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Aim: To determine the frequency of Helicobacter pylori and sociodemographic factors, life habits, and personal and family history of gastroduodenal diseases in patients who required and were taken to GI endoscopy (symptomatic or by screening) in seven endoscopy units in three Antioquia subregions. Materials and methods: A cross-sectional study conducted between 2016 and 2018 included 272 participants. Sociodemographic factors, life habits, and personal and family history were related to H. pylori infection. Descriptive statistics and bivariate analysis were performed to establish the association between the variables, and multivariate analysis (binomial regression) was used to adjust the prevalence ratios of the associated factors. A p-value ≤ 0.05 was considered statistically significant. Results: The frequency of H. pylori infection was 55.9%, with differences by subregion (Valle de Aburrá metropolitan area: 54.3%, Oriente: 64%, and Urabá: 79.2%). Factors associated with H. pylori infection were male sex (adjusted prevalence ratio [APR] = 1.26; 95% confidence interval [CI] = 1.04-1.52), age 18-55 years (APR = 1.62; CI 95% = 1.22-2.16), absence of drinking water (APR = 1.40; 95% CI: 1.15-1.72) and educational level below university (APR = 1.73; 95% CI% = 1.26-2.38). Conclusion: The frequency of H. pylori was higher than in other recent studies because different diagnostic tests were used for its detection, and differences were found in the frequency of infection by region, which is explained by the heterogeneity in the populations analyzed. This study suggests the need to improve the population's living conditions to reduce H. pylori and direct measures of primary prevention of the infection, especially in family groups, men, individuals between 18 and 55 years old without drinking water, and with an educational level lower than university.

Objetivo: determinar la frecuencia de Helicobacter pylori y la presencia de factores sociodemográficos, hábitos de vida y antecedentes personales y familiares de enfermedades gastroduodenales en pacientes que requirieron y fueron llevados a endoscopia digestiva (sintomáticos o por tamización) en siete unidades de endoscopia de tres subregiones de Antioquia. Materiales y métodos: estudio transversal realizado entre 2016 y 2018 que incluyó a 272 participantes. Los factores sociodemográficos, hábitos de vida, antecedentes personales y familiares se relacionaron con la infección por H. pylori. Se realizó estadística descriptiva y análisis bivariado para establecer la asociación entre las variables y el análisis multivariado (regresión binomial) para ajustar las razones de prevalencia de los factores asociados. Un valor p ≤ 0,05 se consideró estadísticamente significativo. Resultados: la frecuencia de infección por H. pylori fue de 55,9%, con diferencias por subregión (área metropolitana del Valle de Aburrá: 54,3%, oriente: 64% y Urabá: 79,2%). Los factores asociados a la infección por H. pylori fueron sexo masculino (razón de prevalencia ajustada [RPA] = 1,26; intervalo de confianza [IC] del 95% = 1,04-1,52), edad de 18-55 años (RPA = 1,62; IC 95% = 1,22-2,16), ausencia de agua potable (RPA = 1,40; IC 95%: 1,15-1,72) y nivel educativo inferior al universitario (RPA = 1,73; IC 95% = 1,26-2,38). Conclusión: la frecuencia de H. pylori fue mayor que en otros estudios recientes porque se emplearon diferentes pruebas diagnósticas para su detección y se demostraron diferencias en la frecuencia de la infección por región, lo cual se explica por la heterogeneidad en las poblaciones analizadas. Este estudio sugiere la necesidad de mejorar las condiciones de vida de la población para reducir la infección por H. pylori y dirigir medidas de prevención primaria de la infección especialmente en los grupos familiares, en hombres, individuos entre 18 y 55 años, sin agua potable y con un nivel educativo inferior al universitario.

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Posterior a un tratamiento endodóntico, muchas veces el remanente es insuficiente para la retención de un material de restauración, por este motivo es necesario la colocación de un sistema de poste-muñón para otorgar retención a la restauración final. Con la aparición de diversos materiales para las restauraciones estéticas, se utilizan actualmente resinas reforzadas con fibra de vidrio como sistemas de postes y muñones para la restauración de dientes tratados endodónticamente. El objetivo del presente trabajo fue comparar la fuerza de adhesión en la prueba push-out de dos diferentes tipos de postes de fibra de vidrio; 3M RelyX y Rebilda Post GT (VOCO) adheridos con cementos duales correspondientes a la marca de los postes; RelyX U-200® Automix (3M ESPE) y Rebilda DC (VOCO). Se llevó a cabo un análisis de ANOVA de dos vías para comparar la fuerza adhesiva con la prueba push-out entre ambos grupos de estudio. Pese a que se observó que los postes Rebilda presentaron una media de fuerza de adhesión ligeramente mayor en comparación con los postes 3M (sin diferencia estadística significativa P>0,05) los últimos son clínicamente más fáciles de colocar, lo cual pudiera ser un factor decisivo para el clínico en el momento de la elección de un poste y su sistema de adhesión.

After an endodontic treatment, many times the remnant is insufficient for the retention of a restorative material, for this reason it is necessary to place a post-stump system to provide retention to the final restoration. With the advent of various materials for esthetic restorations, fiberglass-reinforced resins are now used as post and core systems for the restoration of endodontically treated teeth. The objective of the present work was to compare the bond strength in the push-out test of 2 different types of fiberglass posts; 3M RelyX and Rebilda Post GT (VOCO) bonded with dual cements corresponding to the post brand; RelyX U-200® Automix (3M ESPE) and Rebilda DC (VOCO). A 2-way ANOVA analysis was performed to compare push-out strength between both study groups. Although it was observed that the Rebilda posts presented a slightly higher mean bond strength compared to the 3M posts (with no significant statistical difference P>0.05), the latter are clinically easier to place, which could be a decisive factor for the clinician at the time of choosing a post and its adhesion system.

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Resumen Introducción: Helicobacter pylori es una bacteria asociada con enfermedades gastroduodenales inflamatorias y neoplásicas. La histopatología es uno de los métodos diagnósticos empleados para su detección, la cual tiene sensibilidad del 90% al 95% cuando hay alta densidad de H. pylori; sin embargo, la bacteria puede pasar desapercibida en infecciones de baja densidad porque la coloración de rutina de hematoxilina y eosina (H&E) no es una tinción específica para su detección y presenta variabilidad interobservador. El objetivo de este estudio fue determinar la utilidad de la tinción complementaria de Giemsa para el diagnóstico de H. pylori en lesiones preneoplásicas en las que la bacteria se encuentra en baja densidad. Materiales y métodos: se realizó un estudio descriptivo retrospectivo y prospectivo que incluyó a 65 pacientes con diagnóstico de lesiones preneoplásicas. Las biopsias gástricas se tiñeron con H&E y Giemsa, y fueron evaluadas por dos patólogos. Resultados: la coloración de Giemsa diagnosticó 20,3% de casos más de infección por H. pylori que la H&E, la mayoría de ellos con baja densidad de la bacteria. No hubo diferencias estadísticamente significativas en el diagnóstico de H. pylori de acuerdo con el tipo de muestra. Conclusión: este estudio encontró que la tinción de Giemsa mejora el diagnóstico histopatológico de H. pylori en pacientes con lesiones preneoplásicas.

Abstract Introduction: Helicobacter pylori is a bacterium associated with inflammatory and neoplastic gastroduodenal diseases. Histopathology is one of the diagnostic methods used for its detection, which has a sensitivity of 90% to 95% when there is a high density of H. pylori; however, the bacterium may be missed in low-density infections because routine hematoxylin and eosin (H&E) staining is not specific for its detection and has interobserver variability. This study aimed to determine the usefulness of complementary Giemsa staining for diagnosing H. pylori in preneoplastic lesions where the bacterium was found in low density. Materials and methods: A retrospective/prospective descriptive study was carried out that included 65 patients diagnosed with preneoplastic lesions. Gastric biopsies were stained with H&E and Giemsa and evaluated by two pathologists. Results: Giemsa staining analyzed 20.3% more cases of H. pylori than H&E, most with a low density of the bacteria. There were no statistically significant differences in the diagnosis of H. pylori according to the sample type. Conclusion: This study found that Giemsa staining improves the histopathological diagnosis of H. pylori in patients with preneoplastic lesions.

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Resumen La infección por Helicobacter pylori se asocia con enfermedades gastroduodenales como gastritis crónica, úlcera péptica y adenocarcinoma gástrico. Actualmente se dispone de diferentes esquemas terapéuticos, sin embargo, el uso indiscriminado de antibióticos generó resistencia en este agente, razón para estudiar alternativas y reevaluar los criterios que determinan la selección de un esquema en específico. El objetivo de esta revisión fue describir los principios generales de tratamiento de acuerdo a guías de referencia y recomendaciones de autores independientes, y exponer el uso de la rifabutina como alternativa terapéutica. En la búsqueda bibliográfica se usaron los términos "Helicobacter pylori" AND "rifabutin", en las bases de datos PubMed, SciELO y el motor de búsqueda Google Scholar®. La evidencia actual sugiere que el uso de rifabutina como terapia de rescate es apropiado y seguro, y sería la alternativa ideal en casos de multirresistencia o difícil acceso a pruebas de susceptibilidad antibiótica. MÉD.UIS.2022;35(1): 31-42.

Abstract Helicobacter pylori infection is associated with gastroduodenal diseases such as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. Nowadays, there are different therapeutic regimens, however, the indiscriminate use of antibiotics generated resistance in this agent, reason to study alternatives and reevaluate the criteria that determines the selection of a specific regimen. The aim of this review was to describe the general principles of treatment according to reference guidelines and recommendations of independent authors, and to present the use of rifabutin as a therapeutic alternative. The bibliographic search was performed using the terms "Helicobacter pylori" AND "rifabutin" in the databases PubMed, SciELO and the search engine Google Scholar®. Current evidence suggests that the use of rifabutin as rescue therapy is appropriate and safe, and would be an ideal alternative in cases of multidrug resistance or difficult access to antibiotic susceptibility tests. MÉD.UIS.2022;35(1): 31-42.

