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INTRODUCTION AND OBJECTIVES: The most widely used staging system for hepatocellular carcinoma (HCC) is the Barcelona Liver Clinic Cancer (BCLC) system, which considers tumor burden, performance status, and liver function. Tumor burden is assessed with cross sectional imaging of the abdomen and chest, controversy surrounds the routine use of bone scintigraphy (BS) for detecting extrahepatic metastases. This study evaluated the role of BS in staging HCC in Mexican patients. PATIENTS AND METHODS: Retrospective cross-sectional study of all adults with HCC at a Mexican referral center from 2000 to 2018. Staging included abdominal computed tomography (CT) or magnetic resonance imaging, chest CT, and BS. The main outcome was the impact of BS on staging and/or therapy plans. RESULTS: Among 238 patients, 2 with fibrolamellar variant and 44 with incomplete data were excluded. Median age was 66 years, 84 % had cirrhosis, and the predominant etiology was hepatitis C virus (43 %). BCLC stages were distributed as follows: A (14 %), B (7 %), C (68 %), and D (11 %). Extrahepatic disease was present in 18 %; only 8 % patients had a positive BS. Among the positive cases, 4 were true positives, but they did not alter staging or therapy plans. CONCLUSIONS: Routine BS in HCC staging demonstrated low yield, with a notable rate of false positives. Considering the implications of extrahepatic disease, BS may be justified for liver transplant candidates outside conventional criteria. Our study highlights the limited role of BS in early-stage HCC and advocates for a more selective utilization.

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Various complications occur after a biliary-digestive reconstruction. Volvulus of a segment of the biliodigestive loop has not been described. Two patients who underwent biliodigestive bypass, years later, began with sudden and intense abdominal pain, associated with a volvulus with necrosis of a segment of this biliodigestive loop. This complication occurred many years after the initial correction, and manifested with sudden abdominal pain without impaired liver function, as occurred in these patients.

Diversas complicaciones pueden ocurrir después de una reconstrucción biliodigestiva. El vólvulo de un segmento del asa biliodigestiva no ha sido descrito. Dos pacientes operados de derivación biliodigestiva, años después iniciaron con dolor abdominal súbito e intenso, asociado a un vólvulo con necrosis de un segmento de la asa interpuesta. Se ha descrito el vólvulo de toda el asa interpuesta, pero no el de solo una pequeña porción de esta. La complicación ocurrió muchos años después de la corrección inicial y se manifiesto con dolor abdominal súbito sin deterioro de la función hepática, como sucedió en estos pacientes.

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This study aims to evaluate the sensitization distribution of aeroallergens in patients with allergic conjunctivitis (AC) living in a temperate subhumid region and to describe the prevalence in a Mexican cohort. A total of 761 patient records were revisited, including the results of the skin prick test (SPT) for 45 aeroallergens. We found 292 patients with AC and a positive SPT in a 5-year period. The most frequent aeroallergens include dust mites (69.2% for Dermatophagoides pteronyssinus and 47.6% for Dermatophagoides farinae), trees (36% for cypress and 22.6% for ash), animals (33.9% for dogs and 26.7% for cats), and grasses (21.2% for Paspalum notalum and 19.9% for Poa pratensis). Among the studied population, a prevalence of 38.4% for the disease was calculated. House dust mites were responsible for most sensitizations found in the studied population. There is a high prevalence of AC in the selected cohort during the period studied.

