Embarazo cornual roto. ¿Por qué no debemos olvidar al embarazo como causa de dolor abdominal? / Broken cornual pregnancy. Why not forget pregnancy with abdominal pain?

Resumen ANTECEDENTES: el embarazo ectópico cornual es excepcional y pone en riesgo la vida de la madre. Puede manifestarse con hemorragia materna grave durante la rotura cornual. El embarazo cornual se diagnostica por anamnesis, examen clínico, análisis de laboratorio y ecografía transvaginal. CASO CLÍNICO: paciente de 31 años de edad, con un embarazo ectópico cornual roto que requirió intervención quirúrgica.

Abstract BACKGROUND: Cornual ectopic pregnancy is a rare condition. This is the most dangerous tipe of ectopic pregnancy. A severe maternal hemorrhage can result during a cornual rupture. Cornual pregnancy is diagnosis by anamnesis, clinical examination, plasma markers and transvaginal ultrasound. CLINICAL CASE: We present the case of 31 years old female patient with a ruptured cornual ectopic pregnancy. The patient was submitted to surgery.

Burnout, liderazgo y satisfacción laboral en el personal asistencial de un hospital de tercer nivel en Bogotá / Burnout, Leadership and Job Satisfaction in Health Professionals of a Third Level Hospital in Bogotá

El propósito de este estudio fue identificar la presencia del Síndrome de Burnout, los estilos de liderazgo y la satisfacción laboral de los profesionales asistenciales de un hospital de tercer nivel y observar su relación, considerando variables sociodemográficas. Para ello, se utilizó el MBI, el TAP y el Test de Satisfacción Laboral S20/23, respectivamente. De acuerdo con los resultados, se encontró baja presencia de Burnout y altos niveles de realización personal, a pesar de las condiciones laborales adversas precursoras del síndrome. Contrario a lo reportado en la literatura, las personas con el síndrome o en riesgo de padecerlo presentan alta satisfacción laboral, sustentada en su motivación intrínseca, lo cual constituye un factor protector. No se encontró relación directa entre liderazgo y Burnout, pero el liderazgo sí se relaciona con la satisfacción laboral a través de la motivación intrínseca. Por último, se confirma el papel mediador de las variables sociodemográficas.

The aim of this study is identify the presence of burnout; leadership styles and job satisfaction of professionals in a third level hospital and see if these are related, considering sociodemographic variables. We used the Spanish version of MBI, the TAP and Job Satisfaction Test S20/23. According to the results, we found low presence of burnout and high levels of personal accomplishment, despite the adverse labor conditions, commonly precursors of the syndrome. Contrary to reported in the literature, people with the syndrome or significant risk, have high job satisfaction, based on intrinsic motivation, which constitute a protective factor. There was no direct relationship between leadership and burnout, but leadership is relates to job satisfaction through intrinsic motivation. The mediating role of sociodemographic variables is confirmed.

Maternal influence of prolyl endopeptidase on fat mass of adult progeny.

BACKGROUND: Maternal genotype has lifetime effects on progeny, but few specific genes, and no proteases, are known to underlie maternal effects. Prolyl endopeptidase (PREP) is a serine protease with putative substrates that regulate appetite or milk production. OBJECTIVE: To test effects of PREP on obesity phenotypes in mice. DESIGN: Mice with a gene trap (GT) of PREP (PREP(gt/gt)) on the C57BL/6J (B6) background were generated. Minimal PREP protein was detected by western blot. In Experiment 1, direct effects of PREP were measured in littermate mice derived from intercrosses of heterozygotes (PREP(WT/gt)). In Experiment 2, maternal effects of PREP were measured in reciprocal crosses of heterozygous (PREP(WT/gt)) and wild-type (WT) (PREP(WT/WT)) males and females. DIETS: Mice were fed either low-fat (LF, Experiments 1 and 2) or high-fat (HF, Experiment 1) defined diets. MEASUREMENTS: Adiposity index (AI) was calculated from body weight (BW) and weights of four fat depots measured in 120-day-old mice. Fasting plasma glucose, insulin and leptin were measured. In vivo plasma alpha-MSH levels were measured by targeted quantitative peptidomics. RESULTS: Experiment 1-In intercross mice, there were significant diet effects, but few genotype effects. There were no genotype effects on BW or AI in males or females on either diet. Experiment 2-In contrast, reciprocal crosses of heterozygous males or females with WT B6 revealed highly significant parent of origin effects on all traits except body length. Progeny (WT and heterozygous genotypes and both sexes) born to female PREP(WT/gt) heterozygotes had fat pads that weighed as much as -twofold more at 120 days old than progeny born to male heterozygotes. CONCLUSION: Heterozygosity for PREP GT results in highly significant maternal effects, whereas homozygosity for the PREP(gt/gt) mutation has a much more limited direct effect.

Genes and networks expressed in perioperative omental adipose tissue are correlated with weight loss from Roux-en-Y gastric bypass.

CONTEXT: Gastric bypass surgery is the most commonly performed bariatric surgical procedure in the United States. Variable weight loss following this relatively standardized intervention has been reported. To date, a method for reliable profiling of patients who will successfully sustain weight loss for the long term has not been established. In addition, the mechanisms of action in accomplishing major weight loss as well as the explanation for the variable weight loss have not been established. OBJECTIVE: To examine whether gene expression in perioperative omental adipose is associated with gastric bypass-induced weight loss. DESIGN: Cross-sectional study of gene expression in perisurgical omental adipose tissues taken/available at the time of operation and total excess weight loss (EWL). SUBJECTS: Fifteen overweight individuals who underwent Roux-en-Y gastric bypass (RYGB) surgery at the University of California Davis Medical Center (BMI: 40.6-72.8 kg/m(2)). MEASUREMENTS: Body weight before and following weight stabilization 18-42 months after surgery. Perioperative omental adipose RNA isolated from 15 subjects was hybridized to Affymetrix HG-U133A chips for 22,283 transcript expression measurements. RESULTS: Downstream analysis identified a set of genes whose expression was significantly correlated with RYGB-induced weight loss. The significant individual genes include acyl-coenzyme A oxidase 1 (ACOX1), phosphodiesterase 3A cGMP-inhibited (PDE3A) and protein kinase, AMP-activated, beta 1 non-catalytic subunit (PRKAB1). Specifically, ACOX1 plays a role in fatty acid metabolism. PDE3A is involved in purine metabolism and hormone-stimulated lipolysis. PRKAB1 is involved in adipocytokine signaling pathway. Gene network analysis revealed that pathways for glycerolipid metabolism, breast cancer and apoptosis were significantly correlated with long-term weight loss. CONCLUSION: This study demonstrates that RNA expression profiles from perioperative adipose tissue are associated with weight loss outcome following RYGB surgery. Our data suggest that EWL could be predicted from preoperative samples, which would allow for informed decisions about whether or not to proceed to surgery.