Biopsia renal. Descripción clinicopatológica, complicaciones y evolución en un hospital general del Perú: Kidney biopsy. Clinicopathological description, complications and evolution in a general hospital in Peru

Introduction: Kidney biopsy is one of the essential tests for the characterization of chronic kidney disease (CKD). Objective: To determine the most frequent primary and secondary glomerulonephritis, complications of renal biopsy and the number of patients on hemodialysis when undergoing renal biopsy. Methods: Observational, descriptive, case series, retrospective and cross-sectional study, carried out at the E. Rebagliati Matins-Peru national hospital. The medical records of patients older than 15 years of age who underwent kidney biopsy between 2008-2016 were reviewed. The data were processed in Stata 16.1 Results: Of 2278 medical records, they corresponded to 1234 women and 1044 men. The most frequent primary and secondary glomerulonephritis were focal and segmental glomerulosclerosis (FSGS) 683 (29.98%) and systemic lupus erythematosus (SLE). ) 434 (19.04%) respectively. Of 1644 biopsied patients, 36 (2.19%) and 241 (14.66%) had major and minor complications respectively. Major complications were more frequent when the procedure was performed by radiology with ultrasound guidance compared to that performed by the nephrologist without ultrasound guidance (p = 0.03694). In 1,324 patients, 329 underwent kidney biopsy while on hemodialysis; of them 43 (13.07%) managed to get out of this therapy and 144 (51.99%) had major or minor complications. Conclusions: GEFyS and SLE were the most frequent primary and secondary glomerulonephritis, respectively. In 1644 patients the major and minor complications were 36 (2.19%) and 241 (14.66%) respectively. In 1,324 patients, 329 (24.8%) were biopsied while on hemodialysis and 144 (51.99%) of them had major or minor complications.Introducción: La biopsia renal es uno de los exámenes esenciales para la caracterización de la enfermedad renal crónica (ERC). Objetivo: Determinar las glomerulonefritis primarias y secundarias más frecuentes, las complicaciones de la biopsia renal y el número de pacientes en hemodiálisis al ser sometidos a biopsia renal. Métodos: Estudio observacional, descriptivo, de serie de casos, retrospectivo y transversal, realizado en el hospital nacional E. Rebagliati Matins-Perú. Se revisaron las historias clínicas de pacientes mayores de 15 años de edad sometidos a biopsia renal entre 2008-2016. Los datos fueron procesados en Stata 16.1 Resultados: De 2278 historias clínicas, correspondieron a mujeres 1234 y a hombres 1044. Las glomerulonefritis primarias y secundarias más frecuentes fueron glomeruloesclerosis focal y segmentaria (GEFyS) 683 (29,98%) y lupus eritematoso sistémico (LES) 434 (19,04%) respectivamente. De 1644 pacientes biopsiados, 36 (2,19%) y 241 (14,66%), tuvieron complicaciones mayores y menores respectivamente. Las complicaciones mayores fueron más frecuentes cuando el procedimiento lo realizó radiología con guía ecográfica en relación al realizado por el nefrólogo sin guía ecográfica (p = 0,03694). En 1324 pacientes, 329 fueron sometidos a biopsia renal estando en hemodiálisis; de ellos 43 (13,07%) lograron salir de esta terapia y 144 (51,99%) tuvieron complicaciones mayores o menores. Conclusiones: La GEFyS y LES fueron las glomerulonefritis primarias y secundarias más frecuentes, respectivamente. En 1644 pacientes las complicaciones mayores y menores fueron 36 (2,19%) y 241 (14,66%) respectivamente. En 1324 pacientes, 329 (24,8%) fueron biopsiados estando en hemodiálisis y de ellos 144 (51,99%) tuvieron complicaciones mayores o menores

Macromolecular composition of phloem exudate from white lupin (Lupinus albus L.)

