Neoplasia papilar intraductal de la vía biliar / Intraductal papillary neoplasm of the bile duct / Neoplasia papilar intraductal da via biliar

La neoplasia papilar intraductal de la vía biliar (NPIVB) es una entidad infrecuente caracterizada por el crecimiento exofítico papilar del epitelio biliar hacia la luz ductal. Previamente incluida en el grupo de tumores del mismo nombre de localización pancreática, presenta diferencias evidentes con ellos y desde 2010 se considera una entidad propia con demostrado potencial de malignización hacia colangiocarcinoma.

Papillary intraductal neoplasia of the bile duct (NPIVB) is a rare entity characterized by exophytic papillary growth of the biliary epithelium towards the ductal lumen. Previously included in the group of tumors of the same name in pancreatic location, it presents obvious differences with them and since 2010 it has been considered a separate entity with demonstrated potential for malignancy towards cholangiocarcinoma.

O neoplasma papilar intraductal da via biliar (NPIVB) é uma entidade infrequente por el creciento exofítico papilar do epitélio biliar hacia la luz ductal. Obviamente incluído no grupo de tumores do mismo nombre de localização pancreática, apresenta diferenças evidentes com ellos e desde 2010 se considerar uma entidade propia com potencial demonstrado de malignización hacia cholangiocarcinoma.

Characterization of Electrospun Poly(ε-caprolactone) Nano/Micro Fibrous Membrane as Scaffolds in Tissue Engineering: Effects of the Type of Collector Used.

Electrospinning is an electrohydrodynamic technique that transforms a polymer solution into nano/microscopic diameter fibers under the influence of a high-voltage electric field. Its use in the fabrication of nano/micro fibrous membranes as scaffolds for tissue engineering has increased rapidly in recent years due to its efficiency and reproducibility. The objective of this study is to show how the use of the same polymeric solution (polycaprolactone 9% w/v in chloroform: isopropanol 50:50) and identical electrohydrodynamic deposition parameters produces fibers with different characteristics using a flat collector platform with movements in the X and Y axes vs. a conventional rotary collector. The manufactured nano/microfibers show significant differences in most of their characteristics (morphology, roughness, hydrophilicity, and mechanical properties). Regarding the diameter and porosity of the fibers, the results were similar. Given that scaffolds must be designed to guarantee adequate survival and the proliferation and migration of a certain cell type, in this study we analyze how the variations in the characteristics of the fibers obtained are essential to defining their potential application.

Prevalent subtypes and one-year outcomes of an HIV-cohort from an urban Philippine center.

ABSTRACT: Circulating HIV subtypes in the Philippines have increasingly diversified, potentially affecting treatment. We monitored outcomes of a treatment-naïve cohort and their virus subtype prevalence.Retrospective/prospective study cohort.HIV-I-REACT clinic patients co-enrolled in the Virology Quality Assurance Program (RUSH-VQA) from 7/2017-6/2019 were included. Relevant demographic and laboratory information were collected. The ViroSeq HIV-1 Genotyping System v.3 and HIV-1 Integrase Genotyping Kit identified protease-reverse transcriptase and integrase drug resistance mutations (DRM). Sequence subtyping followed using the Stanford University Drug Resistance Database and the REGA HIV-1 Subtyping Tool v.3. The jpHMM HIV-1 Tool and REGA HIV-1 Subtyping Tool provided additional subtype analysis of this cohort's 5'LTR-VIF regions after Sanger sequencing. One-year outcomes included virologic suppression, mortality, and follow-up.86/88 patients were males. Median age was 30 (range 19-65) years; 61/88 were MSM. 15/85 carried baseline DRM. ViroSeq-generated sequences included subtypes CRF01_AE (66/85), B (14/85), and newer recombinants (4/85). Extensive sequencing (n = 71) of the 5'-LTR-GAG-Pol genes showed CRF01_AE (n = 50), subtype B (n = 7), and other recombinants (n = 13). Bootstrap analysis identified 7 pairs of highly related strains. Discordant DRM appeared in 2/7 pairs, where 1/2 strains displayed DRM. After 1 year, 87 individuals were alive, with 19 lost to care. Viral load (VL) was repeated for only 31/77 (40.2%). Follow-up CD4 testing for 39/77 (50.6%) showed an increase to a median of 327 cells/mm3.Our cohort currently carries subtype CRF01_AE (∼68%-70%), followed by subtype B and CRF01_AE/B recombinants. Outcomes were favorable, regardless of subtype after 1 year on cART.

Hemangioma de colon Descripción de caso y revisión de la literatura / HEMANGIOMA OF THE COLON. Case report and literature review

El hemangioma de colon y recto es una entidad poco frecuente. El tipo cavernoso, es aún más raro por lo que existen pocos reportes de esta patología. Afecta mayormente al recto y al sigmoides, y el modo de presentación más común es la proctorragia indolora en el 90% de los casos. Más frecuente en adultos jóvenes. Esta entidad para su diagnóstico requiere alta sospecha y la realización de los estudios pertinentes ya que suele confundírsela con patologías más comunes. En esta revisión se presenta el caso de un paciente masculino de 58 años con un hemangioma cavernoso de colon transverso que se manifestó inicialmente como hematoquecia asociada a astenia. Luego de realizar estudios complementarios, se decide conducta quirúrgica. Se realizó resección de colon transverso con buena evolución postoperatoria. El resultado de anatomía patológica nos informa Hemangioma Cavernoso de colon transverso.

The hemangioma of the colon and rectum is a rare entity. The cavernous type is even more rare, so there are few reports of this pathology. It mainly affects the rectum and the sigmoid, and the most common presentation is painless proctorrhagia in 90% of cases. More frequent in young adults. This entity for its diagnosis requires high suspicion and the realization of the pertinent studies since it is usually confused with more common pathologies. In this review we present the case of a 58-year-old male patient with a cavernous hemangioma of the transverse colon that initially manifested as hematochezia associated with asthenia. After performing complementary studies, surgical behavior is decided. Transverse colon resection was performed with good postoperative evolution. The result of pathological anatomy informs us Cavernous hemangioma of transverse colon

Impact of a medication reconciliation program on cardiac surgery patients.

Background Cardiac surgery patients are at high risk of medication errors. Resumption of home medications reduces the significance and number of medication errors. This could be achieved by implementing a medication reconciliation program. Patients and Methods Patients were eligible for inclusion in this prospective study if they were admitted, transferred, and/or discharged under cardiac surgery team care from September 2015 to March 2016. The primary outcome was the number and proportion of unintentional medication discrepancies. Secondary outcomes included the number of interventions to resolve discrepancies and their clinical significance, and the medication regimen complexity index and its correlation with discrepancies. Results There were 374 patients included and 1000 encounters tracked. Four-hundred and seventy (47%) of the included encounters were for adult patients. Of the 260 medication discrepancies detected, 181 (69.61%) were detected during admission. Discrepancies among adults were 0.913, 0.307, and 0.176 on admission, transfer, and discharge, respectively. Two-hundred (76.92%) of the interventions recommended by the pharmacy residents were accepted by the medical team, and the remaining were accepted with modifications, with no rejections. One-hundred and sixty-six (83%) of the accepted interventions were of high clinical significance. There was a significant correlation between the number of medication discrepancies and medication regimen complexity index on admission ( p < 0.0001, r = 0.34), transfer, and discharge. Conclusion Implementation of a medication reconciliation program in cardiac surgery units and its step-down units can be a powerful mean of identifying medication errors in post-cardiac surgery patients at admission and throughout the transition of care.

Un brote de salmonelosis no tífica entre internos de medicina en un hospital general / An outbreak of non-typhoid salmonellosis among interns of medicine in a general hospital

Objetivo. Revisar las manifestaciones clínicas de un brote de salmonelosis no tífica en internos de medicina en un hospital general. Material y Métodos. Estudio prospectivo, descriptivo y serie de casos. Se entrevistó a 13 internos afectados. Se obtuvo datos de demográficos, clínicos y de laboratorio. resultadOs. La edad promedio fue de 24,5 años, el tiempo de enfermedad entre horas hasta dos días. El cuadro clínico se caracterizó por diarrea de 6 a 12 cámaras diarias (que varió desde acuosa hasta disentérica), fiebre, dolor abdominal de tipo cólico, náuseas, vómitos y compromiso de conciencia. Las muestras de heces fueron enviadas al Instituto Nacional de Salud. Se aisló Salmonella enteritidis en todas las muestras.

Objective. To review the clinical manifestations of a non- typhoid salmonellosis outbreak among medicine interns in a general hospital. Materials and Methods. It was done a prospective, descriptive and cases series study. Thirteen medicine interns were interviewed. Demographic, clinical and laboratorial data were obtained. The stool samples were sent to the National Institute of Health. results. The mean age was 24,5 year old-age; the onset of symptomswas between hours until two days. The clinical manifestations included diarrhea (that varied from secretory to dysenteric type), fever, abdominal cramps, nausea, vomits and disorientation.