RESUMEN
PURPOSE: We aimed to perform a systematic review to assess perioperative outcomes, complications, and survival in studies comparing ureteral stent and percutaneous nephrostomy in malignant ureteral obstruction. MATERIALS AND METHODS: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Meta-analyses were performed on procedural data; outcomes; complications (device-related, accidental dislodgement, febrile episodes, unplanned device replacement), dislodgment, and overall survival. Continuous variables were pooled using the inverse variance of the mean difference (MD) with a fixed effect, and 95% confidence interval (CI). The incidences of complications were pooled using the Cochran-Mantel-Haenszel method with the random effect model and reported as Odds Ratio (OR), and 95% CI. Statistical significance was set two-tail p-value < 0.05 Results: Ten studies were included. Procedure time (MD -10.26 minutes 95%CI -12.40-8.02, p< 0.00001), hospital stay (MD -1.30 days 95%CI -1.69 - -0.92, p< 0.0001), number of accidental tube dislodgments (OR 0.25 95% CI 0.13 - 0.48, p< 0.0001) were significantly lower in the stent group. No difference was found in mean fluoroscopy time, decrease in creatinine level post procedure, overall number of complications, interval time between the change of tubes, number of febrile episodes after diversion, unplanned device substitution, and overall survival. CONCLUSION: Our meta-analysis favors stents as the preferred choice as these are easier to maintain and ureteral stent placement should be recommended whenever feasible. If the malignant obstruction precludes a stent placement, then PCN is a safe alternative.
Asunto(s)
Nefrostomía Percutánea , Obstrucción Ureteral , Humanos , Creatinina , Nefrostomía Percutánea/efectos adversos , Nefrostomía Percutánea/métodos , Estudios Retrospectivos , Stents/efectos adversos , Obstrucción Ureteral/etiología , Obstrucción Ureteral/cirugíaRESUMEN
With the onset of Listeria monocytogenes resistance to the bacteriocin nisin, the search for alternative antimicrobial treatments is of fundamental importance. In this work, we set out to investigate proteins and lipids involved in the resistance mechanisms of L. monocytogenes against the antimicrobial peptides (AMPs) nisin and fengycin. The effect of sub-lethal concentrations of nisin and lipopeptide fengycin secreted by Bacillus velezensis P34 on L. monocytogenes was investigated by mass spectrometry-based lipidomics and proteomics. Both AMPs caused a differential regulation of biofilm formation, confirming the promotion of cell attachment and biofilm assembling after treatment with nisin, whereas growth inhibition was observed after fengycin treatment. Anteiso branched-chain fatty acids were detected in higher amounts in fengycin-treated samples (46.6%) as compared to nisin-treated and control samples (39.4% and 43.4%, respectively). In addition, a higher relative abundance of 30:0, 31:0 and 32:0 phosphatidylglycerol species was detected in fengycin-treated samples. The lipidomics data suggest the inhibition of biofilm formation by the fengycin treatment, while the proteomics data revealed downregulation of important cell wall proteins involved in the building of biofilms, such as the lipoteichoic acid backbone synthesis (Lmo0927) and the flagella-related (Lmo0718) proteins among others. Together, these results provide new insights into the modification of lipid and protein profiles and biofilm formation in L. monocytogenes upon exposure to antimicrobial peptides.
Asunto(s)
Bacteriocinas , Listeria monocytogenes , Nisina , Péptidos Antimicrobianos , Lípidos , Listeria monocytogenes/fisiología , Nisina/farmacologíaRESUMEN
La adquisición de los equipos de Cromatografia líquida Ultra Rápida (UHPLC) y el desarrollo de las metodologías para el análisis de los productos del PNSSyPR permitió aumentar la productividad y acelerar los tiempos de respuesta requeridos por el Ministerio de Salud de la Nación a fin de proceder a la distribución de los anticonceptivos alcanzados por el programa, de manera eficiente y segura, y garantizando a la comunidad el acceso a una medicación de calidad. La virtud de la técnica no sólo radica en la reducción de los tiempos de análisis, sino que además permite optimizar recursos humanos y equipamiento dado que, tal como se mostró, la capacidad de analizar siete lotes de producto por día, empleando un único cromatógrafo de UHPLC permite contar con la disponibilidad de los otros equipos del Departamento de Química y Física para la resolución de otras muestras. Se observó que los resultados son óptimos con una disminución del consumo de solventes nocivos para el medio ambiente en un 94%; dado que con esta nueva tecnología se emplean flujos de alrededor de 0,2 ml/ min, mientras que por HPLC se emplean comúnmente flujos entre 1 y 2 ml/min. En la Figura 4 se muestra como resultó afectado el consumo de solvente y los tiempos de análisis al emplear esta nueva tecnología (UHPLC) para el análisis del total de lotes ingresados durante los años 2014 y 2015 respecto de los requeridos para llevar a cabo los ensayos por HPLC.