RESUMEN
Several groups have demonstrated that healthy individuals can present the t(14;18) translocation. In this report, the presence of the translocation was examined in healthy blood donors in Brazil, a country considered an ethnic melting pot. The translocation was detected by nested PCR in 227 peripheral blood samples from individuals with different ethnic backgrounds. The t(14;18) translocation was found in 45 of 85 White individuals (52.94%); in 57 of 72 Black individuals (79.17%); and in 68 of 70 individuals (97.14%) of Japanese-descent. In conclusion, the frequency of the t(14;18) translocation in the Brazilian population varies according to the ethnic background.
Asunto(s)
Cromosomas Humanos Par 14 , Cromosomas Humanos Par 18 , Linfoma Folicular/etnología , Linfoma Folicular/genética , Translocación Genética , Adolescente , Adulto , Anciano , Donantes de Sangre , Brasil/etnología , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Adulto JovenRESUMEN
A diatom data-base of 255 species obtained from 14 oceanographic cruises (14801 entries of 647 sampling sites) together with the analysis of oceanic features were used to establish four local regions in the southern Gulf of Mexico. In addition, common species for each region were designated. This study is based on the application of cluster analysis and the species frequency data. Material for this undertaking consisted of water and net samples obtained between June 1979 and December 2002. Results show that the most frequent species (> 40%) were: Asterionellopsis glacialis, Bacteriastrum delicatulum, B. hyalinum, Chaetoceros affinis, C. coarctatus, C. compresus, C. curvisetus, C. danicus, C. decipiens, C. diversus, C. lorenzianus, C. pelagicus, C. peruvianus, Coscinodiscus radiatus, Cylindrotheca closterium, Guinardia flaccida, Hemiaulus hauckii, H. membranaceus, H. sinensis, Leptocylindrus danicus, Neocalyptrella robusta, Nitzschia bicapitata, Pleurosigma diverse-striatum, Proboscia alata, Pseudo-nitzschia pungens, Pseudosolenia calcar-avis, Rhizosolenia imbricata, R. setigera, Skeletonema costatum, Thalassionema bacillare, T frauenfeldii, T nitzschioides and Thalassiosira eccentrica. The species composition for each region and season are discussed. Itis concluded that sampling site assemblages are related to oceanographic conditions. A total list of species composition is given, forty-seven species taxa being new records for this area.
Asunto(s)
Diatomeas , Ecosistema , Monitoreo del Ambiente/métodos , Animales , Bases de Datos Factuales , Golfo de México , Oceanografía , Especificidad de la EspecieRESUMEN
BACKGROUND AND OBJECTIVE: The latency times of midfemoral sciatic nerve blocks vary greatly. This study investigated the correlation between the type of motor response to nerve stimulation on the one hand and latency and block efficacy on the other. PATIENTS AND METHODS: We enrolled 215 consecutive patients (184 women) undergoing orthopedic foot surgery. A tourniquet was applied above the malleolus. The puncture location was found by palpating to locate the groove between the vastus lateralis and biceps femoris muscles, at the mid-point of the line between the posterior edge of the greater trochanter muscle and the insertion of the biceps femoris muscle in the popliteal fossa. A solution of equal proportions (1:1) of 1.5% mepivacaine (with bicarbonate 1:10) and 0.75% levobupivacaine was injected at a dose of 0.45 mL x kg(-1) (maximum 40 mL) using a 10-cm needle. Nerve stimulation was applied at 100-300 ms, 02-0.4 mA, and 2 Hz. Latency was classified as response in less than 15 minutes, in 15 to 30 minutes, or later than 30 minutes. RESULTS: The evoked motor response was inversion in 30 patients, flexion or extension in 38, plantar flexion in 101, dorsiflexion in 37, and eversion in 9. Shorter latencies (15 minutes) were observed in all patients with inversion or flexion/extension and in 84 (83%) of the 101 patients with plantar flexion. Mid-range latencies were observed in 13% of those with a plantar flexion response and in 29.7% of those with dorsiflexion. All 9 patients with eversion and 17 (45.9%) of the 37 patients with dorsiflexion had the longest latencies. The surgical block was complete for all patients. CONCLUSIONS: This approach provides an effective block with minimum latency in patients who have a flexion or extension motor response in the foot and/or fingers, inversion, or plantar flexion, which assumes that the injection has reached the common trunk of the sciatic or tibial nerve. However, a longer latency is associated with a peroneal motor response, particularly eversion.
