Analgesia interpleural con Morfina y Bupivacaína en el neumotórax

Introduction:interpleural block offers postoperative analgesia with significant results in surgical interventions. Objective:to evaluate the benefits of interpleural block with 0.5 % Bupivacaine and Morphine by means of interpleural catheter in patients operated on pneumothorax pain relief. Method:an observational, analytical study of cases and controls was carried out in patients undergoing emergency surgery for pneumothorax at Abel Santamaria Cuadrado general teaching hospital, from January to October 2018. The patients were randomized 1:1 (20 cases / 20 controls). Results:a predominance of patients over 65 years of age was found. Pulmonary emphysema predominated (40 % in the case group / 50 % in the controls). ASA II patients predominated. No significant variations were found in the hemodynamic parameters or their association with the type of analgesia (p> 0,05). It was found that the quality of analgesia evaluated and the type of analgesia applied showed a significant relationship (p = 0,0001). In the case group, nausea (0,5 %) and hypotension (0,5 %) predominated; and in controls the tachycardia (75 %). Conclusions:the administration of Bupivacaine and Morphine using interpleural catheter in patients operated on pneumothorax presented good results with few complications, stable hemodynamic parameters and satisfactory postoperative analgesia.Introducción:el bloqueo interpleural ofrece una analgesia posoperatoria con resultados significativos en las intervenciones quirúrgicas.Objetivo: evaluar los beneficios del bloqueo interpleural con Bupivacaina al 0.5% y morfina por catéter Interpleural en pacientes intervenidos por neumotórax para el alivio del dolor.Método: Se realizó un estudio observacional, analítico de casos y controles, en pacientes intervenidos de urgencia por neumotórax en el Hospital Provincial “Abel Santamaría Cuadrado”, desde enero y hasta octubre de 2018. Los pacientes fueron tomados de forma aleatoria simple 1:1 (20 casos /20 controles). Resultando:Se encontró un predominio de pacientes mayores de 65 años de edad. Predominó como comorbilidad el enfisema pulmonar (40 % en el grupo casos/ 50 % en los controles). Predominaron los pacientes ASA II. No se encontraron variaciones significativas en los parámetros hemodinámicos ni su asociación con el tipo de analgesia (p>0,05). Se encontró que la calidad de la analgesia evaluada y el tipo de analgesia empleada mostraron una relación significativa (p=0,0001). En el grupo casos predominaron las náuseas (0,5 %) y la hipotensión (0,5 %); y en los controles la taquicardia (75 %).Conclusiones:la administración de Bupivacaina y morfina por catéter Interpleural en pacientes intervenidos por neumotórax se encuentran buenos resultados al presentarse pocas complicaciones, mantenerse estables los parámetros hemodinámicos y obtenerse una analgesia posoperatoria satisfactori

E-Cadherin gene expression in oral cancer : clinical and prospective data

Low protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. Objective: The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression

Patients with advanced oral squamous cell carcinoma have high levels of soluble E-cadherin in the saliva

The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the presence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin expression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). The results suggest that sE-cadherin levels are significantly increased in patients with oral cancer and that its low expression within the membrane as well as the progression of the disease appear to be inversely associated with levels of sE-cadherin in the saliva

Patients with advanced oral squamous cell carcinoma have high levels of soluble E-cadherin in the saliva

Background: The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the resence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. Material and Methods: Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. Results: sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin xpression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). Background: The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the resence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. Material and Methods: Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. Results: sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin xpression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). Background: The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the resence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. Material and Methods: Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. Results: sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin xpression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037)

Estandarización y estudio analítico del extracto acuoso de Jatropha dioica

Las plantas desde épocas remotas han sido el recurso natural más importante en la vida del hombre, ya que pueden influir como alimento y como medicamento. Existe una gran variedad de plantas relacionadas con efectos terapéuticos, como es el caso de la Jatropha dioica (Sangre de Grado), apreciada por sus numerosas actividades como antiviral, antibacteriano, cicatrizante, inmunomodulador y antiinflamatorio. El presente trabajo tuvo como objetivo establecer un método optimizado para estandarizar la extracción y realizar el estudio analítico de la raíz de Sangre de Grado con la finalidad de evaluar la presencia de estructuras diversas mediante técnicas colorimétricas, para explotar en un futuro inmediato su efecto etnofarmacologico. Se establecieron condiciones experimentales en donde se realizaron diversas extracciones con distintos solventes y bajo diferentes condiciones. Resultando para este tipo de trabajo como solvente ideal el agua, mediante un procedimiento a base de secado, macerado y liofilizado. A su vez el análisis fitoquímico evidenció la presencia de flavonoides, taninos, saponinas, cumarinas, alcaloides, quinonas, glicósidos cardiacos, glicósidos cianogénicos, azucares reductores y antronas. Se concluye a partir del análisis colorimétrico una mayor variedad de fitocompuestos presentes en Jatropha dioica mediante el método de extracción acuosa, evidenciando información general acerca de su posible efecto etnofarmacologico en actividades terapéuticas

Estudio comparativo del consumo de aminoácidos y amonio en acetificaciones con cultivo superficial y amonio en acetificaciones con cultivo superficial y sumergido

Se han estudiado los cambios en el contenido de aminoácidos y amonio durante diferentes procesos de acetificación de tres vinos tintos mediante cultivo superficial y cultivo sumergido (8 acetificaciones superficiales y 3 sumergidas). Se tomaron muestras al inicio y al final de las mismas. La determinación de aminoácidos y amonio se realizó por CLAE-fluorescencia empleando AQC como agente de derivatización precolumna. Este método, validado satisfactoriamente, demostró su utilidad para el análisis rutinario de dichos compuestos durante la acetificación. Los resultados mostraron que al inicio de la acetificación el aminoácido más abundante fue prolina seguido de arginina. Se observó un comportamiento diferente entre los dos métodos de acetificación, siendo mucho menor el consumo de aminoácidos en la acetificación sumergida que en la superficial. En esta última, el más consumido fue la prolina, siendo la arginina la principal fuente de nitrógeno en los sistemas sumergidos, lo cual parece estar relacionado con la especie de bacterias acéticas implicadas en el proceso. Además, parece existir cierta correlación entre requerimiento de nitrógeno de estas bacterias y duración del proceso de acetificación

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

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries