Interval gastric cancer: A call to attentiveness and action.

INTRODUCTION AND AIMS: Endoscopy is the most effective method for identifying gastric adenocarcinoma (GAC). Interval gastric cancer (IGC) is GAC that is diagnosed 2-3 years after a normal endoscopy. Its characteristics are unknown in the Colombian environment. The clinical, histopathologic, and endoscopic characteristics were evaluated, along with the presentation rate, proton pump inhibitor (PPI) use, and IGC survival rate, and compared with other types of GAC. METHODS: A retrospective, analytic study was conducted on a prospective cohort. It evaluated 513 patients with GAC treated at our institution, within the time frame of January 2012 and June 2018. The patients had endoscopic diagnosis of GAC and endoscopy within the past three years that was negative for tumor. RESULTS: A total of 513 patients diagnosed with GAC were evaluated. Forty-two of the patients had IGC (8.2%): 9 early lesions and 33 advanced lesions (79%). The IGCs were smaller (31 vs. 41 mm; P < .01), as well as flatter and more depressed (P < .01). There was no association with PPI use, but there was an association with a history of gastrectomy and anastomosis (P = .02), as well as the absence of red flags (P < .003). The most frequent locations were the gastric body (52%) and the antrum (26%). Overall two-year survival was similar between IGC and GAC (37.1 vs. 39.3%, P = .72). CONCLUSION: A total of 8.2% of recently diagnosed GAC were cases of IGC. The presence of anastomosis and the absence of red flags were related to IGC. Overall survival was poor and there were no differences from the other types of GAC detected.

BOPHYs versus BODIPYs: A comparison of their performance as effective multi-function organic dyes.

The computationally-aided photophysical and lasing properties of a selected battery of BOPHYs are described and compared to those of related BODIPY counterparts. The present joined theoretical-experimental study helps to put into context the weaknesses and strengths of both dye families under different irradiation conditions. The chemical versatility of the BOPHY scaffold has been also comparatively explored to modulate key photonic properties towards the development of red-emitting dyes, chiroptical dyes and singlet oxygen photosensitizers. Thus, BOPHY BINOLation by fluorine substitution with enantiopure BINOLs endows the BOPHY chromophore with chiroptical activity, as supporting by the simulated circular dichroism, decreasing deeply its fluorescent response due to the promotion of fluorescence-quenching intramolecular charge transfer (ICT). Interestingly, the sole alkylation of the BOPHY core strongly modulates the promotion of ICT, allowing the generation of highly bright BINOL-based BOPHY dyes. Moreover, 3,3'-dibromoBINOLating BOPHYs can easily achieve singlet-oxygen photogeneration, owing to spin-orbit coupling mediated by heavy-atom effect feasible in view of the theoretically predicted disposition of the bromines surrounding the chromophore. From this background, we have established the master guidelines to design bright fluorophores and laser dyes, photosensitizers for singlet oxygen production and chiroptical dyes based on BOPHYs. The possibility to finely mix and balance such properties in a given molecular scaffold outstands BOPHYs as promising dyes competing with the well-settled BODIPY dyes.

Papel de las técnicas de imagen en el diagnóstico y seguimiento del carcinoma vesical músculo invasivo / Role of imaging techniques in the diagnosis and follow-up of muscle-invasive bladder carcinoma

Introducción: Las neoplasias vesicales con invasión muscular suponen un 20-30% del total. En estos pacientes se requiere la realización de pruebas de imagen para determinar la estadificación local y a distancia. Objetivo: Describir el papel de las diferentes pruebas de imagen en el diagnóstico, estadificación y seguimiento del cáncer vesical músculo-invasivo. Evaluar los últimos avances en radiología orientados a mejorar la sensibilidad y especificidad de la estadificación local y la respuesta al tratamiento. Adquisición de la evidencia Se ha realizado una revisión actualizada de la bibliografía. Síntesis de la evidencia: La tomografía computarizada y la resonancia magnética son las pruebas de imagen de elección para realizar una adecuada estadificación previa a la cirugía. La tomografía computarizada con fase de urografía es la técnica más empleada actualmente, aunque presenta limitaciones en la estadificación local. La ecografía continúa teniendo un papel limitado. Los últimos avances en resonancia magnética han mejorado su capacidad para la estadificación local y se postula como prueba de elección en el seguimiento, con resultados prometedores en la valoración de respuestas al tratamiento. La tomografía por emisión de positrones podría mejorar la detección de adenopatías y de enfermedad metastásica extrapélvica. Conclusiones: Las pruebas de imagen son fundamentales en el diagnóstico, estadificación y seguimiento del cáncer vesical músculo-invasivo. Los últimos avances técnicos han supuesto una importante mejora en la estadificación local y abren la posibilidad de valorar respuestas al tratamiento