Asunto(s)
Nervio Femoral/fisiología , Pie/cirugía , Bloqueo Nervioso/métodos , Adulto , Anciano , Anciano de 80 o más Años , Anestésicos Locales/farmacología , Bupivacaína/análogos & derivados , Bupivacaína/farmacología , Femenino , Nervio Femoral/anatomía & histología , Nervio Femoral/efectos de los fármacos , Pie/anatomía & histología , Pie/inervación , Humanos , Levobupivacaína , Masculino , Mepivacaína/farmacología , Persona de Mediana Edad , Movimiento , Procedimientos Ortopédicos , Estudios Prospectivos , Tiempo de Reacción/efectos de los fármacos , Tiempo de Reacción/fisiología , Adulto JovenRESUMEN
PURPOSE: Organ preservation has been investigated in patients (p) with infiltrating transitional cell carcinoma (TCC) of the bladder over the past decade as an alternative to radical cystectomy. This is a trimodal schedule study, including transurethral resection of bladder tumor (TURB), neoadjuvant chemotherapy and concomitant radiochemotherapy (RTC). PATIENTS AND METHODS: From April 1996 until August 2005, 29 evaluable patients (p) with T2-T3NXM0 bladder cancer were enrolled. After a transurethral resection of bladder tumor (TURB), we administered 2 cycles of induction chemotherapy with CMV (15 p) or Gemcitabine-Cisplatin (14 p) followed by radiotherapy 45 Gy 1.8 Gy/fraction and two cycles of concomitant cisplatin 70 mg/m(2). 2-3 weeks later, a cystoscopy with tumor-site biopsy was performed. If complete histological response, p were treated with consolidation radiotherapy until 64.8 Gy. For p with residual or recurrent tumor, cystectomy was performed. RESULTS: We included 28 men and 1 women (median age 63, range 39-72 years) with PS (ECOG) 0-1. The stage was: 21 p T2; 6 p T3a; and 2 p T3b. Toxicity was higher in CMV compared with Gem- Cis: grade (3/4) neutropenia 4/15 (26%) vs 1/14 (7%); febrile neutropenia 3/15 (20%) vs 1/14 (7%); grade (3/4) trombocytopenia 2/15 (13%) vs 1/14 (7%). Toxicities with concomitant RCT were low-moderate: urocystitis (26%) and enteritis (18%). RESPONSE: microscopically complete TURB was obtained in 20 p (69%), but not in 9 p (31%) (7 microscopic, and 2 macroscopic residual tumor). We found a complete histologic response after induction RCT in 25 p (86%). After a median follow-up of 69.4 months (m) (range: 8-97.7), there were 8 deaths, with a overall survival of 72%. Furthermore 14 of 29 p (48%) were alive with intact bladder, and median survival time with intact bladder was 63.6 m (50.1-77.2); were predictive of best outcome T2 stage vs T3 (p < 0.0001), and complete histologic resection in initial TURB vs residual tumor (p = 0.0004). CONCLUSIONS: Combined treatment provide high response rates and can be offered as an alternative option to radical cystectomy in selected patients with TCC. Patients with T2 stage and complete histologic resection in initial TURB had the best outcome.
Asunto(s)
Antineoplásicos , Carcinoma de Células Transicionales/terapia , Terapia Neoadyuvante , Radioterapia , Neoplasias de la Vejiga Urinaria/terapia , Procedimientos Quirúrgicos Urológicos , Adulto , Anciano , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Carcinoma de Células Transicionales/mortalidad , Cisplatino/administración & dosificación , Terapia Combinada , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Terapia Neoadyuvante/efectos adversos , Terapia Neoadyuvante/métodos , Estadificación de Neoplasias , Radioterapia/efectos adversos , Radioterapia/métodos , Neoplasias de la Vejiga Urinaria/mortalidad , Procedimientos Quirúrgicos Urológicos/métodos , Vinblastina/administración & dosificación , GemcitabinaRESUMEN
Anesthesiology has progressed spectacularly over the last two decades, largely parallel to developments in basic and clinically applied sciences such as immunology. The anesthesiologist's involvement now extends to all matters involved in perioperative care. Surgery, anesthetic procedures themselves, and other associated techniques such as blood transfusion all alter the patient's immune response and all fall within the range of procedures monitored by the anesthesiologist. The repercussions on the patient are important, given that alterations suppose increased risk of postoperative infection and increased recurrence of neoplastic disease. The present article reviews available knowledge on how and to what extent the patient's immune status is affected in the perioperative period. Generally, surgery and anesthesia induce immune system depression. It is possible to demonstrate a decrease in the number and activity of circulating immune cells and alterations of various types in interleukins and in protein synthesis during acute phase response. Research in this field is complex given that the individual effect of each factor involved is difficult to measure and experimental or clinical designs usually yield only biased views. Replacement of lost red blood cells is another factor leading to immunological changes. New anesthetic techniques, the optimization of methods already in use, and the development of modern, less immunodepressant drugs and of alternatives to homologous blood transfusion are all solutions that have been proposed. This is an exciting field of study in which today, perhaps more than ever, the anesthesiologist has a critical role to play.
Asunto(s)
Anestesia , Transfusión Sanguínea , Sistema Inmunológico/fisiología , Procedimientos Quirúrgicos Operativos , HumanosRESUMEN
Zinc acexamate (ZAM) is an antiulcer agent with antisecretory and gastroprotective properties. The aim of this study was to evaluate endoscopically and morphometrically the efficacy of ZAM in the prophylaxis of gastroduodenal lesions induced by pyroxicam. Thirty nine patients from 30 to 70 years of age diagnosed with osteoarthritis without lesions in the upper digestive tract on basal endoscopy were studied. A randomized, double blind study was designed in which the patients received 20 mg/day of pyroxicam together with 300 mg/day of ZAM or placebo for 4 weeks. Clinical controls were undertaken on days 0, 14, 28 and endoscopic and histologic controls performed on days 0 and 28. The two groups were homogeneous regarding basal parameters. Endoscopic grading of the gastroduodenal lesions at the end of the study was lower in the group treated with ZAM (p < 0.001). Ulcers were found in only 2 patients (one antral and one duodenal) both of whom were in the placebo group (10.5%). Histologic scoring following treatment demonstrated higher values in the placebo group (p < 0.001) and scarce alterations with respect to base values in the group treated with ZAM. Morphometric quantification showed lower cell densities in both groups at the body level (p < 0.001). However, these did not vary in the antrum in the group treated with ZAM but increased in the placebo group (p < 0.001) as an expression of proliferative cell response to mucosal damage. At a single nightly dosis of 300 mg ZAM is effective in the prophylaxis of gastric and duodenal lesions induced by pyroxicam.
Asunto(s)
Aminocaproatos , Antiinflamatorios no Esteroideos/efectos adversos , Antiulcerosos/uso terapéutico , Mucosa Gástrica/efectos de los fármacos , Osteoartritis/tratamiento farmacológico , Piroxicam/efectos adversos , Adulto , Anciano , Ácido Aminocaproico/uso terapéutico , Método Doble Ciego , Femenino , Mucosa Gástrica/patología , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/patología , Enfermedades Gastrointestinales/prevención & control , Gastroscopía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Ten cases of xanthogranulomatous cholecystitis are presented, 5 women and 5 men, from a total of 439 cholecystectomies (2.2%). In 50% of cases the clinical course was consistent with acute cholecystitis; in 30%, gallbladder cancer was suspected preoperatively; and in 70% of cases cancer was suspected during surgery but intraoperative biopsies showed no malignancy. Definitive pathological findings included early carcinoma of the gallbladder in two patients, and a cholecystocolic fistula in one patient. A perforated gallbladder was found in one patient. The incidence of postoperative septic complications was 18.1%, a figure that doubles that of elective biliary surgery in our hospital.
Asunto(s)
Colecistitis/complicaciones , Granuloma/complicaciones , Xantomatosis/complicaciones , Anciano , Anciano de 80 o más Años , Colecistitis/diagnóstico , Colecistitis/cirugía , Femenino , Enfermedades de la Vesícula Biliar/complicaciones , Enfermedades de la Vesícula Biliar/diagnóstico , Enfermedades de la Vesícula Biliar/cirugía , Granuloma/diagnóstico , Granuloma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Xantomatosis/diagnóstico , Xantomatosis/cirugíaRESUMEN
Aclacinomycin (ACM) is an oncostatic substance on the family of the Anthracyclines, with a proven activity in human and rodents. Splenic cells from C57BL/6 ACM injected mice by intraperitoneal or intravenous route four days before their sacrifice showed a significant increase in the proliferative and cytotoxic response respectively measured by incorporation of 3H-TdR and by the liberation of 51Cr when stimulated in vitro with irradiated mouse DBA/2 splenic cells. This response is doses dependent, and one can clearly observe different effects on the proliferative and cytotoxic responses at high doses. The cultures supernatants of splenic cells from mice treated with ACM during allogeneic stimulation showed a greater activity to induce the proliferation of a line of T cytotoxic cells dependent on Interleukin-2. Finally, the cytotoxic activity of splenic cells induced by the allogeneic stimulation in vitro, of mice treated with ACM, was found in a subpopulation of cells non adherent to plastic, mainly made up of lymphocytes.