rats. Study Design:In-vivoacute toxicity, haematological and Biochemical effect ofChrysanthemum indicum.Place and Duration of the Study: Department of Chemical Science Technology, Federal Polytechnic Mubi, Adamawa State, between October to December 2017.Methodology:For acute toxicity, four groups of 3 male rats each were dosed orally with Chrysanthemum indicum aqueous extractat 500, 1000, 2000 and 4000mg/kg body weight, the animals were observed for mortality, clinical sign and gross pathological changes for a period of 14days. For sub-acute toxicity and other parameters, four groups of five albino rats wereequally dosed orally with 0 (control), 75, 150 and 300mg/kg (experimental group) body weight of an aqueous extract of Chrysanthemumindicumfor six (6) weeks. After, complete administration, the biochemical and haemological indices were investigated and determined appropriately.Results:The aqueous extract of Chrysanthemumindicumwas found to be safe at 4000mg/kg body weight in acute toxicity study. Results further showed that there are changes compared to control and group administered the extract in sub-acute toxicity study. In RBC, from 5.40 to 5.10, and MCV, from 78.00 to 82.30 which were significantly different (p<0.05) but non-significant decrease (p<0.05) was noticed in AST, albumin, and urea. However, the level Protein, (13.00 to 10.00) ALT, (7.00 to 5.00) ALP (15.00 to 10.25) bilirubin (13.00 to 10.00) and creatinine (88.00 to 84.00) significantly reduced (p<0.05) in the experimental groups when compared to the control group.Conclusion:Although the acute toxicity of Chrysanthemumindicum suggests its safety at 4000mg/kg body weight, however, the findings of sub-acute toxicity suggest that the therapeutic and herbal tea use of Chrysanthemumindicum plant is not safe especially when taken orally in high dose for a prolonged period of time
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Fundamento: mantener la salud y bienestar personal ha sido una de las metas de todo individuo; sin embargo, existen situaciones o sucesos que pueden tornar un ambiente saludable en poco saludable o viceversa, y el disponer de activos de salud al alcance de todos es una vía de gran valor para reducir o minimizar esas situaciones. Objetivo: determinar la existencia de mapas de activos de salud en las unidades educativas de la provincia de Esmeraldas. Métodos: se realizó una investigación cuanti-cualitativa, longitudinal prospectiva, en dos fases, entre diciembre de 2015 y agosto de 2016; una primera fase, de diagnóstico, donde la población la conformaron las 121 unidades educativas de la ciudad de Esmeraldas, República del Ecuador y como muestra se seleccionaron 22 colegios de educación básica. En la segunda se realizó un estudio analítico de intervención a través de la investigación, acción participativa que culminó con la elaboración del mapeo de los activos de salud de la unidad educativa fiscal Luis Vargas Torres. Resultados: el resultado negativo obtenido en la fase 1 conllevó a realizar una prueba piloto en una de las instituciones, en la que se logró promover la participación estudiantil en la solución de sus propias necesidades, donde ellos fueron los que identificaron los activos de salud presentes en su unidad educativa, que permitieron elaborar el mapa de los activos de salud de la unidad objeto de estudio. Conclusiones: se logró dejar plasmado un mapa de activos de salud que exponen todos los activos con que cuenta la institución educativa. De igual forma, se obtuvo el empoderamiento de esta teoría en un grupo de estudiantes y docentes luego del proceso de socialización.
Background: keeping personal health and well-being has been one of the goals of every individual; however, there are situations or events that can make a healthy environment unhealthy or vice versa, and having health assets available to all is a valuable way to reduce or minimize such situations. Objective: to determine the existence of maps of health assets in the educational units of the Esmeraldas province. Methods: a quantitative-qualitative, prospective longitudinal study was carried out in two phases between December 2015 and August 2016; a first phase of diagnosis, where the population was made up of 121 educational units in the city of Esmeraldas, Republic of Ecuador and as sample 22 schools of primary education were selected. The second phase was developed through an analytical methodology of intervention, carried out through participatory action research. This methodology describes the resources and activities carried out for mapping the health assets. Results: the negative result obtained in the first phase led to a pilot test in one of the institutions, in order to promote student participation in solving their own needs, being themselves who identified the health assets in their educational institution. Conclusions: it was possible to leave a map of health assets that show all the assets that the institution has. In the same way, the empowerment of this theory was achieved in a group of students and teachers alike, after the socialization process.
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Abstract Background: Despite new improvements on cardiopulmonary resuscitation (CPR), brain damage is very often after resuscitation. Objective: To assess the prognostic value of cerebral oxygen saturation measurement (rSO2) for assessing prognosis on patients after cardiopulmonary resuscitation. Design: Retrospective analysis. Measurements and results: We analyzed 25 post-CPR patients (12 female and 13 male). All the patients were cooled to a target temperature of 33-34 °C. The Glascow Coma Scale (GCS), Corneal Reflexes (CR), Pupillary Reflexes (PR), arterial Base Excess (BE) and rSO2 measurements were taken on admission. The rewarming GCS, CR, PR, BE and rSO2 measurements were made after the patient's temperature reached 36 °C. Results: In survivors, the baseline rSO2 value was 67.5 (46-70) and the percent difference between baseline and rewarming rSO2 value was 0.03 (0.014-0.435). In non-survivors, the baseline rSO2 value was 30 (25-65) and the percent difference between baseline and rewarming rSO2 value was 0.031 (-0.08 to -20). No statistical difference was detected on percent changes between baseline and rewarming values of rSO2. Statistically significant difference was detected between baseline and rewarming GCS groups (p = 0.004). No statistical difference was detected between GCS, CR, PR, BE and rSO2 to determine the prognosis. Conclusion: Despite higher values of rSO2 on survivors than non-survivors, we found no statistically considerable difference between groups on baseline and the rewarming rSO2 values. Since the measurement is simple, and not affected by hypotension and hypothermia, the rSO2 may be a useful predictor for determining the prognosis after CPR.
Resumo Justificativa: Apesar dos novos avanços em reanimação cardiopulmonar (RCP), o dano cerebral muitas vezes ocorre após a reanimação. Objetivo: Avaliar o valor prognóstico de medir a saturação de oxigênio cerebral (rSO2) para estimar o prognóstico em pacientes após a reanimação cardiopulmonar. Projeto: Análise retrospectiva. Medidas e resultados: Foram avaliados após RCP 25 pacientes (12 do sexo feminino e 13 do masculino). Todos os pacientes foram submetidos à hipotermia (temperatura alvo de 33-34 °C). As mensurações da Escala de Coma de Glascow (GCS), dos reflexos corneanos (RC), dos reflexos pupilares (RP) e do excesso de base (EB) e rSO2 foram feitas na admissão. Na hipertermia, as mensurações de GCS, RC, RP, EB e rSO2 foram feitas depois que a temperatura atingiu 36 °C. Resultados: Em sobreviventes, o valor basal de rSO2 foi de 67,5 (46-70) e a diferença percentual entre o valor basal e a hipertermia de rSO2 foi de 0,03 (0,014-0,435). Em não sobreviventes, o valor basal de rSO2 foi de 30 (25-65) e a diferença percentual entre o valor basal de hipotermia de rSO2 foi de 0,031 (-0,08-20). Não houve diferença estatística nas variações percentuais entre os valores da rSO2 na fase basal e de reaquecimento. Uma diferença estatisticamente significativa foi observada entre os valores da GCS na fase basal e de reaquecimento dos grupos (p = 0,004). Não houve diferença estatisticamente significativa entre GCS, RC, RP, EB e rSO2 para determinar o prognóstico. Conclusão: Embora os valores da rSO2 tenham sido mais elevados em sobreviventes do que em não sobreviventes, não observamos uma diferença estatisticamente significativa dos valores da rSO2 entre os grupos na fase basal e de reaquecimento. Como a mensuração é simples, e não afetada por hipotensão e hipotermia, a rSO2 pode ser um indicador útil para determinar o prognóstico após a RCP.
Sujet(s)
Humains , Mâle , Femelle , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Jeune adulte , Consommation d'oxygène , Encéphale/métabolisme , Oxymétrie , Réanimation cardiopulmonaire , Pronostic , Études rétrospectives , Adulte d'âge moyenRÉSUMÉ
Background: The difficulties with airway management is the main reason for pediatric anesthesia-related morbidity and mortality. Objective: To assess the value of modified Mallampati test, Upper-Lip-Bite test, thyromental distance and the ratio of height to thyromental distance to predict difficult intubation in pediatric patients. Design: Prospective analysis. Measurements and results: Data were collected from 5 to 11 years old 250 pediatric patients requiring tracheal intubation. The Cormack and Lehane classification was used to evaluate difficult laryngoscopy. Sensitivity, specificity, positive predictive value and AUC values for each test were measured. Results: The sensitivity and specificity of modified Mallampati test were 76.92% and 95.54%, while those for ULBT were 69.23% and 97.32%. The optimal cutoff point for the ratio of height to thyromental distance and thyromental distance for predicting difficult laryngoscopy was 23.5 (sensitivity, 57.69%; specificity, 86.61%) and 5.5 cm (sensitivity, 61.54%; specificity, 99.11%). The modified Mallampati was the most sensitive of the tests. The ratio of height to thyromental distance was the least sensitive test. Conclusion: These results suggested that the modified Mallampati and Upper-Lip-Bite tests may be useful in pediatric patients for predicting difficult intubation. .
Justificativa: As dificuldades no manejo das vias aéreas são a principal causa de morbidade e mortalidade relacionada à anestesia pediátrica. Objetivo: Avaliar o valor do teste modificado de Mallampati, teste da mordida do lábio superior, distância tireomentoniana e relação altura-distância tireomentoniana para prever intubação difícil em pacientes pediátricos. Projeto: Análise prospectiva. Mensurações e resultados: Dados coletados de 250 pacientes pediátricos, com idades entre 5 e 11 anos, submetidos à intubação traqueal. A classificação de Cormack e Lehane foi usada para avaliar laringoscopia difícil. Os valores de sensibilidade, especificidade, preditivo positivo e AUC para cada teste foram registrados. Resultados: A sensibilidade e especificidade do teste modificado de Mallampati foram 76,92% e 95,54%, enquanto para o ULBT foram 69,23% e 97,32%. O ponto de corte ideal para a relação altura-distância tireomentoniana e distância tireomentoniana para prever laringoscopia difícil foi 23,5 (sensibilidade, 57,69%; especificidade, 86,61%) e 5,5 cm (sensibilidade, 61,54%; especificidade, 99,11%). O teste de Mallampati modificado foi o mais sensível dos testes. A relação entre altura-distância tireomentoniana foi o teste menos sensível. Conclusão: Esses resultados sugerem que os testes de Mallampati modificado e da mordida do lábio superior podem ser úteis em pacientes pediátricos para a previsão de intubação difícil. .
Introducción: Las dificultades en el manejo de las vías aéreas son la principal causa de morbi-mortalidad relacionada con la anestesia pediátrica. Objetivo: Evaluar el valor del test modificado de Mallampati, test de la mordida del labio superior, distancia tiromentoniana y relación altura-distancia tiromentoniana para prever la intubación difícil en pacientes pediátricos. Proyecto: Análisis prospectivo. Medidas y resultados: Datos recopilados de 250 pacientes pediátricos con edades entre 5 y 11 años sometidos a la intubación traqueal. La clasificación de Cormack y Lehane fue usada para calcular laringoscopia difícil. Se registraron los valores de sensibilidad, especificidad, predictivo positivo y AUC para cada test. Resultados: La sensibilidad y la especificidad del test modificado de Mallampati fueron del 76,92 y del 95,54%, mientras que para el ULBT fueron del 69,23 y del 97,32%. El punto de corte ideal para la relación altura-distancia tiromentoniana y distancia tiromentoniana para prever la laringoscopia difícil fue 23,5 (sensibilidad, 57,69%; especificidad, 86,61%) y 5,5 cm (sensibilidad, 61,54%; especificidad, 99,11%). El test de Mallampati modificado fue el más sensible de los test. La relación entre altura-distancia tiromentoniana fue el test menos sensible. Conclusión: Esos resultados indican que los test de Mallampati modificado y de la mordida del labio superior pueden ser útiles en pacientes pediátricos para la previsión de la intubación difícil. .
Sujet(s)
Humains , Enfant d'âge préscolaire , Enfant , Intubation trachéale/méthodes , Anesthésie/méthodes , Malocclusion dentaire/diagnostic , Valeur prédictive des testsRÉSUMÉ
To investigate the neuroprotective effects of Sulindac on the hippocampal complex after global cerebral ischemia/reperfusion (I/R) injury in rats. Thirty one Sprague-Dawley rats were used, distributed into group I (sham) n:7 were used as control. For group II (n:8), III (n:8) and IV (n:8) rats, cerebral ischemia was performed via the occlusion of bilateral internal carotid artery for 45 minutes and continued with reperfusion process. 0.3 mL/kg/h 0.9 % sodium chloride was infused intraperitoneally to the Group II rats before ischemia, 5μg/kg/h/0.3 ml sulindac was infused intraperitoneally to the Group III rats before ischemia and 5μg/kg/h/0.3 ml sulindac was infused intraperitoneally to the Group IV rats after ischemia and before reperfusion process. The levels of MDA, GSH and MPO activity were measured in the left hippocampus tissue. The hippocampal tissue of all group members were taken for histopathological study. The MDA and MPO levels increased from group I (control) to group II (I/R) (P<0.05) and decreased from group II (I/R) to group III (presulindac + I/R) and IV (postsulindac + I/R) (P<0.05). Beside these, the GSH levels decreased from group I (control) to group II (I/R) (P<0.05) and increased from group II (I/R) to group III (presulindac + I/R) and IV (postsulindac + I/R) (P<0.05).The number of apoptotic neurons increased from group I (control) to group II (I/R) (P<0.05) and decreased from group II (I/R) to group III (presulindac + I/R) and IV (postsulindac + I/R) (P<0.05). The Sulindac may have neuroprotective effects on ischemic neural tissue to prevent the reperfusion injury after ischemia.
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Animaux , Rats , Neuroprotecteurs/analyse , Ischémie/anatomopathologie , Reperfusion , Plaies et blessures , Rats/classificationRÉSUMÉ
BACKGROUND: Adhesion formation after peritoneal surgery is a major cause of postoperative bowel obstruction, infertility, and chronic pelvic pain. In this study, we compared the possible individual effects of phosphatidylcholine (PC), Seprafilm® II, and tissue plasminogen activator (t-PA) and the combined effects of phosphatidylcholine and t-PA on postoperative adhesion formation in a rat surgical model. MATERIALS AND METHODS: A total of 50 Wistar male rats underwent median laparotomy and standardized abrasion of the visceral and parietal peritoneum. phosphatidylcholine, Seprafilm II, and t-PA alone and phosphatidylcholine and t-PA in combination were applied intraperitoneally at the end of the surgical procedure. Seven days after surgery, a relaparotomy was performed for adhesion grading and histopathological examination. RESULTS: A comparison of adhesion stages demonstrated a significant difference between the control group and the study groups (p<0.001). The adhesion grade of the combined treatment group was statistically different from that of the other groups (p<0.05). In the t-PA group and the combined group, six and two rats, respectively, developed hematomas locally on the cecum. CONCLUSIONS: PC, t-PA, and Seprafilm II used individually reduced the adhesion grade. The t-PA and phosphatidylcholine combination was most effective in reducing adhesion formation. On the other hand, usage of t-PA alone or in combination may increase risk of bleeding. More detailed studies are needed, and future studies on the efficacy of a material for decreasing adhesion formation should include a comparison of several control materials in the same model.