Anastomotic leak management after a low anterior resection leading to recurrent abdominal compartment syndrome: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Low anterior resection is usually the procedure of choice for rectal cancer, but a series of complications often accompany this procedure. This case report describes successful management of an intricate anastomotic leak after a low anterior resection.</p> <p>Case presentation</p> <p>A 66-year-old Caucasian man was admitted to our hospital and diagnosed with a low rectal adenocarcinoma. He underwent a low anterior resection but subsequently developed fecal peritonitis due to an anastomotic leak. He was operated on again but developed abdominal compartment syndrome, multi-organ failure and sepsis. He was aggressively treated in the intensive care unit and in the operating room. Overall, the patient underwent four laparotomies and stayed in the intensive care unit for 75 days. He was discharged after 3 months of hospitalization.</p> <p>Conclusion</p> <p>Abdominal compartment syndrome may present as a devastating complication of damage control laparotomy. Prompt recognition and goal-directed management are the cornerstones of treatment.</p

Intracellular curvature-generating proteins in cell-to-cell fusion

Cell-to-cell fusion plays an important role in normal physiology and in different pathological conditions. Early fusion stages mediated by specialized proteins and yielding fusion pores are followed by a pore expansion stage that is dependent on cell metabolism and yet unidentified machinery. Because of a similarity of membrane bending in the fusion pore rim and in highly curved intracellular membrane compartments, in the present study we explored whether changes in the activity of the proteins that generate these compartments affect cell fusion initiated by protein fusogens of influenza virus and baculovirus. We raised the intracellular concentration of curvature-generating proteins in cells by either expressing or microinjecting the ENTH (epsin N-terminal homology) domain of epsin or by expressing the GRAF1 (GTPase regulator associated with focal adhesion kinase 1) BAR (Bin/amphiphysin/Rvs) domain or the FCHo2 (FCH domain-only protein 2) F-BAR domain. Each of these treatments promoted syncytium formation. Cell fusion extents were also influenced by treatments targeting the function of another curvature-generating protein, dynamin. Cell-membrane-permeant inhibitors of dynamin GTPase blocked expansion of fusion pores and dominant-negative mutants of dynamin influenced the syncytium formation extents. We also report that syncytium formation is inhibited by reagents lowering the content and accessibility of PtdIns(4,5)P2, an important regulator of intracellular membrane remodelling. Our findings indicate that fusion pore expansion at late stages of cell-to-cell fusion is mediated, directly or indirectly, by intracellular membrane-shaping proteins

ACCIONES EDUCATIVAS PARA LA PERCEPCIÓN DE RIESGO DEL CÁNCER CERVICOUTERINO EN LAS ADOLESCENTES ECUATORIANAS / EDUCATIONAL ACTIONS FOR RISK PERCEPTION OF CERVICAL CANCER IN ECUADORIAN ADOLESCENTS: Array

This article addresses the research results derived from the application of educational actions that contribute to the risk perception of cervical cancer in adolescents from the Health Center No. 6 Guano-Penipe, Parroquia Veloz in the Educational Unit ¨San Felipe Neri¨. (Riobamba, Ecuador). Accordingly, the logical-historical, the analytical-synthetic and the inductive-deductive methods were used. Additionally, a pre-experiment was designed, in combination with other scientific methods (observation, interview, survey, self-assessing scale, document analysis, triangulation). Among the deficiencies found: adolescents have a very low level of risk perception of cervical cancer reflected in the limited knowledge of the subject, the little interest in learning about this disease and some manifestations denoting a negative approach to the possibility of preventing it. The educational actions combined different organizational variants such as; the workshop, video-debate, talks, conferences with digital aids. For their implementation, they were inserted within the framework of the promotion and education activities of the primary health care system. The transformations in the subjects forming the sample indicated considerable knowledge acquisition by the adolescents concerning this disease; greater interest in learning more about the subject and serious reflection on prevention actions.El artículo contiene los resultados investigativos derivados de la aplicación de acciones educativas que contribuyen a la percepción de riesgo del cáncer cervicouterino en las adolescentes del centro de Salud No 6 Guano-Penipe, Parroquia Veloz en la Unidad Educativa “San Felipe Neri, Riobamba, Ecuador. Para ello se utilizaron como métodos el histórico lógico, el analítico-sintético, el inductivo-deductivo, se diseña un pre-experimento que se combina con otros métodos científicos y técnicas (encuesta, entrevista grupal, observación y triangulación). Se identificaron como carencias que las adolescentes tienen muy bajo nivel de la percepción de riesgo hacia el cáncer cervicouterino, lo cual se revela en los escasos conocimientos que tienen, el poco interés por aprender sobre esta enfermedad y algunas manifestaciones que denotan un comportamiento negativo ante la posibilidad de prevenir la enfermedad. Las acciones educativas combinan diferentes formas de organización como el taller, videodebate, conversatorios, conferencias con atractivos productos digitales. Para su instrumentación se insertan en el marco de las propias actividades de promoción y educación de la atención primaria de salud.&nbsp; Las transformaciones ocurridas en los sujetos de la muestra apuntan a un incremento en el nivel de conocimientos de las adolescentes sobre esta enfermedad, mayor interés por conocer más sobre la misma y la reflexión sobre modos de actuación que puedan ayudar a su prevención.&nbsp

ACCIONES EDUCATIVAS PARA LA PERCEPCIÓN DE RIESGO DEL CÁNCER CERVICOUTERINO EN LAS ADOLESCENTES ECUATORIANAS / EDUCATIONAL ACTIONS FOR RISK PERCEPTION OF CERVICAL CANCER IN ECUADORIAN ADOLESCENTS

This article addresses the research results derived from the application of educational actions that contribute to the risk perception of cervical cancer in adolescents from the Health Center No. 6 Guano-Penipe, Parroquia Veloz in the Educational Unit ¨San Felipe Neri¨. (Riobamba, Ecuador). Accordingly, the logical-historical, the analytical-synthetic and the inductive-deductive methods were used. Additionally, a pre-experiment was designed, in combination with other scientific methods (observation, interview, survey, self-assessing scale, document analysis, triangulation). Among the deficiencies found: adolescents have a very low level of risk perception of cervical cancer reflected in the limited knowledge of the subject, the little interest in learning about this disease and some manifestations denoting a negative approach to the possibility of preventing it. The educational actions combined different organizational variants such as; the workshop, video-debate, talks, conferences with digital aids. For their implementation, they were inserted within the framework of the promotion and education activities of the primary health care system. The transformations in the subjects forming the sample indicated considerable knowledge acquisition by the adolescents concerning this disease; greater interest in learning more about the subject and serious reflection on prevention actions.El artículo contiene los resultados investigativos derivados de la aplicación de acciones educativas que contribuyen a la percepción de riesgo del cáncer cervicouterino en las adolescentes del centro de Salud No 6 Guano-Penipe, Parroquia Veloz en la Unidad Educativa “San Felipe Neri, Riobamba, Ecuador. Para ello se utilizaron como métodos el histórico lógico, el analítico-sintético, el inductivo-deductivo, se diseña un pre-experimento que se combina con otros métodos científicos y técnicas (encuesta, entrevista grupal, observación y triangulación). Se identificaron como carencias que las adolescentes tienen muy bajo nivel de la percepción de riesgo hacia el cáncer cervicouterino, lo cual se revela en los escasos conocimientos que tienen, el poco interés por aprender sobre esta enfermedad y algunas manifestaciones que denotan un comportamiento negativo ante la posibilidad de prevenir la enfermedad. Las acciones educativas combinan diferentes formas de organización como el taller, videodebate, conversatorios, conferencias con atractivos productos digitales. Para su instrumentación se insertan en el marco de las propias actividades de promoción y educación de la atención primaria de salud.&nbsp; Las transformaciones ocurridas en los sujetos de la muestra apuntan a un incremento en el nivel de conocimientos de las adolescentes sobre esta enfermedad, mayor interés por conocer más sobre la misma y la reflexión sobre modos de actuación que puedan ayudar a su prevención.&nbsp

A Qualitative Approach for the Assessment of the Genetic Stability of the MON 810 Trait in Commercial Seed Maize Varieties

Maize MON 810 is one of the European Union (EU) authorised genetically modified organisms (GMO) for placing on the food and feed market. The total number of MON 810 varieties registeredin the European Common Catalogues of varieties of agricultural plant species has almost tripled since 2005. One ofthe requirements described in EU legislation, namely the genetic stability of GM seed varieties, was thus assessed by analysing the intactness of the entire MON 810 integration and its genotypic stability in commercial varieties available on the market for at least the last two years. A combined strategy using qualitative analytical methods made possible to determine the presence/absence of the individual genetic elements and of the whole GM construct. The restriction fragment length polymorphism (RFLP)patterns obtained from amplified whole constructs by long PCR were compared side by side. CryIA(b) protein expression levels were determined by ELISA. Twenty-four out of the 26 analysed varieties met the expected stability features. One variety gave negative results in all assays and one variety contained the necessary genetic elements for expressing CryIA(b) protein, although giving negative results for the long PCR product. To our knowledge, this study is the first post-marketing stability analysis performed on GM commerical seed varieties.JRC.I.3-Molecular Biology and Genomic