Correlation between urinary concentration of malondialdehyde and DNA damage in people exposed to mercury

ABSTRACT: To determine whether the extent of DNA damage correlates with the concentration of malondialdehyde (MDA) in urine of individuals occupationally exposed to mercury. Methods: We evaluated 64 medical records (32 from exposed persons and 32 from unexposed controls). In both groups we analyzed the comet assay data (percentage of DNA in the tail), as well as the levels of MDA and mercury in the urine. We compared the MDA concentrations, and the changes in the comet assay between the groups and the correlation between these variables. Results: MDA concentrations were higher in exposed persons than in controls (median 1.28 vs. 0.51 μmol/L, respectively), and a corresponding damage was observed in the comet assay (median of DNA percentage in tail: 27.37 vs. 0.31, respectively). However, we found poor correlation between urinary MDA and genetic damage (r <0.11). Conclusion: No evidence was obtained indicating that higher concentrations of MDA in urine were related to additional genetic damage, but there were more DNA damage and higher concentrations of MDA in individuals occupationally exposed to mercury compared with unexposed people.RESUMEN: Determinar si la magnitud del daño en el ADN se correlaciona con la concentración de malondialdehído (MDA) urinario en individuos expuestos ocupacionalmente a mercurio y en controles no expuestos. Metodología: se evaluaron 64 historias clínicas (32 de expuestos y 32 de controles) en los que se determinó la concentración urinaria de MDA y se hizo el ensayo cometa para detectar el porcentaje de ADN en la cola. Se compararon las concentraciones de MDA y las alteraciones en el cometa entre los grupos y se hizo una correlación entre estas variables. Resultados: hubo mayores concentraciones de MDA en los expuestos que en los controles (mediana 1,28 frente a 0,51 μmol/L, respectivamente), así como mayores daños en el ensayo cometa (mediana del porcentaje de ADN en cola: 27,37 frente a 0,31, respectivamente). Hubo mala correlación entre el MDA en la orina y el daño genético (r <0,11). Conclusión: no se pudo demostrar que a mayores concentraciones de MDA en la orina se presentara mayor daño genético, pero sí hubo mayor daño del ADN y concentraciones más altas de MDA en los expuestos que en los controles

Construcción de un banco de imágenes virtuales de Dermatopatología para la docencia en Posgrado

La digitalización de imágenes, denominado “microscopía virtual”, es una tecnología relativamente reciente, que tiene como objetivo simular el uso del microscopio de luz a través de la digitalización de láminas para crear imágenes de alta resolución. De esta manera las aplicaciones de la digitalización de imágenes en patología cobran importancia a la hora de complementar la visualización directa sobre todo en casos complejos y/o que tengan un gran volumen de consulta, ambas cosas ocurren con la dermatopatología, por tanto, se hace de vital importancia generar bases de datos anotadas, que resalten las características histopatológicas de importancia y que sirvan como complemento tanto para consultas cotidianas, como para la docencia en posgrado. En este trabajo, se seleccionaron cien casos de enfermedades inflamatorias prototípicas de la piel. Se utilizaron los patrones para el diagnóstico histológico de las enfermedades de la piel propuestos por el Dr Ackerman como guía. Para cada caso se definieron los patrones y conceptos histopatológicos a resaltar. Se digitalizaron las imágenes con el microscopio robotizado diseñado por el grupo CIM@LAB de la Universidad Nacional de Colombia. Las imágenes digitalizadas fueron subclasificadas en dos grupos: 1. Conceptos básicos y 2. Patrones de enfermedades inflamatorias de la piel. En cada lámina virtual se realizaron anotaciones para señalar los conceptos importantes para el diagnóstico histopatológico y se describieron las definiciones correspondientes. La herramienta obtenida está disponible para su consulta a través de la URL: http://cimalab.unal.edu.co/microscopioAbstract: Digitalization of histopathology images, called "virtual microscopy", is a relatively recent technology, which aims to simulate the use of light microscope through the digitalization of glass slides to create high resolution images. In dermatopathology, there are numerous and complex cases; in this way, image digitalization becomes important since it is an academic complement for direct visualization. Therefore, it is important to build annotated databases that highlight histopathological main concepts, thereby serving as a complement for both daily consultations and postgraduate teaching. In this work, one hundred cases of prototypical inflammatory skin diseases were selected. Histopathological patterns proposed by Dr. Ackerman were used for the diagnosis. For each case, histopathological pattern and concepts to be highlighted were defined. The images were digitized with the robotic microscope designed by the CIM@LAB group of Universidad Nacional de Colombia. Digitized images were subclassified into two groups: 1. Basic concepts and 2. Patterns of inflammatory skin diseases. In each virtual slide annotations were made to indicate the important concepts for the histopathological diagnosis and the corresponding definitions were described. The developed tool is available for consultation through the URL: http://cimalab.unal.edu.co/microscopio.Otr

Classification of Parkinson&rsquo;s Disease Patients&mdash;A Deep Learning Strategy

(1) Background and objectives: Parkinson&rsquo;s disease (PD) is one of the most prevalent neurodegenerative diseases whose typical symptoms include bradykinesia, abnormal gait and posture, shortened strides, and other movement disorders. In this study, we present a novel framework to evaluate PD gait patterns using state of the art deep learning algorithms. A comparative analysis with three different approaches is presented and evaluated upon three groups of subjects: PD patients, Young Healthy Controls (YHC), and Elderly Healthy Controls (EHC). (2) Methods: The three approaches used in the study include: (i) The energy content of the gait signals in the frequency domain is captured with spectrograms that are used to feed a CNN model, (ii) Temporal information is incorporated by creating GRU networks, (iii) Temporal and spectral information is simultaneously captured by creating a new architecture based on CNNs and GRUs. (3) Results: Accuracies of up to 83.7% and 92.7% are found for the classification between PD vs. EHC and PD vs. YHC, respectively. According to our observations, the proposed approach based on the combination of temporal and spectral information, yields better results than others reported in the state of the art. (4) Conclusions: The results obtained in this study suggest that the combination of temporal and spectral information is more accurate than individual approaches used to classify and evaluate gait patterns in PD patients. To the best of our knowledge, this is the first study in gait analysis where temporal and spectral information is combined in an architecture of deep learning

Classification of Parkinson’s Disease Patients—A Deep Learning Strategy

(1) Background and objectives: Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases whose typical symptoms include bradykinesia, abnormal gait and posture, shortened strides, and other movement disorders. In this study, we present a novel framework to evaluate PD gait patterns using state of the art deep learning algorithms. A comparative analysis with three different approaches is presented and evaluated upon three groups of subjects: PD patients, Young Healthy Controls (YHC), and Elderly Healthy Controls (EHC). (2) Methods: The three approaches used in the study include: (i) The energy content of the gait signals in the frequency domain is captured with spectrograms that are used to feed a CNN model, (ii) Temporal information is incorporated by creating GRU networks, (iii) Temporal and spectral information is simultaneously captured by creating a new architecture based on CNNs and GRUs. (3) Results: Accuracies of up to 83.7% and 92.7% are found for the classification between PD vs. EHC and PD vs. YHC, respectively. According to our observations, the proposed approach based on the combination of temporal and spectral information, yields better results than others reported in the state of the art. (4) Conclusions: The results obtained in this study suggest that the combination of temporal and spectral information is more accurate than individual approaches used to classify and evaluate gait patterns in PD patients. To the best of our knowledge, this is the first study in gait analysis where temporal and spectral information is combined in an architecture of deep learning

Correlation between urinary concentrations of malondialdehyde and DNA damage in people exposed to mercury = Correlación entre la concentración urinaria de malondialdehído y daño en el ADN de personas expuestas a mercurio

Objective: To determine whether the extent of DNA damage is correlated with the concentration of malondialdehyde (MDA) in urine of individuals occupationally exposed and unexposed to mercury Methods: We evaluated 64 medical records (32 reference group and 32 exposed group, they were matched byage, smoke and alcohol consumption). For analysis, comet assay data (olive tail moment, % DNA in the tail and tail length), levels of urinary MDA and urinary mercury were taken. We compared the concentrations of MDA and the changes in the comet assay between the groups and the correlation between these variables. Results: MDA concentrations were higher in exposed than in referents (median 1.28 vs 0.51μmol/L, respectively) and further damage to the comet assay (mean of tail % DNA: 27.37 vs. 0.31, median of Olivetail moment 8.29 vs olive 0.056; median of tail length 35 vs. 3.0, respectively).However there was a poor correlation between urinary MDA and genetic damage(r<0.11). Conclusion: No evidence was obtainedwith higher concentrations of MDA in urine provide additional genetic damage, but there was more DNA damage and higher concentrations of MDA in individuals occupationally exposed to mercury

Predominio del subtipo molecular luminal B en un grupo de mujeres con cáncer de mama infiltrante del eje cafetero de Colombia: análisis por técnica de inmunohistoquímica

Breast cancer is the most common cancer in women and constitutes a public health problem due to its high rates of morbidity and mortality. Diagnosis is made through routine histopathology studies that are complemented by expression studies of hormone receptors (Estrogen and Progesterone Receptors), human epidermal growth factor 2 (HER2) and cell proliferation index (Ki67) for their subtyping into molecular groups (Luminal A, Luminal B, Her2 and triple negative), which have different prognostic and therapeutic implications. Globally, a high prevalence of the Luminal A subtype has been reported, predominantly in North America, Europe, and some Latin American countries; however, the reports in the Colombian population are heterogeneous. The objective of this research is to establish an incidence profile of these molecular subtypes in a population of the coffee region in Colombia. In retrospect, samples of 377 patients with a diagnosis of infiltrating breast cancer were analyzed, between the years 2015 and 2018. The histological diagnoses included: NOS infiltrating ductal carcinomas (339 cases; 89.9 %), infiltrating lobular (23 cases; 6.1%), infiltrating mucinous (6 cases; 1.5%), infiltrating papillary (1 case; 0.2%) and mixed patterns: ductal - lobular (3 cases; 0.7%) and ductal with mucinous component (5 cases; 1.3%), of which 56.2% (212 cases) correspond to luminal B, 22.2% (84 cases) to Luminal A, 14.8% (56 cases) to triple negative and 6.6% (25 cases) to HER2. These findings contrast with the prevalence reported worldwide. Therefore, in the population of the Colombian coffee region, this predominance of the luminal pattern B should be considered when establishing prognosis and treatment from medical staff.El cáncer de mama es el cáncer más frecuente en las mujeres y constituye un problema de salud pública debido a sus altas tasas de morbimortalidad. El diagnóstico se hace a través de estudios rutinarios de histopatología que se complementan con estudios de expresión de receptores hormonales (Receptores de Estrógenos y Progesterona), del factor de crecimiento epidérmico humano 2 (HER2) e índice de proliferación celular (Ki67) para su subtipificación en grupos moleculares (Luminal A, Luminal B, Her2 y triple negativo), los cuales tienen implicaciones pronósticas y terapéuticas diferentes.  Globalmente, se ha reportado una alta prevalencia del subtipo Luminal A, predominantemente en Norteamérica, Europa y algunos países latinoamericanos, sin embargo, los reportes en la población colombiana son heterogéneos.  El objetivo de esta investigación es establecer un perfil de incidencia de dichos subtipos moleculares en una población del eje cafetero en Colombia.  Retrospectivamente se analizaron muestras de 377 pacientes con diagnóstico de cáncer de mama infiltrante, entre los años  2015  a  2018.  Los diagnósticos histológicos incluyeron:  Carcinomas Ductal infiltrante NOS (339 casos; 89.9 %), lobulillar infiltrante (23 casos; 6.1 %), mucinoso infiltrante (6 casos; 1.5 %), papilar infiltrante (1 caso; 0.2 %) y patrones mixtos: ductal-lobulillar (3 casos; 0.7 %) y ductal con componente mucinoso (5 casos; 1.3 %), de los cuales 56.2 % (212 casos) corresponden a luminal B, 22.2 % (84 casos) a Luminal A, 14.8 % (56 casos) a triple negativo y 6.6 % (25 casos) a HER2. Estos hallazgos contrastan con la prevalencia reportada a nivel mundial. Por lo tanto, en la población del eje cafetero colombiano, se debe considerar este predominio del patrón luminal B al momento de establecer pronóstico y tratamiento por parte del personal médico tratante

Predominio del subtipo molecular Luminal B en un grupo de mujeres con cáncer de mama infiltrante del Eje Cafetero de Colombia: Análisis por técnica de inmunohistoquímica

Breast cancer is the most common cancer in women and constitutes a public health problem due to its high rates of morbidity and mortality. Diagnosis is made through routine histopathology studies that are complemented by expression studies of hormone receptors (Estrogen and Progesterone Receptors), human epidermal growth factor 2 (HER2) and cell proliferation index (Ki67) for their subtyping into molecular groups (Luminal A, Luminal B, Her2 and triple negative), which have different prognostic and therapeutic implications. Globally, a high prevalence of the Luminal A subtype has been reported, predominantly in North America, Europe, and some Latin American countries; however, the reports in the Colombian population are heterogeneous. The objective of this research is to establish an incidence profile of these molecular subtypes in a population of the coffee region in Colombia. In retrospect, samples of 377 patients with a diagnosis of infiltrating breast cancer were analyzed, between the years 2015 and 2018. The histological diagnoses included: NOS infiltrating ductal carcinomas (339 cases; 89.9 %), infiltrating lobular (23 cases; 6.1%), infiltrating mucinous (6 cases; 1.5%), infiltrating papillary (1 case; 0.2%) and mixed patterns: ductal - lobular (3 cases; 0.7%) and ductal with mucinous component (5 cases; 1.3%), of which 56.2% (212 cases) correspond to luminal B, 22.2% (84 cases) to Luminal A, 14.8% (56 cases) to triple negative and 6.6% (25 cases) to HER2. These findings contrast with the prevalence reported worldwide. Therefore, in the population of the Colombian coffee region, this predominance of the luminal pattern B should be considered when establishing prognosis and treatment from medical staff.El cáncer de mama es el cáncer más frecuente en las mujeres y constituye un problema de salud pública debido a sus altas tasas de morbimortalidad. El diagnóstico se hace a través de estudios rutinarios de histopatología que se complementan con estudios de expresión de receptores hormonales (Receptores de Estrógenos y Progesterona), del factor de crecimiento epidérmico humano 2 (HER2) e índice de proliferación celular (Ki67) para su subtipificación en grupos moleculares (Luminal A, Luminal B, Her2 y triple negativo), los cuales tienen implicaciones pronósticas y terapéuticas diferentes.  Globalmente, se ha reportado una alta prevalencia del subtipo Luminal A, predominantemente en Norteamérica, Europa y algunos países latinoamericanos, sin embargo, los reportes en la población colombiana son heterogéneos.  El objetivo de esta investigación es establecer un perfil de incidencia de dichos subtipos moleculares en una población del eje cafetero en Colombia.  Retrospectivamente se analizaron muestras de 377 pacientes con diagnóstico de cáncer de mama infiltrante, entre los años  2015  a  2018.  Los diagnósticos histológicos incluyeron:  Carcinomas Ductal infiltrante NOS (339 casos; 89.9 %), lobulillar infiltrante (23 casos; 6.1 %), mucinoso infiltrante (6 casos; 1.5 %), papilar infiltrante (1 caso; 0.2 %) y patrones mixtos: ductal-lobulillar (3 casos; 0.7 %) y ductal con componente mucinoso (5 casos; 1.3 %), de los cuales 56.2 % (212 casos) corresponden a luminal B, 22.2 % (84 casos) a Luminal A, 14.8 % (56 casos) a triple negativo y 6.6 % (25 casos) a HER2. Estos hallazgos contrastan con la prevalencia reportada a nivel mundial. Por lo tanto, en la población del eje cafetero colombiano, se debe considerar este predominio del patrón luminal B al momento de establecer pronóstico y tratamiento por parte del personal médico tratante

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine