[Neutrophil-to-lymphocyte ratio as a predictor of intestinal resection in incarcerated inguinal hernias]. / Otnoshenie neitrofilov k limfotsitam kak prediktor rezektsii kishki u bol'nykh s ushchemlennymi pakhovymi gryzhami.

INTRODUCTION: Inguinal hernia is defined as a projection of an organ through the inguinal canal. This can be incarcerated as a consequence of continuous inflammation of the hernial sac, which will prevent its return, causing damage to the venous and lymphatic return of the viscera. The neutrophil-to-lymphocyte ratio (NLR) is an easily accessible inflammatory biomarker obtained from blood cell counts. Therefore, the objective was to determine if the NLR is useful as a predictor of intestinal resection in incarcerated inguinal hernias. MATERIAL AND METHOD: An observational, analytical, diagnostic test and retrospective study was carried out in a hospital in northern Peru from January 2013 to August 2019 in the Department of General Surgery and Emergency Surgery and Critical Care. Patients diagnosed with unilateral inguinal hernia with intestinal obstruction were included. For the relationship between the event and the exposure, it was analyzed using Chi square (χ2) and T-Student. The sensitivity, specificity, positive predictive value, negative predictive value of the NLR as well as the area under the ROC curve were found to determine the predictive accuracy. RESULTS: 161 patients with incarcerated inguinal hernia were studied: group I (20 patients with intestinal resection) and group II (141 patients without intestinal resection). The mean age in groups I and II were 69±16 and 60±17 years (p<0.05); the frequency in males was 70% in group I and 76% in group II (p>0.05). Intestinal obstruction and duration of incarceration >24 hours and the platelet-to-lymphocyte ratio demonstrated significant differences. With respect to NLR taking a cut-off point ≥6.5, a sensitivity of 75%, a specificity of 93.62%, a positive predictive value of 62.5% and a negative predictive value of 96.35% were observed; In addition, when analyzing with the ROC curve, a value of 5.14 was obtained as a predictor of intestinal resection with a sensitivity of 90% and a specificity of 84.4% (p<0.001). Therefore, the NLR >5.14 predicts intestinal resection in patients with incarcerated inguinal hernias with an area under the curve of 0.92 at the Belen Hospital of Trujillo. CONCLUSIONS: The neutrophil-to-lymphocyte ratio is useful for predicting intestinal resection with a diagnostic accuracy of 92%.

Pre-cancerous changes in urothelial endocytic vesicle leakage, fatty acid composition, and As and associated element concentrations after arsenic exposure.

The urothelium covering the luminal surface of the urinary bladder has developed an efficient permeability barrier that protects it against the back-flow of toxins eliminated in the urine. The subapical endocytic vesicles containing the urinary bladder fluid phase are formed during the micturition cycle by endocytosis processes of the superficial cells. In normal conditions, the permeability barrier of the endocytic vesicles blocks the passage of the fluid phase to the cellular cytoplasm and the fluid is recycled to the bladder lumen. The aim of this work was to investigate the alteration of the endocytic vesicle membrane permeability barrier to toxins such as iAs (inorganic arsenic) administered in drinking water. By using an induced endocytosis model and the fluorescence requenching technique, it is shown that the exposure of rats to ingestion of water containing iAs not only induced pre-cancerous morphological changes, but allowed the differential leakage of an endocytosed fluorescent marker, HPTS, and its quencher, DPX, (hydroxypyrene-1,3,6-trisulfonic acid and p-xylene-bis-pyridinium bromide, respectively) out of the vesicular lumen. The leakage of the cationic DPX was almost complete, while the release of the anionic HPTS molecule was partial and higher in arsenic-treated-rats than in controls. Such membrane alteration would allow the toxins to elude the permeability barrier and to leak out of the endocytic vesicles, thus establishing a "bypass" to the permeability barrier. The retention of As in the urinary bladder, assessed by synchrotron radiation X-ray fluorescence spectrometry (SR-µXRF), was lower than the kidney accumulation of arsenic previously observed by our group and was accompanied by altered concentrations of K, Ca, Fe, Cu and Zn, all ions related to cellular metabolism. The results support the hypothesis that low amounts of endocytosed As can accumulate in the interior of the urothelial superficial cells and initiate the cytotoxic effects reflected in the morphological alterations observed.

Inmigración extranjera y salud mental infantil y juvenil: estudio multicéntrico / No disponible

En España, se ha producido un incremento muyimportante de población inmigrante extranjera en losúltimos años. El presente estudio plantea el fenómenode la inmigración en relación con la atención en saludmental infantil y juvenil en Cataluña, particularmenteen los sectores sanitarios Delta Litoral (Baix Llobregat)y de Hospitalet. En los 5 centros de salud mental infanto-juvenil (CSMIJ) de la Fundació Orienta, fueron atendidos,entre 2003 y 2006, un total de 580 pacientes hijosde inmigrantes extranjeros. Se concluye que el perfil deestos pacientes fue de un varón de 10 años, procedentede América del Sur, derivado desde atención primaria ydiagnosticado de un trastorno neurótico, secundario asituaciones estresantes o somatizaciones. Finalmente, sepropone la necesidad de seguir estudiando diferentesaspectos de la atención en salud mental infanto-juvenilde la población inmigrante extranjera(AU)

In recent years, in Spain, there has been a significantincrease in the immigrant population. The current studydeals with the immigrant’s phenomenon in relation toinfant and adolescence mental health in Catalonia, andparticularly in Delta littoral and Hospitalet catchment’sarea. Between 2003 and 2006, 580 patients who wereoffspring of foreign immigrants were attended in thefive mental health centres of the Fundació Orienta. Itwas concluded that the typical patient profile was a boyof ten years, coming from South America, referred by ahealth care centre and diagnosed with a neurotic, stressrelatedand somatoform disorders. In the discussion, wealso point out the need for different further studies inaspects of infant and adolescence mental health assistancein the foreign immigrant population(AU)