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Whiteflies (Bemisia tabaci) represent an insect pest in horticulture. It serves as a vector for transmitting phytopathogens that inhibit the correct development of plants, affecting crop performance. In this research, whitefly population model was proposed to provide a tool that predicts the pest spread within a crop under greenhouse conditions. The analysis, calibration, and validation of the models, based on logistic functions, were implemented for the three stages (egg, nymph, and adult) of the life cycle of this organism. Temperature (°C), relative humidity (%), initial population (number/cm2), and Growing Degree-Day (GDD) were considered as input variables to describe each development stage. The statistical analysis for the model validation included the coefficient of determination (R2), the percentage standard error of prediction (%SEP), the average relative variance (AVR), and the efficiency coefficient (E). The first period for calibration consisted of 43 d (204.3 GDD), and the second period for validation consisted of 36 d (171.1 GDD). The model efficiently predicts the population growth for the egg, nymph, and adult stages since the values of R2 were 0.9856, 0.9918, and 0.9436, and the values of %SEP were 12.4, 11.9, and 75.1% for the egg, nymph, and adult stages, respectively. Moreover, the validation model obtained an R2 of 0.9287 for the egg stage, 0.9645 for the nymph stage, and 0.9884 for the adult stage. Meanwhile, the values of %SEP were 10.38, 16.89, and 32.59% for the egg, nymph, and adult stages, respectively. In both cases, the values suggest an adequate fit for the model.
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Hemípteros , Animais , Ninfa , Dinâmica Populacional , TemperaturaRESUMO
INTRODUCTION: We are living in the time of greatest dissemination of information in the history of the human race, and this excess of information has resulted in considering human attention as a scarce resource. Information overload is the situation in which the amount or intensity of information exceeds the individual's limited capacity for cognitive processing. OBJECTIVE: To describe the concept of information overload, its possible neurocognitive substrates, associated symptoms, causes, measures to avoid it, as well as its possible relationship with the internet and electronic devices. DEVELOPMENT: People respond differently to information overload, and this depends on individual factors as well as on the amount and characteristics of the informative stimulation. Some symptoms of information overload are: inefficient work, confusion, delay in making decisions, lack of critical evaluation of information, loss of control over information, refusal to receive communication, lack of general perspective, greater tolerance for error, anxiety, stress, etc. The limits of information processing capacity are probably conditioned by the limited metabolic energy that is distributed in the brain and remains constant regardless of the difficulty of the tasks. CONCLUSION: Attention is a limited cognitive function. In order to reduce the adverse effects of information overload, it is necessary to improve the personal management of our own cognitive resources and to understand their relationship with technology. Likewise, it is necessary to improve the handling of information through the organization, filtering and application of cognitive ergonomics design guidelines.
TITLE: Síndrome de la sobrecarga informativa: una revisión bibliográfica.Introducción. Vivimos la época de mayor difusión de información en la historia de la humanidad, y este exceso de información ha dado como consecuencia considerar la atención humana como un bien escaso. La sobrecarga informativa es la situación en la cual la cantidad o la intensidad de información exceden la capacidad limitada de procesamiento cognitivo del individuo. Objetivo. Describir el concepto de sobrecarga informativa, sus posibles sustratos neurocognitivos, síntomas asociados, causas, medidas para evitarla, así como su posible relación con internet y los dispositivos electrónicos. Desarrollo. Las personas responden de forma diferente a la sobrecarga informativa, y esto depende tanto de factores individuales como de la cantidad y características de la estimulación informativa. Algunos síntomas de la sobrecarga informativa son: trabajo ineficiente, confusión, retraso al tomar decisiones, falta de evaluación crítica de la información, pérdida de control sobre la información, rechazo de la recepción en la comunicación, falta de perspectiva general, mayor tolerancia al error, ansiedad, estrés, etc. Probablemente, los límites de la capacidad de procesamiento de información estén condicionados por la energía metabólica limitada que se distribuye en el cerebro y que permanece constante independientemente de la dificultad de las tareas. Conclusión. La atención es una función cognitiva limitada. Para que los efectos adversos de la sobrecarga informativa puedan disminuirse, se requiere mejorar la gestión personal de nuestros propios recursos cognitivos y comprender su relación con la tecnología. Es necesario mejorar el manejo de información mediante la organización, el filtrado y la aplicación de pautas de diseño de ergonomía cognitiva.
