Follicular nodules (Thy3) of the thyroid: is total thyroidectomy the best option?

BACKGROUND: Identification of the best management strategy for nodules with Thy3 cytology presents particular problems for clinicians. This study investigates the ability of clinical, cytological and sonographic data to predict malignancy in indeterminate nodules with the scope of determining the need for total thyroidectomy in these patients. METHODS: The study population consisted of 249 cases presenting indeterminate nodules (Thy3): 198 females (79.5%) and 51 males (20.5%) with a mean age of 52.43 ± 13.68 years. All patients underwent total thyroidectomy. RESULTS: Malignancy was diagnosed in 87/249 patients (34.9%); thyroiditis co-existed in 119/249 cases (47.79%) and was associated with cancer in 40 cases (40/87; 45.98%). Of the sonographic characteristics, only echogenicity and the presence of irregular margins were identified as being statistically significant predictors of malignancy. 52/162 benign lesions (32.1%) and 54/87 malignant were hypoechoic (62.07%); irregular margins were present in 13/162 benign lesions (8.02%), and in 60/87 malignant lesions (68.97%). None of the clinical or cytological features, on the other hand, including age, gender, nodule size, the presence of microcalcifications or type 3 vascularization, were significantly associated with malignancy. CONCLUSIONS: The rate of malignancy in cytologically indeterminate lesions was high in the present study sample compared to other reported rates, and in a significant number of cases Hashimoto’s thyroiditis was also detected. Thus, considering the fact that clinical and cytological features were found to be inaccurate predictors of malignancy, it is our opinion that surgery should always be recommended. Moreover, total thyroidectomy is advisable, being the most suitable procedure in cases of multiple lesions, hyperplastic nodular goiter, or thyroiditis; the high incidence of malignancy and the unreliability of intraoperative frozen section examination also support this preference for total over hemi-thyroidectomy

Acerca del libro: Manual of Hypertension of the European Society of Hypertension

En las 635 páginas y 199 ilustraciones en color que contiene este libro y su versión electrónica correspondiente, con más de noventa autores distribuidos en sus capítulos, desarrolla los más variados aspectos de la hipertensión arterial. El libro se divide en nueve secciones con 59 capítulos en total.El periplo hacia los diferentes temas de la hipertensión se inicia con la epidemiología de la enfermedad y sobre el riesgo cardiovascular total. En los capítulos son considerados también otros factores de riesgo cardiovascular, que pueden acompañar a la hipertensión arterial como por ejemplo la obesidad o la diabetes mellitus, situaciones clínicas muy conocidas en la práctica cotidiana. Los aspectos etiológicos y fisiopatológicos son presentados detalladamente en seis capítulos muy bien logrados.Siguen varios capítulos sobre la evaluación de los daños de órganos blanco, de sumo interés para el manejo adecuado de la hipertensión arterial, así como los procedimientos para medir la presión arterial y el manejo diagnóstico de los pacientes hipertensos.Posteriormente varios capítulos cubren los aspectos terapéuticos de la hipertensión arterial, comenzando con un capítulo que fija las metas a obtener en el control de la hipertensión arterial, de los que se toman conceptos muy enriquecedores para la práctica diaria. Las situaciones especiales de la hipertensión arterial también son consideradas, como la hipertensión resistente, la del diabético y las diversas formas de hipertensión arterial secundari

Bibliometric Analysis of the United Kingdom’s Contribution to Scientific Literature in the Field of Optometry

History: Optometry is a young discipline undergoing expansion, in which English-speaking countries predominate in this scientific field. Purpose: We have conducted a bibliometric analysis of scientific publications of British researchers in the field of Optometry beginning from 1972 (date of first publications) until 2013, to compare its production with other countries. Methods: For this study, the EMBASE database was used using “optomtr*”, “optic*”, “visual”, “vision”, ”eye*” and “ophthalm*” as search terms. To the selected publications, we applied a series of bibliometric indicators such as Price’s law on the increase of scientific literature, the doubling time of production, Lotka’s law of scientific productivity, Price’s transience index, and Bradford’s Law of scattering of scientific literature, and the degree of collaboration among authors was also analysed. Furthermore, the scientific output was correlated with socio-medical data (per capita income and Health expenses). Results: The number of published articles retrieved for the period 1972–2013 was 3,331. The UK ranks second in optometric production. The growth of publications was more linear (r = 0.9093) than exponential (r = 0.8434). The doubling time of scientific production was 4.97. The level of productivity corresponded to medium-size producers (81.70%) and a transience index of 9.75%. %. The collaboration index is 87% and the degree of collaboration is 0.88. The collaboration index was 3.78. The Bradford core was formed by three journals with an impact factor greater than 2, in which Ophthalmic and Physiological Optics with 20.38% accumulated the greatest number of articles. Conclusions: English-speaking countries account for the majority of the production in Optometry. Research in the UK is in an established phase that shows linear growth in scientific output, as demonstrated by the low transience index and the high percentage of authors found to be medium-size producers. We found a high concentration of publications in a small number of journals

Purificación y caracterización preliminar de proteasas del látex de Vasconcellea candicans (A. Gray) A. DC (Mito)

Preliminary studies indicate that, the "Mito" fresh latex, has a specific activity of papain from 1.84 times greater than that found in the latex of papaya, so the objective of this study was to purify and characterize "Mito" fresh latex proteases that have activity of papain. The crude extract protease was obtained from the "Mito" latex which was re-suspended (1:1) in 10 mM Na acetate buffer at pH 5.0; immediately proteins were precipitated at pH 9.0 and then with 45% ammonium sulfate. Subsequently, the proteins were purified on a Sephadex G-100 column and were three fractions: A, B and C. Using as a substrate casein, the enzymatic specific activity (ESA) was measured and was found to be the fraction A was 87.74 nkat.mg-1protein, for fraction B was 14.93 nkat.mg-1protein and for fraction C it was 16.13 nkat.mg-1protein. ESA of fraction A against papain of fresh latex of C. papaya was 13.3 times greater. Electrophoretic analysis (12% denaturant gel) shows for A fraction, two protein bands having one of them a relation similar to the papain standard. In addition, there was observed that the A fraction (papain of "Mito") against different concentrations of casein, used as a substrate, displays a michaeliane sigmoid curve; different volumes of enzyme shows a linear behavior; it has an optimum pH of 7.5 and is active up to 60 °C.Estudios preliminares indican que, el látex fresco del “Mito” tiene una actividad específica de papaína de 1,84 veces mayor a la encontrada en el látex of papaya, por lo que el objetivo de este trabajo fue purificar y caracterizar las proteasas del látex fresco del “Mito” que tuvieran actividad de papaína. El extracto crudo de proteasas se obtuvo a partir del látex de “Mito” el cual fue resuspendido (1:1) en buffer acetato de Na 10 mM a pH 5,0; inmediatamente se precipitaron proteínas a pH 9,0 y luego con sulfato de amonio al 45%. Posteriormente se purificó en una columna de Sephadex G-100 y se obtuvieron tres fracciones: A, B y C; utilizando como sustrato caseína se midió la actividad enzimática específica (AEE). Se encontró que para la Fracción A la AEE fue de 87,74 nkat.mg-1proteína, para la Fracción B fue de 14,93 nkat.mg-1proteína y para la Fracción C fue de 16,13 nkat.mg-1proteína. La AEE de la fracción A frente a la de papaína de látex fresco de C. papaya fue 13,3 veces mayor. En el análisis electroforético (gel desnaturalizante, 12%) se observa para la fracción A dos bandas de proteínas teniendo una de ellas una “relación de frente” semejante al estándar de papaína. Además, se observó que la fracción A (papaína de “Mito”) frente a diferentes concentraciones de caseína, usada como sustrato, presenta una curva sigmoidea michaeliana; a diferentes volúmenes de enzima se muestra un comportamiento lineal; tiene un pH óptimo a 7,5 y es activa hasta 60 ºC

Hiponatremia crónica severa de causa poco común

La hiponatremia es el trastorno electrolítico más frecuentemente encontrado en la práctica médica cotidiana y puede llegar a afectar a pacientes tanto en el medio hospitalario como el extrahospitalario. Presentamos el caso de un varón que se presentó a nuestro hospital con una causa de hiponatremia severa, de etiología poco convencional, que respondió satisfactoriamente al tratamiento impartido

Morfología de Amblyomma tigrinum (Arthropoda: Ixodidae) por microscopía electrónica de barrido

Santa Cruz, A.C.; Sarmiento, N.F.; Acuña, M.J.; Comolli, J.A.: Morfología de Amblyomma tigrinum (Arthropoda: Ixodidae) por microscopía electrónica de barrido. Rev. vet. 22: 1, 68–71, 2011. Palabras clave: Amblyomma tigrinum, Hydrochoerus hydrochaeris, morfología, microscopía electrónica de barrido

Effect of Activated Carbon Made from Cocoa (Theobroma Cacao L.) Shells on the Adsorption of Iron in Aquifer Water

This research aims to determine the effect of activated carbon obtained from cocoa husks (Theobroma cacao L.) on the adsorption of iron (II) present in water of an aquifer for human consumption. Charcoal was prepared at different carbonization temperatures (500, 600 and 700 °C) for 30 minutes and activated with phosphoric acid in the proportions of 1:1. Iron (II) adsorption was determined as a function of variations in mixing speed, contact time, charcoal dosage and stirring speed. It was determined that, over the range considered, agitation speeds had no significant effect on the percentage of iron (II) removal, being the dose of activated carbon and temperature, the most influential variables. The water samples had an initial iron concentration of 3.15 mg/L and 4 mg/L. The best iron (II) adsorption result was obtained with activated carbon at the carbonization temperature of 700 °C, with a mass of 1.5 g of carbon, with efficiencies of 93 % and 98 % for both samples considered. Based on the results, it was concluded water for human consumption is treatable with activated carbon derived from Theobroma cacao L. for the adsorption of iron (II), considering that this parameter is below the maximum limit of 0.3 mg/L allowed by current regulations

Kepler constraints on planets near hot Jupiters

We present the results of a search for planetary companions orbiting near hot Jupiter planet candidates (Jupiter-size candidates with orbital periods near 3 d) identified in the Kepler data through its sixth quarter of science operations. Special emphasis is given to companions between the 2∶1 interior and exterior mean-motion resonances. A photometric transit search excludes companions with sizes ranging from roughly two-thirds to five times the size of the Earth, depending upon the noise properties of the target star. A search for dynamically induced deviations from a constant period (transit timing variations) also shows no significant signals. In contrast, comparison studies of warm Jupiters (with slightly larger orbits) and hot Neptune-size candidates do exhibit signatures of additional companions with these same tests. These differences between hot Jupiters and other planetary systems denote a distinctly different formation or dynamical history