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OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in the homeless population in Medellín, Colombia, using molecular diagnostic methods. It also intended to develop a demographic profile, exploring associated factors and the dynamics of the social and sexual interactions of this community. DESIGN: Cross-sectional study. SETTING: Two homeless care centres in Medellín, Colombia. PARTICIPANTS: Homeless individuals that assisted to the main homeless care centres of Medellín, Colombia from 2017 to 2019. PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence of CT and NG in this population using qPCR detection, factors associated with CT and NG infection, and the sociodemographic profile of the community. RESULTS: The prevalence of CT infection was 19.2%, while that of NG was 22.6%. Furthermore, being a female was significantly correlated to CT infection p<0.05 (adjusted OR, AOR 2.42, 95% CI 1.31 to 4.47). NG infection was significantly associated with factors such as: sexual intercourse while having a sexually transmitted infection p<0.05 (AOR 3.19, 95% CI 1.48 to 6.85), having more than 11 sexual partners in the last 6 months p=0.04 (AOR 2.91, 95% CI 1.04 to 8.09) and having daily intercourse p=0.05 (AOR 3.15, 95% CI 1.02 to 9.74). CONCLUSIONS: The prevalence of CT and NG was higher than that reported in the general population. Additionally, females had a higher percentage of infection compared with males.

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Stomach cancer (SC) incidence and mortality are relevant public health issues worldwide. In Colombia, screening for preneoplastic lesions (PNL) and the presence of H. pylori is not routinely performed. Therefore, the aim of this study was to evaluate OLGA-OLGIM staging and the interobserver agreement in gastritis and preneoplastic lesions in patients with gastroduodenal symptoms from Colombia. A cross-sectional study was conducted in 272 patients with gastroduodenal symptoms. Gastric biopsies were taken following the Updated Sydney System with the OLGA-OLGIM classification, and the results were evaluated by two pathologists. Chronic gastritis and PNL were reported in 76% and 24% of the patients, respectively. Furthermore, 25% of the patients with PNL displayed gastric atrophy (GA) and 75% intestinal metaplasia (IM). Agreement in the histopathological reading for IM was good, whereas for OLGA was variable, and for the H. pylori quantity was poor. OLGA-OLGIM stages 0-II were the most frequent (96%), while stage III (4%) and SC (4%) were the least frequent. Age and coffee consumption were associated with a higher prevalence of PNL. This work determined that 4% of the population is at high risk of developing SC and would benefit from follow-up studies. Reinforcement of training programs to improve the agreement in histopathology readings is required.

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Resumen La afectación del sentido del olfato puede pasar desapercibida en gran parte de los pacientes, siendo únicamente valorada cuando la alteración es importante. Sin embargo, la hiposmia es un síntoma asociado a numerosas patologías, de menor a mayor gravedad. Este sentido está relacionado con nuestros recuerdos y puede alertarnos de potenciales amenazas. Como médicos especialistas en Otorrinolaringología debemos estar alerta ante determinados síntomas que orienten a posible etiología central. Presentamos el caso de una mujer de 39 años que acudió al Servicio de Otorrinolaringología del Hospital General Universitario Morales Meseguer derivada por hiposmia de un año de evolución con cervicalgia y cefalea occipital progresiva, sin otra sintomatología asociada. La exploración otorrinolaringológica resultó normal. Debido a la persistencia sintomática se solicitó una tomografía computarizada de senos paranasales con hallazgos de masa intracraneal extraaxial compatible con meningioma de fosa craneal anterior.

Abstract The affectation of smell can go unnoticed in a great part of the patients, being only valued when the alteration is important. However, this sense is related to our memories and can alert us to potential threats. As otolaryngologists we must be alert to certain symptoms that may lead to a possible central aetiology. We present the case of a 39-year-old woman who went to the otolaryngology service at Morales Meseguer General University Hospital due to one-year evolution of hyposmia with cervicalgia and progressive occipital headache, with no other symptoms associated. The otolaryngology examination was anodyne. In view of symptomatic persistence, a paranasal sinus computed tomography scan was requested with findings of extra-axial intracranial mass compatible with anterior cranial fossa meningioma.

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Abstract Background: Whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) are two treatment modalities commonly utilized to treat brain metastases (BMs). Aim: The purpose of this study is to analyse retrospectively the local control and survival of patients with BMs of breast cancer (BC) treated via radiosurgery using Volumetric Modulated Arc Therapy (VMAT-RS). Methods: 18 patients with 41 BMs of BC and treated by VMAT-RS were studied. They were classified according to the molecular subtype of BC and the modified breast graded prognostic assessment -GPA- index. Patients presented 1-4 BMs, which were treated with 5 non-coplanar VMAT arcs. The spatial distribution of BMs, the influence of receptor status on the location of the lesions and survival assessed via the Kaplan-Meier model were analyzed. Results: The median survival time (MST) was 19.7 months. Statistically significant differences were determined in the MST according to the Karnofsky performance status (p= 0.02) and the HER2 status (p= 0.004), being more prolonged in the HER2+ patients. Finally, our results showed that the cerebellum is the predominant site of breast cancer BMs, and also suggested that HER2+BMs had a predilection for some structures of the posterior circulation, such as the cerebellum, brainstem and occipital lobes (p= 0.048). Conclusions: The VMAT-RS is a technique with an overall survival comparable to other radiosurgery techniques. The baseline situation at the time of treatment, the modified breast-GPA and the molecular subtypes, are factors that significantly influence patient survival.

Resumen Antecedentes: La radioterapia holocraneal (WBRT) y la radiocirugía estereotáctica (SRS) son dos modalidades de tratamiento comúnmente empleados para el tratamiento de las metástasis cerebrales (BMs). Objetivo: El propósito de este estudio es analizar de forma retrospectiva el control local y la supervivencia de los pacientes con BMs de cáncer de mama (BC) tratados mediante radiocirugía empleando arcoterapia volumétrica modulada (VMAT-RS). Métodos: Se analizaron 18 pacientes con 41 BMs de BC tratados mediante VMAT-RS. Se clasificaron según el subtipo molecular de BC y el GPA (Graded Prognostic Assessment) modificado de cáncer de mama. Los pacientes presentaron de 1-4 BMs, las cuales fueron tratadas con 5 arcos VMAT no coplanares. Se analizó la distribución espacial de las BMs, la influencia del status del receptor en la localización de las lesiones y la supervivencia evaluada mediante el modelo de Kaplan-Meier. Resultados: La mediana del tiempo de supervivencia (MST) fue de 19.7 meses. Se hallaron diferencias estadísticamente significativas en el MST según el índice de Karnofsky (p= 0.02) y el status de HER2 (p= 0.004), siendo más prolongado en las pacientes HER2+. Por último, nuestros resultados mostraron que el cerebelo es el lugar predominante de las BMs de cáncer de mama, y también sugirieron que las BMs HER2+ presentaban una predilección por algunas estructuras de la circulación posterior, como el cerebelo, el tronco cerebral y los lóbulos occipitales (p= 0.048). Conclusiones: VMAT-RS es una técnica con una supervivencia global comparable a otras técnicas de radiocirugía. La situación basal en el momento del tratamiento, el GPA modificado de cáncer de mama así como los subtipos moleculares de cáncer de mama, son factores que influyen de forma significativa en la supervivencia de los pacientes.

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RESUMEN Introducción: las actividades de promoción-prevención con relación al cáncer bucal en la Atención Primaria están destinadas a orientar el auto examen bucal y a modificar los hábitos y condicionantes que provocan esta enfermedad. Objetivo: elevar el nivel de conocimientos de los pacientes de 60 años y más en la prevención-promoción del cáncer bucal. Métodos: estudio descriptivo, longitudinal y prospectivo de intervención educativa realizado desde en Santa Inés, Estado Lara, Venezuela, entre los meses de junio 2018 a noviembre 2019, en una población de 821 pacientes de 60 años y más, en una muestra de 230 pacientes de acuerdo a criterios de inclusión y exclusión. Se aplicó una intervención educativa sobre promoción-prevención del cáncer bucal. Resultados: el grupo de edad preponderante fue de 60 a 70 años (42,2 %), y el sexo femenino (42,9 %). Se identificaron como factores de riesgo del cáncer bucal ingestión de bebidas alcohólicas (63 %), hábito de fumar (60,9 %), uso de prótesis desajustadas (43,5 %). Al inicio del estudio un 34,8 % presentaba un adecuado nivel de conocimientos y después de la intervención educativa se obtuvo un incremento hasta el 67,4 % de la muestra. Conclusiones: las mujeres de 60 a 70 años de edad representaban la mayoría de los pacientes y la ingestión de bebidas alcohólicas, hábito de fumar y uso de prótesis desajustadas, resultaron los factores de riesgo que más influían en esta población. La intervención educativa aplicada fue eficaz en más de la mitad de los que presentaban conocimientos inadecuados.

ABSTRACT Introduction: health prevention-promotion activities in relation to oral cancer in Primary Healthcare are aimed at guiding oral self-examination and modifying the habits and conditioning factors that cause this disease. Objective: to increase the level of knowledge of patients aged 60 years and older on oral cancer with health prevention-promotion activities. Methods: a descriptive, longitudinal and prospective study of educational intervention was carried out in Santa Inés, Lara State, Venezuela between the months of June 2018 to November 2019, in a population of 821 patients aged 60 years and older, in a sample of 230 patients according to inclusion and exclusion criteria, applying an educational intervention on oral cancer with health prevention-promotion activities. Results: the predominant age group was 60 to 70 years (42,2 %), and female sex (42,9 %). Alcohol consumption (63 %), smoking (60,9 %) and the use of ill-fitting dentures (43,5 %) were identified as risk factors for oral cancer. At the beginning of the study, 34,8 % had an adequate level of knowledge and after the application of the educational intervention; it increased to 67,4 % of the sample. Conclusions: women between 60 and 70 years old represented the majority of the patients and the consumption of alcoholic beverages, smoking and the use of ill-fitting prostheses were the most influential risk factors in this population. The educational intervention applied modified more than half of those with insufficient levels of knowledge to a satisfactory level of knowledge.

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Motor learning skills are reliable indicators of behavioral acquisition and cognitive disorders. The ease with which learning skills are measured disparities the complexity of the interpretation concerning neural plasticity. Conversely, a wealth of information regarding metabolic derangements has long been reported with direct connection to high sucrose diets. However, the impact of excessive sucrose consumption on undergoing cognitive processes has been only scarcely addressed up to now. Therefore, the goal of this work was to describe the associative relationship between high sucrose consumption and changes in motor learning skills acquisition. Motor learning impairments conditioned by central alterations are hypothesized. Rotarod, elevated plus-maze and open field trials, along with metabolic and pro-inflammatory biomarkers tests in Wistar rats under a high sucrose treatment, were performed. Motor learning impairment in high sucrose diet-treated rats was found while spontaneous locomotor activity remained unchanged. Even though, no anxiety-like behavior under high sucrose diet-treatment was observed. Consistently, the worst outcome in the glucose tolerance test was developed, the worst motor learning performance was observed. Furthermore, insulin resistance correlated positively with a pro-inflammatory state and a decreased latency to fall in the rotarod test. Indeed, C-reactive protein and tumor necrosis factor-α serum levels, along with the homeostasis model assessment of insulin resistance (HOMA-IR), significantly increased in motor learning impairment. Together, these results support behavioral, metabolic and pro-inflammatory changes associated with deleterious changes in central nervous system likely involving crucial motor learning structures. Underlying pro-inflammatory-triggered processes may explain cognitive disorders in advanced states of metabolic derangements.

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BACKGROUND: Culturing primary epithelial cells has a major advantage over tumor-derived or immortalized cell lines as long as their functional phenotype and genetic makeup are mainly maintained. The swine model has shown to be helpful and reliable when used as a surrogate model for human diseases. Several porcine cell lines have been established based on a variety of tissues, which have shown to extensively contribute to the current understanding of several pathologies, especially cancer. However, protocols for the isolation and culture of swine gastric epithelial cells that preserve cell phenotype are rather limited. We aimed to develop a new method for establishing a primary epithelial cell culture from the fundic gland region of the pig stomach. RESULTS: Mechanical and enzymatic dissociation of gastric tissue was possible by combining collagenase type I and dispase II, protease inhibitors and antioxidants, which allowed the isolation of epithelial cells from the porcine fundic glands showing cell viability > 90% during the incubation period. Gastric epithelial cells cultured in RPMI 1640, DMEM-HG and DMEM/F12 media did not contribute enough to cell adhesion, cluster formation and cell proliferation. By contrast, William's E medium supplemented with growth factors supports confluency and proliferation of a pure epithelial cell monolayer after 10 days of incubation at 37 °C, 5% CO2. Mucin-producing cell phenotype of primary isolates was confirmed by PAS staining, MUC1 by immunohistochemistry, as well as the expression of MUC1 and MUC20 genes by RT-PCR and cDNA sequencing. Swine gastric epithelial cells also showed origin-specific markers such as cytokeratin cocktail (AE1/AE3) and cytokeratin 18 (CK-18) using immunohistochemical and immunofluorescence methods, respectively. CONCLUSIONS: A new method was successfully established for the isolation of primary gastric epithelial cells from the fundic gland zone through a swine model based on a combination of tissue-specific proteases, protease inhibitors and antioxidants after mechanical cell dissociation. The formulation of William's E medium with growth factors for epithelial cells contributes to cell adhesion and preserves functional primary cells phenotype, which is confirmed by mucin production and expression of typical epithelial markers over time.

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Background: Whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) are two treatment modalities commonly utilized to treat brain metastases (BMs). Aim: The purpose of this study is to analyse retrospectively the local control and survival of patients with BMs of breast cancer (BC) treated via radiosurgery using Volumetric Modulated Arc Therapy (VMAT-RS). Methods: 18 patients with 41 BMs of BC and treated by VMAT-RS were studied. They were classified according to the molecular subtype of BC and the modified breast graded prognostic assessment -GPA- index. Patients presented 1-4 BMs, which were treated with 5 non-coplanar VMAT arcs. The spatial distribution of BMs, the influence of receptor status on the location of the lesions and survival assessed via the Kaplan-Meier model were analyzed. Results: The median survival time (MST) was 19.7 months. Statistically significant differences were determined in the MST according to the Karnofsky performance status (p= 0.02) and the HER2 status (p= 0.004), being more prolonged in the HER2+ patients. Finally, our results showed that the cerebellum is the predominant site of breast cancer BMs, and also suggested that HER2+BMs had a predilection for some structures of the posterior circulation, such as the cerebellum, brainstem and occipital lobes (p= 0.048). Conclusions: The VMAT-RS is a technique with an overall survival comparable to other radiosurgery techniques. The baseline situation at the time of treatment, the modified breast-GPA and the molecular subtypes, are factors that significantly influence patient survival.

Antecedentes: La radioterapia holocraneal (WBRT) y la radiocirugía estereotáctica (SRS) son dos modalidades de tratamiento comúnmente empleados para el tratamiento de las metástasis cerebrales (BMs). Objetivo: El propósito de este estudio es analizar de forma retrospectiva el control local y la supervivencia de los pacientes con BMs de cáncer de mama (BC) tratados mediante radiocirugía empleando arcoterapia volumétrica modulada (VMAT-RS). Métodos: Se analizaron 18 pacientes con 41 BMs de BC tratados mediante VMAT-RS. Se clasificaron según el subtipo molecular de BC y el GPA (Graded Prognostic Assessment) modificado de cáncer de mama. Los pacientes presentaron de 1-4 BMs, las cuales fueron tratadas con 5 arcos VMAT no coplanares. Se analizó la distribución espacial de las BMs, la influencia del status del receptor en la localización de las lesiones y la supervivencia evaluada mediante el modelo de Kaplan-Meier. Resultados: La mediana del tiempo de supervivencia (MST) fue de 19.7 meses. Se hallaron diferencias estadísticamente significativas en el MST según el índice de Karnofsky (p= 0.02) y el status de HER2 (p= 0.004), siendo más prolongado en las pacientes HER2+. Por último, nuestros resultados mostraron que el cerebelo es el lugar predominante de las BMs de cáncer de mama, y también sugirieron que las BMs HER2+ presentaban una predilección por algunas estructuras de la circulación posterior, como el cerebelo, el tronco cerebral y los lóbulos occipitales (p= 0.048). Conclusiones: VMAT-RS es una técnica con una supervivencia global comparable a otras técnicas de radiocirugía. La situación basal en el momento del tratamiento, el GPA modificado de cáncer de mama así como los subtipos moleculares de cáncer de mama, son factores que influyen de forma significativa en la supervivencia de los pacientes.

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Resumen Helicobacter pylori (H. pylori) es un bacilo gramnegativo microaerófilo, capaz de colonizar la mucosa gástrica. Este microorganismo infecta a más de la mitad de la población mundial, por lo que se ha convertido en la infección bacteriana más común. La prevalencia de la infección y de las enfermedades asociadas a ella es alta, sobre todo en países en vías de desarrollo. El tratamiento recomendado para la erradicación es la triple terapia; sin embargo, su eficacia ha disminuido por el desconocimiento del patrón de susceptibilidad bacteriano por parte del personal médico y dada la aparición de cepas resistentes. La resistencia en H. pylori se asocia con la capacidad de adaptación de la bacteria a ambientes hostiles y al uso de los antibióticos. En Colombia, existen reportes acerca de que H. pylori presenta resistencia a amoxicilina, metronidazol, claritromicina, furazolidona, levofloxacina y tetraciclina. Los estudios del patrón de susceptibilidad determinaron que la frecuencia de resistencia de H. pylori es variable y demuestran la falta de datos en la mayoría del territorio del país. Sobre la base de lo anterior, el objetivo de esta revisión es describir los porcentajes de resistencia de H. pylori a los antibióticos amoxicilina, metronidazol, claritromicina, furazolidona, levofloxacina y tetraciclina, usados en el tratamiento de la infección en los estudios realizados en Colombia.

Abstract Helicobacter pylori (H. pylori) is a microaerophilic gram-negative bacillus that colonizes the gastric mucosa. It infects more than half the world's population, making it the most common bacterial infection. The prevalence of infection and associated diseases is high in developing countries. The recommended treatment for its eradication is triple therapy; however, its efficacy has decreased due to the lack of knowledge of the bacterial susceptibility pattern among the medical staff and the emergence of resistant strains. H. pylori susceptibility is associated with the bacteria's ability to adapt to hostile environments and the use of antibiotics. In Colombia, it has been reported that H. pylori is resistant to amoxicillin, metronidazole, clarithromycin, furazolidone, levofloxacin, and tetracycline. Studies on the susceptibility pattern have determined that the frequency of H. pylori susceptibility is variable and demonstrate the lack of data in most of the Colombian territory. With this in mind, the objective of this review is to describe the percentage of resistance to amoxicillin, metronidazole, clarithromycin, furazolidone, levofloxacin and tetracycline, which are used for the treatment of H. pylori infection, according to studies conducted in Colombia.

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Las infecciones respiratorias agudas constituyen la causa fundamental de mortalidad y morbilidad en el ámbito mundial. Los principales agentes causales de estas infecciones son los virus. La detección rápida y eficaz de estos patógenos es determinante en el tratamiento y la prevención de las enfermedades que estos agentes virales pueden ocasionar. En la actualidad, los métodos moleculares para el diagnóstico virológico son muy útiles por su elevada sensibilidad, especificidad y rapidez en la obtención de los resultados. El objetivo es introducir cuatro ensayos múltiples de transcripción reversa de reacción en cadena de la polimerasa en tiempo real para el diagnóstico y vigilancia de 15 virus respiratorios. Se procesaron 2 441 muestras clínicas respiratorias recibidas en el Laboratorio Nacional de Referencia de Virus Influenza y otros Virus Respiratorios en el período comprendido entre septiembre de 2013 y abril de 2014. Se analizaron 2 352 exudados nasofaríngeos, 77 aspirados bronquiales y 12 muestras de necropsia. A estas se les realizó el diagnóstico molecular por los sistemas múltiples de transcripción reversa de reacción en cadena de la polimerasa en tiempo real mediante el empleo de cebadores y sondas TaqMan. De las 2 441 muestras clínicas estudiadas, 1 290 fueron positivas para alguno de los virus respiratorios (52,85 por ciento). El virus sincitial respiratorio humano se detectó con mayor frecuencia (47,83 por ciento), seguido de los virus influenza (19 por ciento) y los rinovirus humanos (14,73 por ciento). Se concluye que la introducción de los cuatro ensayos de transcripción reversa de reacción en cadena de la polimerasa en tiempo real posibilita la actualización del algoritmo diagnóstico en el Laboratorio Nacional de Referencia de Virus Influenza y otros Virus Respiratorios para la vigilancia de estos agentes en Cuba, lo que contribuye al mejoramiento del Programa Nacional de Prevención y Control de las Infecciones Respiratorias Agudas(AU)

Acute respiratory infections are the major cause of mortality and morbidity worldwide. Respiratory viruses are the main causative agents of acute respiratory infections. Rapid and accurate detection of these pathogens is critical for the treatment and prevention of the diseases these viral agents can cause. Currently, molecular diagnostic methods are useful tools for the virological detection of respiratory viruses due to its high sensitivity, specificity and their speed in obtaining results. The objective of this study was to introduce four multiplex real-time TR-RCP assays for the diagnosis and surveillance of fifteen virus causing acute respiratory infections. 2 441 clinical respiratory samples were processed in the period between September 2013 and April 2014 in the National Laboratory of Reference for Influenza Virus and other Respiratory Viruses. There were analyzed 2 352 nasopharyngeal exudates, 77 bronchial aspirations and 12 necropsy samples. Multiplex real-time TR-RCP was performed using TaqMan primers and probes previously published. From the 2 441 clinical samples studied, 1 290 were positive for some of the respiratory viruses, which represent 52.85 percent Syncytial respiratory virus was the most frequently detected virus (47.83 percent), then influenza viruses (19 percent) and human rhinovirus (14.73 percent). The introduction at the National Reference Laboratory of the four multiplex real-time TR-RCP assays allows updating the algorithm for the diagnosis and surveillance of respiratory viruses in Cuba, as a contribution to the National Program for the Prevention and Control of Acute Respiratory Infection(AU)

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We report a new transthyretin (ATTR) gene c.272C>G mutation and variant protein, p.Leu32Val, in a kindred of Bolivian origin with a rapid progressive peripheral neuropathy and cardiomyopathy. Three individuals from a kindred with peripheral nerve and cardiac amyloidosis were examined. Analysis of the TTR gene was performed by Sanger direct sequencing. Neuropathologic examination was obtained on the index patient with mass spectrometry study of the ATTR deposition. Direct DNA sequence analysis of exons 2, 3, and 4 of the TTR gene demonstrated a c.272 C>G mutation in exon 2 (p.L32V). Sural nerve biopsy revealed massive amyloid deposition in the perineurium, endoneurium and vasa nervorum. Mass spectrometric analyses of ATTR immunoprecipitated from nerve biopsy showed the presence of both wild-type and variant proteins. The observed mass results for the wild-type and variant proteins were consistent with the predicted values calculated from the genetic analysis data. The ATTR L32V is associated with a severe course. This has implications for treatment of affected individuals and counseling of family members.

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BACKGROUND: Postoperative leaks are the most undesirable complication of bariatric surgery and upper gastrointestinal (GI) series are routinely ordered to rule them out. Despite the published literature recommending against its routine use, it is still being customarily used in Chile. AIM: To examine the usefulness of routine upper GI series using water-soluble iodinated contrast media for the detection of early postoperative leaks in patients undergoing bariatric surgery. MATERIAL AND METHODS: A cohort of 328 patients subjected to bariatric surgery was followed from October 2012 to October 2013. Most of them underwent sleeve gastrectomy. RESULTS: Upper GI series on the first postoperative day were ordered to 308 (94%) patients. Postoperative leaks were observed in two patients, with an incidence of 0.6%. The sensitivity for upper GI series detection of leak was 0% and the negative predictive value was 99%. CONCLUSIONS: Routine upper GI series after bariatric surgery is not useful for the diagnosis of postoperative leak, given the low incidence of this complication and the low sensitivity of the technique.

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La decocción de la planta de Tarenaya hassleriana es utilizada en la región del Río de La Plata por sus propiedades como rubefaciente, digestiva, y antiescorbútica. El objetivo del estudio fue investigar caracteres de la hoja y tallo para identificar esta especie a partir de muestras enteras o fragmentadas. Se emplearon técnicas habituales de microscopia óptica y análisis histoquímico para identificar almidón, sustancias lipofílicas, fenólicas y mirosina. Los caracteres diagnósticos fueron: en la hoja, folíolos con venación eucamptódroma, con estomas anomocíticos presentes en ambas caras; tricomas glandulares uniseriados y pluriseriados, con cabezas unicelulares y pluricelulares conteniendo sustancias lipofílicas; mesofilo dorsiventral; en el tallo, la corteza primaria formada por varias capas de colénquima tangencial seguido de parénquima; el cilindro vascular secundario rodea la médula sólida, en cuyo parénquima se halló almidón, cristales poliédricos y esferocristales. Se detectaron idioblastos de mirosina en la epidermis y parénquimas de la hoja y el tallo. Los parámetros micrográficos descriptos garantizan una correcta identificación de T. hassleriana.

