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1.
Cureus ; 15(7): e42723, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37654962

ABSTRACT

The potential adverse effects of electronic cigarette (e-cigarette) use or vaping on pulmonary function have been previously well documented, with the diagnosis of e-cigarette- or vaping-use-associated lung injury (EVALI) has become increasingly common. The potential effects in terms of cardiovascular function and vaping is an area that is less well understood. We present a case of acute respiratory distress and newly onset reduced systolic function in a previously healthy young male.

2.
Cureus ; 15(8): e42945, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37667696

ABSTRACT

Anomalous origin of the right coronary artery (RCA) is a rare congenital cardiovascular anomaly that can pose significant diagnostic challenges during cardiac evaluation. We present a case of a 54-year-old male patient with chest pain and a syncopal episode and subsequently diagnosed with non-ST-elevated myocardial infarction (NSTEMI). Coronary angiography revealed an anomalous origin of the RCA, making it difficult to precisely locate the artery's point of origin with selective contrast injection. During coronary angiography, the use of aortic root non-selective angiographic contrast injection aided in localizing the RCA ostium. Our case highlights the clinical significance of aortic contrast injection as a valuable and safe adjunctive technique in cases of anomalous coronary artery origins. Early detection and precise localization of such anomalies are essential for effective treatment planning and improved patient outcomes. Further studies may help validate the utility of aortic contrast injection in similar cases, thereby enhancing diagnostic accuracy and patient care in the management of anomalous coronary artery ostium.

3.
Int J Dermatol ; 62(9): 1176-1185, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37340535

ABSTRACT

BACKGROUND: Individualization of treatment based on acne type and severity, location, disease burden, and patient preference is required to maximize efficacy, safety, and adherence to therapy. Latin American populations have unique attributes that must be considered as part of this process to improve clinical success and achieve patient goals. Acne is more common among patients with darker skin phototypes, in whom it is often associated with postinflammatory hyperpigmentation and scarring-the most important acne sequelae-potentially due to more frequent and more severe underlying inflammatory processes in this population. DISCUSSION: These data argue for an early and proactive approach to managing acne in these patients with agents that target the inflammatory processes that underlie acne and its sequelae. As a class, retinoids offer a spectrum of activity that may be useful in addressing the unique needs of Latin American populations. CONCLUSION: Trifarotene, a novel, selective retinoid, has been evaluated in relevant patient populations.


Subject(s)
Acne Vulgaris , Dermatologic Agents , Humans , Latin America/epidemiology , Retinoids/adverse effects , Acne Vulgaris/drug therapy , Acne Vulgaris/complications , Cicatrix/complications , Treatment Outcome , Dermatologic Agents/adverse effects
4.
Ecol Evol ; 13(2): e9769, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36744079

ABSTRACT

Technological advances in migratory tracking tools have revealed a remarkable diversity in migratory patterns. One such pattern is leapfrog migration, where individuals that breed further north migrate to locations further south. Here, we analyzed migration patterns in the Painted Bunting (Passerina ciris) using a genetic-based approach. We started by mapping patterns of genetic variation across geographic space (called a genoscape) using 386 individuals from 25 populations across the breeding range. We then genotyped an additional 230 samples from 31 migration stopover locations and 178 samples from 16 wintering locations to map patterns of migratory connectivity. Our analyses of genetic variation across the breeding range show the existence of four genetically distinct groups within the species: Eastern, Southwestern, Louisiana, and Central groups. Subsequent assignment of migrating and wintering birds to genetic groups illustrated that birds from the Central group migrated during the fall via western Mexico or southern Texas, spent the winter from northeastern Mexico to Panama, and migrated north via the Gulf Coast of Mexico. While Louisiana birds overlapped with Central birds on their spring migratory routes along the Gulf Coast, we found that Louisiana birds had a more restricted wintering distribution in the Yucatan Peninsula and Central America. Further estimation of the straight-line distance from the predicted breeding location to the wintering location revealed that individuals sampled at lower winter latitudes traveled to greater distances (i.e., the predicted breeding area was further north; p > .001), confirming that these species exhibit a leapfrog migration pattern. Overall, these results demonstrate the utility of a genoscape-based approach for identifying range-wide patterns of migratory connectivity such as leapfrog migration with a high degree of clarity.

5.
J Pediatr Gastroenterol Nutr ; 76(3): 371-378, 2023 03 01.
Article in English | MEDLINE | ID: mdl-36728827

ABSTRACT

OBJECTIVES: Incidence of hepatitis C virus (HCV) infection is increasing in women of reproductive age, leading to increased prevalence of HCV infection in children via vertical transmission. This quality improvement (QI) project aimed to increase referrals to and appointments scheduled with a specialty pediatric gastroenterology HCV clinic and the number of eligible children with HCV who completed treatment. METHODS: From July 2020 to August 2021, the QI team designed a project using the Model for Improvement and completed Plan Do Study Act cycles to test change ideas to improve HCV awareness and education for medical providers and families; standardize the referral process; track patients; increase clinic capacity; and connect families with community resource care coordination. Referrals to the pediatric HCV clinic, appointments scheduled, no shows, and treatment follow-up were tracked during the project period and a comparison timeframe from July 2019 to June 2020. RESULTS: There were improvements in several measures during the project period versus the comparison timeframe, with 80 versus 48 referrals received (66% increase), 115 versus 59 scheduled clinic visits (95% increase), and 7 versus 5 treatment completers (40% increase), along with a small (7%) decline in the proportion of scheduled clinic visits that were no shows. CONCLUSION: Application of QI methodology increased medical provider and caregiver awareness and engagement in accessing HCV healthcare available for at-risk children. More QI efforts should be accelerated to identify best practices amidst a nationwide HCV epidemic.


Subject(s)
Hepacivirus , Hepatitis C , Humans , Child , Female , Quality Improvement , Hepatitis C/epidemiology , Hepatitis C/prevention & control , Health Services Accessibility , Ambulatory Care
6.
Cardiol Res ; 13(5): 297-302, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36405229

ABSTRACT

Background: Marijuana is the most commonly used illicit drug in the United States. Current research has yet to come to a consensus on its association with acute coronary syndrome (ACS). Herein, we aimed to analyze how marijuana use relates to acute ST elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Methods: Using a retrospective study design, we gathered data from August 2014 to September 2020 on all percutaneous coronary interventions (PCIs) done at Brookdale University Hospital Medical Center (BUHMC) in patients with NSTEMI and STEMI. To compare marijuana users (MUs) with non-users, t-tests and Chi-square tests were used. A total of 195 patients were included, with mean age at presentation of 47 years old; 59 were females (30.3%) and 136 were males (69.7%). We identified 37 patients who were MUs. MUs were younger than non-users (P < 0.01), had higher rates of alcohol (P = 0.025), opiate (P = 0.004) and cigarette (P ≤ 0.001) use. On admission, MUs had lower creatinine (P = 0.031), blood urea nitrogen (BUN) (P = 0.031), pro-B-type natriuretic peptide (PBNP) (P = 0.052), BMI (P = 0.014) and lower right coronary artery (RCA) disease (P = 0.026). Results: After logistic regression analyses, results showed that the severity of coronary artery disease (CAD) and admission diagnosis of STEMI or NSTEMI were not found to be significantly related to marijuana use. Age, alcohol, cigarette, creatinine, BUN, PBNP, BMI and RCA disease were significantly related to marijuana use. There was a negative correlation between marijuana use and RCA disease (MUs = 29.7% vs. non-users = 50%, P = 0.026). There was no significant association with STEMI, NSTEMI or the severity of CAD. Conclusion: As daily cannabis use is on the rise, more researches are needed to further determine the effects of marijuana use on CAD.

7.
J Vasc Surg Cases Innov Tech ; 8(3): 538-541, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36081743

ABSTRACT

Pharmacomechanical therapy and catheter-directed thrombolysis have been shown to be very effective in the treatment of venous thromboembolism; however, there is much less data regarding inferior vena cava thrombi. Tumor thrombi pose an even greater clinical challenge as anti-coagulation and thrombolysis are not effective. We present the case of a 61-year-old male who presented with an inferior vena cava thrombus emanating from an accessory right hepatic vein, treated with aspiration thrombectomy.

8.
Cir. plást. ibero-latinoam ; 48(2): 121-132, abr. - jun. 2022. ilus, tab
Article in Spanish | IBECS | ID: ibc-208935

ABSTRACT

Introducción y objetivo: Presentamos nuestra experiencia en mamoplastia utilizando la técnica a pedículo súpero-medial en bloque, evitando seccionar los conductos galactóforos y la glándula mamaria con la finalidad de conservar la función de lactancia y lograr un fácil ascenso del complejo areola-pezón, preservando su sensibilidad mediante la maniobra de Schwarzmann. Asimismo, utilizamos un colgajo a pedículo inferior, semejante al descrito por Ribeiro, para obtener un buen llenado del polo superior y un resultado estético satisfactorio. El marcaje resulta en un triángulo que va desde el punto A hasta la base de la mama pasando a los lados del complejo areola-pezón, reduciendo la cicatriz inframamaria resultante al no premarcar las proyecciones laterales y sólo resecar las orejar de perro que se forman al momento del cierre de la piel. Material y método: Recogemos 122 pacientes operadas desde enero del 2007 a diciembre del 2019, de diferentes edades, con diferentes grados de hipertrofia, gigantomastia y ptosis, así como casos tras retirada de implantes mamarios y cirugías previas, en los que empleamos la técnica de mamoplastia a pedículo súpero-medial asociada con colgajo a pedículo inferior. Resultados: La edad predominante estuvo entre los 30 y 50 años. El grado de hipertrofia mamaria más frecuente fue de importante a muy importante según la clasificación de Lalardrie y Jouglard. El volumen resecado más frecuente fue de 200 a 600 gr. Las complicaciones más vistas fueron hipoestesia del complejo areola-pezón y cicatrices hipertróficas e hipercrómicas. Logramos un buen resultado estético y funcional con un alto grado de satisfacción en las pacientes, un adecuado posicionamiento del complejo areola-pezón y escondiendo la cicatriz inframamaria dentro del cono mamario. (AU)


Background and objective: We present our experience in mammoplasty using the superomedial pedicle technique avoiding the cut of the lactiferous ducts and the mammary gland in order to preserve the lactation function and achieve an ascent of the nipple areola complex, preserving its sensibility with the Schwartzman's maneuver. We also use a lower pedicle flap, similar to the described by Ribeiro, to obtain a good filling of the upper pole and have a satisfactory aesthetic result. The skin mark results in a triangle which goes from point A to the base of the breast passing to the sides of the nipple areolar complex, reducing the inframammary scar by not pre-marking the lateral projections and only resecting the dog ears that are formed at the time of the skin closure. Methods: We collected 122 patients operated using the superomedial pedicle mammoplasty technique from January 2007 to December 2019, of different ages and different hypertrophy degrees, gigantomastia and ptosis, as well as post-removal of breast implant and previous surgery, in whom the technique of superomedial pedicle mammoplasty associated with a lower pedicle flap was used. Results: The predominant age was between 30 and 50 years old. The most frequent level of breast hypertrophy was from important to very important according to Lalardrie and Jouglard's classification. The most frequent volume resected was 200 to 600 gr. The most observed complications were hypoesthesia of the nipple-areolar complex and hypertrophic and hyperchromic scars. A good aesthetic and functional result was achieved, with a high level of patient satisfaction, an adequate positioning of the nipple-areolar complex and hiding the inframammary scar inside the mammary cone. (AU)


Subject(s)
Humans , Female , Young Adult , Adult , Middle Aged , Mammaplasty , Breast Implants , Personal Satisfaction , Mammary Glands, Human , Nipples , Epidemiology, Descriptive , Retrospective Studies
9.
Softw Syst Model ; 21(1): 311-336, 2022.
Article in English | MEDLINE | ID: mdl-34366763

ABSTRACT

Enterprise architecture has become an important driver to facilitate digital transformation in companies, since it allows to manage IT and business in a holistic and integrated manner by establishing connections among technology concerns and strategical/motivational ones. Enterprise architecture modelling is critical to accurately represent business and their IT assets in combination. This modelling is important when companies start to manage their enterprise architecture, but also when it is remodelled so that the enterprise architecture is realigned in a changing world. Enterprise architecture is commonly modelled by few experts in a manual way, which is error-prone and time-consuming and makes continuous realignment difficult. In contrast, other enterprise architecture modelling proposal automatically analyses some artefacts like source code, databases, services, etc. Previous automated modelling proposals focus on the analysis of individual artefacts with isolated transformations toward ArchiMate or other enterprise architecture notations and/or frameworks. We propose the usage of Knowledge Discovery Metamodel (KDM) to represent all the intermediate information retrieved from information systems' artefacts, which is then transformed into ArchiMate models. Thus, the core contribution of this paper is the model transformation between KDM and ArchiMate metamodels. The main implication of this proposal is that ArchiMate models are automatically generated from a common knowledge repository. Thereby, the relationships between different-nature artefacts can be exploited to get more complete and accurate enterprise architecture representations.

11.
Urol Case Rep ; 40: 101896, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34745894

ABSTRACT

Primary neuroendocrine differentiation in prostate cancer occurs infrequently and represents a therapeutic challenge at present due to the poor prognosis involved. We present the case of a patient with de novo neuroendocrine prostate cancer who later developed metastases to adrenals bilaterally which were initially managed surgically.

12.
Biomed Opt Express ; 11(9): 4901-4914, 2020 Sep 01.
Article in English | MEDLINE | ID: mdl-33014589

ABSTRACT

Diabetic retinopathy (DR) is defined as a microvascular pathology. However, some data have suggested that the retinal photoreceptors (PRs) might be important in the pathogenesis of this ocular disease. In this study the organization of the PRs in control and diabetic-induced rats was compared using multiphoton microscopy. The PR mosaic was imaged at different locations in non-stained retinas. The density of PRs was directly quantified from cell counting. The spatially resolved density presents a double-slope pattern (from the central retina towards the periphery) in both healthy and pathological samples, although the values for the latter were significantly lower all across the retina. Moreover, Voronoi analysis was performed to explore changes in PR topography. In control specimens a hexagonally packed structure was dominant. However, despite the non-controlled effects of the disease in retinal structures, this PR regularity was fairly maintained in diabetic retinas.

13.
Avian Dis ; 64(2): 135-142, 2020 06.
Article in English | MEDLINE | ID: mdl-32550613

ABSTRACT

Aquatic wild birds, especially waterfowl, have been long considered the main reservoirs of the avian influenza A virus; however, recent surveys have found an important prevalence of these viruses among land birds as well. Migration has been suggested as an important factor in the avian influenza virus dissemination. We aimed to estimate the prevalence of influenza A viruses in wild birds (waterbirds and land birds; resident and migratory) in eastern Mexico, where the three main North American migration flyways converge and where there was no previous information on this subject. We detected influenza with reverse transcription coupled with a PCR approach. Of the 534 birds sampled between 2010 and 2012, we detected the influenza A virus in a high proportion of birds (39%). Prevalence was particularly high in land birds (49%) when compared to aquatic birds (26%); there was no difference in overall prevalence between resident (39%) and migratory birds (39%). The high prevalence of the avian influenza virus in land birds was noteworthy in the innermost sampling areas in northern Mexico (Coahuila [82%] and Nuevo Leon [43%]).


Alta prevalencia del virus de la influenza aviar entre aves acuáticas silvestres y aves terrestres de México. Las aves silvestres acuáticas, especialmente las aves anseriformes, han sido consideradas durante mucho tiempo los principales reservorios del virus de la influenza aviar A; sin embargo, muestreos recientes también han encontrado una importante prevalencia de estos virus entre las aves terrestres. Se ha sugerido que la migración es un factor importante en la diseminación del virus de la influenza aviar. El objetivo de este estudio fue estimar la prevalencia de los virus de la influenza A en aves silvestres (aves acuáticas y terrestres; residentes y migratorias) en el este de México, donde convergen las tres rutas migratorias principales de América del Norte y donde no había información previa sobre este tema. Se detectó al virus de influenza mediante transcripción reversa acoplada a PCR. De las 534 aves muestreadas entre los años 2010 y 2012, se detectó al virus de la influenza A en una alta proporción de aves (39%). La prevalencia fue particularmente alta en las aves terrestres (49%) en comparación con las aves acuáticas (26%); no se observó diferencia en la prevalencia general entre las aves residentes (39%) y las migratorias (39%). La alta prevalencia del virus de la influenza aviar en las aves terrestres fue notable en las áreas de muestreo hacia el interior del norte de México (Coahuila [82%] y Nuevo León [43%]).


Subject(s)
Birds , Influenza A virus/isolation & purification , Influenza in Birds/epidemiology , Animal Migration , Animals , Influenza in Birds/virology , Mexico/epidemiology , Prevalence , Reverse Transcriptase Polymerase Chain Reaction/veterinary
14.
PLoS One ; 15(4): e0232282, 2020.
Article in English | MEDLINE | ID: mdl-32352998

ABSTRACT

The magnitude and distribution of genetic diversity through space and time can provide useful information relating to evolutionary potential and conservation status in threatened species. In assessing genetic diversity in species that are of conservation concern, several studies have focused on the use of Toll-like receptors (TLRs). TLRs are innate immune genes related to pathogen resistance, and polymorphisms may reflect not only levels of functional diversity, but may also be used to assess genetic diversity within and among populations. Here, we combined four potentially adaptive markers (TLRs) with one mitochondrial (COI) marker to evaluate genetic variation in the endangered Sierra Madre Sparrow (Xenospiza baileyi). This species offers an ideal model to investigate population and evolutionary genetic processes that may be occurring in a habitat restricted endangered species with disjunct populations (Mexico City and Durango), the census sizes of which differ by an order of magnitude. TLRs diversity in the Sierra Madre Sparrow was relatively high, which was not expected given its two small, geographically isolated populations. Genetic diversity was different (but not significantly so) between the two populations, with less diversity seen in the smaller Durango population. Population genetic structure between populations was due to isolation and different selective forces acting on different TLRs; population structure was also evident in COI. Reduction of genetic diversity in COI was observed over 20 years in the Durango population, a result likely caused by habitat loss, a factor which may be the main cause of diversity decline generally. Our results provide information related to the ways in which adaptive variation can be altered by demographic changes due to human-mediated habitat alterations. Furthermore, our findings may help to guide conservation schemes for both populations and their restricted habitat.


Subject(s)
Polymorphism, Genetic/genetics , Sparrows/genetics , Animals , Biological Evolution , Conservation of Natural Resources/methods , Ecosystem , Endangered Species , Genetics, Population/methods , Microsatellite Repeats/genetics , Phylogeny
15.
Cureus ; 12(4): e7653, 2020 Apr 12.
Article in English | MEDLINE | ID: mdl-32411554

ABSTRACT

Giant aneurysms of the left main coronary artery are one of the rarest findings in cardiology, encountered in less than 0.02% of patients. The presentation is usually the same as coronary artery disease since most coronary aneurysms in the western world are associated with atherosclerosis. Here we report the first case of giant aneurysm of the left main coronary artery presenting as ventricular tachycardia with multiple shocks of the defibrillator in a 57-year-old man with heart failure. We also review the etiology, pathology, and management of coronary aneurysms.

16.
Arch. esp. urol. (Ed. impr.) ; 73(1): 11-18, ene.-feb. 2020. tab, graf
Article in Spanish | IBECS | ID: ibc-192889

ABSTRACT

OBJETIVO: Revisar las características clínicas y el manejo del cáncer de pene (CP) en el Instituto Nacional de Cancerología (INCan) de la Ciudad de México en 20 años de experiencia. MATERIAL Y MÉTODOS: Revisamos de forma retrospectiva a 405 pacientes con diagnóstico de CP tratados en INCan entre enero de 1989 hasta diciembre de 2015. Se describieron la modalidad de presentación de los casos, los resultados de patología, tratamiento y la sobrevida. RESULTADOS: Las informaciones clínico-patológicas y los resultados oncológicos fueron completas en 375 pacientes (edad media 56,82). Al diagnóstico 140 casos (n.37,3%) fueron cN0, 71 casos (18,9%) cN1, 164 casos (43,37%) cN2, 33 casos (8%) cN3. El 14% tuvieron metástasis a distancia (pulmón, huesos). El tratamiento inicial incluyó falectomía parcial (n = 123; 33,6% y falectomía total (n = 126; 33,6%). De 138 (36,2%) pacientes de alto riesgo sometidos a disección de ganglios linfáticos inguinales bilaterales, solo el 8% (n.56) tenían ganglios linfáticos positivos. El análisis de supervivencia de Kaplan-Meier mostró una tasa de SCE (sobrevida cáncer específica) a 10 años del 70%. No hubo diferencias significativas en la supervivencia para el grupo de edad. La CSS a 5 años para pT1, pT2, pT3 y T4 fue del 96%, 88%, 58% y 0%, respectivamente. Se encontró diferencia en la supervivencia entre pT2 y pT3 (p 0,047). CONCLUSIÓN: Los hallazgos de nuestra casuística proporcionan información sobre la historia natural del cáncer de pene en México. La amputación quirúrgica del tumor primario sigue siendo el patrón uro-oncológico para el tratamiento definitivo del CP. No hubo diferencias en la supervivencia para el grupo de edad


OBJECTIVE: The aim of this study was to report clinical features and management of penile cancer (CP) at the National Cancer Institute (INCan) of Mexico City over 20 years. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 405 cases of primary penile cancer (PC) treated at our institution between 1989 until 2015. Diagnosis, treatment and oncological outcomes are reported. RESULTS: Clinicopathologic and demographic information was available for 375 patients (mean age, 56 ys). At diagnosis, 140 (37.3 %) patients were cN0, 71(18.9%) cN1, 164 (43.37%) cN2 and 33 (8%) cN3. 14% had metastatic disease (lung and bone). Initial treatment included partial penectomy (n = 123; 33.6%), and total penectomy (n = 126;33.6%). 138 (36.2%) patients with high risk disease underwent bilateral inguinal lymph node dissection. 8% (56) had positive lymph nodes. Kaplan-Meier survival analysis showed a 10-year CSS (cancer specific survival) rate of 70%. There was no significant difference in CSS when stratifying per age. Five-year CSS for pT1, pT2, pT3 and T4 was 96%, 88%, 58% y T4 0%, respectively. A difference in CSS was found between pT2 and pT3 (p = 0.047). CONCLUSION: The findings of our descriptive análisis provide information on natural history of penile cancer in Mexico. The surgical penile removal of the primary tumour remains standard of care. There was no difference in survival for age group


Subject(s)
Humans , Male , Middle Aged , Young Adult , Adult , Aged , Aged, 80 and over , Penile Neoplasms/diagnosis , Penile Neoplasms/pathology , Penile Neoplasms/therapy , Lymph Node Excision , Lymphatic Metastasis , Mexico , Neoplasm Staging , Retrospective Studies
17.
Arch Esp Urol ; 73(1): 11-18, 2020 Jan.
Article in Spanish | MEDLINE | ID: mdl-31950918

ABSTRACT

OBJECTIVE: The aim of this study was to report clinical features and management of penile cancer (CP) at the National Cancer Institute (INCan) of Mexico City over 20 years. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 405 cases of primary penile cancer (PC) treated at our institution between 1989 until 2015. Diagnosis, treatment and oncological outcomes are reported. RESULTS: Clinicopathologic and demographic information was available for 375 patients (mean age, 56 ys). At diagnosis, 140 (37.3 %) patients were cN0, 71(18.9%) cN1, 164 (43.37%) cN2 and 33 (8%) cN3. 14% had metastatic disease (lung and bone). Initial treatment included partial penectomy (n=123; 33.6%), and total penectomy (n=126;33.6%). 138 (36.2%) patients with high risk disease underwent bilateral inguinal lymph node dissection. 8% (56) had positive lymph nodes. Kaplan-Meier survival analysis showed a 10-year CSS (cancer specific survival) rate of 70%. There was no significant difference in CSS when stratifying per age. Five-year CSS for pT1, pT2, pT3 and T4 was 96%, 88%, 58% y T4 0%, respectively. A difference in CSS was found between pT2 and pT3 (p=0.047). CONCLUSION: The findings of our descriptive analysis provide information on natural history of penile cancer in Mexico. The surgical penile removal of the primary tumour remains standard of care. There was no difference in survival for age group.


OBJETIVO: Revisar las características clínicas y el manejo del cáncer de pene (CP) en el Instituto Nacional de Cancerología (INCan) de la Ciudad de México en 20 años de experiencia.MATERIAL Y MÉTODOS: Revisamos de forma retrospectiva a 405 pacientes con diagnóstico de CP tratados en INCan entre enero de 1989 hasta diciembre de 2015. Se describieron la modalidad de presentación de los casos, los resultados de patología, tratamiento y la sobrevida. RESULTADOS: Las informaciones clínico-patológicas y los resultados oncológicos fueron completas en 375 pacientes (edad media 56,82). Al diagnóstico 140 casos (n.37,3%) fueron cN0, 71 casos (18,9%) cN1, 164 casos (43,37%) cN2, 33 casos (8%) cN3. El 14% tuvieron metástasis a distancia (pulmón, huesos). El tratamiento inicial incluyó falectomía parcial (n=123; 33,6% y falectomía total (n=126; 33,6%). De 138 (36,2%) pacientes de alto riesgo sometidos a disección de ganglios linfáticos inguinales bilaterales, solo el 8% (n.56) tenían ganglios linfáticos positivos. El análisis de supervivencia de Kaplan-Meier mostró una tasa de SCE (sobrevida cáncer específica) a 10 años del 70%. No hubo diferencias significativas en la supervivencia para el grupo de edad. La CSS a 5 años para pT1, pT2, pT3 y T4 fue del 96%, 88%, 58% y 0%, respectivamente. Se encontró diferencia en la supervivencia entre pT2 y pT3 (p 0,047).CONCLUSIÓN: Los hallazgos de nuestra casuística proporcionan información sobre la historia natural del cáncer de pene en México. La amputación quirúrgica del tumor primario sigue siendo el patrón uro-oncológico para el tratamiento definitivo del CP. No hubo diferencias en la supervivencia para el grupo de edad.


Subject(s)
Penile Neoplasms , Humans , Lymph Node Excision , Lymphatic Metastasis , Male , Mexico , Middle Aged , Neoplasm Staging , Penile Neoplasms/diagnosis , Penile Neoplasms/pathology , Penile Neoplasms/therapy , Retrospective Studies
18.
Molecules ; 24(19)2019 Sep 26.
Article in English | MEDLINE | ID: mdl-31561514

ABSTRACT

In the fields of Security and Defense, explosive traces must be analyzed at the sites of the terrorist events. The persistence on surfaces of these traces depends on the sublimation processes and the interactions with the surfaces. This study presents evidence that the sublimation process of these traces on stainless steel (SS) surfaces is very different than in bulk quantities. The enthalpies of sublimation of traces of four highly energetic materials: triacetone triperoxide (TATP), 2,4-dinitrotoluene (DNT), 2,4,6-trinitrotoluene (TNT), and 1,3,5- trinitrohexahydro-s-triazine (RDX) deposited on SS substrates were determined by optical fiber coupled-grazing angle probe Fourier Transform Infrared (FTIR) Spectroscopy. These were compared with enthalpies of sublimation determined by thermal gravimetric analysis for bulk amounts and differences between them were found. The sublimation enthalpy of RDX was very different for traces than for bulk quantities, attributed to two main factors. First, the beta-RDX phase was present at trace levels, unlike the case of bulk amounts which consisted only of the alpha-RDX phase. Second, an interaction between the RDX and SS was found. This interaction energy was determined using grazing angle FTIR microscopy. In the case of DNT and TNT, bulk and traces enthalpies were statistically similar, but it is evidenced that at the level of traces a metastable phase was observed. Finally, for TATP the enthalpies were statistically identical, but a non-linear behavior and a change of heat capacity values different from zero was found for both trace and bulk phases.


Subject(s)
Explosive Agents/chemistry , Models, Chemical , Algorithms , Explosive Agents/chemical synthesis , Spectroscopy, Fourier Transform Infrared , Thermogravimetry , X-Ray Diffraction
19.
Syst Biol ; 68(6): 956-966, 2019 11 01.
Article in English | MEDLINE | ID: mdl-31135028

ABSTRACT

Incomplete or geographically biased sampling poses significant problems for research in phylogeography, population genetics, phylogenetics, and species delimitation. Despite the power of using genome-wide genetic markers in systematics and related fields, approaches such as the multispecies coalescent remain unable to easily account for unsampled lineages. The Empidonax difficilis/Empidonax occidentalis complex of small tyrannid flycatchers (Aves: Tyrannidae) is a classic example of widely distributed species with limited phenotypic geographic variation that was broken into two largely cryptic (or "sibling") lineages following extensive study. Though the group is well-characterized north of the US Mexico border, the evolutionary distinctiveness and phylogenetic relationships of southern populations remain obscure. In this article, we use dense genomic and geographic sampling across the majority of the range of the E. difficilis/E. occidentalis complex to assess whether current taxonomy and species limits reflect underlying evolutionary patterns, or whether they are an artifact of historically biased or incomplete sampling. We find that additional samples from Mexico render the widely recognized species-level lineage E. occidentalis paraphyletic, though it retains support in the best-fit species delimitation model from clustering analyses. We further identify a highly divergent unrecognized lineage in a previously unsampled portion of the group's range, which a cline analysis suggests is more reproductively isolated than the currently recognized species E. difficilis and E. occidentalis. Our phylogeny supports a southern origin of these taxa. Our results highlight the pervasive impacts of biased geographic sampling, even in well-studied vertebrate groups like birds, and illustrate what is a common problem when attempting to define species in the face of recent divergence and reticulate evolution.


Subject(s)
Genetic Markers/genetics , Phylogeny , Songbirds/classification , Songbirds/genetics , Animals , Genetic Variation , Mexico , Selection Bias , United States
20.
Paidéia (Ribeirão Preto, Online) ; 29: e2911, 2019. tab, graf
Article in English | LILACS, Index Psychology - journals | ID: biblio-1002731

ABSTRACT

Abstract Passion is an important element among the psychological processes involved in the performance of any activity, including sports practice. Given the scarcity of nationally valid and reliable instruments, this study has the purpose of presenting the adaptation processes of the Passion Scale to the Brazilian context. A total of 789 Brazilian athletes (age:16.62±3.20; 58.4% men) participated in the study. To evaluate their psychometric properties, the scale dimensionality was estimated through the Hull method and Exploratory Structural Equation Modeling, and the accuracy by composite reliability. The factorial invariance model was estimated between men and women, and between participants of different competitive levels. Results showed the two-factor structure of the scale, according to the theoretical hypothesis, with desirable accuracy indicators. Equivalence of the measurement model was demonstrated when evaluating participants of different sexes and different competitive levels. Results suggest adequacy of the Brazilian version for the evaluation of this construct.


Resumo A paixão é um importante elemento dentre os processos psicológicos envolvidos na realização de qualquer atividade, inclusive na prática esportiva. Dada a escassez de instrumentos válidos e fidedignos nacionalmente, esse estudo objetivou apresentar os processos de adaptação da Escala de Paixão para o contexto brasileiro. Participaram da pesquisa 789 atletas brasileiros (idade:16,62 ± 3,20; 58,4% homens). Visando a avaliação de suas propriedades psicométricas, a dimensionalidade da escala foi estimada através do método Hull e Exploratory Structural Equation Modeling, e a precisão pela fiabilidade compósita. Também se estimou a invariância do modelo fatorial entre homens e mulheres, e entre os participantes de diferentes níveis competitivos. Os resultados revelaram a estrutura bifatorial da escala, conforme hipótese teórica, com indicadores desejáveis de precisão. Também foi demostrada a equivalência do modelo de medida ao avaliar participantes dos diferentes sexos e diferentes níveis competitivos. Os resultados sugerem adequação da versão brasileira para avaliação deste construto.


Resumen La pasión es un importante elemento entre los procesos psicológicos involucrados en la realización de cualquier actividad, incluso en la práctica deportiva. Considerando la escasez de instrumentos válidos y fiables en ámbito nacional, este estudio busca presentar los procesos de adaptación de la Escala de Pasión al contexto brasileño. En el estudio participaron 789 atletas brasileños (edad: 16,62 ± 3,20; un 58,4% hombres). Para la evaluación de sus propiedades psicométricas, la dimensionalidad de la escala se estimó por medio del método Hull y Exploratory Structural Equation Modeling; y la precisión, por la fiabilidad compuesta. También se calculó la invariancia del modelo factorial entre los hombres y las mujeres, y entre los participantes de diferentes niveles competitivos. Los resultados revelaron la estructura bifactorial de la escala, que confirma la hipótesis teórica, con indicadores deseables de precisión. También se demostró la equivalencia del modelo de medida en la evaluación de los participantes de ambos sexos y diferentes niveles competitivos. Los resultados sugieren adecuar la versión brasileña para la evaluación en este constructo.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Athletes , Psychology, Sports
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