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Comunicação , Processos Mentais , HumanosRESUMO
Introducción: Vivimos la época de mayor difusión de información en la historia de la humanidad, y este exceso de información ha dado como consecuencia considerar la atención humana como un bien escaso. La sobrecarga informativa es la situación en la cual la cantidad o la intensidad de información exceden la capacidad limitada de procesamiento cognitivo del individuo. Objetivo: Describir el concepto de sobrecarga informativa, sus posibles sustratos neurocognitivos, síntomas asociados, causas, medidas para evitarla, así como su posible relación con internet y los dispositivos electrónicos. Desarrollo: Las personas responden de forma diferente a la sobrecarga informativa, y esto depende tanto de factores individuales como de la cantidad y características de la estimulación informativa. Algunos síntomas de la sobrecarga informativa son: trabajo ineficiente, confusión, retraso al tomar decisiones, falta de evaluación crítica de la información, pérdida de control sobre la información, rechazo de la recepción en la comunicación, falta de perspectiva general, mayor tolerancia al error, ansiedad, estrés, etc. Probablemente, los límites de la capacidad de procesamiento de información estén condicionados por la energía metabólica limitada que se distribuye en el cerebro y que permanece constante independientemente de la dificultad de las tareas. Conclusión: La atención es una función cognitiva limitada. Para que los efectos adversos de la sobrecarga informativa puedan disminuirse, se requiere mejorar la gestión personal de nuestros propios recursos cognitivos y comprender su relación con la tecnología. Es necesario mejorar el manejo de información mediante la organización, el filtrado y la aplicación de pautas de diseño de ergonomía cognitiva.(AU)
Introduction: We are living in the time of greatest dissemination of information in the history of the human race, and this excess of information has resulted in considering human attention as a scarce resource. Information overload is the situation in which the amount or intensity of information exceeds the individuals limited capacity for cognitive processing. Objective: To describe the concept of information overload, its possible neurocognitive substrates, associated symptoms, causes, measures to avoid it, as well as its possible relationship with the internet and electronic devices. Development: People respond differently to information overload, and this depends on individual factors as well as on the amount and characteristics of the informative stimulation. Some symptoms of information overload are: inefficient work, confusion, delay in making decisions, lack of critical evaluation of information, loss of control over information, refusal to receive communication, lack of general perspective, greater tolerance for error, anxiety, stress, etc. The limits of information processing capacity are probably conditioned by the limited metabolic energy that is distributed in the brain and remains constant regardless of the difficulty of the tasks. Conclusion: Attention is a limited cognitive function. In order to reduce the adverse effects of information overload, it is necessary to improve the personal management of our own cognitive resources and to understand their relationship with technology. Likewise, it is necessary to improve the handling of information through the organization, filtering and application of cognitive ergonomics design guidelines.(AU)
Assuntos
Humanos , Masculino , Feminino , Acesso à Informação , Acesso à Internet , Neurociência Cognitiva , Memória , Ergonomia , Atenção , Neurologia , Doenças do Sistema Nervoso , Processos MentaisRESUMO
Biofilm has recently been highlighted as a complicating feature of necrotizing soft tissue infections (NSTI) caused by Streptococcus pyogenes (i.e., group A Streptococcus [GAS]) contributing to a persistence of bacteria in tissue despite prolonged antibiotic therapy. Here, we assessed the standard treatment of benzylpenicillin and clindamycin with or without rifampin in a tissue-like setting. Antibiotic efficacy was evaluated by CFU determination in a human organotypic skin model infected for 24 or 48 h with GAS strains isolated from NSTI patients. Antibiotic effect was also evaluated by microcalorimetric metabolic assessment in in vitro infections of cellular monolayers providing continuous measurements over time. Adjunctive rifampin resulted in enhanced antibiotic efficacy of bacterial clearance in an organotypic skin tissue model, 97.5% versus 93.9% (P = 0.006). Through microcalorimetric measurements, adjunctive rifampin resulted in decreased metabolic activity and extended lag phase for all clinical GAS strains tested (P < 0.05). In addition, a case report is presented of adjunctive rifampin treatment in an NSTI case with persistent GAS tissue infection. The findings of this study demonstrate that adjunctive rifampin enhances clearance of GAS biofilm in an in vitro tissue infection model.
