RESUMO
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
Assuntos
Melanoma , Doenças da Unha , Neoplasias Cutâneas , Humanos , Idoso , Melanoma/patologia , Estudos de Coortes , Neoplasias Cutâneas/patologia , Doenças da Unha/diagnóstico , PrognósticoRESUMO
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
Assuntos
Melanoma , Doenças da Unha , Neoplasias Cutâneas , Humanos , Idoso , Melanoma/patologia , Estudos de Coortes , Neoplasias Cutâneas/patologia , Doenças da Unha/diagnóstico , PrognósticoRESUMO
Tetraspanins are a family of transmembrane proteins that form membrane microdomains. They play important roles in migration, adhesion and other cellular processes. TspanC8, a subfamily of tetraspanins, was found to associate and promote ADAM10 trafficking and cell surface localization. One of its members, Tspan33, is expressed in activated B cells. Using RT-PCR and flow cytometry, we analysed the pattern of expression of Tspan33 in B cells from healthy donors. We found Tspan33 expression in early and late stages of B cell development. However, Tspan33 expression did not correlate with ADAM10 surface expression. We also found expression of Tspan33 early in the activation process. Given its predominant expression in activated B cells and in several lymphomas, but not in naive B cells, we hypothesize that Tspan33 could be a potential target for therapeutic purposes.
Assuntos
Proteína ADAM10/imunologia , Linfócitos B/imunologia , Memória Imunológica/imunologia , Tetraspaninas/imunologia , Proteína ADAM10/genética , Antígenos CD/imunologia , Antígenos CD/metabolismo , Antígenos CD19/imunologia , Antígenos CD19/metabolismo , Antígenos de Diferenciação de Linfócitos T/imunologia , Antígenos de Diferenciação de Linfócitos T/metabolismo , Linfócitos B/metabolismo , Linhagem Celular Tumoral , Células Cultivadas , Citometria de Fluxo , Expressão Gênica/imunologia , Humanos , Lectinas Tipo C/imunologia , Lectinas Tipo C/metabolismo , Ativação Linfocitária/genética , Ativação Linfocitária/imunologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tetraspaninas/genética , Fatores de TempoRESUMO
Resumen ANTECEDENTES: puesto que la retención urinaria posparto no es un suceso que se considere grave, la información de su tratamiento en las unidades obstétricas es muy limitada, sobre todo en América Latina. MÉTODO: búsqueda de información publicada, en español e inglés, entre los años 2000 y 2016 relacionada con las medidas preventivas y tratamientos de la retención urinaria posparto en dos bases de datos de bibliografía biomédica: Pubmed y Scopus. RESULTADOS: se encontraron 31 artículos científicos en inglés relacionados con el tratamiento de la retención urinaria posparto y pocos estudios en modelos animales de retención urinaria aguda, ninguno en español. El diagnóstico de la retención urinaria posparto se establece con el auxilio de métodos invasivos y no invasivos: catéteres y ultrasonido. El tratamiento incluye acciones preventivas (reducción de problemas del parto mediante adiestramiento adecuado del personal de las unidades obstétricas o la aplicación de masaje en la región sacra) y posteriores al parto (uso de catéteres uretrales o suprapúbicos). CONCLUSIONES: la retención urinaria posparto es una complicación clínica que requiere entender que el diagnóstico y tratamiento tempranos contribuyen sustancialmente a disminuir la alta prevalencia de disfunciones vesicales femeninas. En esta revisión se evidenció la necesidad de estudios preclínicos que permitan conocer la repercusión a largo plazo de la retención urinaria y probar nuevos tratamientos.
Abstract BACKGROUND: since postpartum urinary retention is not a condition that is considered severe, information of its treatment in obstetrical units is very limited, especially in Latin America. METHOD: search of published information in Spanish and English, between 2000 and 2016 related to preventive measures and treatment of postpartum urinary retention in two data bases of biomedical bibliography: Pubmed and Scopus. RESULTS: 31 scientific articles in English related to the treatment of postpartum urinary retention were found as well as a few studies of acute urinary retention in animal models, none of them in Spanish. The diagnosis of postpartum urinary retention is established using invasive and non-invasive methods: catheters and ultrasound. Treatment includes preventive measures (reduction of delivery issues through appropriate training of obstetrical unis or the use of massage on the sacral region) and after delivery (use of urethral or suprapubic catheters). CONCLUSIONS: postpartum urinary retention is a clinical complication, thus we have to understand that early diagnosis and treatment substantially contribute to decreasing the high prevalence of female bladder dysfunctions. In this review, we proved the need for preclinical tests that allow us to recognize the long term repercussion of urinary retention and test new treatments.
