51 research outputs found
Single-Incision Laparoscopic Cholecystectomy: Is It a Plausible Alternative to the Traditional Four-Port Laparoscopic Approach?
The current standard-of-care for treatment of cholecystectomy is the four port laparoscopic approach. The development of single incision/laparoendoscopic single site surgery (SILC/LESS) has now led to the development of new techniques for removal of the gallbladder. The use of SILC/LESS is now currently being evaluated as the next step in treatment of cholecystectomy. This review is an attempt to consolidate the current knowledge and analyze the feasibility of world-wide implementation of SILC/LESS
Perfusion Decellularization of Extrahepatic Bile Duct Allows Tissue-Engineered Scaffold Generation by Preserving Matrix Architecture and Cytocompatibility
Reconstruction of bile ducts damaged remains a vexing medical problem. Surgeons have few options when it comes to a long segment reconstruction of the bile duct. Biological scaffolds of decellularized biliary origin may offer an approach to support the replace of bile ducts. Our objective was to obtain an extracellular matrix scaffold derived from porcine extrahepatic bile ducts (dECM-BD) and to analyze its biological and biochemical properties. The efficiency of the tailored perfusion decellularization process was assessed through histology stainings. Results from 4â-6-diamidino-2-phenylindole (DAPI), Hematoxylin and Eosin (H&E) stainings, and deoxyribonucleic acid (DNA) quantification showed proper extracellular matrix (ECM) decellularization with an effectiveness of 98%. Immunohistochemistry results indicate an effective decrease in immunogenic marker as human leukocyte antigens (HLA-A) and Cytokeratin 7 (CK7) proteins. The ECM of the bile duct was preserved according to Masson and Herovici stainings. Data derived from scanning electron microscopy (SEM) and thermogravimetric analysis (TGA) showed the preservation of the dECM-BD hierarchical structures. Cytotoxicity of dECM-BD was null, with cells able to infiltrate the scaffold. In this work, we standardized a decellularization method that allows one to obtain a natural bile duct scaffold with hierarchical ultrastructure preservation and adequate cytocompatibility
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
PhDAY 2020 -FOO (Facultad de Ăptica y OptometrĂa)
Por cuarto año consecutivo los doctorandos de la Facultad de Ăptica y OptometrĂa de la Universidad Complutense de Madrid cuentan con un congreso propio organizado por y para ellos, el 4Âș PhDAY- FOO. Se trata de un congreso gratuito abierto en la que estos jĂłvenes cientĂficos podrĂĄn presentar sus investigaciones al resto de sus compañeros predoctorales y a toda la comunidad universitaria que quiera disfrutar de este evento. Apunta en tu agenda: el 15 de octubre de 2020. En esta ocasiĂłn serĂĄ un Congreso On-line para evitar que la incertidumbre asociada a la pandemia Covid-19 pudiera condicionar su celebraciĂłn
ATENCION A LOS PRINCIPALES PROBLEMAS DE LA POBLACION DE JALISCO Y LA ZONA METROPOLITANA DE GUADALAJARA EN 1989
Hasta antes de iniciarse la actual administraciĂłn esÂtatal de Jalisco y durante el periodo de campaña elecÂtoral de diversos candidatos se recibieron mĂșltiples peticiones referentes a mejorar la prestaciĂłn de los servicios pĂșblicos y la seguridad pĂșblica. EspecĂficaÂmente en la Zona Metropolitana de Guadalajara (ZMG)surgieron peticiones por parte dela poblaciĂłn referentes a mejorar los servidos de transporte urbaÂno y seguridad pĂșblica
New insights into the pathophysiology of achalasia and implications for future treatment
Uso clĂnico de la realidad virtual para la distracciĂłn y reducciĂłn del dolor postoperatorio en pacientes adultos
Pain control is one of the most important challenges
that professionals are working in treating
surgical patients and is an indicator of good medical
practice both as a high-quality care. In addition
to pharmacological techniques they have been
extensively studied other techniques and one that
has generated greater effects is the distraction of
pain. This study explores the clinical use of Virtual
Reality for distraction and pain reduction in
surgical patients. The study involved surgical patients
(n=6) with surgery and laparoscopic surgery
open hospitalized, the average age was 33.50 years
(10.42). Was utilized a repeated measures design
without control group. Were used Visual Analog
Scales 0-10 points (strength, control and time thinking
about the pain) Anxiety-state Scale and Catastrophism
Pain Scale (PCS) before and after intervention
with Virtual Reality. Patients were given
analgesics for pain management throughout the
post-operative and after six hours of recovery. The
results show significant decrease in pain intensity
levels after the use of Virtual Reality, also lower
levels in two of the three aspects of catastrophism.
However, anxiety levels showed no decrease with
the intervention. This study shows that virtual reality
can be effective not only to reduce the physical
component of the post-operative pain but also
cognitive and affective component.El control del dolor es uno de los retos mĂĄs importantes
a los que se enfrentan los profesionales
tratantes de los pacientes quirĂșrgicos y es un indicador
tanto de buena pråctica médica como de
una atención de alta calidad. Adicional a las técnicas
farmacolĂłgicas se han estudiado ampliamente
otras técnicas y una de las que ha generado mayores
efectos es la distracciĂłn del dolor. El presente estudio
explora el uso clĂnico de la Realidad Virtual
para la distracciĂłn y reducciĂłn del dolor en pacientes
quirĂșrgicos. En el estudio participaron pacientes
quirĂșrgicos (n=6) intervenidos con cirugĂa laparoscĂłpica
abierta y hospitalizados, la media de edad
fue de 33.50 años (10,42). Se planteó un diseño de
medidas repetidas sin grupo control. Fueron empleadas
Escalas Visuales AnalĂłgicas de 0-10 puntos
(Intensidad, control y tiempo pensando en el dolor),
Escala de Ansiedad-Estado (IDARE) y la Escala de
Catastrofismo al Dolor (PCS) antes y después de la
intervenciĂłn con Realidad Virtual. Los pacientes
recibieron analgésicos indicados para el manejo del
dolor durante todo el post-operatorio y después de
seis horas de recuperación. Los resultados señalan
disminuciĂłn significativa en los niveles de intensidad
del dolor despuĂ©s del uso de Realidad Virtual, asĂ
mismo menores niveles en dos de los tres aspectos
del catastrofismo. No obstante, los niveles de ansiedad
no mostraron descenso con la intervenciĂłn. El
presente estudio evidencia que la Realidad Virtual
puede ser efectiva no solo para disminuir el componente
fĂsico del dolor post-operatorio sino tambiĂ©n
los componente cognitivos y afectivos del mism
Barrettâs Oesophagus in an Achalasia Patient: Immunological Analysis and Comparison with a Group of Achalasia Patients
The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES) from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue samples (gastrooesophageal junction) from transplant donors were included as control groups. A conspicuous systemic inflammation was determined in BE/achalasia patient and achalasia versus healthy volunteer group. Nonetheless, a predominance of Th22, Th2, IFN-α-producing T cells, Tregs, Bregs, and pDCregs was observed in BE/achalasia patient versus achalasia group. A low percentage of Th1 subset in BE/achalasia versus achalasia group was determined. A noticeable increase in tissue of Th22, Th17, Th2, Tregs, Bregs, and pDCregs was observed in BE/achalasia versus achalasia group. Th1 subset was lower in the BE/achalasia patient versus achalasia group. This study suggests that inflammation is a possible factor in the pathogenesis of BE/achalasia. Further research needs to be performed to understand the specific cause of the correlation between BE and achalasia
Cardiovascular dysautonomia in Achalasia Patients: Blood pressure and heart rate variability alterations.
Achalasia is a disease characterized by the inability to relax the esophageal sphincter due to a degeneration of the parasympathetic ganglion cells located in the wall of the thoracic esophagus. Achalasia has been associated with extraesophageal dysmotility, suggesting alterations of the autonomic nervous system (ANS) that extend beyond the esophagus. The purpose of the present contribution is to investigate whether achalasia may be interpreted as the esophageal manifestation of a more generalized disturbance of the ANS which includes alterations of heart rate and/or blood pressure. Therefore simultaneous non-invasive records of the heart inter-beat intervals (IBI) and beat-to-beat systolic blood pressure (SBP) of 14 patients (9 female, 5 male) with achalasia were compared with the records of 34 rigorously screened healthy control subjects (17 female, 17 male) in three different conditions: supine, standing up, and controlled breathing at 0.1 Hz, using a variety of measures in the time and spectral domains. Significant differences in heart rate variability (HRV) and blood pressure variability (BPV) were observed which seem to be due to cardiovagal damage to the heart, i.e., a failure of the ANS, as expected according to our hypothesis. This non-invasive methodology can be employed as an auxiliary clinical protocol to study etiology and evolution of achalasia, and other pathologies that damage ANS
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