Índices pronósticos y complicaciones quirúrgicas: Rendimiento y aplicabilidad

Introducción: La evaluación del riesgo quirúrgico es cada vez más importante, convirdiendose en una necesidad para valorar la morbilidad y mortalidad postoperatoria. Para ello se utilizan índices pronósticos y escalas de riesgo quirúrgico. El sistema ideal tendría que ser objetivo, económico, sencillo, preciso y basado en la información disponible en el preoperatorio. Existen diferentes índices pronósticos analizados en este trabajo: POSSUM, SRS, ACS NSQIP y ASA. Pacientes y métodos: Las diferentes escalas (excepto POSSUM y P-POSSUM) se han aplicado de forma retrospectiva a los pacientes intervenidos de forma programada o urgente en la unidad de Cirugía Endocrina durante el mes de Noviembre de 2016. Se han incluido 61 casos, de los cuales 53 fueron programados y 8 urgentes. También se estudiaron las complicaciones postoperatorias. Resultados: La mortalidad global observada fue de 0% y la morbilidad global observada de 9,83%. El SRS presentó una puntuación media de 6, por lo tanto una mortalidad esperada inferior al 10%. La ACS NSQIP predijo una mortalidad de 0,34% y una morbilidad de 4,2%. La mayoría de pacientes, 36,06% y 32,78% presentaron una puntuación ASA de I y II, respectivamente. Conclusiones: Las escalas de riesgo son útiles e imprescindibles en los servicios de cirugía. Permiten comparar los resultados y mejoran la calidad asistencial

Unsteady boundary layer flow and heat transfer over a stretching sheet: heat flux case

Unsteady two-dimensional boundary layer flow and heat transfer over a stretching flat plate in a viscous and incompressible fluid of uniform ambient temperature is investigated in this paper. It is assumed that the velocity of the stretching sheet and the heat flux from the surface of the plate vary inverse proportionally with time. Two equal and opposite forces are impulsively applied along the plate so that the plate is stretched keeping the origin fixed. Using appropriate similarity variables, the basic partial differential equations are transformed into a set of two ordinary differential equations. These equations are solved numerically for some values of the governing parameters using the Runge-Kutta method of fourth order. Flow and heat transfer characteristics are determined and represented in some tables and figures. It is found that the structure of the boundary layer depends on the ratio of the velocity of the potential flow near the stagnation point to that of the velocity of the stretching surface. In addition, it is shown that the heat transfer from the plate increases when the Prandtl number increases. The present results include also the steady situation as a special case considered by other authors. Comparison with known results is very good

Effect of the magnetic field and heat generation on the free convection flow in a tall cavity filled with a porous medium

An analytical study of the steady magnetohydrodynamics (MHD) free convection in an tall cavity filled with a fluid-saturated porous medium and with internal heat generation has been performed. It is considered that the Darcy law model is used. It is assumed that a uniform magnetic field normal to the walls of the cavity is externally imposed. The values of the governing parameters are as follows: Hartmann number $\operatorname{Ha}=0, 10$ and $50$, Rayleigh number $\operatorname{Ra} = 10^{3}$, and the aspect ratio $a=0.01$. The velocity and temperature profile are determined. These profiles are presented graphically at the center line of the cavity. It is found that the analytical solution is in very good agreement with the numerical solution which is obtained by solving partial differential equations using a finite-difference method

Intake of Plant Based Foods and Colorectal Cancer. A Case-Control Study in Romania

Colorectal cancer (CRC) represents the third most common type of cancer worldwide with high incidence rates in our country as well. Both dietary habits and lifestyle factors have a strong contribution in preventing colorectal cancer. A healthy dietary pattern based on adequate intake of fruit, non-starchy vegetables, and whole grains is associated with positive outcomes regarding CRC development. The aim of the present study was to evaluate the dietary intake of plant-based food and food groups, along with lifestyle habits of CRC patients. A case-control study was conducted during April 2015 – October 2017. Patients (n=151) recently diagnosed with CRC and undergoing conventional treatment were recruited from Medisprof Oncology Hospital. Controls (n=151) were selected randomly from generally healthy adults. Dietary and lifestyle data were collected during a face to face interview and the applied lifestyle questionnaire included 74 items. The results showed that intake of specific food groups with high content of bioactive components was significantly higher in the control group compared to the CRC group (p<0.05), even though overall vegetable intake was similar between groups (p=0.51). Results also showed significant lower intakes of fiber-rich foods such as whole grains, nuts and legumes in the CRC group

Role of pentraxin-3 in risk assessment of patients with metabolic syndrome

Background Inflammation plays a major role in the development of metabolic syndrome (MetS) and its progression. Recent studies have shown that pentraxin-3 (PTX-3), osteoprogerin (OPG), and tumor necrosis factor-alpha (TNF-α) are key factors in MetS pathophysiology, but evidence for endorsing their clinical use is currently unclear and insufficient. Aim The study aimed to evaluate the association between the inflammatory biomarkers’ levels and the severity of MetS. Methods The study was observational, transversal, prospective, cohort, and analytical type. We enrolled 80 patients (M:F = 1, mean age = 55 ± 10.77 years) who met MetS criteria. The study protocol included: medical history, physical examination, 6-min walk test distance (6MWTD), biochemical tests, electrocardiogram, echocardiography, and carotid ultrasonography. We also performed plasmatic measurement of PTX-3, OPG, and TNF-α, in addition to standard biochemical tests. Results Subjects with severe MetS had higher values of body mass index (BMI) and waist circumference (p  Conclusion PTX-3 was correlated with the severity of MetS, with other inflammatory parameters and cardiovascular tests. CCA-IMT and 6MWTD are useful in differentiating between mild and severe MetS

Erectile dysfunction, physical activity and metabolic syndrome: differences in markers of atherosclerosis

<p>Abstract</p> <p>Background</p> <p>Erectile dysfunction (ED), impaired arterial elasticity, elevated resting heart rate as well as increased levels of oxidized LDL and fibrinogen associate with future cardiovascular events. Physical activity is crucial in the prevention of cardiovascular diseases (CVD), while metabolic syndrome (MetS) comprises an increased risk for CVD events. The aim of this study was to assess whether markers of subclinical atherosclerosis are associated with the presence of ED and MetS, and whether physical activity is protective of ED.</p> <p>Methods</p> <p>57 MetS (51.3 ± 8.0 years) and 48 physically active (PhA) (51.1 ± 8.1 years) subjects participated in the study. ED was assessed by the International Index of Erectile Function (IIEF) questionnaire, arterial elasticity by a radial artery tonometer (HDI/PulseWave™ CR-2000) and circulating oxLDL by a capture ELISA immunoassay. Fibrinogen and lipids were assessed by validated methods. The calculation of mean daily energy expenditure of physical exercise was based on a structured questionnaire.</p> <p>Results</p> <p>ED was more often present among MetS compared to PhA subjects, 63.2% and 27.1%, respectively (p < 0.001). Regular physical exercise at the level of > 400 kcal/day was protective of ED (OR 0.12, 95% CI 0.017-0.778, p = 0.027), whereas increased fibrinogen (OR 4.67, 95% CI 1.171-18.627, p = 0.029) and elevated resting heart rate (OR 1.07, 95% CI 1.003-1.138, p = 0.04) were independently associated with the presence of ED. In addition, large arterial elasticity (ml/mmHgx10) was lower among MetS compared to PhA subjects (16.6 ± 4.0 <it>vs</it>. 19.6 ± 4.2, p < 0.001), as well as among ED compared to non-ED subjects (16.7 ± 4.6 <it>vs</it>. 19.0 ± 3.9, p = 0.008). Fibrinogen and resting heart rate were highest and large arterial elasticity lowest among subjects with both MetS and ED.</p> <p>Conclusions</p> <p>Markers of subclinical atherosclerosis associated with the presence of ED and were most evident among subjects with both MetS and ED. Thus, especially MetS patients presenting with ED should be considered at high risk for CVD events. Physical activity, on its part, seems to be protective of ED.</p> <p>Trial registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01119404">NCT01119404</a></p

A new class of glycomimetic drugs to prevent free fatty acid-induced endothelial dysfunction

Background: Carbohydrates play a major role in cell signaling in many biological processes. We have developed a set of glycomimetic drugs that mimic the structure of carbohydrates and represent a novel source of therapeutics for endothelial dysfunction, a key initiating factor in cardiovascular complications. Purpose: Our objective was to determine the protective effects of small molecule glycomimetics against free fatty acid­induced endothelial dysfunction, focusing on nitric oxide (NO) and oxidative stress pathways. Methods: Four glycomimetics were synthesized by the stepwise transformation of 2,5­dihydroxybenzoic acid to a range of 2,5­substituted benzoic acid derivatives, incorporating the key sulfate groups to mimic the interactions of heparan sulfate. Endothelial function was assessed using acetylcholine­induced, endotheliumdependent relaxation in mouse thoracic aortic rings using wire myography. Human umbilical vein endothelial cell (HUVEC) behavior was evaluated in the presence or absence of the free fatty acid, palmitate, with or without glycomimetics (1µM). DAF­2 and H2DCF­DA assays were used to determine nitric oxide (NO) and reactive oxygen species (ROS) production, respectively. Lipid peroxidation colorimetric and antioxidant enzyme activity assays were also carried out. RT­PCR and western blotting were utilized to measure Akt, eNOS, Nrf­2, NQO­1 and HO­1 expression. Results: Ex vivo endothelium­dependent relaxation was significantly improved by the glycomimetics under palmitate­induced oxidative stress. In vitro studies showed that the glycomimetics protected HUVECs against the palmitate­induced oxidative stress and enhanced NO production. We demonstrate that the protective effects of pre­incubation with glycomimetics occurred via upregulation of Akt/eNOS signaling, activation of the Nrf2/ARE pathway, and suppression of ROS­induced lipid peroxidation. Conclusion: We have developed a novel set of small molecule glycomimetics that protect against free fatty acidinduced endothelial dysfunction and thus, represent a new category of therapeutic drugs to target endothelial damage, the first line of defense against cardiovascular disease

A one-step spline method for the numerical solution of ordinary 331 differential equations

Not available

Impacts of Non-Uniform Border Temperature Variations on Time-Dependent Nanofluid Free Convection within a Trapezium: Buongiorno’s Nanofluid Model

The present study develops the influence of inclined border temperature variations on the isotherms, streamlines, and isoconcentrations for unsteady free convection in a trapezoidal region filled with the water-based nanofluid. The considered mathematical nanofluid approach was formulated based on the Buongiorno&rsquo;s model. The set of governing partial differential equations formulated using non-dimensional primitive variables such as velocity, pressure, temperature, and nanoparticles concentration volume fraction was solved numerically using the finite element method for various magnitudes of control characteristics. It was revealed that control characteristics affected the liquid circulation and energy transport coefficients. The Nusselt number is a growing function of wave number, amplitude, and the Rayleigh number