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OBJECTIVE: To establish the influence of overweight/obesity, medicated hypothyroidism, and medicated non-syndromic hypogrowth on maxillary and mandibular growth. MATERIALS AND METHODS: The relation between 10 craniofacial anthropometric measurements and hypothyroidism (n = 216), overweight/obesity (n = 108), and non-syndromic hypogrowth (n = 250) were evaluated in patients aged 1-19 years and a control group of healthy patients (n = 587). A subgroup analysis was performed at the peak growth in all groups. RESULTS: Patients with overweight/obesity and hypothyroidism showed increased craniofacial growth, while hypogrowth patients showed differences in zygomatic width and nasal base growth. Females with hypothyroidism and non-syndromic hypogrowth showed decreased head circumference at peak growth. Several anthropometric measurements were increased in patients with overweight/obesity, including head circumference. When all age groups were analyzed, overweight/obese and hypothyroidism patients showed increased zygomatic width while decreased hypogrowth. Overall, most craniofacial anthropometric measurements in overweight/obese patients were increased. Finally, the peak growth in males with hypothyroidism and subjects with non-syndromic hypogrowth was delayed compared to the control group (p < 0.05). CONCLUSIONS: Children and adolescents with overweight/obesity and endocrine disorders showed alterations in craniofacial growth. Clinicians must be aware that the growth peak in these patients may be delayed when planning maxillary and mandibular orthopedic treatment.
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Hipotireoidismo , Sobrepeso , Masculino , Criança , Feminino , Humanos , Adolescente , Estudos Transversais , Colômbia , Obesidade/complicações , Hipotireoidismo/complicações , Índice de Massa CorporalRESUMO
The classification of jets induced by quarks or gluons is important for New Physics searches at high-energy colliders. However, available taggers usually rely on modeling the data through Monte Carlo simulations, which could veil intractable theoretical and systematical uncertainties. To significantly reduce biases, we propose an unsupervised learning algorithm that, given a sample of jets, can learn the SoftDrop Poissonian rates for quark- and gluon-initiated jets and their fractions. We extract the Maximum Likelihood Estimates for the mixture parameters and the posterior probability over them. We then construct a quark-gluon tagger and estimate its accuracy in actual data to be in the 0.65-0.7 range, below supervised algorithms but nevertheless competitive. We also show how relevant unsupervised metrics perform well, allowing for an unsupervised hyperparameter selection. Further, we find that this result is not affected by an angular smearing introduced to simulate detector effects for central jets. The presented unsupervised learning algorithm is simple; its result is interpretable and depends on very few assumptions.
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Bone metastases are very common complications associated with certain types of cancers that frequently negatively impact the quality of life and functional status of patients; thus, early detection is necessary for the implementation of immediate therapeutic measures to reduce the risk of skeletal complications and improve survival and quality of life. There is no consensus or universal standard approach for the detection of bone metastases in cancer patients based on imaging. Endorsed by the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) a group of experts met to discuss and provide an up-to-date review of our current understanding of the biological mechanisms through which tumors spread to the bone and describe the imaging methods available to diagnose bone metastasis and monitor their response to oncological treatment, focusing on patients with breast and prostate cancer. According to current available data, the use of next-generation imaging techniques, including whole-body diffusion-weighted MRI, PET/CT, and PET/MRI with novel radiopharmaceuticals, is recommended instead of the classical combination of CT and bone scan in detection, staging and response assessment of bone metastases from prostate and breast cancer.Clinical trial registration: Not applicable.
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Neoplasias Ósseas , Neoplasias da Mama , Neoplasias da Próstata , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Feminino , Humanos , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Qualidade de Vida , Compostos RadiofarmacêuticosRESUMO
AIM: To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register. METHODS: A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted. RESULTS: A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000). CONCLUSION: In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis.
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BACKGROUND: An essential element imbalance in the joint might favor gradual degeneration of the articular cartilage. It has been reported that cadmium (Cd) plays an antagonistic role with regards to the presence of essential elements, such as zinc (Zn), iron (Fe), and manganese (Mn), which may favor the development of disabling diseases, like osteoarthritis (OA) and osteoporosis. METHODS: 3D cultures of human chondrocytes were phenotyped with the Western blot technique and structurally evaluated with histological staining. The samples were exposed to 1, 5, and 10 µM of CdCl2 for 12 h, with a non-exposed culture as control. The concentration of Cd, Fe, Mn, Zn, chromium (Cr), and nickel (Ni) was quantified through plasma mass spectrometry (ICP-MS). The data were analyzed with a Kruskal Wallis test, a Kendall's Tau test and Spearman's correlation coefficient with the Stata program, version 14. RESULTS: Our results suggest that Cd exposure affects the structure of micromass cultures and plays an antagonistic role on the concentration of essential metals, such as Zn, Ni, Fe, Mn, and Cr. CONCLUSION: Cd exposure may be a risk factor for developing joint diseases like OA, as it can interfere with cartilage absorption of other essential elements that maintain cartilage homeostasis.
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Cádmio/farmacologia , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Adulto , Western Blotting , Cádmio/metabolismo , Humanos , Imunofenotipagem , Ferro/metabolismo , Masculino , Espectrometria de Massas , Níquel/metabolismo , Osteoartrite/metabolismo , Adulto Jovem , Zinco/metabolismoRESUMO
The contribution of Hg from volcanic emanations is decisive for assessing global mercury emissions given the impact of this highly toxic contaminant on human health and ecosystems. Atmospheric Hg emissions from Popocatépetl volcano and their dispersion were evaluated carrying out two gaseous elemental mercury (GEM) surveys during a period of intense volcanic activity. Continuous GEM measurements were taken for 24 h using a portable mercury vapor analyzer (Lumex RA-915M) at the Altzomoni Atmospheric Observatory (AAO), 11 km from the crater. In addition, a long-distance survey to measure GEM was conducted during an automobile transect around the volcano, covering a distance of 129 km. The evaluation of the GEM data registered in the fixed location showed that heightened volcanic activity clearly intensifies the concentration of atmospheric Hg, extreme values around 5 ng m-3. Highest concentrations of GEM recorded during the mobile survey were about 10 ng m-3. In both surveys, the recorded concentrations during most of the measurement time were below 2 ng m-3, but measurements were taken at a considerable distance from the crater, and GEM is subject to dilution processes. During both surveys, recorded GEM did not exceed the 200 ng m-3 concentration recommended by the WHO (Air quality guidelines for Europe, 2000) as the regulatory limits for Hg in the atmospheric environment for long-term inhalation. Because this study was carried out in inhabited areas around the volcano during a period of intense volcanic activity, it can be concluded that the Popocatépetl does not represent a risk to human health in terms of Hg.
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Poluentes Atmosféricos/análise , Mercúrio/análise , Erupções Vulcânicas , Poluentes Atmosféricos/toxicidade , Poluição do Ar , Exposição Ambiental , Monitoramento Ambiental , Humanos , Mercúrio/toxicidade , México , Saúde Pública , Erupções Vulcânicas/análiseRESUMO
BACKGROUND: Regional anesthesia techniques can have adverse effects, like peripheral nerve injuries. This can affect the practitioner on the choice of techniques when offering multimodal analgesia. CASE REPORT: We present the case of an arthroscopic rotator cuff repair on a patient with no comorbidities who presented peripheral nerve injury during post-op. Initially thought to have occurred as a consequence of the anesthetic technique, further study of the patient revealed the injuries to have been produced by the arthroscopic surgery. CONCLUSION: There are multiple factors that influence the possibility of peripheral nerve injury associated with nerve blocks. They can be grouped as related to the patient, the anesthetic technique or the surgical technique, the latter being the most relevant. If a patient manifests signs of peripheral nerve injury high-resolution magnetic resonance of the neural tissue must be performed immediately. Sensory nerve conduction study and electromyography must be performed 4 weeks after by an expert neurologist.
INTRODUCCIÓN: La anestesia regional puede producir como efecto adverso lesiones de nervios periféricos, lo que puede hacer desistir al anestesiólogo de realizar técnicas que mejoran la analgesia multimodal. CASO CLÍNICO: Se presenta el caso de un paciente sin comorbilidades que se operó de reparación artroscópica del manguito rotador y presentó daño neurológico postoperatorio. Inicialmente se sospechó que el daño había sido producido durante la técnica anestésica, sin embargo, el estudio adecuado demostró que el daño se relacionaba con la técnica quirúrgica. CONCLUSIÓN: Existen factores que influyen en la posibilidad de daño neurológico asociado a bloqueos de nervios periféricos que pueden ser propios del paciente, de la técnica anestésica o quirúrgicos, siendo estos últimos los más relevantes. En un paciente con clínica compatible debe realizarse resonancia magnética del tejido neural de alta resolución de forma inmediata; estudio de conducción neural sensitiva y electromiografía a las 4 semanas de evolución por un neurólogo experto.
