Comparison between Two Types of 22-Gauge Fine-Needle Biopsy for Solid Pancreatic Tumors.

Background: Tissue sampling using endoscopic ultrasound-guided fine-needle aspiration is the gold standard for diagnosing malignant pancreatic tumors; however, its sensitivity and specificity are highly variable. Thus, fine-needle biopsy using cutting needles has been developed to overcome current limitations and improve diagnostic yield. Our study compared two fine-needle biopsy needles for tissue sampling for pancreatic solid lesions. Materials and Methods: Samples obtained from patients with pancreatic solid lesions using the 22-gauge fine-needle biopsy needles (Franseen needle or reverse bevel needle) were retrospectively analyzed. The primary outcomes were diagnostic yield and sample adequacy. The secondary outcome was diagnostic performance. The analysis was performed using 2 × 2 tables to calculate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for each needle type. Proportions were compared using the Z test. For quantitative variables, a comparative analysis was performed using Student's t test. Qualitative and unpaired outcome variables were described using Fisher's exact test. Results: Sixty-three patients with pancreatic lesions were included in the analysis. The fine-needle biopsy Franseen and reverse bevel groups included 33 and 30 patients, respectively. An adequate sample was obtained in 97% of patients in the Franseen needle group versus 80% in the reverse bevel needle group; the diagnostic yields in these groups were 93.9 and 66.7%, respectively. Neither differences between needle passes nor complications were noted. The sensitivity and specificity were 93.5 and 100%, respectively, in the fine-needle biopsy Franseen group, versus 71 and 100%, respectively, in the reverse bevel needle group. Conclusions: The Franseen needle was more effective for sampling pancreatic tumors than the reverse bevel needle.

Introdução: A aquisição de tecido através de punção com agulha fina guiada por ecoendoscopia é o padrão para o diagnóstico de neoplasias pancreáticas malignas; contudo, a sua sensibilidade e especificidade é altamente variável. A biópsia por agulha fina (FNB) usando agulhas cortantes foi desenvolvida para ultrapassar as limitações atuais. Este estudo comparou duas agulhas de FNB na aquisição de tecido de lesões pancreáticas sólidas. Métodos: Amostras obtidas de doentes com lesões pancreáticas sólidas utilizando agulha de FND de 22 gauge (Franseen ou reverse bevel) foram avaliadas retrospetivamente. Os outcomes primárias foram a rentabilidade diagnóstica e a adequabilidade das amostras. O outcome secundário foi a performance diagnóstica. A análise estatística foi realizada através de tabelas de contingência 2 × 2 para cálculo da sensibilidade, especificidade, valor preditivo positivo e negativo e acuidade para cada tipo de agulha. As proporções foram calculadas utilizando o teste-Z. Para variáveis quantitativas foi realizada análise comparativa com teste t-Student. Variáveis qualitativas e não pareadas foram comparadas com teste exato de Fisher. Resultados: Foram incluídos 63 doentes com lesões pancreáticas (33 no grupo FNB Franseen e 30 no grupo reverse bevel). Foram obtidas amostras adequadas em 97% do grupo Franseen vs 80% no grupo reverse bevel, sendo a rentabilidade diagnóstica de 93.9 e 66.7%, respetivamente. Não houve diferenças no número de passagens nem nas complicações. A sensibilidade e especificidade foram, respetivamente, de 93.5 e 100% no grupo Franseen versus 71 e 100% no grupo reverse bevel. Conclusões: A agulha Franseen foi mais efetiva na aquisição de amostras de lesões pancreáticas do que a agulha reverse bevel.

Genetic diversity, population structure, and demographic history of the chilhuil sea catfish Bagre panamensis in Northwestern Mexico inferred from mitochondrial DNA.

The chilhuil sea catfish (Bagre panamensis) is an ecologically relevant species contributing to the structure, organization, and functioning of the ecosystems it inhabits. Also, it is an important artisanal fishery resource in the Mexican Pacific coast. This study aimed to determine the genetic diversity, population structure, and historical demography of B. panamensis in the Mexican Pacific. The mitochondrial DNA was amplified from two distinct regions, r16S and COI, resulting in an 1142 bp of the concatenated genes. Low genetic diversity levels were detected for r16S (H = 12; h = 0.131; π = 0.0003) and high genetic diversity levels for COI (H = 57; h = 0.9128; π = 0.0039) and the concatenated gene fragments (H = 62; h = 0.9307; π = 0.0023). Population structure analysis indicated 'panmixia' for B. panamensis along the Mexican Pacific. Furthermore, historical demographic analysis (Tajima's D, Fu's Fs, mismatch distribution, and Bayesian Skyline plot analyses) supported a population expansion scenario for the studied species.

Effect of microbial immunostimulants on WSSV infection percentage and the expression of immune-related genes in white shrimp (Litopenaeus vannamei) / Efecto de los inmunoestimulantes microbianos en el porcentaje de infección con WSSV y la expresión de genes relacionados con el sistema inmune del camarón blanco (Litopenaeus vannamei) / Efeito de imunoestimulantes microbianos sobre a porcentagem de infecção por WSSV e a expressão de genes relacionados ao sistema imune em camarões brancos (Litopenaeus vannamei)

Abstract Background: The white spot syndrome virus (WSSV) causes high mortalities in aquaculture. The use of immunostimulants increases animal resistance. Objective: To evaluate the WSSV infection percentage and the immunostimulant effect of lactic acid bacteria and yeast (MI= microbial immunostimulants) on WSSV infected Litopenaeus vannamei. Methods: A bioassay was performed for 33 d, with treatments in triplicate. The MI was added to the feed at 8.5 mg/kg feed and offered to shrimp (9.9 ± 3.1 g) daily, every 2 days, or every 3 days. Shrimp were infected with WSSV at 9 and 19 days. The expression of four immune system-related genes was studied using qRT-PCR. Results: No significant differences were observed in growth and survival among treatments. At the end of the bioassay, WSSV infection percentage (low viral load) decreased 8.3 and 25% in treatments III and IV as compared to the control group. Treatments with MI showed significant differences in the relative expression of LvToll, transglutaminase, and prophenoloxidase genes when MI was offered daily as compared to the control group. The MI did not regulate the expression of the superoxide dismutase gene. The WSSV infection percentage decreased when feed with MI was offered every 3 d. Conclusion: The MI decrease WSSV infection percentage in L. vannamei infected with low viral load when it is offered every three days. The MI up-regulates LvToll, Tgase, and proPO genes when it is offered daily. Further research is needed regarding prophylactic treatment with microbial immunostimulants against WSSV in commercial shrimp farms.

Resumen Antecedentes: El virus del síndrome de la mancha blanca (WSSV) ocasiona alta mortalidad en acuacultura. El empleo de inmunoestimulantes incrementa la resistencia de los animales. Objetivo: Evaluar el porcentaje de infección de WSSV y el efecto inmunoestimulante de bacterias ácido lácticas y levadura (MI= inmunoestimulantes microbianos) en Litopenaeus vannamei infectado con WSSV. Métodos: Se realizó un bioensayo durante 33 días con tratamientos por triplicado. Se agregó MI al alimento (8,5 mg/kg de alimento), suministrandolo al camarón (9,9 ± 3,1 g) diariamente, cada 2, o cada 3 días. Los camarones se infectaron con WSSV a los 9 y 19 días. Se estudió la expresión de cuatro genes relacionados con el sistema inmune utilizando qRT-PCR. Resultados: No hubo diferencias significativas en el crecimiento y la sobrevivencia entre los tratamientos. Al final del bioensayo, el porcentaje de infección de WSSV (baja carga viral) disminuyó un 8,3 y un 25% en los tratamientos III y IV en comparación con el grupo control. Los tratamientos con MI mostraron diferencias significativas en la expresión relativa de los genes LvToll, transglutaminasa, y profenoloxidasa cuando se suministró MI diariamente en comparación con el grupo control. Los MI no regularon la expresión del gen de la superóxido dismutasa. El porcentaje de infección de WSSV disminuyó cuando el alimento con MI se aplicó cada 3 d. Conclusiones: Los MI disminuyen el porcentaje de infección de WSSV en L. vannamei infectado con baja carga viral cuando se aplican cada tres días. Además, los MI causan una sobre-expresión de los genes LvToll, Tgase y proPO cuando se administran diariamente. Se necesita más investigación sobre los inmunoestimulantes microbianos como tratamiento profiláctico contra WSSV en granjas comerciales de camarón.

Resumo Antecedentes: O vírus da mancha branca (WSSV) causa alta mortalidade na aqüicultura e o uso de imunoestimulantes aumenta a resistência em animais. Objetivo: Este trabalho avaliou a prevalência do WSSV e o efeito imunoestimulante de bactérias ácido lácticas e levadura (MI= inmunoestimulantes microbianos) em Litopenaeus vannamei infectado con WSSV. Métodos: Se realizou um bioensayo durante 33 dias com tratamientos por triplicado. Se agregou MI al alimento (8,5 mg/kg feed) e se o fornecimento de camarão (9,9 ± 3,1 g) diariamente, cada 2 e cada 3 d. Los camarones foram infectados com WSSV a los 9 y 19 d. Se estudió a expressão de quatro genes relacionados com o sistema imune, use qRT-PCR. Resultados: No hubo diferencias significativas no crescimento e na supervisão entre os tratamientos. Al final del bioensayo, a prevalência do WSSV diminuiu um 8.3 e não 25% nos tratamentos III e IV em comparação com o grupo de controle. Os tratamentos com MI mostraram diferenças significativas na expressão relativa dos genes. LvToll, transglutaminasa e prophenoloxidase quando se administraron em diários de MI em comparação com o controle de grupo. Los MI não regularam a expressão do genótipo da superóxido dismutasa. A prevalência do WSSV diminuiu quando o alimento com MI se aplicó cada 3 d. Conclusões: Los IM diminuir a prevalência de WSSV em L. vannamei infectado com baixa carga viral quando aplicável a cada três dias. Além disso, os IM causaram uma sobre-expressão dos genes LvToll, Tgase e proPO quando se administran diariamente. Há mais informações sobre imunoestimulantes microbianos como tratamento profiláctico contra WSSV en granjas comerciales de camarón.

Tratamiento de hematoma subdural: comparación entre drenaje subdural a presión negativa contra otro tipo de drenajes / Treatment of subdural hematoma: comparative analysis between subdural drainage with negative pressure versus other drainages

La ultrasonografía es un método de evaluación rápido y eficaz en los departamentos de emergencias, siempre en manos entrenadas. La lesión vascular periférica es un cuadro que en lo que trauma se refiere, debe tener un veloz diagnóstico y tratamiento por los riesgos que significa: En lesiones abiertas, la hemorragia; y en lesiones cerradas se añade el síndrome compartimental. Lograr la evaluación de la indemnidad o no del árbol vascular en los miembros, se torna importante a la hora de prevenir eventos que requieran intervención quirúrgica (reparación y/o fasciotomía). El objetivo de este trabajo consiste en demostrar la utilidad del conocimiento del árbol vascular periférico y su evaluación mediante doppler para el manejo del trauma vascular periférico, mental (n=77) = 11 (14,78 %). Resolución: lesión vascular = 1 (1,3 %) síndrome compartimental= 1 (1,3 %) con resolución quirúrgica. La utilización de la ultrasonografía y del doppler para la evaluación vascular periférica es útil para el reconocimiento precoz del riesgo a desarrollar desde una lesión vascular simple hasta un síndrome compartimental. La utilización de listas de verificación durante la simulación para la generación del criterio, son útiles en la formación de residentes de cirugía

Report the recurrence rate ofnegative pressure subdural drainage (NPSD) versusto other kind of drains (OD). Design and Methods: Astudy was conducted cross-sectional and weretrospectively analyzed on the database of theneurosurgical service and we looked for all surgicalprocedures recorded from January 2006 to December2015. Procedures with preoperative diagnosis ofsubdural hematoma (SDH) were selected, with a to-tal of 364 interventions, were excluded patients withpostoperative diagnosis different from SDH andeliminated those who did not have complete data,recurrence was identified, a statistical analysis wasperformed describing frequency measurementspercentage and standard deviation, RM and chi-square was obtained by software EPIDAT 3.1. 277 surgeries were performed in 230 patients, Thepopulation was divided into two groups: the first thoseinterventions with negative pressure subduraldrainage versus a second group with other differentdrains, and finally we compared the recurrence ratein each group, 44 surgeries had recurrence of SDH.The proportion of recurrence was found 16 % of thesurgeries, 16 % (n=7) of these were performed withnegative pressure subdural drainage and theremaining 84 % (n=37) by other drainage. The reasonfor prevalence found was 0.36 (95 % CI , 0.15 to0.85), with statistically significant differences (p =0.0165). The chi-square was 5.75 for the SDH withNPSD. It was found that patients treated with NPSDhave a lower risk of recurrence compared with OD,which acts as a protective factor for patients treatedwith this type of drain, this is statistically significant.

