Mortality in psoriasis and psoriatic arthritis: systematic review and meta-analysis

We had found contradictory results that have been reported in recent publications regarding the mortality risk of patients with psoriasis (Pso) and psoriatic arthritis (PsA). These patients have aggregated risk behaviors, which directly impacted their morbidity/mortality. We included 15 studies, with a total population of that reported mortality risk in Pso and PsA patients. We calculated crude mortality rate (CMR) of each one and pooled CMR by group and 95% confidence intervals (CI). The pooled CMR for Pso was 14/1000 (95% CI: 6-21%), 12/1000 (95% CI: 10-15%) in mild, 19/1000 (95% CI: 15-23%) in severe and 12/1000 was observed (95% CI: 10-14%) in PsA. Mortality was relatively higher in PsA patients when compared with Pso, with a RR of 1.03 (95% CI: 1.01-1.06, p<0.01). Pso was associated with increased mortality when compared to the general population. Mild Pso and PsA have the same increased mortality, then again as the severity of Pso increased, so does its mortality. The final comparative mortality between patients with PsA and those with Pso was around 3%

Tubular electrospun scaffolds tested in vivo for tissue engineering

Tissue engineering has been widely used for its great variety of functions. It has been seen as a solution to satisfy the need for vascular substitutes like small diameter vessels, veins, and nerves. One of the most used methods is electrospinning, due to the fact that it allows the use of various polymers, sizes, mandrels and it can adjust the conditions to create personalized scaffolds. For the creation of scaffolds is fundamental to understand the advantages and disadvantages of each polymer, of this, will depend the biodegradability, biocompatibility, porosity, cellular adhesion, and cell proliferation as it is essential to mimic the extracellular matrix and provide structural support for the cells. The aim of this review was to investigate which materials are being used for the creation of tubular scaffolds by electrospinning. Here we selected only in vivo evaluation to demonstrate remodeling of the grafts into native-like tissues, in vitro evaluations had been excluded from this review. We analyze the conditions like speed, distance and voltage and the modifications like growth factors and combinations of natural and synthetic polymers that allow the authors to have a functional scaffold that will suit its purpose

Endoscopic balloon dilatation in caustic-induced gastric outlet obstruction: case report

The ingestion of caustic substances is a not infrequent problem that requires multidisciplinary, medical, surgical and endoscopic management, since it can cause minor burns to total necrosis of the digestive tract wall. A 76 years old male patient with a history of chronic alcoholism presented to the emergency department complaining of heartburn and abdominal pain after ingesting muriatic acid, accidentally mistaking it for alcohol. Computed tomography (CT) scan showed no signs of perforation and endoscopy revealed grade IIIB stomach burns. On day 45 a new endoscopy was performed, documenting fibrosis scars in the antrum with significant retraction and secondary pyloric stenosis, which was managed with endoscopic balloon dilatation (EBD) without complications. In this case, as in most patients with caustic-induced gastric outlet obstruction (GOO) can be successfully treated by EBD

Effectivity of the PGA rapid Atramat® and PGA Atramat® sutures for the closure of minimal invasion and abdominal-inguinal wounds in surgery

Background: The use of suture materials for the closure of wounds is a practice described in Egyptian parchments since 3500 b.C. through the use of linen, animal hair, vegetable fiber, silk, leather and others. The election of the ideal suture material has to be based in the appropriate resistance to traction, tissue biocompatibility and resorption rates..Methods: An open longitudinal clinical trial was performed with data recollection in a prospective way, in which was calculated the incidence of complications; dehiscence, wound seroma, surgical site infection hemorrhage and abscess when PGA Atramat® and PGA rapid Atramat® was employed in laparoscopic and open surgery for treatment of inguinal and umbilical plasties.Results: During the period from January 2016 to August 2016, the procedures included: 31 laparoscopic cholecystectomies, 18 laparoscopic fundoplications, 45 laparoscopic appendicectomies, 12 abdominal plasties and 16 inguinal plasties. This series shows the null incidence of complications in 31 cholecystectomies, 18 fundoplications, 16 inguinal plasties and 12 abdominal plasties.Conclusions: The employment of the PGA Atramat® and PGA rapid Atramat® sutures maintains the features of a braided, absorbable suture, and it also results a feasible and secure resource for its use in minimal invasion surgery, abdominal and inguinal plasties, showing low incidence of surgical site infection