Plant decoction of Tarenaya hassleriana is used as a traditional medicine in the Río de La Plata area. It has rubefacient, digestive, and antiscorbutic properties. The aim of this study was to investigate leaf and stem microcharacters to identify this species from whole or fragmented samples. The usual techniques of optical microscopy were employed. Histochemical tests for starch, lipophilic substances, phenolic substances, and mirosina were used. The main differential traits were: leaflets with eucamptodromous venation, amphistomatic with anomocytic stomata type; uniseriate and pluriseriate glandular trichomes, with unicellular and pluricellular heads containing lipophilic substances; dorsiventral mesophyll; stem with a primary cortex formed by tangential collenchyma followed by parenchyma; the secondary vascular cylinder surrounding the pith with starch, polyhedral microcrystals and spherocrystals. Idioblast of myrosin were detected in the epidermis and parenchyma of leaves and stems. The micrographic parameters described ensure a correct identification of T. hassleriana.

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Background: Postoperative leaks are the most undesirable complication of bariatric surgery and upper gastrointestinal (GI) series are routinely ordered to rule them out. Despite the published literature recommending against its routine use, it is still being customarily used in Chile. Aim: To examine the usefulness of routine upper GI series using water-soluble iodinated contrast media for the detection of early postoperative leaks in patients undergoing bariatric surgery. Material and Methods: A cohort of 328 patients subjected to bariatric surgery was followed from October 2012 to October 2013. Most of them underwent sleeve gastrectomy. Results: Upper GI series on the first postoperative day were ordered to 308 (94%) patients. Postoperative leaks were observed in two patients, with an incidence of 0.6%. The sensitivity for upper GI series detection of leak was 0% and the negative predictive value was 99%. Conclusions: Routine upper GI series after bariatric surgery is not useful for the diagnosis of postoperative leak, given the low incidence of this complication and the low sensitivity of the technique.

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ANTECEDENTES: En el semen, algunos microorganismos pueden encontrar las condiciones óptimas para sobrevivir, ocasionando daños a los espermatozoides y desencadenando procesos de infertilidad o infecciones del tracto reproductivo. Entender el papel de los microorganismos aislados en el semen, contribuye a mejorar el diagnóstico de casos de infertilidad donde la única causa aparente son los procesos infecciosos. OBJETIVO: Describir y correlacionar los parámetros seminales y el crecimiento bacteriano del eyaculado. MÉTODOS: Identificación de los microorganismos aislados en 43 espermocultivos-clínicos y 28 espermocultivos-investigación. Se realizó conteo de las unidades formadoras de colonia a los espermocultivos-investigación y análisis de las características espermáticas. Resultados: Se obtuvo crecimiento bacteriano en 14 (32,6%) de los espermocultivos-clínicos y 15 (53,6%) de los espermocultivos-investigación. Los microorganismos aislados fueron Enterococcus faecalis, Escherichia coli, Morganella morganii, Staphylococcus spp coagulasa negativo, Klebsiella pneumoniae y microbiota mixta. En este estudio se observó abundante crecimiento de cocos aerobios. Finalmente, no se encontró asociación entre la disminución en la calidad de los parámetros seminales y los microorganismos. CONCLUSIONES: La presencia de bacterias en el semen no afecta la calidad seminal.

BACKKGROUND: Microorganisms can find the optimal conditions for survival in semen, causing damage to the spermatozoa and triggering processes of infertility or reproductive tract infections. Therefore, understanding the role of the microorganisms present in semen can help to improve the diagnosis of infertility cases where the only apparent cause is infectious processes. OBJECTIVE: To describe and correlate semen parameters and bacterial growth in ejaculate. METHODS: Identification of microorganisms isolated in 43 clinical spermocultures and 28 research spermocultures. We assessed colony-forming unit counts and sperm characteristics of research spermocultures. In addition, semen parameters were evaluated in each ejaculate. RESULTS: Bacterial growth was obtained in 14 (32.6%) of the 43 clinical spermocultures and 15 (53.6%) of the 28 research spermocultures. The isolated microorganisms were Enterococcus faecalis, Escherichia coli, Morganella morganii, Staphylococcus coagulase negative, Klebsiella pneumoniae and mixed microbiota. Finally, in this study a large growth of aerobic cocci was observed. We did not find association between the decline in the quality of semen parameters and microorganisms. CONCLUSION: The presence of bacteria in semen does not affect semen quality.

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In this work, hybrid nanocomposites based on anatase titania:polypyrrole (TiO(2):PPy) were directly obtained from a simple, one-step, ultrasonic (UT)-assisted synthesis. The properties of these crystalline nanocomposites were compared with those of others fabricated using cold (Cold)-assisted synthesis without any UT assistance, which required a hydrothermal treatment (HT) to yield crystalline anatase titania in the nanocomposite (TiO(2):PPy) at low temperature (130°C) and in a short time (3h). The SEM results demonstrated that the UT-assisted synthesis is a feasible method to obtain anatase TiO(2):PPy nanocomposites with controlled morphology using low energy. The Fourier transform infrared (FT-IR) bands of the crystalline nanocomposites exhibited a shift with respect to neat components, which was attributed to the strong interaction between the secondary amine groups (N-H) of PPy and the oxygen from TiO(2). The acceptable absorption in the visible region (λ(max)=670nm) indicates that these nanocomposites are good candidates for harvesting energy in solar cells. Devices based on these nanocomposites were built to evaluate their electrical properties. An increase in the photocurrent was observed for the devices prepared with the nanocomposites from the UT-assisted synthesis.