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Humanos , Masculino , Pessoa de Meia-Idade , Neurite do Plexo Braquial/etiologia , Traumatismos dos Nervos Periféricos/etiologia , Anestesia por Condução/efeitos adversos , Artroscopia/efeitos adversos , Neurite do Plexo Braquial/prevenção & controle , Fatores de Risco , Traumatismos dos Nervos Periféricos/prevenção & controle , Anestesia Local/efeitos adversos , Bloqueio Nervoso/efeitos adversosRESUMO
La trisomía 9 es una enfermedad rara, que ha sido descrita por primera vez en 1970, a la fecha existen más de 150 casos reportados, caracterizados por dismorfias faciales, anomalías congénitas y retraso en el desarrollo psicomotor y/o discapacidad intelectual. Este es el primer caso reportado en nuestra población en un infante de sexo masculino con peso y talla bajos, fisura labiopalatina y retraso madurativo en varias áreas del desarrollo, en quien el cariotipo mostró un mosaico cromosómico con el 70% de sus células con la trisomía del cromosoma 9. El asesoramiento genético en estos casos es de vital importancia para orientar a los padres sobre posibles causas y explicar sobre la condición genética, su manejo y establecer pautas de seguimiento para hacer prevención terciaria
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Humanos , Masculino , Pré-Escolar , Trissomia/patologia , Cariótipo , Anormalidades Congênitas , Corantes Azur , Aberrações CromossômicasRESUMO
Resumen Introducción: La hipnosis anestésica puede ser un recurso útil para procedimientos dolorosos. Desarrollo: Se reporta caso de una joven que requiere exodoncia de terceros molares, con uso de hipnosis como único anestésico. El proceso de enfermería inicia con la valoración según patrones funcionales, impresiona lo sana que se encuentra, sin antecedentes mórbidos relevantes ni contraindicación para anestesia química. Se selecciona diagnóstico NANDA de Disposición para mejorar el confort. Dentro del plan se incorporan el NIC 5920 Hipnosis y 5922 Facilitar la autohipnosis, con buena evolución según lo planificado. Resultados: La extracción con hipnosis anestésica se desarrolló de forma similar a la cirugía con anestesia química, la cual se realizó sin dolor. En posoperatorio, paciente practica autohipnosis, sin necesitar analgésicos y evolucionó favorablemente. Discusión: La hipnosis requiere mayor evidencia científica, pero su uso es prometedor. Se constataron los beneficios de la hipnosis en el abordaje del dolor. Conclusión: La hipnosis anestésica, fue útil como intervención de enfermería en cirugía dental. La autohipnosis contribuyó al buen resultado. El profesional de Enfermería entrenado en hipnosis está en condiciones de incorporarla en la gestión del cuidado. El caso resulta interesante, dado que la paciente opta por la hipnosis, sin contraindicación para anestesia química, ya que no se encontró otro reporte de hipnoanestesia inducida por profesional de Enfermería, como anestésico único. Anecdóticamente, durante la filmación del procedimiento, una periodista entra espontáneamente en trance, por lo que requiere intervención del profesional de Enfermería para salir de él.
Abstract Introduction: Anesthetic hypnosis can be a useful resource to address painful procedures. Development: The case is of a young female patient requiring third-molars exodontia who underwent it under anesthetic hypnosis. The nursing process began with the assessment according to functional patterns. The patient was found healthy and without relevant morbid antecedents nor drug-anesthesia contraindications. A comfort improving disposition NANDA diagnosis was selected. NIC 5922 and 5920 were incorporated to the intervention plan. Results: The extraction under anesthetic hypnosis was performed in a similar form in comparison to a drug-anesthesia extraction procedure. During the post operatory stage, the patient used self-hypnosis and responded favorably without analgesics. Discussion: While hypnosis requires more scientific evidence, its use appears to be promising. In this case, diverse benefits from using hypnosis to address a painful procedure were acknowledged. Conclusion: Anesthetic hypnosis proved being helpful in a dental-surgery related nursing intervention. Self-hypnosis also contributed to the favorable outcome. A nursing professional who is well trained in hypnosis can incorporate this kind of procedure into her care management approach. This particular case was interesting because the patient chose hypnosis over drug anesthesia, and no other report on a nursing staff induced anesthetic hypnosis was found. Anecdotally, during the filming of this procedure, a journalist suffered an emotional trance which required immediate nursing intervention.
Resumo Introdução: A hipnose anestésica pode ser um recurso útil para procedimentos dolorosos. Desenvolvimento: Informa-se o caso de uma garota que requer exodontia de terceiros molares, com uso de hipnoses como único anestésico. O processo de enfermagem inicia com a valoração segundo padrões funcionais, impressiona o saudável que se encontra, sem antecedentes mórbidos relevantes nem contraindicação para anestesia química. Seleciona-se diagnóstico NANDA de Disposição para melhorar o conforto. Dentro do plano se incorporam o NIC 5920 Hipnose e 5922 Facilitar a auto-hipnose, com boa evolução segundo o planejado. Resultados: A extração com hipnose anestésica desenvolveu-se de forma similar à cirurgia com anestesia química, a qual se realizou sem dor. Em pós-operatório, o paciente prática auto-hipnose, sem precisar analgésicos e evolucionou favoravelmente. Discussão: A hipnose requer maior evidencia científica, mas seu uso é promissor. Verificaram os benefícios da hipnose na abordagem da dor. Conclusão: A hipnose anestésica foi útil como intervenção de enfermagem em cirurgia dental. A auto-hipnose contribuiu para o bom resultado. O profissional de Enfermagem treinado em hipnose está em condições de incorporá-la na gestão do cuidado. O caso resulta interessante, dado que a paciente opta pela hipnose, sem contraindicação para anestesia química, já que não se encontrou outro relatório de hipnoanestesia induzida por profissional de Enfermagem, como anestésico único. Anedoticamente, durante a filmagem do procedimento, uma jornalista entrou espontaneamente em transe, pelo qual se requereu intervenção do profissional de Enfermagem para sair dele.
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Nitrogen compounds play a key role on grape and wine quality. Their composition in grapes depends mainly on variety, viticultural management, and terroir, and affects fermentation kinetics and the volatile compound formation. The aim of this work was to study grape and wine amino acid composition of ungrafted or grafted onto cv. País Carignan grapevines growing under rainfed conditions in ten sites of the Maule Valley (Chile). The results showed that proline was the most abundant amino acid in grapes and wines. In general, Carignan noir grapevines grafted over País showed lower grape amino acid content respect to ungrafted vines. Cool night index (CI) was inversely correlated to several amino acids, showing that their plant synthesis or accumulation increased with lower minimum temperatures during the last month before harvest. Truquilemu (Tru) and Ciénaga de Name (Cdn) sites showed the highest concentration for several amino acids and total amino acid content in grapes, which led to a faster alcoholic fermentation.
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Aminoácidos/análise , Raízes de Plantas/química , Chuva , Vitis/química , Vinho/análise , Aminoácidos/química , Chile , Clima , Raízes de Plantas/metabolismo , Análise de Componente PrincipalRESUMO
En el presente artículo se revisa el caso de una persona adulta hospitalizada en una unidad de paciente crítico, quien ha evolucionado con agitación durante la estadía hospitalaria y que requiere curación de úlceras por presión. A la valoración la enfermera se anticipa a la reacción negativa que podría tener el paciente ante el dolor asociado a la técnica, por lo cual utiliza la hipnosis clínica con el objetivo de favorecer la disposición del paciente a mejorar su comodidad; para lograr realizar la curación sin signos de dolor en la monitorización ni en el reporte subjetivo, se constata el mejoramiento del bienestar general del paciente relacionado con la relajación involucrada en el proceso. Se presenta el proceso de enfermería, la descripción del procedimiento y se motiva a los profesionales de enfermería a incorporar la hipnosis dentro de su repertorio de competencias para la gestión del cuidado.
In this article, we review the case of an adult person hospitalized in a critical patient unit, who has become agitated, and who requires treatment for pressure sores. During assessment, the nurse anticipates the patient's possible negative reaction associated to the pain, and thus uses the clinical hypnosis technique in order to favor the patient's better disposition. This procedure improved the patient's comfort, and the healing treatment was performed without signs of pain. As a result of the enhanced relaxation, the patient's overall wellbeing was ensured. The nursing process is presented as well as the specific procedure. Nursing professionals are encouraged to incorporate the hypnosis into their competences repertoire for the care management.
No presente artigo revisa-se o caso de uma pessoa adulta hospitalizada em uma unidade de paciente crítico, quem tem evoluído com agitação durante a estadia hospitalar e que requer cura de úlceras por pressão. À avaliação, a enfermeira antecipa-se à reação negativa que poderia ter o paciente perante a dor associada à técnica, pelo qual utiliza a hipnose clínica com o objetivo de favorecer a disposição do paciente para melhorar seu conforto, consegue-se realizar a cura sem signos de dor na monitorizarão nem no relatório subjetivo, constata-se a melhora do bem-estar geral do paciente relacionado com a relaxação envolvida no processo. Apresenta-se o processo de enfermagem, a descrição do procedimento e motiva-se aos profissionais de enfermagem a incorporar a hipnose dentro de seu repertório de competências para a gestão do cuidado.
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Humanos , Masculino , Idoso , Idoso de 80 Anos ou mais , Enfermagem , HipnoseRESUMO
OBJECTIVE: Controlling vaccine-preventable infectious diseases is a public health priority in French Guiana but there is currently no epidemiological data on pediatric bacterial meningitis in this overseas department. Our aim was to describe data related to pediatric bacterial meningitis in French Guiana and compare it with that of metropolitan France. METHODS: We conducted a multicenter retrospective study from 2000 to 2010 to describe the clinical picture, biological data, epidemiology, and outcome of pediatric bacterial meningitis case patients in French Guiana. RESULTS: The median age of bacterial meningitis patients was 6months [0-15] and the sex ratio 1.06. We observed a total of 60 bacterial meningitis case patients. Most presented with pneumococcal meningitis (24 patients; 40%); 11 with Haemophilus influenzae type b meningitis (23%), five with group B streptococcal meningitis (8.5%), and five others (8.5%) with staphylococcal meningitis (three patients presented with coagulase-negative staphylococci and two with Staphylococcus aureus). Only one patient presented with group B meningococcal meningitis, an 18-month-old infant. We recorded 14 deaths (overall case fatality: 23%); eight were due to Streptococcus pneumoniae (case fatality: 33%). The overall sequelae rate was 28%. It was 32% for patients presenting with pneumococcal meningitis. We observed that 38% of children who had never been vaccinated were infected by a vaccine-preventable bacterium. We observed many differences in the distribution of the bacteria and in the patients' prognosis when comparing the French Guiana data with that of metropolitan France. CONCLUSION: Improving vaccination coverage would decrease the incidence of H. influenzae meningitis.
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Meningites Bacterianas/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , França/epidemiologia , Guiana Francesa/epidemiologia , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
Chile se encuentra siendo testigo de una creciente problemática asociada al envejecimiento poblacional: el aumento de las necesidades de cuidado en personas mayores en situación de dependencia. A partir de esto, existen iniciativas que buscan dar respuesta a esta realidad, siendo una de ellas el Programa de Adultos Mayores Dependientes de la Fundación Cerro Navia Joven, experiencia de carácter comunitaria en la que una persona mayor voluntaria realiza semanalmente una visita domiciliaria, junto a un equipo especializado, a personas mayores que se encuentran en situación de dependencia y su cuidador/a, pertenecientes a la misma comuna. Frente a esto, esta investigación tiene como propósito el conocer cuáles son las percepciones de las personas participantes de este programa, conformada por la tríada persona mayor en situación de dependencia, su cuidador/a y la persona mayor voluntaria. Para esto, se realizó un estudio de tipo cualitativo, utilizando la entrevista como instrumento de recolección de la información. El análisis de datos se realizó empleando la técnica del análisis de contenido. Dentro de los resultados se identificaron factores como cambios asociados a la rutina, valoración del rol de voluntario/a, acompañamiento, establecimiento de vínculo, percepción de los beneficios de las visitas, motivación, percepción de los cuidados y del apoyo social, los que fueron analizados bajo la mirada de la ocupación.
We are witnessing a growing problem associated with an aging population: increased care needs in older people in situations of dependency. Given this, there are initiatives that seek to respond to this reality, one being the Dependent Elderly Program of the Cerro Navia Joven Foundation, a community experience in which an elderly volunteer does a weekly home visit, accompanied by a specialized team, to elderly people who are in a dependency situation and the caregiver, from the same neighborhood. Thus, this research aims to compile the perceptions of the participants of this program, formed by the triad dependent elderly, caregiver and elderly volunteer. For this, a qualitative study was conducted using the interview as a tool for collecting information. The data analysis was carried out using the content analysis technique. Amongst the results were identified factors such as changes associated to routine, assessment of the role of the volunteer, assistance, linkage establishment, perception of benefits of the visits, motivation, perception of care and social support, which were analyzed under the point of view of the occupation.
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Humanos , Masculino , Feminino , Idoso , Cuidadores , Idoso Fragilizado , Visita Domiciliar , Terapia Ocupacional , Chile , Entrevistas como Assunto , Estudos de Avaliação como AssuntoRESUMO
Five Andean blackberry Rubus genotypes, three resistant and two susceptible to anthracnose, were used to identify regions in the Rubus genome with homology to disease-resistance genes found in other plant species. Polymerase chain reaction amplification with 12 pairs of primers and fragment cloning yielded 520 clones, of which 151 showed inserts between 500 and 700 bp long. When sequenced, 47 clones showed homology with two types of resistance genes, non-Toll/interleukin-1 receptor (TIR) nucleotide binding site (NBS) leucine-rich repeat (LRR) and TIR-NBS-LRR, thereby confirming their designation as resistance gene analogs (RGAs). The number of RGAs detected per Rubus genotype ranged from 7 to 11, with the highest in a wild resistant and a cultivated susceptible genotype. Rubus RGAs were also homologous with several non-TIR- and TIR-type RGAs found in other members of the Rosaceae family (Rosa hybrid cultivar, Rosa roxburghii, Malus × domestica, M. prunifolia, M. baccata, M. floribunda, Pyrus communis, Prunus persica, P. kansuensis, P. avium, and Fragaria vesca). Three RGAs shared identity with two Rosaceae RGAs associated with the CRPM1 locus for powdery mildew resistance in R. roxburghii and the Rosa hybrid cultivar. This is the first report on RGAs present in the Andean blackberry in Colombia.
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BACKGROUND AND PURPOSE: Anastomotic recurrence after radical sphincter-preserving surgery preceded by neoadjuvant therapy in locally advanced rectal cancer is an uncommon event that merits further assessment. The aim of this study is to analyze the effect of preoperative chemoradiation on the risk of anastomotic recurrence. Based on the initial extension of the tumor, we analyzed whether the distal surgical section was calculated through the virtual initial extension of the rectal tumor. PATIENTS AND METHODS: Eligible patients with locally advanced rectal cancer were offered preoperative chemoradiation, sphincter sparing surgery and intraoperative radiation therapy boost. RESULTS: 180 patients were treated with anterior resection (40 %), low anterior resection (45.6 %) and ultra-low anterior resection (14.4 %). With a median follow-up of 41.1 months (0.36-143 months), anastomotic recurrence was diagnosed in 9 patients (5 %). There was no statistical correlation with downstaging (T or N), downsizing effects, or with distance from the lower limit of the residual lesion to the distal margin. Virtual intratumoral surgical section was speculated in 44 patients (3 developed anastomotic recurrence; 6.8 vs 4.8 %, p = 0.482). CONCLUSION: Anastomotic recurrence in patients with rectal cancer treated with neoadjuvant chemoradiation is an infrequent event. Virtual intratumoral surgical sections followed by anastomosis do not contribute to an excessive risk of recurrence. Our findings encourage the development of policies for preservation of the ano-rectal complex in rectal cancer patients.
Assuntos
Adenocarcinoma/terapia , Anastomose Cirúrgica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Retais/terapia , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia/etiologia , Estadiamento de Neoplasias , Tratamentos com Preservação do Órgão , Cuidados Pré-Operatórios , Prognóstico , Neoplasias Retais/patologia , Fatores de RiscoRESUMO
Cassava (Manihot esculenta Crantz) is a major staple crop in developing countries and a large source of raw material for industrial purposes as flour, starch, and ethanol. In July 2012, 24 cassava genotypes (corresponding to 1.85% of the accessions) with typical symptoms of frogskin disease (CFSD) were observed in one of the maintenance areas of the Brazilian Cassava Germplasm (located at Embrapa Cassava & Fruits, Cruz das Almas, Bahia State, Brazil). All diseased plants were asymptomatic on the aboveground parts (leaves and stem). However, for accessions BGM 880, BGM 1094, BGM 1100, BGM 1212, BGM 1218, and BGM 1526, all roots showed a woody appearance, thickened cork-like peel with opaque aspect, and coalescent lip-like slits in a honeycomb pattern. Based on literature description, two pathogens could be associated with CFSD: a dsRNA virus (belonging to family Reoviridae) and a 16SrIII-L phytoplasma (1). To investigate the presence of phytoplasma associated with the CFSD symptoms, total DNA was extracted from 0.5 g of root tissue collected from both symptomatic and asymptomatic roots by scratching the secondary vessel at the center of the cassava root with a CTAB method. The nested PCR was carried out using phytoplasma-specific primer set P1/Tint followed by R16F2n/R16R2, targeting the 16S rRNA gene sequence of 1.2 kb in length, for the final reaction (4). No phytoplasma was detected in asymptomatic cassava roots that were sampled from the same field. A posterior extraction of total RNA was made but no dsRNA was noticed on the agarose gel, and reaction of RT-PCR with specific primers (2) had no amplification. In order to characterize the strains, the 1.2-kb amplicon was digested with BamHI, MseI, MspI, KpnI, and TaqI endonucleases. The resulting patterns indicated that the symptomatic accessions were infected with a phytoplasma belonging to the 16SrIII group, sharing similarities with pseudo gel mapping from the reference strain of Peach X-Disease Phytoplasma (GenBank Accession No. L33733). Nested PCR products from accessions BGM 1526 and BGM 1212 were purified and sequenced by Macrogen, (Seoul, South Korea) in both directions, manually edited, and the consensus sequences were deposited in the NCBI database (GenBank Accession Nos. KF019184 and KF019185). Phylogenetic studies were conducted based on maximum parsimony, neighbor-joining, and maximum likelihood analysis for 16S rRNA. The phytoplasma 16S rRNA gene sequences from both strains had 99% identity (P < 0.0001) with the 16SrIII-L CFSD phytoplasma (EU346761 and AY737647), described by Alvarez et al. (1) infecting cassava in Colombia. To our knowledge, this is the first report of a phytoplasma associated with Cassava Frogskin Disease in Brazil, where only the dsRNA virus was recognized as causing this symptom (3). This is not likely to be an isolated case, and possibly more cassava plants are infected with this phytoplasma in Brazil. Due to the difficulties to observe the symptoms at the field level, this could be an emerging disease in that country. References: (1) E. Alvarez et al. Plant. Dis. 93:1139, 2009. (2) L. A. Calvert et al. J. Phytopathol. 156:647, 2008. (3) L. S. Poltroniere et al. Comun. Tec., Belem-PA. 006:2p, 1999. (4) C. D. Smart et al. Appl. Environ. Microb. 62:2988, 1996.
RESUMO
Una de las maloclusiones más complejas de diagnosticar y de tratar es la maloclusión clase III. Se caracteriza por una alteración en la relación sagital de los maxilares, ya sea por una deficiencia o retrusión maxilar o por un prognatismo o macrognatismo mandibular, o bien sea una combinación de las anteriores. La etiología es multifactorial y es debida a una interacción de factores hereditarios y ambientales. Se presenta una paciente de 4 años de edad, sexo femenino, con patrón hereditario de clase III en su familia materna. Relación esquelética clase III con mandíbula aumentada en longitud, protruida, rotando posterior y maxilar superior retruído. Tipo de crecimiento vertical, con un perfil recto y mordida cruzada anterior y posterior unilateral izquierda. Se instauró tratamiento con aparatología ortopédica durante el periodo de dentición decidua hasta la dentición permanente, para lograr así, equilibrar el crecimiento maxilomandibular. Uno de los aspectos clínicos más complicados del manejo ortopédico de la maloclusión clase III es la recidiva después del período de tratamiento activo; sin embargo en nuestra paciente se consiguen cambios a nivel esquelético, dental y estéticos que se mantuvieron durante el tratamiento.
One of the most difficult malocclusions to diagnose and treat is Class III malocclusion. It is characterized by an alteration in the sagittal relationship of the jaws, either by a deficiency or maxillary retrusion or mandibular prognathism, or whether a combination of the above. The etiology is multifactorial and is due to an interaction of hereditary and environmental factors. A 4-year-old female with hereditary pattern of class III malocclusion in his mother's family is presented. Skeletal Class III, increased jaw length, protruded, rotating posterior and maxilla retruded. Vertical growth type, straight profile, anterior crossbite and posterior left-sided. Orthopedic appliance therapy was instituted during the deciduous dentition to the permanent dentition, to achieve , balancing the maxillomandibular growth. One of the most complex aspects of orthopedic clinical management of Class III malocclusion is the possibility of relapse after active treatment period, however, in our patient changes in skeletal, dental and aesthetic aspects achieved during treatment have been stable.
Uma das más oclusoes mais complexas de diagnosticar e tratar é a má oclusao de Classe III. Caracteriza-se por uma alteração na relação sagital dos maxilares, seja por deficiéncia ou retrusao maxilar ou por prognatismo ou macrognatismo mandibular, ou ainda por uma combinação desses eventos. A etiologia é multifatorial e envolve uma interação de fatores hereditários e ambientais. Este artigo apresenta o caso de uma paciente de 4 anos de idade, do sexo feminino, com padrão hereditário de classe III em sua família materna. Apresentava relação esquelética de classe III, protuída, com rotação posterior e maxila superior retruída. Crescimento vertical, com um perfil reto e mordida cruzada anterior e posterior unilateral esquerda. Foi instituído tratamento com aparatologia ortopédica na dentição decídua o qual permaneceu até a dentição permanente, com objetivo de equilibrar o crescimento maxilomandibular. Um dos aspectos clínicos mais complicados do manejo ortopédico da má oclusao de Classe III é a recidiva depois do período de tratamento ativo, entretanto, nesse paciente foram conseguidas modificações a nível esquelético, dentais e estéticos durante o tratamento que se mantiveram estáveis.
Assuntos
Humanos , Má Oclusão Classe III de Angle , Terapêutica , Efetividade , Aparelhos AtivadoresRESUMO
INTRODUCTION: To report feasibility, tolerance, anatomical sites of upper abdominal locoregional recurrence and long-term outcome of gastric cancer patients treated with surgery and a component of intraoperative electron beam radiotherapy (IORT). MATERIALS AND METHODS: From January 1995 to December 2010, 32 patients with primary gastric adenocarcinoma treated with curative resection (R0) [total gastrectomy (n = 9; 28 %), subtotal (n = 23; 72 %) and D2 lymphadenectomy in all patients] and apparent disease confined to locoregional area [Stage: II (n = 15; 47 %), III (n = 17; 53 %)] were treated with a component of IORT (IORT applicator size 5-9 cm in diameter, dose 10-15 Gy, beam energy 6-5 MeV) over the celiac axis and peripancreatic nodal areas. Sixteen (50 %) patients also received adjuvant treatment (external beam radiotherapy n = 6, chemoradiation n = 9, chemotherapy alone n = 1). RESULTS: With a median follow-up time of 40 months (range, 2-60), locoregional recurrence was observed in five (16 %) patients (4 nodal in hepatic hilum and 1 anastomotic). Only pN1 patients developed locoregional relapse. No recurrence was observed in the IORT-treated target volume (celiac trunk and peripancreatic nodes). Overall survival at 5 years was 54.6 % (95 % CI: 48.57-60.58). Postoperative mortality was 6 % (n = 2) and postoperative complications 19 % (n = 6). CONCLUSIONS: It is feasible to integrate IORT as a component of radiotherapy in combined modality therapy of gastric cancer. Local control is high in the radiation boosted area, but marginal regional extension (in particular, involving the hepatic hilum) might be considered as part of the anatomic IORT target volume at risk in pN+ patients.
Assuntos
Adenocarcinoma/radioterapia , Cuidados Intraoperatórios , Recidiva Local de Neoplasia/radioterapia , Neoplasias Gástricas/radioterapia , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Terapia Combinada , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Dosagem Radioterapêutica , Radioterapia Adjuvante , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia , Taxa de SobrevidaRESUMO
La expectativa de vida ha ido aumentando en Chile y en el mundo, lo que ha causado un gran impacto a nivel del número de cirugías que se realiza en la población añosa. El objetivo de este trabajo es describir la experiencia de nuestro centro en cirugías urológicas en pacientes mayores de 80 años y analizar que factores aumentan el riesgo de complicaciones postquirúrgicas.Materiales y método: Análisis retrospectivo de 138 cirugías urológicas realizadas en 120 pacientes mayores de 80 años, durante los años 2000 a 2012. Se obtuvo información sociodemográfica, riesgo quirúrgico (ASA), tipo y duración de cirugía realizada, complicaciones post-operatorias (escala de Clavien) y tiempo de hospitalización. Los datos obtenidos fueron analizados mediante el programa SPSS v17. Se realizó análisis multivariado y se estableció el riesgo relativo para el desarrollo de complicaciones. Se consideró signi ficativo p<0,05. Resultado: La edad promedio de los pacientes fue de 84+/-3.7 años, 86.2 por ciento fueron hombres. El 96.7 por ciento presentaba algún tipo de comorbilidad, con predominio de hipertensión arterial (60,84 por ciento) y diabetes mellitus tipo 2 (24,16 por ciento). La mayoría de las intervenciones fue de complejidad intermedia (77.27 por ciento), donde la anestesia regional (56,8 por ciento) y la vía endo urológica (84,78 por ciento) fueron las más utilizadas, con un tiempo operatorio promedio de 62+/-52.4 minutos. El riesgo quirúrgico prevalente fue ASA2 (62.7 por ciento). El promedio de hospitalización fue de 2,8+/-2.7 días. El 15.21 por ciento de los pacientes presentó algún tipo de complicación, con predominio de clasifi cación tipo 1 de Clavien (38 por ciento). En el análisis multivariado se evidenció como factores de riesgo signi ficativos para complicaciones, edad mayor a 90 años (p=0.03), presencia de insu ciencia renal (p=0.01), portar 4 o más comorbilidades (p=0.04), cirugía mayor a 3 horas (p=0.03) y tener riesgo quirúrgico ASA3 (p=0.04)...
Life expectancy has been increasing in Chile and in the World. This has caused a great impact over the number of surgeries being performed in the elderly population. The aim of this paper is to describe the experience of our center in urological surgery in patients older than 80 years and analyze which factors increase the risk of postoperative complications.Materials and methods: Retrospective analysis of 138 urological surgeries performed in 120 patients older than 80 years, during the years 2000-2012. Sociodemographic information, surgical risk (ASA), type and duration of surgery, postoperative complications (Clavien scale) and length of hospitalization was obtained. The data were analyzed using SPSS v17. Multivariate analysis was performed and the relative risk for developing complications was established. Signi cance was p <0.05. Average age of the patients was 84 +/- 3.7 years, 86.2percentwere men. The 96.7 percenct had some kind of comorbidity, with prevalence of hypertension (60.84 percent) and diabetes mellitus type 2 (24.16 percent). Most of the interventions was of intermediate complexity (77.27percent), where regional anesthesia (56.8 percent) and endourological aproach (84.78 percent) were the most used, with average operative time of 62 +/- 52.4 minutes. Most common Surgical risk was ASA2 (62.7 percent). Average hospital stay was 2.8 +/- 2.7 days. 15.21 percent of patients had some type of complication, with a predominance of type 1 Clavien classication (38 percent). The multivariate analysis showed signi cant risk factors for complications: age greater than 90 years (p = 0.03), renal failure (p = 0.01), carrying 4 or more comorbidities (p = 0.04), surgery Langer than 3 hours (p = 0.03) and ASA3 surgical risk (p =.04). No mortality was reported in our series. In this study, although most of our patients underwent endourological procedures, we evidence that surgery in patients older than 80 years is feasible...