Complicaciones del tratamiento de cáncer rectal. Informe de caso

La neoplasia de recto se considera una enfermedad frecuente y altamente mortal, su incidencia es mayor en los países desarrollados. El tratamiento implica conjunción de quimioterapia e intervenciones quirúrgicas cuyos beneficios aún están en discusión. Se reporta un caso de una paciente con neoplasia de recto medio tratada en Hospital Provincial Universitario Clínico-Quirúrgico Dr. Gustavo Aldereguía Lima. Se realiza intervención quirúrgica electiva. Presentó un deterioro del estado general durante la estancia hospitalaria y fallece 10 días después de la intervención

In Vitro activity of amphotericins and Triazoles in Combination with Polyphenols, Pentacyclic Triterpenoids and Fatty Acid Derivatives Against Biofilms of Candida Albicans

Introduction: Candida species cause 6,3% of all hospital infections, however, they are responsible for 22% of systemic candidemia cases which result in 19-24% mortality rate. Candida biofilms are more resistant to drugs in comparison with planktonic forms. For that reason, it is important to seek for new treatment opportunities. Catheters, immunosuppression and prolonged antibiotic use are the main risk factors of biofilms producing C. albicans infections. Aim: To investigate the antimicrobial interactions between polyphenols, triterpenoids and fatty acid derivatives in combination with Amphotericin B (AmB) and Fluconazole (Flu) against C. albicans biofilms. Materials and methods: Biofilm production in C. albicans was quantified by crystal violet assay. CLSI (M38-A2) broth microdilution methodology was used to determine MICs for Flu, AmB, rosmarinic acid (R), pentacyclic triterpenoid (betulinic acid, B), fatty acid (oleic acid, O) against 3 isolates of planktonic and biofilm associated C. albicans. Viability of C. albicans was determined using AlamarBlue assay. Viable C. albicans quantified by serial dilution and plating. Synergistic relations of drugs were analyzed by fractional inhibitory concentration (FIC) determination. Results: Both planktonic and biofilm associated C. albicans showed high level resistance to Flucanozole (MIC>200 µg /mL). Planktonic forms and biofilms were both equally sensitive to AmB (MIC 0.1 µg/mL ). AmB versus its combination with rosmarinic acid (MICAmB/ R= 0.01/5.7 µg/mL) had significantly decreased biofilm formation (OD600 nm 1.291 versus 0.866, p=0.0119, α=0.05), which refers to synergistic drug relation (ΣFIC=0.10099). Moreover, rosmarinic acid in combination with Fluconazole (MIC Flu/R= 20/570 µg/mL, OD600 nm 0.585, p=0.0024) showed synergistic impact on biofilms (ΣFIC=0.199). Other single and combined antifungals did not show statistically significant impact on C. albica[...]

Trends in incidence and mortality of primary liver cancer in Lithuania 1998–2015

Background: Recently, reports have suggested that rates of liver cancer have increased duringthe last decades in developed countries; increasing hepatocellular carcinoma and cholangiocarcinomarates were reported. The aim of this study was to examine time trends in incidence and mortalityrates of liver cancer for the period of 1998–2015 in Lithuania by sex, age, and histology.Methods: Weexamined the incidence of liver cancer from 1998 to 2015 using data from the Lithuanian CancerRegistry. Age-standardized incidence rates were calculated by sex, age, and histology. Trends wereanalyzed using the Joinpoint Regression Program to estimate the annual percent change.Results: Atotal of 3086 primary liver cancer cases were diagnosed, and 2923 patients died from liver cancer. Thetotal number of liver cancer cases changed from 132 in 1998 to 239 in 2015. Liver cancer incidencerates changed during the study period from 5.02/100,000 in 1998 to 10.54/100,000 in 2015 in menand from 2.43/100,000 in 1998 to 6.25/100,000 in 2015 in women. Annual percentage changes(APCs) in the age-standardized rates over this period were 4.5% for incidence and 3.6% for mortality.Hepatocellular cancer incidence rates were stable from 1998 to 2005 (APC−5.9,p= 0.1) and laterincreased by 6.7% per year (p< 0.001). Intrahepatic ductal carcinoma incidence increased by 8.9% peryear throughout the study period. The rise in incidence was observed in all age groups; however, inage groups < 50 and between 70 and 79 years, observed changes were not statistically significant. Formortality, the significant point of trend change was detected in 2001, where after stable mortality,rates started to increase by 2.4% per year.Conclusions: Primary liver cancer incidence and mortalityincreased in both sexes in Lithuania. The rise om incidence was observed in both sexes and mainhistology groups. The increasing incidence trend may be related to the prevalence of main risk factors(alcohol consumption, hepatitis B and C infections. and diabetes

Epidemiology, antimicrobial resistance and clinical features of infections caused by Escherichia coli in Lithuania

Escherichia coli (E. coli) is the most common urinary tract infections (UTIs) agent. The rise of antibiotic resistance among pathogenic E. coli is a worldwide threat. Resistant strains of E. coli are a concern, as resistance-coding genes can easily transfer to other strains. This work aim is to analyze the frequency of antimicrobial resistance among E. coli strains and evaluate relations of resistance and clinical diagnosis. During March - August, 2016, clinically unrelated E. coli strains (n=200) were collected from collaborating Lithuanian hospitals. Susceptibility to: trimethoprim (5 μg), tobramycin (10 μg), pefloxacin (5 μg), amoxicillin/clavulanic acid (20/10 μg), ampicillin (10 μg), amikacin (30 μg), cefuroxime (30 μg), meropenem (10 μg), nitrofurantoin (100 μg), ciprofloxacin (5 μg), gentamicin (10 μg), ceftazidime (10 μg), cefapime (30 μg), cefadroxil (30 μg), trimethoprim/sulfamethoxazole (1.25/23.75 μg), cefotaxime (5 μg), imipenem (10 μg), piperacillin/tazobactam (30/6 μg), ampicillin/sulbactam (10/10 μg/) was evaluated as recommended by EUCAST 7.1 standard. 96.5% of E.coli was isolated from urine (n=193), 3.5% (n=7), from another sites. Isolates represented a wide predominance of age (1-100), mostly isolated from female patients (78.5%; n=157). 6.5% (n=13) of E. coli was isolated from patients with UTIs, 79% (n=158) represented other clinical cases. Frequent resistance was observed to ampicillin (47.3%), ampicillin/sulbactam (60%), cefepime (43.2%). The lowest resistancy frequence was observed for amikacin (3.5%). 5.8% (n=5) strains showed decreased susceptibility to imipenem. We demonstrate increasing incidence of infections, caused by antibiotic resistant E. coli in Lithuania. First-line ampicillin antimicrobial therapy, ampicillin/sulbactam and cefepime should be prescribed with caution

Trends in Pancreatic Cancer Incidence and Mortality in Lithuania, 1998&ndash;2015

Background: Pancreatic cancer is one of the deadliest cancers worldwide, and its incidence is increasing. The aim of this study was to examine the time trends in the incidence and mortality rates of pancreatic cancer for the period of 1998&ndash;2015 for the first time in Lithuania by sex, age, subsite, and stage. Methods: This study was based on all cases (deaths) of pancreatic cancer diagnosed between 1998 and 2015. Age-standardized incidence (mortality) rates and group-specific rates were calculated for each sex using the direct method (European Standard). TNM classification-based information reported to the cancer registry was grouped into three categories: (1) localized cancer: T1-3/N0/M0; (2) cancer with regional metastasis: any 1-3/N+/M0; (3) advanced cancer: any T/any N/M+. Joinpoint regression was used to provide annual percentage changes (APCs) and to detect points in time where statistically significant changes in the trends occurred. Results: Overall, 8514 pancreatic cancer cases (4364 in men and 3150 in women) were diagnosed and 7684 persons died from cancer of the pancreas. Pancreatic cancer incidence rates were considerably lower for women than for men, with a female:male ratio of 1:2. Incidence rates changed during the study period from 14.2 in 1998 to 15.0/100,000 in the year 2015 in men, and from 6.7 to 9.8/100,000 in women. Incidence rates over the study period were stable for men (APC = 0.1%) and increasing for women by 1.1% per year. Similarly, mortality rates increased in women by 0.9% per year, and were stable in men. During the study period, incidence and mortality rates of pancreatic cancer were close. For the entire study period, rates increased significantly in the 50&ndash;74 years age group; only cancer of the head of pancreas showed a decline by 0.9%, while tail and not-specified pancreatic cancer incidence increased by 11.4% and 4.51%, respectively. Conclusions: The increasing pancreatic cancer incidence trend in the Lithuanian population may be related to the prevalence of its main risk factors (smoking, obesity, physical inactivity, diet, and diabetes)

Synthesis and Biological Activity Characterization of Novel 5-Oxopyrrolidine Derivatives with Promising Anticancer and Antimicrobial Activity

The 1-(4-acetamidophenyl)-5-oxopyrrolidine carboxylic acid was applied for synthesizing derivatives bearing azole, diazole, and hydrazone moieties in the molecule. Modification of an acetamide fragment to the free amino group afforded compounds with two functional groups, which enabled to provide a series of 4-substituted-1-(4-substituted phenyl)pyrrolidine-2-ones. The resulted compounds 2 and 4&ndash;22 were subjected to the in vitro anticancer and antimicrobial activity determination. The compounds 18&ndash;22 exerted the most potent anticancer activity against A549 cells. Furthermore, compound 21 bearing 5-nitrothiophene substituents demonstrated promising and selective antimicrobial activity against multidrug-resistant Staphylococcus aureus strains, including linezolid and tedizolid-resistant S. aureus. These results demonstrate that 5-oxopyrolidine derivatives are attractive scaffolds for the further development of anticancer and antimicrobial compounds targeting multidrug-resistant Gram-positive pathogens

Experimental study of precision angle encoder

The application of new and advanced production processes plays an important role in the development of the manufacturing industry. This trend is especially relevant to the automotive industry, where each element must ensure high quality requirements. Therefore, automating the automotive manufacturing process is necessary to ensure the highest level of control methods. For this purpose, various sensors are used, the signals of which are analyzed and the control plan itself is adjusted. Experimental investigations of a precision angle encoder were performed in the work. During the research, the dynamic characteristics of the created stand were determined. Experimental studies yielded the results of an experimental study of a precision angle encoder when the system is subjected to shock and harmonic excitation. In order to elucidate the effect of oscillations on the accuracy of a high-resolution coded precision angle encoder, primary electrical signals and their change under oscillations were recorded. Studies have shown that high-resolution code-precision angle encoders have different design responses to dynamic effects depending on the direction of the vibrations acting