Introduction: Muscle-invasive bladder malignancies represent 20-30% of all bladder cancers. These patients require imaging tests to determine the regional and distant staging. Objective: To describe the role of various imaging tests in the diagnosis, staging and follow-up of muscle-invasive bladder cancer. To assess recent developments in radiology aimed at improving the sensitivity and specificity of local staging and treatment response. Acquisition of evidence: We conducted an updated literature review. Synthesis of the evidence: Computed tomography and magnetic resonance imaging (MRI) are the tests of choice for performing proper staging prior to surgery. Computed tomography urography is currently the most widely used technique, although it has limitations in local staging. Ultrasonography still has a limited role. Recent developments in MRI have improved its capacity for local staging. MRI has been suggested as the test of choice for the follow-up, with promising results in assessing treatment response. Positron emission tomography could improve the detection of adenopathies and extrapelvic metastatic disease. Conclusions: Imaging tests are essential for the diagnosis, staging and follow-up of muscle-invasive bladder cancer. Recent technical developments represent important improvements in local staging and have opened the possibility of assessing treatment response

Role of imaging techniques in the diagnosis and follow-up of muscle-invasive bladder carcinoma. / Papel de las técnicas de imagen en el diagnóstico y seguimiento del carcinoma vesical músculo invasivo.

INTRODUCTION: Muscle-invasive bladder malignancies represent 20-30% of all bladder cancers. These patients require imaging tests to determine the regional and distant staging. OBJECTIVE: To describe the role of various imaging tests in the diagnosis, staging and follow-up of muscle-invasive bladder cancer. To assess recent developments in radiology aimed at improving the sensitivity and specificity of local staging and treatment response. ACQUISITION OF EVIDENCE: We conducted an updated literature review. SYNTHESIS OF THE EVIDENCE: Computed tomography and magnetic resonance imaging (MRI) are the tests of choice for performing proper staging prior to surgery. Computed tomography urography is currently the most widely used technique, although it has limitations in local staging. Ultrasonography still has a limited role. Recent developments in MRI have improved its capacity for local staging. MRI has been suggested as the test of choice for the follow-up, with promising results in assessing treatment response. Positron emission tomography could improve the detection of adenopathies and extrapelvic metastatic disease. CONCLUSIONS: Imaging tests are essential for the diagnosis, staging and follow-up of muscle-invasive bladder cancer. Recent technical developments represent important improvements in local staging and have opened the possibility of assessing treatment response.

Use of the gluteus maximus muscle as the neosphincter for restoration of anal function after abdominoperineal resection.

BACKGROUND: Our aim was to evaluate complications and long-term functional outcome in patients who had sphincter reconstruction using the gluteus maximus muscle as the neosphincter after abdominoperineal resection for rectal cancer treatment. METHODS: Seven patients underwent reconstruction from 2000 to 2010. First, the sigmoid colon was brought down to the perineum as a perineal colostomy, with the procedure protected by a loop ileostomy. Reconstruction of the sphincter mechanism using the gluteus maximus took place 3 months later, and after another 8-12 weeks, the loop ileostomy was closed. We studied the functional outcome of these interventions with follow-up interviews of patients and objectively assessed anorectal function using manometry and the Cleveland Clinic Florida (Jorge-Wexner) fecal incontinence score. RESULTS: The mean follow-up was 56 months (median 47; range 10-123 months). One patient had a perianal wound infection and another had fibrotic stricture in the colocutaneous anastomosis that required several digital dilatations. Anorectal manometry at 3-month follow-up showed resting pressures from 10 to 18 mm Hg and voluntary contraction pressures from 68 to 187 mm Hg. Four patients had excellent sphincter function (Jorge-Wexner scores ≤5). CONCLUSIONS: Our preliminary results show that sphincter reconstruction by means of gluteus maximus transposition can be effective in restoring gastrointestinal continuity and recovering fecal continence in patients who have undergone APR with permanent colostomy for rectal cancer. Furthermore, the reconstruction procedure can be performed 2-4 years after the APR.