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Infecções dos Tecidos Moles , Infecções Estreptocócicas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Humanos , Rifampina/farmacologia , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenesRESUMO
RESUMEN Introducción La aceptación de la diabetes mellitus tipo 2 contribuye al apego del tratamiento y al control de la enfermedad. Pero se ha reportado que los hombres tienen menor aceptación al diagnóstico de este padecimiento. En los hombres mexicanos la no aceptación puede estar relacionada con el machismo. Objetivo Identificar la relación del machismo con la aceptación de la diabetes mellitus tipo 2. Metodología Se realizó un estudio transversal y correlacional. La población de interés fue de hombres con diabetes mellitus tipo 2 entre 20 y 59 años de edad registrados en centros de atención primaria del área metropolitana de Monterrey, Nuevo León, México. Se obtuvo una muestra de 121 participantes a través de un muestreo por conveniencia. Los instrumentos utilizados fueron el Inventario de Conformidad de las Normas Masculinas y la Escala Aceptación en DMT2. Para el análisis estadístico se empleó el programa SPSS versión 25; se realizó un modelo de regresión lineal múltiple. Resultados Los resultados señalan que los hombres con percepción de mayor machismo, jornadas laborales extensas y consumo elevado de cigarrillos aceptan menos el diagnóstico y la enfermedad de la diabetes mellitus tipo 2. Para las subdimensiones del machismo, la homofobia fue el mejor predictor de la aceptación o no de la diabetes mellitus tipo 2. Conclusiones El profesional de salud debe desarrollar programas para la aceptación de la diabetes mellitus tipo 2 en hombres de reciente diagnóstico que contribuyan a aceptar su enfermedad, y así, permitan mejorar el autocuidado, control glucémico y prevención de complicaciones.
ABSTRACT Introduction Accepting a diagnosis of type 2 diabetes mellitus contributes to the adher- ence to the treatment and control of the illness; however, it has been reported that men tend to have a lower acceptance of this diagnosis. Among Mexican men, in particular, this low acceptance could be related to their machismo. Objective To identify the relationship of machismo with the acceptance of a type 2 diabetes mellitus diagnosis. Methodology This is a transversal and correlational study. The population of interest were Mexican men diagnosed with type 2 diabetes mellitus between 20 and 59 years registered in centers of primary attention in the city of Monterrey, Mexico. The sample was constituted of 121 participants chosen by convenience. The instruments used were the Conformity to Masculine Norms Inventory and the Acceptance Scale for DM2. The statistical analysis and the multiple linear regression model were carried out using SPSS v25. Results Findings suggest that men who show machismo, who have long labor shifts, and who consume large quantities of cigarettes tend not to accept a diagnosis of type 2 diabetes mellitus. Regarding the subdimensions of the machismo construct, homophobia was the best predictor of accepting or not a diagnosis of type 2 diabetes mellitus. Conclusions Healthcare professionals should develop programs aimed at improving the acceptance attitude of a type 2 diabetes mellitus diagnosis among men, including those with machismo, in order to better manage self-care, glucose control, and also prevent complications.
RESUMO Introdução A aceitação do diabetes mellitus tipo 2 contribui para a adesão ao tratamento e controle da doença. Mas, tem sido relatado que os homens têm menos aceitação do diagnóstico desta doença. Nos homens mexicanos, a não aceitação pode estar relacionada ao machismo. Objetivo Identificar a relação do machismo com a aceitação do diabetes mellitus tipo 2. Metodologia Foi realizado um estudo transversal e correlacional. A população de interesse foram homens com diabetes mellitus tipo 2 entre 20 e 59 anos registrados em centros de atenção primária na área metropolitana de Monterrey, Nuevo León, México. Foi obtida uma amostra de 121 participantes por amostragem de conveniência. Os instrumentos utilizados foram o Inventário de Conformidade com Normas Masculinas e a Escala de Aceitação DMT2. Para a análise estatística utilizou-se o programa SPSS versão 25; um modelo de regressão linear múltipla foi realizado. Resultados Os resultados indicam que homens com percepção de maior machismo, longas jornadas de trabalho e alto consumo de cigarro aceitam menos o diagnóstico e a doença de diabetes mellitus tipo 2. Para as subdimensões do machismo, a homofobia foi o melhor preditor de aceitação ou não de diabetes melito tipo 2. Conclusões O profissional de saúde deve desenvolver programas de aceitação da diabetes mellitus tipo 2 em homens recém-diagnosticados que contribuam para a aceitação da sua doença e, assim, permitam melhorar o autocuidado, o controlo glicémico e a prevenção de complicações.
