Utilidad ddel bloqueo poplíteo por vía lateral vs bloqueo espinal en procedimientos quirúrgicos de miembros inferiores en pacientes de alto riesgo en Hospital Escuela Dr. Roberto Calderón Gutiérrez, 2016-enero del 2017.

En cirugía ortopédica son frecuentes las intervenciones localizadas en el tercio distal de las extremidades inferiores, muchos de estos pacientes suelen ser portadores de comorbilidades y con frecuencia presentan un elevado riesgo anestésico. (Kaufman, y otros, 2011). Es un estudio ensayo clínico por conveniencia, en donde se estudiaron 40 pacientes que ingresaron a realizar algún procedimiento quirúrgico de miembros inferiores que entran como emergencia, los cuales se dividieron en 2 grupo; el grupo A fue sometido a bloqueo espinal (20 pacientes), mientras el grupo B se le aplicó bloqueo poplíteo lateral (20 pacientes). Esta investigación pretende evaluar la eficacia y seguridad del Bloqueo poplíteo por vía lateral vs bloqueo espinal en procedimientos quirúrgicos de miembros inferiores en pacientes de alto riesgo en Hospital Escuela Dr. Roberto Calderón Gutiérrez, octubre 2016 - enero del 2017. Concluyendo que la mayoría de los pacientes en estudio eran mayores de 60 años, femeninas, con escolaridad de primaria, de procedencia urbana, el procedimiento que se realizaron fue un lavado quirúrgico Y dentro de los antecedentes patológicos que se encontraron prevaleció la diabetes mellitus se presentó en un 85%, Hipertensión Arterial (HTA) en un 80% y otras en porcentajes menores de EPOC, insuficiencia venosa, crónica y otros. La mayoría de los procedimientos realizados tuvo una duración mayor a los 30 minutos. Durante estas intervenciones los bloqueos fueron satisfactorios en la evaluación del dolor a los, y. En relación a la percepción del dolor después del procedimiento quirúrgico (postquirúrgico) se evidencia que el bloqueo poplíteo presentaba resultados más satisfactorios. Donde a las 4 horas del bloqueo poplíteo el 100% no presentaba dolor mientras que en el espinal un paciente presentaba un dolor leve que presentaba el 5%, a las 6 horas se observó, mientras que en las 8 horas 2 personas que representa el 0% no presentaba dolor, 16 personas que representa 80% presentaban dolor leve y 2 personas que representa el 10% presentaba dolor moderado mientras que en el bloqueo poplíteo a las 8 horas 17 personas no presentaban dolor que presentan el 85% y solo 3 personas presentaban dolor leve equivalente al 15% a las 10 horas evaluando el dolor en el bloqueo espinal 1 paciente no presentaba dolor, 18 personas presentaban dolor leve que representan 90%, presentaba dolor moderado 1persona que representa el 5 % el bloqueo poplíteo el dolor evaluado en 17 personas no lo presentaban en un 85%, un paciente presento dolor leve que presenta 5% y en dolor moderado 2 pacientes que representan 10%, a las 12 horas se observa en el bloqueo espinal un paciente no presentaba dolor que representa el 5%, 16 pacientes presentaban dolor leve que representa 80% y 3 pacientes con dolor moderado que representa el 15% mientras en el bloqueo poplíteo 10 de los pacientes no presentaban dolor que representan un 50% y 8 pacientes presentaban dolor leve para un 40% y 2 pacientes que presentan dolor moderado que equivale al 10%. Los participantes en estudio no presentaron complicaciones en su mayoría, siendo el bloqueo poplíteo el que menos complicaciones presentó (1 presento hematoma, a diferencia del bloqueo espinal que presento náuseas y mareos. En la valoración posquirúrgica del dolor… Palabras claves: bloqueo espinal, bloqueo poplíteo, EVA, dolor

Elevated MED28 expression predicts poor outcome in women with breast cancer

Abstract Background MED28 (also known as EG-1 and magicin) has been implicated in transcriptional control, signal regulation, and cell proliferation. MED28 has also been associated with tumor progression in in vitro and in vivo models. Here we examined the association of MED28 expression with human breast cancer progression. Methods Expression of MED28 protein was determined on a population basis using a high-density tissue microarray consisting of 210 breast cancer patients. The association and validation of MED28 expression with histopathological subtypes, clinicopathological variables, and disease outcome was assessed. Results MED28 protein expression levels were increased in ductal carcinoma in situ and invasive ductal carcinoma of the breast compared to non-malignant glandular and ductal epithelium. Moreover, MED28 was a predictor of disease outcome in both univariate and multivariate analyses with higher expression predicting a greater risk of disease-related death. Conclusions We have demonstrated that MED28 expression is increased in breast cancer. In addition, although the patient size was limited (88 individuals with survival information) MED28 is a novel and strong independent prognostic indicator of survival for breast cancer

Differential expression of anterior gradient gene AGR2 in prostate cancer

<p>Abstract</p> <p>Background</p> <p>The protein AGR2 is a putative member of the protein disulfide isomerase family and was first identified as a homolog of the <it>Xenopus laevis </it>gene XAG-2. AGR2 has been implicated in a number of human cancers. In particular, AGR2 has previously been found to be one of several genes that encode secreted proteins showing increased expression in prostate cancer cells compared to normal prostatic epithelium.</p> <p>Methods</p> <p>Gene expression levels of AGR2 were examined in prostate cancer cells by microarray analysis. We further examined the relationship of AGR2 protein expression to histopathology and prostate cancer outcome on a population basis using tissue microarray technology.</p> <p>Results</p> <p>At the RNA and protein level, there was an increase in AGR2 expression in adenocarcinoma of the prostate compared to morphologically normal prostatic glandular epithelium. Using a tissue microarray, this enhanced AGR2 expression was seen as early as premalignant PIN lesions. Interestingly, within adenocarcinoma samples, there was a slight trend toward lower levels of AGR2 with increasing Gleason score. Consistent with this, relatively lower levels of AGR2 were highly predictive of disease recurrence in patients who had originally presented with high-stage primary prostate cancer (P = 0.009).</p> <p>Conclusions</p> <p>We have shown for the first time that despite an increase in AGR2 expression in prostate cancer compared to non-malignant cells, relatively lower levels of AGR2 are highly predictive of disease recurrence following radical prostatectomy.</p

Availability and quality of paraffin blocks identified in pathology archives: A multi-institutional study by the Shared Pathology Informatics Network (SPIN)

BACKGROUND: Shared Pathology Informatics Network (SPIN) is a tissue resource initiative that utilizes clinical reports of the vast amount of paraffin-embedded tissues routinely stored by medical centers. SPIN has an informatics component (sending tissue-related queries to multiple institutions via the internet) and a service component (providing histopathologically annotated tissue specimens for medical research). This paper examines if tissue blocks, identified by localized computer searches at participating institutions, can be retrieved in adequate quantity and quality to support medical researchers. METHODS: Four centers evaluated pathology reports (1990–2005) for common and rare tumors to determine the percentage of cases where suitable tissue blocks with tumor were available. Each site generated a list of 100 common tumor cases (25 cases each of breast adenocarcinoma, colonic adenocarcinoma, lung squamous carcinoma, and prostate adenocarcinoma) and 100 rare tumor cases (25 cases each of adrenal cortical carcinoma, gastro-intestinal stromal tumor [GIST], adenoid cystic carcinoma, and mycosis fungoides) using a combination of Tumor Registry, laboratory information system (LIS) and/or SPIN-related tools. Pathologists identified the slides/blocks with tumor and noted first 3 slides with largest tumor and availability of the corresponding block. RESULTS: Common tumors cases (n = 400), the institutional retrieval rates (all blocks) were 83% (A), 95% (B), 80% (C), and 98% (D). Retrieval rate (tumor blocks) from all centers for common tumors was 73% with mean largest tumor size of 1.49 cm; retrieval (tumor blocks) was highest-lung (84%) and lowest-prostate (54%). Rare tumors cases (n = 400), each institution's retrieval rates (all blocks) were 78% (A), 73% (B), 67% (C), and 84% (D). Retrieval rate (tumor blocks) from all centers for rare tumors was 66% with mean largest tumor size of 1.56 cm; retrieval (tumor blocks) was highest for GIST (72%) and lowest for adenoid cystic carcinoma (58%). CONCLUSION: Assessment shows availability and quality of archival tissue blocks that are retrievable and associated electronic data that can be of value for researchers. This study serves to compliment the data from which uniform use of the SPIN query tools by all four centers will be measured to assure and highlight the usefulness of archival material for obtaining tumor tissues for research