ABSTRACT
The objectives of this study were to evaluate the degree of concordance between specialists (physicians) in relation to the process of medical care of patients with amebic liver abscess and to elaborate a model that contains the minimum elements considered as indispensable for the diagnosis, treatment and follow-up of an illness, based on the consensus of physicians that usually treat these patients. The design of the study was a comparative survey. Twenty eight specialists (physicians) were interviewed (nine infectologists, two gastroenterologists, six internists and eleven general surgeons) affiliated with second and third level hospitals (medical centers) of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security) located in the southern part of Mexico City. A three-part structured questionnaire was applied: the first part consisting of 57 questions focused on the diagnosis, the second corresponded to treatment and consisted of 16 questions and the third part referred to follow-up and included five questions. The agreement among the internists for the overall process (diagnosis+treatment) was the highest (kappa (k) = 0.64), followed by the surgeons (k = 0.63) and the infectologists (k = 0.49); the difference among these three groups of specialists was considered statistically significant (p = 0.001). When the therapeutic process was analyzed in separated form, this same statistical difference was sustained, which on the other hand was not identified for the diagnosis and follow-up processes. When comparing each group, the degree of agreement obtained from the members of each group did not express statistically significant differences.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Gastroenterology , General Surgery , Internal Medicine , Liver Abscess, Amebic/therapy , Observer Variation , Practice Patterns, Physicians'/statistics & numerical data , Adult , Female , Humans , Liver Abscess, Amebic/diagnosis , Male , Models, Theoretical , Surveys and QuestionnairesABSTRACT
Inherent DNA damage in the form of single strand breaks and alkali labile sites is generated by essential intracellular processes, such as DNA replication and repair. Utilizing the in situ DNA unwinding assay and the comet assay (single cell gel), we have observed high levels of alkali induced DNA strand breaks in cells isolated from mouse kidney tissue homogenate. Kidney cell DNA demonstrated a 7.4 x increase in nucleoid expansion and a 7 x increase in comet length compared to negative control cells (thymocytes and splenocytes) in the two assay systems, comparable to epididymal sperm cells which have previously been demonstrated to contain abundant alkali-labile sites. These results argue for the existence of prevalent alkali-labile sites in kidney cell DNA.
Subject(s)
DNA Damage , Kidney/metabolism , Alkalies , Animals , DNA/chemistry , DNA/metabolism , Male , Mice , Mice, Inbred BALB C , Spermatozoa/metabolismABSTRACT
DNA damage is central to research in many fields, especially cancer research and toxicology. The possible loss of DNA structural integrity during freezing or sustained maintenance at low temperatures may present difficulties in the interpretation of data accumulated in studies of tissues collected over a period of time and subsequently evaluated. Using laser scanning microscopic analysis of the recently developed single-cell gel (SCG) assay to measure DNA strand breaks in individual cells, we found that the basal levels of DNA damage in frozen tissue was higher than fresh tissue, but tissues frozen for greater lengths of time do not appear to contain significantly more DNA damage than those frozen for a short period. Evaluation of DNA damage in tumors stored by or collected using cryopreservation may produce artificially exaggerated levels of damage, which could limit analytical interpretations.