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INTRODUCTION: Aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor. Aryl hydrocarbon receptor interacting protein (AIP) in one of AHR ligands. The aim of this study is to analyze the prognostic influence of AIP in pancreatic carcinoma. MATERIAL AND METHODS: Retrospective case series with immunohistochemical analysis of AIP. We have estimated a multivariate Cox's model for the outcome (progression free and overall survival). RESULTS: 204 patients were included in the study. As expected prognosis was poor and 67.8% died of disease. As for AIP 9.8% of the cases showed nuclear staining of the epithelial tumor cells and 59.4% a cytoplasmic one. Stroma was stained in 53.1% of the cases. Univariate survival analysis revealed a significantly worse prognosis of patients with cytoplasmic AIP expression (stroma and epithelium), but nuclear expression was associated to a better prognosis. In the multivariate analysis stromal AIP expression was an independent prognosticator of progression free survival, together with pT stage, histological grade and history of diabetes. DISCUSSION: AIP Is a conserved cochaperone protein binding to many proteins. AIP has been proposed as a potential tumor suppressor gene. To date, no study has analyzed the immunohistochemical expression of AIP in pancreatic carcinoma. Our results indicate that both epithelial and stromal cytoplasmic expression of AIP is associated to bad prognosis, while nuclear translocation seems to improve prognosis. CONCLUSION: Although we must deepen into the complex signaling pathways underlying this potential association, our results open a way to inhibiting AHR as a potential target against pancreatic carcinoma.
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Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Receptores de Hidrocarboneto Arílico/metabolismo , Idoso , Feminino , Humanos , Imuno-Histoquímica/métodos , Sistema de Sinalização das MAP Quinases/genética , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Estadiamento de Neoplasias/métodos , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Prognóstico , Intervalo Livre de Progressão , Receptores de Hidrocarboneto Arílico/efeitos dos fármacos , Estudos Retrospectivos , Análise de Sobrevida , Neoplasias PancreáticasRESUMO
We report a method for remote excitation of the RF signal for preclinical-equivalent ultra high field Magnetic Resonance Imaging (MRI). A parallel-plate waveguide together with a bio-inspired surface coil were used to perform remote excitation experiments to acquire images with a small-bore MR imager at 15.2 T. The imager bore size limits the RF coil transmitter dimensions, so the Gielis super-formula was used to design an RF coil with small dimensions. Electromagnetic simulations of the principal mode were run to study the waveguide filled with air and loaded with a saline solution-filled tube. Radiation patterns were also computed in a semi-anechoic chamber for the same scenarios as above. A saline solution-filled spherical phantom and a formaldehyde-fixed mouse phantom were used to acquire images. Radiation patterns showed an omnidirectional distribution with no side lobes, and a very smooth behaviour with almost no loss of information in the saline solution-filled tube and without. The theoretical wave impedance was calculated and compared with simulated results showing an excellent correspondence. Spherical phantom image data and simulation results of B1 were contrasted and showed an important correlation. Ex vivo mouse images were of high quality and exhibited clear delineation of anatomical structures. These imaging results are in very good agreement with the simulations. Numerical, theoretical and experimental results validate this approach, using a bio-inspired surface coil with a simple waveguide for preclinical small-bore MRI at ultra high field.
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Imageamento por Ressonância Magnética/instrumentação , Animais , Desenho de Equipamento , Camundongos , Imagens de Fantasmas , Ondas de RádioRESUMO
BACKGROUND: Transmission of resistance mutations to integrase strand transfer inhibitors (INSTIs) in HIV-infected patients may compromise the efficacy of first-line antiretroviral regimens currently recommended worldwide. Continued surveillance of transmitted drug resistance (TDR) is thus warranted. OBJECTIVES: We evaluated the rates and effects on virological outcomes of TDR in a 96 week prospective multicentre cohort study of ART-naive HIV-1-infected subjects initiating INSTI-based ART in Spain between April 2015 and December 2016. METHODS: Pre-ART plasma samples were genotyped for integrase, protease and reverse transcriptase resistance using Sanger population sequencing or MiSeq™ using a ≥ 20% mutant sensitivity cut-off. Those present at 1%-19% of the virus population were considered to be low-frequency variants. RESULTS: From a total of 214 available samples, 173 (80.8%), 210 (98.1%) and 214 (100.0%) were successfully amplified for integrase, reverse transcriptase and protease genes, respectively. Using a Sanger-like cut-off, the overall prevalence of any TDR, INSTI-, NRTI-, NNRTI- and protease inhibitor (PI)-associated mutations was 13.1%, 1.7%, 3.8%, 7.1% and 0.9%, respectively. Only three (1.7%) subjects had INSTI TDR (R263K, E138K and G163R), while minority variants with integrase TDR were detected in 9.6% of subjects. There were no virological failures during 96 weeks of follow-up in subjects harbouring TDR as majority variants. CONCLUSIONS: Transmitted INSTI resistance remains rare in Spain and, to date, is not associated with virological failure to first-line INSTI-based regimens.
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Infecções por HIV , Inibidores de Integrase de HIV , Integrase de HIV , HIV-1 , Estudos de Coortes , Farmacorresistência Viral , Genótipo , Infecções por HIV/tratamento farmacológico , Integrase de HIV/genética , Inibidores de Integrase de HIV/farmacologia , Inibidores de Integrase de HIV/uso terapêutico , HIV-1/genética , Humanos , Integrases , Mutação , Estudos Prospectivos , Espanha/epidemiologiaRESUMO
No disponible
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Humanos , Hipertensão/diagnóstico , Exercício Físico/fisiologia , Teste de Esforço , Prognóstico , Hipertensão/etiologiaRESUMO
Resumen Introducción: La prevalencia global de diabetes mellitus tipo 2 (DMT2) en los hombres es alta. Para el tratamiento de la enfermedad el hombre debe realizar acciones de autocuidado, por lo que es importante conocer factores relacionados con su cumplimiento. Objetivo: Identificar la relación entre variables demográficas, clínicas, la angustia, la depresión, la autoeficacia y su influencia sobre el autocuidado en hombres con DMT2. Métodos: Estudio transversal y correlacional, en una muestra de 96 hombres con DMT2, usuarios de 13 centros de salud. Los instrumentos utilizados fueron el cuestionario de acciones de cuidado en diabetes, la escala Self-Efficacy for Diabetes, la escala depresión (CES-D) y la escala angustia por diabetes (DDS). Resultados: El autocuidado se correlacionó de manera positiva con la autoeficacia y negativamente con la angustia por diabetes. Las variables que explicaron el autocuidado con el 47.7% de varianza fueron: la autoeficacia (β = .39), el consumo de alcohol (β = -.29), las horas sentado/parado (β= -.27), el tiempo de diagnóstico (β= -.22) y la edad (β =.18). Discusión: Los hombres tuvieron un bajo autocuidado y mantienen conductas de riesgo, lo cual puede atribuirse a sus creencias, estilo de vida o al tipo de trabajo que desempeñan. Conclusiones: Los resultados ofrecen evidencia sobre factores que influyen en el autocuidado de hombres con DMT2, que pueden orientar a los profesionales de enfermería en la atención del paciente. Se sugiere realizar investigaciones de enfermería en hombres, que contribuyan a mejorar la autoeficacia y el autocuidado.
Abstract Introduction: The global prevalence of type 2 diabetes mellitus among men is high; and these patients need to follow self-care routines. Therefore, knowing the factors which can affect their level of compliance is an important issue for nursing. Objective: To identify the relationship between demographic and clinical variables such as anguish and depression, and self-care efficacy in men suffering from type 2 diabetes mellitus. Methods: This a transversal and correlational study on a sample of 96 men with type 2 diabetes mellitus who were registered in 13 health centers. The instruments used were the Questionnaire of Actions of Care in Diabetes, the Self-Efficacy for Diabetes Scale (SED), the Mexico Center of Epidemiological Studies of Depression Scale (CES-D), and the Diabetes Distress Scale (DDS). Results: Self-care was positively correlated to self-efficacy, and negatively correlated to diabetes-related anguish and depression. Variables which accounted for 47.7% of the self-care variance were: self-efficacy (β = .39), alcohol consumption (β = -.29), number of hours sitting or standing (β= -.27), years of being diagnosed (β= -.22), and age (β =.18). Discussion: The sample demonstrated a low level of diabetes self-care which included risky behaviors. This attitude could be a result of the patients' beliefs, lifestyles, and/or type of job. Conclusions: The findings provide evidence on the factors which can influence self-care among men with type 2 diabetes. These results can orient nursing professionals while providing patient attention. Further related studies are suggested in order to help improve efficacy in type 2 diabetes self-care.
Resumo Introdução: A prevalência global de diabetes mellitus tipo 2 (DMT2) nos homens é alta. Para o tratamento da doença o homem deve realizar ações de autocuidado, pelo que é importante conhecer fatores relacionados com sua conformidade. Objetivo: Identificar a relação entre variáveis demográficas, clínicas, a angustia, a depressão, a autoeficácia e sua influência sobre o autocuidado em homens com DMT2. Métodos: Estudo transversal e correlacional, em uma amostra de 96 homens com DMT2, usuários de 13 centros de saúde. Os instrumentos utilizados foram o questionário de ações de cuidado em diabetes, a escala Self-Efficacy for Diabetes, a escala depressão (CES-D) e a escala angustia por diabetes (DDS). Resultados: O autocuidado correlacionou-se de maneira positiva com a autoeficácia e negativamente com a angustia por diabetes. As variáveis que explicaram o autocuidado com o 47.7% de variância foram: a autoeficácia (β = .39), o consumo de álcool (β = -.29), as horas sentado/parado (β= -.27), o tempo de diagnóstico (β= -.22) e a idade (β =.18). Discussão: Os homens tiveram um baixo autocuidado e mantém condutas de risco, o qual pode atribuir-se a suas crenças, estilo de vida ou ao tipo de trabalho que desempenham. Conclusões: Os resultados oferecem evidência sobre fatores que influem no autocuidado de homens com DMT2, que podem orientar aos profissionais de enfermagem na atenção do paciente. Sugere-se realizar pesquisas de enfermagem em homens, que contribuam a melhorar a autoeficácia e o autocuidado.
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Sarcoidosis is a systemic granulomatous disease of unknown aetiology characterised by the appearance of noncaseifying epithelioid granulomas in the affected organs, most commonly the lungs, skin, and eyes (Iannuzzi et al. 2007). Necrotizing Sarcoid Granulomatosis (NGS) is a rare and little-known form of disease, which also presents nodular lung lesions, and it shares pathologic and clinical findings with sarcoidosis, where the presence of necrosis may lead to misdiagnosis of tuberculosis (TB), leading to a consequent delay in treatment of the underlying entity (Chong et al. 2015). This is exactly what happened with the two cases that we present here.
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Although many experts position statements on autologous stem cell mobilization have been published, there are some aspects that are still under discussion. A Spanish Hematologist expert group was summoned to settle on agreements and uncertainties on PBSCs mobilization, including factors not always considered; as apheresis and cytometry key factors that determine a successful PBSC collection. This document reviews critical factors that define poor mobilizer patients and the tools to better collect the desired stem cells for a successful autologous haematopoietic stem cell transplant.
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Remoção de Componentes Sanguíneos , Células-Tronco de Sangue Periférico , Consenso , Mobilização de Células-Tronco Hematopoéticas , Humanos , Transplante AutólogoRESUMO
BACKGROUND: Chemotherapy-associated liver injury (CALI) is a matter of concern for hepatobiliary surgeons as it can entail postoperative liver failure after an extensive hepatectomy. Recent studies have taken special interest in liver function parameters which can correlate with CALI to decrease this adverse event. Therefore, the current study investigates the usefulness of splenic volume as a biomarker of CALI through a portal hypertension mechanism, in patients with colorectal liver metastases (CRLM). STUDY DESIGN: We carried out a study in patients with CRLM operated on between 2009 and 2014 in our center. All samples of healthy liver were graded for non-alcoholic fatty liver disease (NAFLD) and sinusoidal obstructive syndrome. Computarized tomography scans for spleen volumetry were analyzed for each patient at CRLM diagnosis, after neoadjuvant chemotherapy, 1 and 6 months after resection. RESULTS: A group of 65 consecutive patients with CRLM of large bowel adenocarcinoma submitted to liver resection were included. Patients receiving neoadjuvant chemotherapy had a greater spleen volume increase than those who did not receive treatment (p = 0.053), finding a statistically significant spleen growth in patients with NAFLD (p = 0.036). There was no correlation between spleen enlargement and postoperative complications or average stay. However, survival was decreased in patients with spleen growth and CALI. CONCLUSIONS: Patients who receive neoadjuvant chemotherapy for liver metastasis surgery have a greater splenic volume increase, which correlates with NAFLD and a lower survival.
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Adenocarcinoma/terapia , Antineoplásicos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/patologia , Neoplasias Colorretais/patologia , Hepatectomia , Hepatopatia Veno-Oclusiva/patologia , Neoplasias Hepáticas/terapia , Hepatopatia Gordurosa não Alcoólica/patologia , Baço/diagnóstico por imagem , Adenocarcinoma/secundário , Antineoplásicos/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Fígado Gorduroso/induzido quimicamente , Fígado Gorduroso/patologia , Hepatopatia Veno-Oclusiva/induzido quimicamente , Humanos , Neoplasias Hepáticas/secundário , Metastasectomia , Terapia Neoadjuvante , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Tamanho do Órgão , Oxaliplatina/efeitos adversos , Oxaliplatina/uso terapêutico , Complicações Pós-Operatórias , Baço/patologia , Taxa de Sobrevida , Tomografia Computadorizada por Raios XRESUMO
El presente trabajo pretende socializar los principales resultados alcanzados en la aplicación de un plan de acciones comunitarias para contribuir a la atención de menores con Necesidades Educativas Especiales desde el trabajo intersectorial salud-educación en un Consejo Popular en el municipio Yaguajay, como parte de un proyecto institucional en función de la tesis de maestría en Gestión del Desarrollo Local. La metodología utilizada asume como método general el dialéctico materialista. Se emplearon métodos teóricos, empíricos y estadísticos matemáticos para el procesamiento de datos. Se revisaron los referentes teóricos que dieron sustento a esta investigación y permitieron la proyección de las acciones comunitarias intersectoriales, las mismas permiten el vínculo entre sectores como el MINED, MINSAP, INDER, FMC, CDR, Cultura, Órgano del Trabajo, Biblioteca pública, ANAP, Gobierno y PCC en la atención a menores con Necesidades Educativas Especiales en el Consejo Popular.[AU]
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Humanos , Política Pública , Colaboração IntersetorialRESUMO
OBJECTIVES: Our objective was to identify patient factors associated with being untreated for hepatitis C virus (HCV) infection in HIV-coinfected patients. METHODS: A prospective longitudinal study was carried out. HIV-infected patients with active chronic HCV infection included in the HERACLES cohort (NCT02511496) constituted the study population. The main study outcome was receipt of HCV direct-acting antiviral (DAA) treatment from 1 May 2015 to 1 May 2017. The population was divided into patients who were receiving HCV treatment during follow-up and those who were not. RESULTS: Of the 15 556 HIV-infected patients in care, 3075 (19.7%) presented with chronic HCV infection and constituted the study population. At the end of the follow-up, 1957 patients initiated HCV therapy (63.6%). Age < 50 years, absence of or minimal liver fibrosis, being treatment-naïve, HCV genotype 3 infection, being in the category of people who inject drugs using opioid substitutive therapy (OST-PWID), and being in the category of recent PWID were identified as significant independent risk factors associated with low odds of DAA implementation. When a multivariate analysis was performed including only the PWID population, both OST-PWID [odds ratio (OR) 0.552; 95% confidence interval (CI) 0.409-0.746) and recent PWID (OR 0.019; 95% CI 0.004-0.087) were identified as independent factors associated with low odds of treatment implementation. CONCLUSIONS: We identified factors, which did not include prioritization of a DAA uptake strategy, that limited access to HCV therapy. The low treatment uptake in several populations seriously jeopardizes the elimination of HCV infection in the coming years.
Assuntos
Antivirais/uso terapêutico , Coinfecção/tratamento farmacológico , Uso de Medicamentos/estatística & dados numéricos , Infecções por HIV/complicações , Hepatite C Crônica/tratamento farmacológico , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
INTRODUCTION: Our aim is to find features that define prognosis in surgically resected ductal pancreatic adenocarcinoma readily accessible in everyday practice. MATERIALS AND METHODS: Longitudinal retrospective case series of pancreatic adenocarcinoma operated with a curative intent in a large tertiary hospital in Madrid between 2009 and 2015. RESULTS: 162 were enrolled. 40.8% survived less than 1 year. Multivariate Cox's regression model revealed that gender, presence of symptoms, T and N stage independently influenced progression-free survival, while overall survival was determined by gender, smoking, presence of symptoms and N stage. Logistic regression analysis revealed that only symptoms at diagnosis could predict death, while gender, symptoms, histopathological type, vessel invasion, T stage and necrosis could independently predict recurrence. DISCUSSION: Our series show that patients with symptomatic disease at the time of diagnosis and females showed a shorter progression-free and overall survival. We herein propose a regression model to predict outcome.
Assuntos
Adenocarcinoma/patologia , Carcinoma Ductal Pancreático/patologia , Medicina Molecular , Recidiva Local de Neoplasia/patologia , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia/métodos , Adenocarcinoma/cirurgia , Idoso , Carcinoma Ductal Pancreático/cirurgia , Progressão da Doença , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Recidiva Local de Neoplasia/cirurgia , Neoplasias Pancreáticas/cirurgia , Prognóstico , Estudos RetrospectivosRESUMO
The case is of a 59-year-old male with history of severe ischemic colitis following emergent intervention for a ruptured infrarenal aortic aneurysm who subsequently underwent left hemicolectomy, partial proctectomy, and Hartmann colostomy. The patient later underwent reversal of the Hartmann colostomy with diverting ileostomy. The surgery was complicated by a right ureteral and posterior bladder injury that resulted in a large rectovesical fistula involving the right hemitrigone and right ureteral orifice. An attempt to repair the rectovesical fistula at an outside facility was unsuccessful. Then, he underwent a robotic-assisted laparoscopic repair of rectovesical fistula, including simple prostatectomy, excision of rectovesical fistulous tract, rectal closure, peritoneal and omental flap interposition, bladder neck reconstruction, vesicourethral anastomosis and right ureteral reimplantation. There were no intraoperative or postoperative complications, and the patient was discharged at postoperative day 4; cystoscopy at 6-week follow-up demonstrated a successful closure of the fistula, at which time the ureteral stents were removed.
Assuntos
Colostomia/métodos , Ileostomia/métodos , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Fístula Retal/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Fístula da Bexiga Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Ruptura Aórtica/cirurgia , Colectomia , Colite Isquêmica/cirurgia , Emergências , Humanos , Masculino , Pessoa de Meia-Idade , Protectomia , Prostatectomia/métodos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
La piomiositis (PM) es una infección aguda bacteriana que afecta al músculo estriado, generalmente causada por Staphylococcus aureus y suele acompañarse de la formación de un absceso en el músculo. Esta entidad clínica fue descrita por primera vez en 1885 por Scriba1 como enfermedad endémica en los trópicos. En las últimas dos décadas se ha observado un incremento notable del número de casos en países de clima templado, probablemente asociado a un aumento de pacientes inmunodeprimidos. Las infecciones profundas de músculos pélvicos son difíciles de diagnosticar por ocasionar signos clínicos inespecíficos y que hacen pensaren otras patologías más comunes. Comunicamos el caso de una paciente de 33 años diabética que consultó por dolor inguinal acompañado de tumoración en la misma zona y fiebre de 4 días de evolución. Recibió tratamiento sintomático sin respuesta. La resonancia nuclear magnética pélvica fue compatible con piomiositis de músculo pectíneo. Recibió tratamiento antibiótico, evolucionando satisfactoriamente. La piomiositis es una entidad poco frecuente, que requiere un elevado índice de sospecha, para un adecuado diagnóstico y tratamiento, siendo la terapia antibiótica y drenaje en caso de absceso los pilares de éste último. Este tratamiento debe instaurarse de forma precoz, ya que su evolución puede ser potencialmente letal
Pyomyositis (PM) is an acute bacterial infection of skeletal muscle, usually caused by Staphilococcus Aureus and it is frenquently associated to a muscle abcess. This clinical entity was first described by Scriba1 at 1885 as a tropic endemic pathology. In the past two decades the number of cases at countries of temperate climate has rised notably due to the number of patients with inmunosuppression. Unfortunately, diagnosis of deep pelvic muscle infection is often delayed since they usually present with non-specific physical signs suggesting other more common diseases. The authors communicate a case of a diabetic33-year-old female who suffered inguinal acute pain and mass with history of fever since 4 days before. She initially received symptomatic treatment with no success. Pelvis magnetic resonance imaging showed pyomyositis of the piriformis muscle. Antibacterial treatment was administered, resulting in a good outcome. Pyomyositis is a rare condition that demands a high index of suspicion to make an adequate diagnosis and prompt treatment, including antibacterial treatment and drainage, particularly in case of abscess formation. This treatment should be established promptly since its outcome may be potentially lethal
Assuntos
Humanos , Feminino , Adulto , Piomiosite/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Antibacterianos/uso terapêutico , Piomiosite/tratamento farmacológico , Espectroscopia de Ressonância Magnética/métodos , Piperacilina/uso terapêutico , Polimiosite/fisiopatologiaRESUMO
In this work we study, by means of ab initio calculations, the structural, electronic and magnetic properties of Y-doped BiFeO3 compounds. We determine that there is a morphotropic phase boundary at an yttrium concentration of [Formula: see text], where the structure changes from R3c to Pnma. This structural transition is driven by the chemical pressure induced by the dopant. By analyzing the evolution of the oxygen octahedral tilts we find an enhanced antiferrodistortive distortion when increasing the Y-doping, together with a reduction of the ferroelectric distorsion, that gives rise to a smaller value of the electric polarization. These cooperative effects should lead to a larger canting of the Fe magnetic moments and to a larger ferromagnetic response in the R3c phase, as it is observed in the experiments.