<p>Abstract</p> <p>Background</p> <p>Members of the legume genus <it>Lupinus </it>exude phloem 'spontaneously' from incisions made to the vasculature. This feature was exploited to document macromolecules present in exudate of white lupin (<it>Lupinus albus </it>[L.] <it>cv </it>Kiev mutant), in particular to identify proteins and RNA molecules, including microRNA (miRNA).</p> <p>Results</p> <p>Proteomic analysis tentatively identified 86 proteins from 130 spots collected from 2D gels analysed by partial amino acid sequence determination using MS/MS. Analysis of a cDNA library constructed from exudate identified 609 unique transcripts. Both proteins and transcripts were classified into functional groups. The largest group of proteins comprised those involved in metabolism (24%), followed by protein modification/turnover (9%), redox regulation (8%), cell structural components (6%), stress and defence response (6%) with fewer in other groups. More prominent proteins were cyclophilin, ubiquitin, a glycine-rich RNA-binding protein, a group of proteins that comprise a glutathione/ascorbate-based mechanism to scavenge oxygen radicals, enzymes of glycolysis and other metabolism including methionine and ethylene synthesis. Potential signalling macromolecules such as transcripts encoding proteins mediating calcium level and the Flowering locus T (FT) protein were also identified. From around 330 small RNA clones (18-25 nt) 12 were identified as probable miRNAs by homology with those from other species. miRNA composition of exudate varied with site of collection (e.g. upward versus downward translocation streams) and nutrition (e.g. phosphorus level).</p> <p>Conclusions</p> <p>This is the first inventory of macromolecule composition of phloem exudate from a species in the Fabaceae, providing a basis to identify systemic signalling macromolecules with potential roles in regulating development, growth and stress response of legumes.</p

Effects of two different training programs with same workload on throwing velocity by experienced water polo players

To investigate the effects of two different strength-training programs with the same workload (impulse) on throwing velocity in water polo, 30 water polo players (M age = 17.1 yr., SD = 4.9; M mass = 71.2 kg, SD = 14.7; M height = 1.75 m, SD = 0.09 m) were randomly divided in two groups based upon throwing performance with water polo ball. The medicine-ball training group performed 3 x 6 reps with a 3-kg medicine ball, while the combination training group completed 1 x 9 repetitions with the 3-kg medicine ball, followed by 3 x 14 repetitions with a water polo ball. Both groups trained eight weeks twice per week in addition to their regular water polo training. Throwing velocity was measured with a Doppler radar gun before and after the training period. Testing included throws with a water polo ball on land and in water, as well as with 1-kg and 3-kg medicine balls on land. Statistically significant increases were found in mean peak throwing velocity with the water polo, 1-kg, and 3-kg medicine balls after training. No differences between the groups were found, except in throwing velocity with water polo on land, with a statistically significantly larger increase for the combination training group (+7.6%) than the medicine-ball training group (+3.4%). These findings indicate that after training with the same workload (impulse), increases in throwing velocity in water polo are similar and suggesting workload may be a critical variable for training results.info:eu-repo/semantics/publishedVersio

Using “Omics” and Integrated Multi-Omics Approaches to Guide Probiotic Selection to Mitigate Chytridiomycosis and Other Emerging Infectious Diseases

Emerging infectious diseases in wildlife are responsible for massive population declines. In amphibians, chytridiomycosis caused by Batrachochytrium dendrobatidis, Bd, has severely affected many amphibian populations and species around the world. One promising management strategy is probiotic bioaugmentation of antifungal bacteria on amphibian skin. In vivo experimental trials using bioaugmentation strategies have had mixed results, and therefore a more informed strategy is needed to select successful probiotic candidates. Metagenomic, transcriptomic, and metabolomic methods, colloquially called “omics,” are approaches that can better inform probiotic selection and optimize selection protocols. The integration of multiple omic data using bioinformatic and statistical tools and in silico models that link bacterial community structure with bacterial defensive function can allow the identification of species involved in pathogen inhibition. We recommend using 16S rRNA gene amplicon sequencing and methods such as indicator species analysis, the Kolmogorov–Smirnov Measure, and co-occurrence networks to identify bacteria that are associated with pathogen resistance in field surveys and experimental trials. In addition to 16S amplicon sequencing, we recommend approaches that give insight into symbiont function such as shotgun metagenomics, metatranscriptomics, or metabolomics to maximize the probability of finding effective probiotic candidates, which can then be isolated in culture and tested in persistence and clinical trials. An effective mitigation strategy to ameliorate chytridiomycosis and other emerging infectious diseases is necessary; the advancement of omic methods and the integration of multiple omic data provide a promising avenue toward conservation of imperiled species