Hernia de hiato simulando un bocio endotorácico en la gammagrafía tiroidea / Hiatus hernia mimicking an endothoracic goiter in thyroid scintigraphy

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Analysis of specific immunoglobulin G subclass antibodies for serological diagnosis of Echinococcosis by a standard enzyme-linked immunosorbent assay.

The potential roles of specific antibodies of the different immunoglobulin G (IgG) subclasses in the serological diagnosis of cystic echinococcosis (CE) and alveolar echinococcosis (AE) were investigated by an enzyme-linked immunosorbent assay based on hydatid fluid as antigen. Specific antibodies of subclass 1 were found to be of major importance. In sera collected at the time of diagnosis (i.e., before any therapeutic intervention was initiated) they could be demonstrated in 14 of 15 sera from patients with CE and in all 12 sera from patients with AE. The most discriminatory and the most specific antibodies found in this study belonged to IgG subclass 4. Only one false-positive reaction was observed with 253 sera from healthy volunteers, and no cross-reactions occurred in 80 sera from patients with different parasitic infections. Specific IgG4 antibodies could be demonstrated in 61.0 to 66.7% (CE) or 47.6 to 66.7% (AE) of the cases. Antibody levels of IgG subclass 2 were elevated only moderately, and subclass 3 antibodies were detected in a few cases only. In addition, nonspecific reactions in sera of healthy volunteers or patients with other parasitic infections could partially be attributed to antibodies of subclasses 2 and 3.

Liposarcoma of the stomach.

We present a case of gastric liposarcoma, a very uncommon pathology; only nine cases have been reported in the literature. We describe the radiologic findings of this neoplasm and emphasize the correlation between computed tomography (CT) and the macroscopic morphology of the tumor, which is conditioned by its histology. In our case, CT demonstration of fatty areas within the gastric mass facilitated the diagnosis. This finding has not been described for liposarcomas of the stomach.

Bionomics of Lutzomyia evansi (Diptera: Psychodidae) vector of visceral leishmaniasis in northern Columbia.

The feeding behavior, seasonality, and natural infection rate of Lutzomyia evansi (Nuñez-Tovar) with Leishmania chagasi (Cuna & Chagas) was studied during a 12-mo period at 2 hamlets, El Contento and Vidales. Sand fly abundance in extra-, peri-, and intradomestic habitats was evaluated with sticky traps and CDC light traps, whereas human bait and Shannon trap collections were made only in peridomestic habitats. All trapping methods showed a clear predominance of L. evansi throughout the year. Sand flies were present during most of the year, with the exception of the driest months (February and March). Although the total number of sand flies was higher in El Contento than in Vidales, a larger proportion of L. evansi was found in intradomestic habitat than in the peri- and extradomestic habitats at Vidales. Also, sand flies from Vidales had a higher infection rate with L. chagasi than did those from El Contento. Although 2 of 9 promastigote infections detected in L. evansi were identified as L. chagasi, the difficulty of isolating and propagating leishmania strains from this visceral leishmaniasis focus precluded characterization of most parasite samples. Parous and infected sand flies were most abundant toward the end of the rainy season (October-December). For this reason, control strategies based on reducing sand fly populations or avoiding human-vector contact should be concentrated during the October-December period.

La Unidad de Reanimacion Digestiva en una clinica quirurgica general. 17.000 hs. de reanimacion nutriciometabolica enteral. / Digestive Rehabilitation Unit in a general surgical clinic. 17.000 hours of enteral nutritional-metabolic rehabilitation

Se presenta la experiencia de una Unidad de Reanimacion Digestiva a traves de 2 anos de actividad, de 32 enfermos sometidos a Reanimacion Enteral y que configuran 16.968 horas de atencion por bomba de alimentacion.Se analizan diferentes aspectos de la casuistica y se discuten los resultados con particular referencia a los fracasos concluyendo que los mismos son evitables en parte y no atribuibles a la RNM por otra