RESUMO
OBJECTIVES: To analyze morbidity-mortality and results of surgical treatment for colonic volvulus. METHODS: Retrospective review of 33 patients who underwent surgical treatment for colonic volvulus from 1986 through 1996. RESULTS: Mean age was 62 +/- 20 years (SD) with predominance of female sex (2:1). There were 25 cases of sigmoid volvulus (76%), 7 in the cecum (21%) and 1 in the transverse colon (3%). Colonic necrosis and/or perforation were most frequently seen in the right and transverse colon (50%) than in the sigmoid (4%) (P < 0.002). Operative morbidity was 45% with mortality of 21%. Age was the only variable statistically significant for operative morbidity (52 +/- 23 years in patients without morbidity vs 71 +/- 17 years in patients with morbidity, P = 0.02). Surgical procedures for sigmoid volvulus were resection in 13 and fixation in 12. Recurrence after fixation was 38% to 12 months and 69% to 24 months (Kaplan-Meier), with associated mortality of 50%. There was no recurrence after resections. Treatment for cecal volvulus was cecopexy in 4 cases, with one recurrence; and right hemicolectomy without recurrence. CONCLUSIONS: The results should encourage resective procedures in sigmoid volvulus because the risk of recurrence after fixation is high and the morbidity-mortality is similar. Elderly patients are more susceptible to complications.
Assuntos
Doenças do Colo/cirurgia , Obstrução Intestinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças do Ceco/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Recidiva , Estudos Retrospectivos , Doenças do Colo Sigmoide/cirurgia , Fatores de TempoRESUMO
UNLABELLED: It has been recently reported that repeated large volume paracentesis (LVP) is a safe and efficacious procedure to treat cirrhotics with tense ascitis. In this paper we present the results of our experience with the use of this method. We studied 10 cirrhotics with tense ascites. The criteria for exclusion are described in the text. During LVP, iv albumin infusion was given (25 g each tap). Patients were followed during 3-4 months after discharge from the hospital. RESULTS: Eighteen LVP were made in 10 patients. The mean age was 56 years (range 37-77). Six had peripheral edema. The mean volume of ascitic removed was 6.75 L (range 5-12) per tap. No clinic or hemodynamic complications were observed. With exception of serum cholesterol, which showed a decrease after LVP, laboratory tests did not show any significant modification. Two patients died 3 and 6 weeks after LVP due to hepatic failure and digestive hemorrhage. The procedure was well tolerated. Two were readmitted to the hospital after three months because of ascites. We conclude that LVP plus 25 g of i.v. albumin infusion is a safe and efficacious method to treat cirrhotic tense ascites. After three months no renal function impairment was observed. LVP decrease serum cholesterol.
Assuntos
Albuminas/administração & dosagem , Ascite/terapia , Cirrose Hepática/complicações , Punções/métodos , Adulto , Idoso , Ascite/etiologia , Ascite/fisiopatologia , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-IdadeRESUMO
The trisaccharide allyl O-(3,4-di-O-methyl-beta-D-glucopyranosyl)-(1----4)-O-(2,3-di-O-methyl-al pha-L- rhamnopyranosyl)-(1----2)-3-O-methyl-alpha-L-rhamnopyranoside was synthesized from partially methylated monosaccharide derivatives. Condensation of 1,4-di-O-acetyl-2,3-di-O-methyl-alpha-L-rhamnopyranose promoted by boron trifluoride etherate with the appropriate alcohol proceeded stereoselectively and with very high yields. Selective deacetylation and glycosylation with 2,4-di-O-acetyl-3,6-di-O-methyl-alpha-D-glucopyranosyl bromide led to a trisaccharide. The acrylamide copolymers of mono-, di-, and tri-saccharide were compared in their ability to specifically bind antibodies from leprosy patients.