Risk factors of tobacco use in adolescents

Objetivo. Analizar factores de riesgo para fumar en adolescentes. Material y métodos. Estudio observacional, transversal, descriptivo y relacional sobre creencias, antecedentes, entorno, acceso al tabaco, hábito de fumar, etc., mediante “Encuesta Consumo de Tabaco en Adolescentes”, por regresión logística binaria de predicción de haber fumado durante último mes. Resultados. De 1122 estudiantes analizados, 270 fumaron durante el último mes (24.1%). Fueron factores de riesgo significativos: creer que fumar hace más atractivo (OR=263.0), beber alcohol (OR=155.2); fuman los padres (OR=30.9), no creer que es perjudicial (OR=22.5), algún amigo fuma (OR=11.5), posee algo con logotipo de tabaco (OR=8.8), no escuchar mensajes contra el tabaco (OR=4.0) y ser mujer (OR=2.6; IC95% 1.0-6.7). Conclusión. Son factores protectores para no fumar, el evitar la imagen atractiva del fumador, tener padres no fumadores, informar sobre efectos dañinos asociados y evitar el consumo de alcohol. Las adolescentes tienen mayor riesgo de fumar precozmente.Objective. To analyze risk factors for smoking among adolescents. Material and methods. Observational, cross-sectional, descriptive and relational study on beliefs, antecedents, environment, access to tobacco, smoking habit, etc., by means of “Survey of Tobacco Consumption in Adolescents”, by binary logistic regression of prediction of having smoked during last month. Results: Of 1122 students analyzed, 270 smoked during the last month (24.1%). There were significant risk factors: to believe that smoking makes more attractive (OR=263.0), to drink alcohol (OR=155.2); smoke the parents (OR=30.9), do not believe that it is harmful (OR=22.5), some friend smokes (OR=11.5), owns something with tobacco logo (OR=8.8), does not listen to messages against tobacco (OR=4.0) and being a woman (OR=2.6, IC95% 1.0-6.7). Conclusion. Are protective factors for not smoking, to prevent the attractive image of the smoker, to have non-smoking parents, provide information and avoid the harmful effects associated with alcohol consumption. Adolescents have a higher risk of early smoking

Transfusion related acute lung injury: a case report

Transfusion Related Acute Lung Injury (TRALI) is one of the most serious complications of blood transfusion. All blood components have been implicated and most often those that contain plasma. The diagnosis is based fundamentally on the integration of clinical, radiological and gasometry elements, once the rest of the possible causes of acute lung injury have been ruled out. The differential diagnosis of a patient who develops a sudden pattern of respiratory failure after a transfusion of blood products must include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products, haemolytic transfusion reaction and TRALI. Author presented the clinical case of a 33-year-old female patient with grade III hypovolemic shock due to a ruptured ectopic pregnancy, reanimated with crystalloid solutions, globular packages and fresh frozen plasma. The patient developed TRALI for what was managed with ventilatory and hemodynamic support in ICU

Neurophysiology of learning in basic skills of laparoscopic surgery in undergraduate students

Background: The development and progress in laparoscopic surgery requires greater emphasis on surgical skills, developing skills in undergraduate students allows them to be at the forefront in health demands.Methods: An experimental and descriptive study of a group of 30 undergraduate students of the Faculty of Medicine. They attended 30 hours of theoretical and practical sessions distributed by 10 sessions, supported by basic simulators minimally invasive, being evaluated by checklist. Their brain activity was monitored with an electroencephalography before and after the development of skills.Results: It was observed that the average necessary for the acquisition of skills is 5 sessions. The competition in which further progress was observed is video assistance. There is an increase in the activity of the prefrontal cortex on the electroencephalography.Conclusions: A series of neurophysiologic processes involved in learning of laparoscopic surgery are described. Laparoscopic skills development lies in keeping them updated on the teaching-learning, where the use of simulators is growing

Clinical profile of the first 1000 fatalities for influenza A (H1N1) in Mexico

Background: Influenza is an acute respiratory disease responsible for several episodes of high mortality throughout human history. In 2009, Mexico experienced an atypical influenza outbreak caused by a mutant strain of the influenza A (H1N1) subtype, which generated significant mortality. The aim of this paper was to analyze the clinical and sociodemographic conditions of the first 1000 fatalities recorded during this outbreak.Methods: We conducted a study based on an analysis of the clinical files of patients positive for influenza A (H1N1) using Real-Time-Polymerase Chain Reaction (RT-PCR) to conduct an analysis of deaths compared to deaths in the general population.  Results: The majority of deaths occurred in patients aged 35-84 years (65.8%). Average time between symptom onset and death was 13.8 days, with an average of 7.8 days from time of hospitalization until death. Ca. 25% of deaths occurred in residents from Mexico City and from the nearby State of Mexico. In the majority of cases, we found that patients who died had a low educational and socioeconomic status along with co-morbidities such as metabolic syndrome and its individual components, as well as respiratory illnesses. In 80% of cases, patients received mechanical ventilation, and a similar percentage received antiviral therapy (oseltamivir, zanamivir).  Conclusions: The primary-care level was not utilized by patients who died from influenza. The higher prevalence of chronic degenerative diseases among deaths compared with the general population indicates that these groups of patients should be considered and prioritized in the event of future outbreaks.