Number and timing of primary cleft lip and palate repair surgeries in England: whole nation study of electronic health records before and during the COVID-19 pandemic

Objective: To quantify differences in number and timing of first primary cleft lip and palate (CLP) repair procedures during the first year of the COVID-19 pandemic (1 April 2020 to 31 March 2021; 2020/2021) compared with the preceding year (1 April 2019 to 31 March 2020; 2019/2021)./ Design: National observational study of administrative hospital data./ Setting: National Health Service hospitals in England./ Study population: Children <5 years undergoing primary repair for an orofacial cleft Population Consensus and Surveys Classification of Interventions and Procedures-fourth revisions (OPCS-4) codes F031, F291)./ Main exposure: Procedure date (2020/2021 vs 2019/2020)./ Main outcomes: Numbers and timing (age in months) of first primary CLP procedures./ Results: 1716 CLP primary repair procedures were included in the analysis. In 2020/2021, 774 CLP procedures were carried out compared with 942 in 2019/2020, a reduction of 17.8% (95% CI 9.5% to 25.4%). The reduction varied over time in 2020/2021, with no surgeries at all during the first 2 months (April and May 2020). Compared with 2019/2020, first primary lip repair procedures performed in 2020/2021 were delayed by 1.6 months on average (95% CI 0.9 to 2.2 months). Delays in primary palate repairs were smaller on average but varied across the nine geographical regions./ Conclusion: There were significant reductions in the number and delays in timing of first primary CLP repair procedures in England during the first year of the pandemic, which may affect long-term outcomes

Comportamiento Epidemiológico de las lesiones pre- Invasoras del cervix diganosticadas por papanicolaou en mujeres atendidas en el Centro de Salud Manuel Orozco del Municipio de San Isidro, Matagalpa en el Periodo de Enero–Diciembre, 2018

El presente estudio tiene por objetivo describir el comportamiento epidemiológico de las lesiones pre-Invasoras del cérvix diagnosticadas por Papanicolaou en mujeres atendidas en el centro de salud Manuel Orozco del municipio de San Isidro, Matagalpa en el periodo de enero a diciembre 2018. Se trata de un estudio descriptivo, de corte transversal, con una muestra constituida por 159 expedientes de pacientes con diagnóstico de lesión pre- invasora del cérvix. El cáncer cérvicouterino representa una de las primeras causas de morbimortalidad en la mujer nicaragüense. A través de los resultados obtenidos en este estudio se proponen pautas dirigidas a un proceso de mejora ya que nos da una perspectiva de la situación actual de dicho municipio y podemos ofrecer recomendaciones dirigidas a la detección de las lesiones pre-invasivas y así poder prevenir la progresión y desarrollo del cáncer cérvicouterino con el fin de brindar una atención de calidad con enfoque integral a la mujer nicaragüense. Dentro de los resultados predominantes se encontraron: respecto a las características sociodemográficas la mayoría de las pacientes tenían una edad mayor a 34 años con una cantidad de 85 (53.5%), de procedencia rural con 92 (57.9%), escolaridad primaria con 81 pacientes (50.9%), de ocupación ama de casa 139 pacientes (87.4%) y de estado civil unión libre 108 pacientes (67.9%). Por otra parte, en relación a los antecedentes personales no patológicos en la totalidad de las pacientes no había datos relevantes. En lo que respecta a los antecedentes gíneco-obstétricos de las pacientes predominó un IVSA entre los 15-19años con 104 de ellas (65.4%), la mayoría con un promedio de un compañero sexual y el método de planificación familiar más utilizado fue el inyectable en una cantidad de 91 pacientes (57.2%). La mayoría de las pacientes eran multigestas con un total de 49 (30.8%), con partos vía vaginal. En relación a las infecciones de transmisión sexual predominó candidiasis en un total de 38 (23.9%). En cuanto a la lesión pre-invasora predominante diagnosticada por PAP fue VPH con 156 (83.9%). Debemos incrementar esfuerzos por mantener la campaña de promoción continua de realización de PAP anual a toda paciente posterior a su inicio de vida sexual activa, con o sin factores de riesgo para lesiones pre-invasoras del cérvix para poder prevenir, detectar y tratar de manera oportuna cualquier alteración, refiriendo a estas pacientes a atención especializada para su seguimient

Plan de negocio para desarrollar la exportación de servicio mundial mediante la minería de la criptomoneda Ehereum en la ciudad de Arequipa

Los cambios en la economía mundial se ven reflejados por la utilización de tecnologías innovadoras que permiten reducir costos, reducir intermediaciones, y lo más importante reducir tiempo. Esta tecnología es llamada Blockchain (Cadena de bloques), es como un libro contable gigante que registra cada transacción que se realiza, y que va guardando toda la información en los miles de computadores que están interconectadas lo que permite una seguridad increíble, el Ethereum nace a base de esta tecnología desarrollada por el Bitcoin, que trata de realizar contratos inteligentes mediante el uso de la blockchain o cadena de bloques, para facilitar en las transacciones de bienes y servicios que requieran contratos. La idea de negocio es brindar un soporte para que esta red gigante funcione y sea auto sostenible, la función primordial es brindar un soporte para validar, confirma y verificar cada transacción que se realice en su cadena de bloques, además de mantener una copia de seguridad de toda la red, esto será efectiva teniendo un poder de procesamiento alto, para generar mayor eficiencia en la red y poder generar mayores rentabilidades, a todo este procedimiento se le denomina minería de criptomonedas.Changes in the global economy are reflected by the use of innovative technologies that reduce costs, reduce intermediation, and, most importantly, reduce time. This technology is called Blockchain, it is like a giant accounting book that registers each transaction that is made, and that keeps all the information in the thousands of computers that are interconnected, which allows incredible security, the Ethereum is born based on this technology developed by Bitcoin, which tries to make intelligent contracts through the use of the blockchain or chain of blocks, to facilitate transactions in goods and services that require contracts. The business idea is to provide a support for this giant network to work and be self-sustaining, the main function is to provide support to validate, confirm and verify each transaction that takes place in its chain of blocks, in addition to maintaining a backup of all the network, this will be effective having a high processing power, to generate greater efficiency in the network and to generate higher profitability, this whole process is called cryptocurrency mining.Trabajo de suficiencia profesionalCampus Lima Centr

Prevention of breast cancer by recapitulation of pregnancy hormone levels

At the present time, the only approved method of breast cancer prevention is use of the selective estrogen receptor modulator (SERM) tamoxifen. Many breast cancers are driven to grow by estrogen, and tamoxifen exploits this by blocking estrogen action at the estrogen receptor. A counter-intuitive and controversial approach to breast cancer prevention is administration of estrogen and progestin at an early age to achieve pregnancy levels. This approach is supported by the fact that breast cancer incidence is halved by early (≤ 20 years of age) full-term pregnancy. Moreover, it has been demonstrated in rodent models that mimicking the hormonal milieu can effectively prevent carcinogen-induced mammary cancer. In this issue of Breast Cancer Research Rajkumar and colleagues use the rodent model to further define the timing and type of hormonal therapy that is effective in preventing mammary carcinogenesis. Clearly, application of this approach in humans may be difficult, but the potential benefit is intriguing

A video life-world approach to consultation practice: The relevance of a socio-phenomenological approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes