Dyskinesias and Treatment with Pramipexole in Patients with Parkinson's Disease

Dopamine agonists such as pramipexole (PPX) have first been proposed as adjunctive treatment to levodopa (L-DOPA) for patients with Parkinson's disease (PD) and then as a monotherapy alternative to alleviate dyskinesia. Treatment with PPX has overall been associated with improvement in parkinsonian symptoms. Although the majority of placebo-controlled studies demonstrated that dyskinesia was more prevalent in the PPX compared to the placebo groups, some studies did not detect any dyskinesia as a side effect of this medication. PPX was consistently associated with lower risk for developing dyskinesia compared to L-DOPA. Moreover, the presence of these symptoms in the placebo groups suggests involvement of non-PPX-related factors for developing dyskinesia. It is suggested that future research should aim at ascertaining whether cotherapy with L-DOPA, PPX dosage, and other patient characteristics are contributory factors for the development of PPX-related dyskinesia in patients with PD

Depression in Tourette syndrome:a controlled and comparison study

Background Tourette syndrome (TS) is a neurodevelopmental condition characterised by multiple tics and co-morbid behavioural problems. Previous research found that up to 76% of patients with TS experience affective symptoms, with 13% fulfilling diagnostic criteria for depression. Objectives We aimed to assess the severity of depression and profile of depressive symptoms in adult patients with TS compared to patients with major depression and healthy controls. Methods Depression ratings were collected from patients with TS (N = 65) using the BDI-II and from patients with recurrent major depressive disorder (rMDD, N = 696) and healthy controls (N = 293) using the Beck Depression Inventory (BDI)-IA. Direct comparisons were possible for 14/21 BDI items. Results Patients with TS scored significantly higher on the BDI than controls (P <0.001) and all individual symptoms were reported more frequently by patients with TS than by controls (P <0.001). Total BDI score in TS was not significantly different to that in rMDD, however irritability was significantly more frequently reported in the TS group and this remained significant after controlling for age and gender differences between the two groups (OR 5.24, 95% CI 1.97-14.00; P = 0.001). Conclusions Our findings show that depression is a prominent feature in TS and may present with a more irritable phenotype than rMDD. Patients with TS should be routinely screened for depression to implement treatment as appropriate

Guideline of Guidelines: Muscle Invasive Bladder Cancer

© 2020 Turkish Society of Urology. Final publication available at https://dx.doi.org/10.5152/tud.2020.20337.Muscle-invasive bladder cancer accounts for 25% of bladder cancer cases and represents a spectrum of disease, which can result in significant morbidity and mortality for anyone affected. Current management has evolved through years of research and clinical practice. It is based on a risk-benefit approach, which is often tailored to the individual requirements of patients and involves cystectomy, neoadjuvant and adjuvant therapies, and multimodal surveillance paradigms to achieve high survival rates. Multiple guidelines exist to assist the clinicians in this decision-making process, but their adherence is often variable. In this article, we aimed to review the 4 most commonly used guidelines from the European Association of Urology, the National Institute for Health and Care Excellence, the National Comprehensive Cancer Network, and the American Urological Association.Peer reviewe

Energías alternativas en la amazonia colombiana

Dadas las actuales condiciones que viene afrontando nuestro planeta, la humanidad está en mora de tomar medidas inmediatas sobre el uso de recursos no renovables en los sistemas de generación de energía eléctrica, dependiendo de las necesidades de cada región, es así que focalizando los análisis en la materia, el presente trabajo pretende brindar a la comunidad académica un panorama claro respecto a la aplicación de energías alternativas en los diferentes sistemas eléctricos de la amazonia colombiana. Se presentan las actuales características de los sistemas de generación de energía eléctrica en el departamento del Amazonas, analizando el tipo de combustible que utilizan, y su incidencia en los niveles de contaminación de la región, de la misma manera se determinarán las condiciones geográficas, sociales y políticas del departamento con el fin de verificar el impacto que representaría para estas comunidades. Considerando que la implementación de las nuevas tecnologías en nuestro país, presenta connotaciones de tipo regulatorio y tributario, el presente estudio analizara como el marco normativo y legislativo incide en la aplicación e incentivación de este tipo de energías alternativas en el departamento del Amazonas.Given the current conditions facing our planet, humanity is in the process of taking immediate action on the use of non-renewable resources in the systems of regeneration of electric energy, depending on the needs of each region, so focusing the analyzes in The present work intends to offer to the academic community a clear panorama regarding the application of alternative energies in the different electrical systems of the Colombian Amazon. The present characteristics of the systems of electric power generation in the department of Amazonas are presented, analyzing the type of fuel they use and their incidence in the levels of pollution of the region, in the same way the geographic, social conditions, Policies of the department in order to verify the impact that would represent for these communities. Considering that the implementation of the new technologies in our country presents regulatory and tax connotations, this study will analyze how the normative and legislative framework affects the application and incentive of this type of alternative energy in the department of Amazonas

A Rare Case of Prostatic Stromal Tumour of Uncertain Malignant Potential Surrounding Ejaculatory Ducts in a Patient With Concurrent Prostate Adenocarcinoma

© 2022 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., https://creativecommons.org/licenses/by/4.0/Stromal tumour of uncertain malignant potential (STUMP) is exceedingly rare. Diagnosis and management of STUMP present a challenge to the urologist due to the absence of specific clinical findings and its unpredictable clinical course. Thus, radical resection is often recommended. Here, we present a case of a 64-year-old male, who presented with mild obstructive voiding symptoms with a raised age-specific prostate-specific antigen (PSA) of 3.1. Magnetic resonance imaging (MRI) showed an area of suspicion, in an area thought to be the left seminal vesicle, containing a malignant lesion within it. Biopsy of this area and the prostate confirmed concurrent prostatic STUMP and Gleason 3+3=6 adenocarcinoma of the prostate, managed with robotic-assisted laparoscopic radical prostatectomy with wide local excision.Peer reviewe

Factores asociados al trauma fatal en motociclistas en Medellín, 2005-2008

Introduction. Motorcycles have come into widespread use as mode of transport and commuting to work. Given the degree of trauma occurring in motorcycle accidents, this increased use has generated adverse consequences for public health. Categorization of factors associated with these events can form the basis for prevention strategies.Objective. The characteristics of person, time, place, vehicle and circumstances of occurrence were described for motorcycle accidents involving rider injury, and the associations were explored with fatal trauma in the city of Medellín, Colombia, in 2005-2008.Materials and methods. A cross-sectional case-control retrospective study was conducted based on population data from the Secretaría de Transporte y Tránsito and Secretaría de Salud. Records were analyzed of incidents involving 24,062 injuries and 345 fatalities. The odds ratio statistic (95% CI) was used to detect significant associations between fatalies and characteristics of trauma exposure; adjusted ORs (95% CI) were obtained by logistic regression analysis.Results. A strong association emerged between fatal trauma and collision with a fixed object. There is a greater chance of dying at railroad crossings, approaches to intersections or roundabouts, and (in the districts of Robledo, Aranjuez and Guayabal) two lane roads. Males, motorcyclists between 20-30 yrs, between 40 and 49 yrs, and &gt;50 yrs were more likely to die. Motorcycle models prior to 1991, travel in early morning hours, or periods of high vehicular density were additional factors of high association.Conclusions. Because motorcyclists have greater exposure, crashes against fixed objects were much more lethal than in other kinds of events. Although an increased mortality occurred at roundabouts and intersections, a greater mortalities occurred at railroad crossings in the sections of single-rail, doublerail and other configurations.Introducción. En medio de un cambio en la movilidad vial, en el que la motocicleta se ha generalizado como herramienta de transporte y de trabajo, se da el trauma en motociclistas que genera consecuencias desfavorables para la salud pública, por lo que el conocimiento de sus factores asociados sirve de base para formular estrategias de prevención.Objetivo. Describir las características de persona, tiempo, lugar, vehículo y circunstancias de los accidentes de tránsito en motociclistas y explorar su asociación con trauma fatal en Medellín entre 2005 y 2008.Materiales y métodos. Se hizo un estudio transversal con análisis de caso y controles de datos retrospectivos de la población de la Secretaría de Transporte y Tránsito y de la Secretaría de Salud. Se analizaron 24.062 registros de motociclistas lesionados y 345 fallecidos. Se calculó la razón de momios (odds ratio, OR) (IC95%) para explorar la asociación entre el trauma fatal y las características de exposición, y la OR ajustada (IC95%) mediante un análisis de regresión logística.Resultados. Se encontró una fuerte asociación entre el trauma fatal en motociclistas y el choque contra objeto fijo. Hay mayores posibilidades de morir en los tramos de vía y vías diferentes a intersección o glorieta, vías de dos carriles, en las comunas Robledo, Aranjuez y Guayabal. Los hombres y motociclistas entre 20 y 30 años, entre 40 y 49, y los mayores 50 años, tienen mayores posibilidades de morir e, igualmente, cuando conducen motocicletas de modelo anterior a 1991, o conducen en la madrugada o en horas de alta densidad vehicular.Conclusiones. En Medellín, los motociclistas son un grupo de interés en el sistema vial; por su mayor exposición, la energía que acumulan en los choques contra un objeto fijo es mucho mayor y más letal que la acumulada en otra clase de accidentes, y aunque hay más accidentes de tránsito en glorietas e intersecciones, la mayor posibilidad de morir se presenta en los tramos de vía de doble carril y en otras vías. DOI: http://dx.doi.org/10.7705/biomedica.v32i1.60

RXRA DT448/9PP generates a dominant active variant capable of inducing maturation in acute myeloid leukemia cells.

RARA and RXRA contribute to myeloid maturation in both mice and humans, and deletion of Rxra and Rxrb augments leukemic growth in mice. While defining the domains of RXRA that are required for anti-leukemic effects in murine KMT2A-MLLT3 leukemia cells, we unexpectedly identified RXRA DT448/9PP as a constitutively active variant capable of inducing maturation and loss of their proliferative phenotype. RXRA DT448/9PP was associated with ligand-independent activity in reporter assays, with enhanced co-activator interactions, reduced engraftment in vivo, and activation of myeloid maturation transcriptional signatures that overlapped with those of cells treated with the potent RXRA agonist bexarotene, suggestive of constitutive activity that leads to leukemic maturation. Phenotypes of RXRA DT448/9PP appear to differ from those of two other RXRA mutations with forms of constitutive activity (F318A and S427F), in that DT448/9PP activity was resistant to mutations at critical ligand-interacting amino acids (R316A/L326A) and was resistant to pharmacological antagonists, suggesting it may be ligand-independent. These data provide further evidence that activated retinoid X receptors can regulate myeloid maturation and provide a novel constitutively active variant that may be germane for broader studies of retinoid X receptors in other settings.This work was supported by National Institutes of Health grant R01 HL128447 (JSW) , by the Siteman Investment Program (JSW) , the Washington University SPORE DRP (JSW and MAF) , the Children's Discovery Institute (JSW) , the Alex's Lemonade Stand Foundation Young Investigator Award (MAF) , the National Institutes of Health 5K12HD07622408 (MAF) , and grants from the Spanish Ministerio de Ciencia e Innovacion (MCI) (SAF2017-90604-REDT-NurCaMeIn, RTI2018-095928-BI00) (MR).S

Recreando la vida desde masculinidades y feminidades democráticas. Programa universitario de prevención del VIH desde la perspectiva de género / Recreating life from masculinities and democratic feminities. University program on HIV prevention from a gender perspective

Se presentan los principales resultados de una investigación de corte cualitativo, estudio de caso, realizado con estudiantes durante 10 años (2008 – 2018). Cada semestre, los jóvenes inscritos en el curso “El SIDA como realidad del proceso vital humano” en la Universidad Nacional de Colombia, recrean los significados del género y las posibilidades de vivir con el VIH a través de: talleres, performances, dibujos, videos cortos y un componente teórico transversal. Mediante la hermenéutica y la etnografía críticas se ha encontrado que emergen categorías contemporáneas que hablan de un tránsito más democrático de encarnar y vivir el género y perviven otras de carácter tradicionalista ligadas al patriarcado y al heterocentrismo que les podrían poner en riesgo de adquirir y transmitir el VIH

Estudio de prefactibilidad para la creación de una microempresa dedicada a la fabricación y comercialización de productos artesanales para mujeres a base de yanchama, y elaboración del plan de gestión para su ejecución

La artesanía colombiana ha venido demostrando que es uno de los sectores con un fuerte atractivo y un alto potencial de desarrollo, es por esto que las acciones en materia turística deben apostarle a la creación, desarrollo y consolidación de ventajas competitivas. El sector artesanal posee una importante ventaja comparativa, ya que se encuentra fuertemente ligado al sector turístico, constituyéndose como un factor diferenciador que a la vez permite su constante impulso, a través de una alianza intersectorial que simultáneamente une dicho sector artesanal a otros sectores de desarrollo. Actualmente en el mercado nacional se presentan vacíos en la fabricación y en la comercialización de productos artesanales, básicamente las empresas que existen solo ofrecen productos, estilos y diseños repetidos, sin brindar la posibilidad al cliente de encontrar y obtener productos únicos que los diferencien de los demás. Existe mucha imitación en los productos artesanales ya que su materia prima es de fácil acceso. Sin embargo, estos no ofrecen servicios adicionales en el momento previo de la compra y postventa de la misma, por lo que los clientes se muestran en ocasiones insatisfechos.Incluye bibliografía, anexos e índic

Comparing different pneumoperitoneum (12 vs. 15 mmHg) pressures with cytokine analysis to evaluate clinical outcomes in patients undergoing robotic‐assisted laparoscopic radical cystectomy and intracorporeal robotic urinary diversion

© 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company. This is an open access article under the terms of the Creative Commons Attribution License. https://creativecommons.org/licenses/by/4.0/Background: Robotic cystectomy is the mainstay surgical intervention for treatment‐refractory non muscle‐invasive and muscle‐invasive bladder cancer. However, paralytic ileus may complicate the postoperative recovery and may be a consequence of an inflammatory response associated with transient gut ischaemia. We have therefore investigated clinical, operative and inflammatory biomarker associations between paralytic ileus in the context of robotic cystectomy and intracorporeal ileal conduit urinary diversion. Methods: Prospective consecutive patients referred for robotic cystectomy were consented and included in the study, while patients >75 years old and converted to open procedure were excluded. The pneumoperitoneum pressure (PP) for carbon dioxide insufflation required to perform the procedure efficiently and safely was recorded (12 or 15 mmHg). We also recorded the postoperative days patients passed flatus and stools, whether they developed ileus, as well as other standard clinical and demographic data. The expression of select proinflammatory and anti‐inflammatory cytokines was determined by multiplex analysis using a cytometric bead array with changes in profiles correlated with the pressures applied and with the existence of an ileus. Results: Twenty‐seven patients were recruited, but only 20 were used in the study with 10 patients in each PP group. Seven patients were excluded all of whom had an extracorporeal ileal conduit formation. There were differences in the 40‐min shorter operative time and 1 day shorter length of stay, as well as passing flatus 1 day and stools 1.5 days earlier in the 12 mmHg compared with the 15 mmHg group. More patients had ileus in the 15 mmHg group vs 12 mmHg group (30% vs. 10.0%). These were not statistically significant. Similarly, there were no statistical differences in the expression of proinflammatory cytokines at the two different pressures or between patient groups, but there were outliers, with the median indicating nonsymmetrical distribution. By comparison, anti‐inflammatory cytokines showed some significant differences between groups, with IL‐6 and IL‐10 showing elevated levels post surgery. No statistical difference was observed between pressures or the existence of an ileus, but the maximum levels of IL‐6 and IL‐10 detected in some patients reflect a pressure difference. Conclusions: The initial findings of this novel scientific study indicated a higher risk of paralytic ileus postrobotic cystectomy and robotic intracorporeal urinary diversion when a higher pressure of 15 mmHg is used compared with 12 mmHg. Although further studies are required to establish the linkage between cytokine profile expression, pressure and ileus, our initial data reinforces the advantages of lower pressure robotic cystectomy and intracorporeal urinary diversion in patient outcomes.Peer reviewe