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The purpose of this study was to generate novel chitosan hydrogels (CHs) loaded with silver nanoparticles (AgNPs) and ampicillin (AMP) to prevent early formation of biofilms. AgNPs and CHs were characterized by UV-Vis, DLS, TEM, rheology, FT-IR, Raman, and SEM. The antibiofilm effect of the formulations was investigated against four multidrug-resistant and extensively drug-resistant pathogens using a colony biofilm, a high cell density and gradients model. Also, their hemostatic properties and cytotoxic effect were evaluated. Rheology results showed that CHs with AgNPs and AMP are typical non-Newtonian pseudoplastic fluids. The CH with 25 ppm of AgNPs and 50 ppm AMP inhibited the formation of biofilms of Acinetobacter baumannii, Enterococcus faecium and Staphylococcus epidermidis, while a ten-fold increase of the antimicrobial's concentration was needed to inhibit the biofilm of the ß-lactamase positive Enterobacter cloacae. Further, CH with 250 ppm of AgNPs and 500 ppm AMP showed anticoagulant effect, and it was shown that all formulations were biocompatible. Besides to previous reports that described the bioadhesion properties of chitosan, these results suggest that AgNPs and AMP CHs loaded could be used as prophylactic treatment in patients with central venous catheter (CVC), inhibiting the formation of biofilms in their early stages, in addition to their anticoagulant effect and biocompatibility, those properties could keep the functionality of CVC helping to prevent complications such as sepsis and thrombosis.

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In this work, we present a commercial CMOS (Complementary Metal Oxide Semiconductor) Raspberry Pi camera implemented as a Near-Infrared detector for both spatial and temporal characterization of femtosecond pulses delivered from a femtosecond Erbium Doped Fiber laser (fs-EDFL) @ 1.55 µm, based on the Two Photon Absorption (TPA) process. The capacity of the device was assessed by measuring the spatial beam profile of the fs-EDFL and comparing the experimental results with the theoretical Fresnel diffraction pattern. We also demonstrate the potential of the CMOS Raspberry Pi camera as a wavefront sensor through its a nonlinear response in a Shack-Hartmann array and for the temporal characterization of the femtosecond pulses delivered from the fs-EDFL through TPA Intensity autocorrelation measurements. The direct pulse detection and measurement, through the nonlinear response with a CMOS, is proposed as a novel and affordable high-resolution and high-sensitivity alternative to costly detectors such as CCDs, wavefront sensors and beam profilers @ 1.55 µm. The measured fluence threshold, down to 17.5 µJ/cm2, and pJ/pulse energy response represents the lowest reported values applied as a beam profiler and a TPA Shack-Hartmann wavefront sensor, to our knowledge.

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The objective of this study was to evaluate the effect of transportation time, type of truck (one, two or three decks), farm of origin, time of year, transporter and producer, on the mortality of fattening pigs and the pre-slaughter stage in which the deaths occur. A retrospective study was made in a Colombian slaughterhouse during 2012, 2013 and 2014, to collect information on 76286 pigs that belonged to 1554 lots of 76 producers. The mortality/year was 0.176%, 0.173% and 0.20% respectively. The highest mortality rates were observed in trucks with one deck, particularly when the transport time was ≤1 hour. A total of 55.4% of the deaths occurred in the trucks, 41% in the slaughterhouse pens, and 4.4% during unloading. The mean mortality was higher for producers marketing smaller lots. The results indicate that transportation times ≤1 hour, truck design, and the type of producers increased the mortality during transportation of fattening pigs.

El objetivo de este estudio fue evaluar el efecto del tiempo de transporte, el tipo de camión (un piso, dos pisos, tres pisos), la granja de origen, la época del año, el transportador y el productor, sobre la mortalidad de cerdos de ceba y la etapa del presacrificio en la cual sucede la muerte. Se hizo un estudio retrospectivo en una planta de beneficio colombiana durante los años 2012, 2013 y 2014, para recolectar la información de 76.286 cerdos, que correspondían a 1554 lotes de 76 productores. La mortalidad/año fue 0,176% 0,173% y 0,20%, con respecto a cada año. La mayor tasa de muertes se observó en los camiones de carrocería de un piso, en particular, cuando el tiempo de transporte fue ≤1h. El 55,4% de las muertes ocurrieron en el camión, el 41% en los corrales de la planta de beneficio, y el 4,4% durante el descargue. La mortalidad promedio fue mayor en los productores que comercializan lotes de menor tamaño. Los resultados indican que los tiempos de transporte <1h, el diseño del camión y el tipo de productor incrementan la mortalidad en el transporte de cerdos de ceba.