Neurocisticercosis racemosa del Valle Silviano con aneurisma inflamatorio de la arteria cerebral media derecha / Racemose neurocysticercosis of the Silviano Valley with inflammatory aneurysm of the right middle cerebral artery: case report

La neurocisticercosis (NCC) es la parasitosis más común del cerebro y presenta gran variedad de patrones pudiendo mimetizarse con numerosas patologías. Presentamos el caso de un paciente con aneurisma inflamatorio, del cual sólo encontramos 5 casos reportados en la literatura, y sólo uno cuenta con reporte histopatológico. El presente caso reporta un paciente con antecedente de diabetes mellitus e hipertensión arterial, que inició su padecimiento con crisis parciales simples secundariamente generalizadas.Al estudiar el paciente se le diagnosticó neurocisticercosis racemosa, se realizó resección de lesiones con ruptura transoperatoria de aneurisma inflamatorio secundario a NCC con clipaje exitoso. En la literatura se describen cambios inflamatorios en la pared del aneurisma y de la arteria dependiente, secundarios al proceso inmune con vasculitis asociada a un proceso inflamatorio crónico, estos cambios en la pared del aneurisma incrementa la posibilidad de rotura intraoperatoria. El reporte histopatológico fue concluyente con neurocisticercosis.

Neurocysticercosis (NCC) is themost common parasitic disease of the brain, has awide variety of patterns of presentation and can mimic many diseases. We report a patient with inflammatory aneurysm, and found only 5 cases reported in the literature, and only one has histopathological report.This is a case report of a patient with diabetes and arterial hypertension condition which started with simple secondary generalized partial seizures. The study reported the patient was diagnosed with neurocysticercosis racemosa, resection of lesions was performed with secondary inflammatory rupture intraoperative aneurysm clipping successful NCC,inflammatory changes in the literature described in the aneurysm wall and the dependent artery,secondary to immune process with vasculitis associated with a chronic inflammatory process, these changes in the aneurysm wall increase the possibility of intraoperative rupture. Histopathological report was conclusive with neurocysticercosis.

Manejo endodóntico conservador de un caso de Dens Invaginatus tipo III con vitalidad y lesión periapical / Conservative endodontic treatment of a dens invaginatus type III case with vitality and periapical lesion

En una paciente de sexo femenino de 22 años de edad, se presenta un caso exitoso con tratamiento endodóntico no quirúrgico de un Dens Invaginatus tipo III clasificación de Oehlers en un incisivo lateral superior izquierdo, diagnosticado durante examen radiográfico rutinario de control ortodóntico. Paciente asintomática, presentaba clínicamente en el 22 color y traslucidez normal. Había defecto anatómico en la corona por palatino; en la radiografía periapical se observó forma irregular de la raíz, la cual presentaba tres conductos, lesión radiolúcida periapical y ápice abierto. Al realizar las pruebas de vitalidad pulpar, hubo respuesta positiva. Se diagnosticó Dens Invaginatus tipo III con pulpa sana y periodontitis apical crónica no supurativa. Se realizó apexificación del conducto palatino; colocando hidróxido de calcio como medicación temporal y durante siete meses. Hubo disminución de la lesión y formación de cierre apical; se realizó obturación definitiva con técnica de condensación lateral; en los controles al año y dos años se encontró reparación total, restablecimiento del espacio del ligamento periodontal y mantenimiento del color, traslucidez y conservación de la vitalidad. A pesar del mal pronóstico de los dientes con Dens Invaginatus tipo III, debido a su compleja anatomía interna y a la dificultad de lograr los principios endodónticos de limpieza, conformación y obturación, en este inusual caso fue posible lograr un tratamiento exitoso; el tratamiento endodóntico convencional fue la primera elección.

A case of a 22 years-old female patient with a successful non-surgical endodontic treatment of a Dens Invaginatus type III (classification of Oehlers) in a maxillary left lateral incisor is presented. This case was diagnosed during a routine radiographic examination for orthodontic control. The patient was asymptomatic and clinically the tooth presented a crown with normal and translucent color. In addition to the palatal anatomical defect, the periapical radiographs showed three canals, extensive periapical radiollucency lesion, open apex and the tooth responded positively to the vitality tests. Consequently, Dens Invaginatus type III associated to normal pulp and nonsupurative chronic apical periodontitis was diagnosed. Apexification was the treatment of choice but only for the palatal canal using calcium hydroxide as temporary medication for seven months. After reduction of the periapical lesion and closing of the open apex the canal was obturated using lateral condensation technique. After two years of follow-ups a complete repair and reestablishment of the periodontal ligament space and maintenance of the color, translucency and vitality was observed. In spite of poor prognosis for the teeth with unusual Dens Invaginatus type III; due to its complex internal anatomy and the difficulties to obtain excellent cleaning, conformation and obturation, we demonstrated successful results. The conventional endodontic treatment should be the first election for these cases.