ABSTRACT
Background: Colon leakage score (CLS) was developed for risk prediction of anastomotic leak (AL) in the left-sided colorectal surgery. Although the risk factors for leakage are well known and accepted by the surgical community, an accurate forecast of AL is still a difficult task. Objective: The study aims to apply the CLS in patients undergoing left-sided colorectal surgery. Methods: Retrospective study in patients with the left-sided colorectal surgery and primary anastomosis without diverting stoma. CLS was calculated in patients, who were classified in AL and NO-AL groups. Predictive value of CLS was evaluated by receiver operator characteristic. Correlation between CLS and AL was determined. 208 patients (55% male, mean age 59 years) were included in the study. Results: Overall, AL was 7.2%. Mean CLS of all patients was 7.2 ± 3.2 (0-17). Patients with AL had a higher CLS (11.8 ± 2.3) than NO-AL patients (6.8 ± 3) (p = 0.0001). The area under the curve for the prediction of AL by CLS was 0.898 ([CI] 0.829-0.968, p = 0.0001). A CLS of 8.5 had 93% sensitivity and 72% specificity. There was a statistically significant odds ratio for CLS and AL (0.58: [CI] 0.46-0.73, p = 0.0001). Conclusion: CLS is a useful tool to predict AL in the left-sided colorectal surgery.
Antecedentes: La puntuación de fugas de colon (CLS) se desarrolló para la predicción del riesgo de fuga anastomótica (AL) en la cirugía colorrectal del lado izquierdo, con la finalidad de obtener un pronóstico preciso. Objetivo: Este estudio tiene el objetivo de aplicar el CLS en pacientes con cirugía colorrectal de lado izquierdo. Método: Estudio retrospectivo en pacientes con cirugía colorrectal izquierda y anastomosis primaria sin estoma de derivación. Se calculó el CLS en los pacientes, los cuales fueron clasificados en los grupos con AL y sin AL. Resultados: La media del CLS de todos los pacientes fue de 7.2 ± 3.2 (0-17). Los pacientes con AL tenían un CLS más alto (11.8 ± 2.3) que los pacientes sin AL (6.8 ± 3) (p = 0.0001). El área bajo la curva para la predicción de la AL mediante el CLS fue de 0.898 (intervalo de confianza (CI) 0.829-0.968; p = 0.0001). Un CLS de 8.5 tuvo una sensibilidad del 93% y una especificidad del 72%. Además, se obtuvo un Odds Ratio con una diferencia estadísticamente significativa para el CLS y AL (0.58; CI 0.46-0.73; p = 0.0001). Conclusión: La CLS es una herramienta útil para predecir la AL en la cirugía colorrectal del lado izquierdo.
ABSTRACT
Immunological factors, such as cytokines, have been proposed as a cause of changes in the lipid profile of dengue patients. We studied whether serum lipid levels and serum TNF-α levels are associated in a group of dengue patients from an endemic region in the Northwest of Mexico. We found statistically important differences in the serum lipid profile and the TNF-α levels of dengue patients compared with the control group, were observed. However, TNF-α levels did not correlate with the lipid profile of dengue patients.
Subject(s)
Dengue/pathology , Lipids/blood , Tumor Necrosis Factor-alpha/blood , Adult , Aged , Blood Donors , Case-Control Studies , Female , Humans , Male , Mexico , Middle Aged , Serum/chemistryABSTRACT
Dengue virus (DENV) is an arbovirus, which replicates in the endoplasmic reticulum. Although replicative cycle takes place in the cytoplasm, some viral proteins such as NS5 and C are translocated to the nucleus during infection in mosquitoes and mammalian cells. To localized viral proteins in DENV-infected C6/36 cells, an immunofluorescence (IF) and immunoelectron microscopy (IEM) analysis were performed. Our results indicated that C, NS1, NS3 and NS5 proteins were found in the nucleus of DENV-infected C6/36 cells. Additionally, complex structures named strand-like structures (Ss) were observed in the nucleus of infected cells. Interestingly, the NS5 protein was located in these structures. Ss were absent in mock-infected cells, suggesting that DENV induces their formation in the nucleus of infected mosquito cells.