Neste estudo objetivou-se avaliar o efeito do tempo de transporte, tipo de caminhão (um, dois e três andares), fazenda de origem, época do ano, transportador e produtor, na mortalidade de suínos de engorda e estágio de préabate, em que ocorre a morte. Um estudo retrospectivo foi feita num abatedouro na Colômbia entre os anos 2012 a 2014, coletando informações de 76.286 suínos correspondentes a 1554 lotes de 76 produtores. A mortalidade/ano foi de 0,176%, 0,173% e 0,20% para cada ano. A maior taça de mortalidade foi observada nos caminhões de um andar, particularmente, quando o tempo de transporte foi <1h. O 55,4% das mortes ocorreram no caminhão, o 41% nos corrais do abatedouro e, o 4,4% durante o desembarque. A mortalidade promedia foi maior em produções com lotes de menor tamanho. Os resultados indicam que os tempos de transporte <1h, o tipo de caminhão e tipo de produtor incrementam a mortalidade de suínos de engorda.

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The optimal noise amplitude for Stochastic Resonance (SR) is located employing an Artificial Neural Network (ANN) reference model with a nonlinear predictive capability. A modified Kalman Filter (KF) was coupled to this reference model in order to compensate for semi-quantitative forecast errors. Three manifestations of stochastic resonance, namely, Periodic Stochastic Resonance (PSR), Aperiodic Stochastic Resonance (ASR), and finally Coherence Resonance (CR) were considered. Using noise amplitude as the control parameter, for the case of PSR and ASR, the cross-correlation curve between the sub-threshold input signal and the system response is tracked. However, using the same parameter the Normalized Variance curve is tracked for the case of CR. The goal of the present work is to track these curves and converge to their respective extremal points. The ANN reference model strategy captures and subsequently predicts the nonlinear features of the model system while the KF compensates for the perturbations inherent to the superimposed noise. This technique, implemented in the FitzHugh-Nagumo model, enabled us to track the resonance curves and eventually locate their optimal (extremal) values. This would yield the optimal value of noise for the three manifestations of the SR phenomena.

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The purpose of this article is to discuss how a community agency based in Washtenaw County, the Washtenaw Interfaith Coalition for Immigration Rights (WICIR), emerged in response to increasing punitive immigration practices and human rights abuses toward the Latino community. The article discusses how WICIR is engaged in advocacy, community education on immigration issues, and political action toward a more humane immigration reform. Detailed examples of human rights abuses and the WICIR activities described in response to the abuses serve as illustrations of social work advocacy, education, and policy formulation that affect the general public, policymakers, and law enforcement officials.

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A strategy to optimize biotechnological process design is illustrated for the production of fructose-rich syrups via enzymatic hydrolysis of agave fructo-oligosaccharides. The optimization process includes ecological studies from natural fermentations leading to the selection of a strain with capacity for inulinase synthesis, and variable optimization for the synthesis, and enzymatic hydrolysis using the response surface methodology. The results lead to the selection of Kluyveromyces marxianus , endogenous strains isolated from aguamiel (natural fermented sugary sap from agave plants), as the main strain with high capacity for enzyme synthesis with inulinase activity. Production optimization at bioreactor level revealed that operation at 30.6 degrees C, 152 rpm, 1.3 VVM of aeration, and pH 6.3 leads to maximum inulinase synthesis, whereas 31 degrees C, 50 rpm, and pH 6.2 leads to maximum hydrolysis of agave fructo-oligosaccharides. HPLC analysis of the fructose-rich syrups obtained at these optimal conditions showed an average composition of 95% of fructose and 5% of glucose and the absence of sucrose. The analysis also revealed that the syrups are free of residues and toxic compounds, an undesirable occurrence often present when traditional methods based on thermal or acid hydrolysis are applied for their obtainment. Therefore, the product may be suitable for use as additive in many applications in the food and beverage industries.

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Enzymatic treatments using noncommercial enzymes as a means to the improve the extraction of carotenoids and capsaicinoids from chili fruits are explored in this study. The results show that it is possible to obtain chili fruit powder with a higher concentration of both capsaicinoids and carotenoids than previously reported for similar processes. Furthermore, extraction yields above 96% for carotenoids and 85% for capsaicinoids as separate fractions can be achieved using a sequential and selective two-stage extraction. Evidence is presented demonstrating that the content and extraction yield depend directly on the extent of the enzymatic hydrolysis of chili cell walls, and higher yields are obtained when the sample is completely hydrolyzed. The enzymatic treatment described here is a promising alternative to current industrial practices, and it improves the extraction of carotenoids and capsaicinoids from chili fruits.

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We present the first theoretical comparison between ketene dimerization in gas phase and ketene dimerization in solution. Density functional theory (DFT) calculations on the ketene dimerization were carried out considering the following product dimers: diketene (d-I), 1,3-cyclobutanedione (d-II), 2,4-dimethylene-1,3-dioxetane (d-III), and 2-methyleneoxetan-3-one (d-IV). All structures were optimized at the PW86x+PBEc/DZP level of theory. Based on these geometries, a total of 58 meta and hybrid functionals were used to evaluate the heat of dimerization. The MPW1K functional was found to fit the experimental data best and subsequently used in the final analyses for all energy calculations. It was found on both kinetic and thermodynamic grounds that only d-I and d-II are formed during ketene dimerization in gas phase and solution. In gas phase, d-I is favored over d-II by 2 kcal/mol. However, the dimerization barrier for d-I is 1 kcal/mol higher than for d-II. Solvation makes dimerization more favorable. On the enthalpic surface this is due to a favorable interaction between the dimer dipole moment and solvent molecules. The dimer is stabilized further on the Gibbs energy surface by an increase of the dimerization entropy in solution compared to gas phase. The species d-I remains the most stable dimer in solution by 1 kcal/mol. Kinetically, the dimerization barriers for the relevant species d-I and d-II are cut in half by solvation, due to both favorable dimer-dipole/solvent interactions (DeltaH++, DeltaG++) and an increase in the activation entropies (DeltaS++). While the dimerization barrier for d-II is lowest for the gas phase and toluene, the barrier for d-I formation becomes lowest for the more polar solvent acetone by 1 kcal/mol as d-I dimerization has the most polar transition state.

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En la primera etapa de la investigación se realizó un estudio bibliográfico sobre los efectos, causas y consecuencias que provoca el consumo de drogas de tipo legal, fundamentalmente alcohol y tabaco, la relación de éstas con enfermedades de transmisión sexual como el SIDA, para ello se seleccionó una muestra representativa de 50 alumnos de la Filial Simón Bolívar y vecinos del consultorio 47, Comunidad Hermanos Cruz, este tema se insertó al proyecto priorizado de Atención a la Familia y Prevención de Salud, por ser la familia la más afectada por este flagelo de adicción y consumo de drogas, siendo la droga portera el alcohol, cuyos efectos provocan considerables daños a la salud desde el punto de vista biológico, psicológico y social. El proyecto pretende buscar alternativas de solución para la prevención, detección precoz y su educación mediante la aplicación de una estrategia integrada por un equipo multidisciplinario, pues el problema trasciende las barreras de la Atención Primaria de Salud para convertirse en un problema holístico, interdisciplinario donde esté involucrada toda la sociedad.

In the first stage of the research a bibliographic study about the effects, causes and consequences that drugs of legal use provoke (mainly alcohol and tobacco) related with sexually transmitted diseases such as AIDS was conducted. To carry out this research a representative sample of 50 students belonging to Simón Bolívar Medical Branch and neighbours from No. 47 Doctor?s Office in Hermanos Cruz Community was taken. This topic is inserted into prioritized projects of Family Care and Health Prevention because the family is the most affected by drug addiction and drug use being alcohol "known as a Porter Drug" one of the most harmful. Alcohol provokes significant harms to health from biological psychological and social points of view. The project is aimed at finding out alternatives of solution for the prevention, early detection and education by means of the application of a comprehensive strategy. A multidisciplinary team is taking the responsibility the study of this problem because it goes beyond Primary Health Care to become into a holistic, interdisciplinary and an intersectorial problem where all social factors are involved. Though this research is expected to be used on Primary Health Care as one of the most important link inside social community system to face this problematic situation of international repercussion.

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In this work is studied the effect of a noncommercial enzyme preparation on xanthophyll extraction from marigold flower (Tagetes erecta). The enzymatic extract was synthesized by endogenous microorganisms previously isolated and identified as Flavobacterium IIb, Acinetobacter anitratus, and Rhizopus nigricans. The results show that the extraction yield depends directly on the extent of the enzymatic hydrolysis of cell walls in the flower petals and that it is possible to reach yields in excess of those previously reported for treatments with commercially available enzymes (29.3 g/kg of dry weight). HPLC analysis of the product indicates that the original xanthophyll profile is not altered. The enhanced extraction system appears to be very competitive when compared to the traditional process and current alternatives.

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Se presentan dos casos de niños referidos a consulta de neurocirugía por macrocranea y dilatación de los espacios subaracnoideos en la convexidad y cisternas basales. Ambos evolucionan con resolución espontánea de esta anomalía, demostrada y seguida con tomografía computarizada (TC) y resonancia magnética (RM). Sin alteraciones significativas en su desarrollo psicosomático

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Se presenta el caso de dos pacientes con meningioma del surco olfatorio. Uno de ellos sólido y el otro quístico. Ambos pacientes del sexo masculino. Acuden a consulta por crisis convulsivas; previo al evento convulsivo, los síntomas o signos de la neoplasia pasaron desapercibidos para el paciente o sus familiares o bien no se les dio interés. Destacando la importancia de la tomografía computarizada (CT) y la resonancia magnética (MR) en el diagnóstico y en la definición de la estrategia quirúrgica

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Se presentan dos casos de glioma de las vías ópticas. El primero, en una niña de tres años diez meses, localizado en la porción intraorbitaria del nervio óptico izquierdo, fue diagnosticado y operado en 1977. Se hizo una resección subtotal y se aplicó radioterapia posoperatoria. Fue reoperado en 1982 con resección subtotal y se aplicó radiación con acelerador lineal. Actualmente, la paciente tiene 18 años y aparentemente esta curada, con amaurosis izquierda. El segundo caso se presenta en una niña de tres años, de localización optoquiasmática e hipotalámica late-realizado a la derecha con resección subtotal, presentando amaurosis derecha y diabetes insípida. Siendo tratada con quimioterapia posquirúrica

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El beneficio de la terapia con trombolisis en el infarto agudo del miocardio ha sido ampliamente documentado en muchos estudios multicéntricos. Aquí se demuestra que la terapia con estreptoquinasa intravenosa en dosis más pequeñas obtiene beneficios similares con complicaciones menores y que este tratamiento se puede practicar en unidades de cuidado intensivo de hospitales de la comunidad, sin equipos de hemodinamia sofisticados. En la unidad de cuidado intensivo del Hospital Bocagrande en Cartagena se estudiaron 19 pacientes con infarto agudo del miocardio, de menos 6 horas de evolución desde el comienzo del dolor. recibieron estreptoquinasa en dosis de 750.000 unidaes en infusión intravenosa siguiendo un protocolo previamente establecido. La evaluación de la respuesta al tratamiento se hizo tomando en consideración parámetros de carácter no invasivo. La tasa de mortalidad en estos pacientes fue de 5 por ciento. La tasa de reperfusión fue de 68.4 por ciento y hubo una alta tasa de angina post-infarto, la cual respondió satisfactoriamente a tratamiento farmacológico

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La observación de litiasis vaginal es sumamente rara y en el presente informe se analiza un método diagnóstico sencillo, económico y pocas veces utilizado, como lo es la vaginografía. El diagnóstico fue corrobarado por cirugía

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