Carbon nanoparticle-based lateral flow assay for the detection of specific double-tagged DNA amplicons of Paracoccidioides spp.

To overcome the limitations of current methods for diagnosing paracoccidioidomycosis (PCM), it is critical to develop novel diagnostic strategies that can be implemented in low-resource settings and dramatically improve turnaround times. This study focused on the development of a portable molecular test to screen for Paracoccidioides spp. The proposed approach integrated double-tagging polymerase chain reaction (PCR) and a paper-based lateral flow assay (LFA) for readout, using carbon nanoparticles as a signal generation system. Primers tagged with biotin and digoxigenin were employed to conduct the double-tagging PCR, which can be conveniently carried out on portable thermocyclers. This method can generate billions of tagged DNA copies from a single target molecule, which can be rapidly detected by the LFA platform, providing results within minutes. Avidin-modified carbon nanoparticles served as a signal generation system, enabling detection in the immunochromatographic assay. The LFA demonstrated the capability to detect double-tagged amplicons as low as 0.21 ng or 0.10 ng, depending on whether the results were assessed visually or with a smartphone equipped with an image processor. These findings suggest that the proposed approach holds great promise as a point-of-care diagnostic tool for the early and accurate detection of PCM in low-resource settings. The diagnostic test is rapid and inexpensive, requires minimal handling and can be easily introduced into the general practitioner's armoury for ambulatory screening of infection. This innovative approach has the potential to make a substantial contribution to PCM diagnosis, ultimately reducing morbidity and mortality associated with this disease.

Comparative Study of Gold and Carbon Nanoparticles in Nucleic Acid Lateral Flow Assay.

A lateral flow assay (LFA) is a paper-based, point-of-need test designed to detect a specific analyte in complex samples in low-resource settings. Although LFA has been successfully used in different applications, its use is still limited when high sensitivity is required, especially in the diagnosis of an early-stage condition. The limit of detection (LOD) is clearly related to the signal-generating system used to achieve the visual readout, in many cases involving nanoparticles coupled to a biomolecule, which, when combined, provides sensitivity and specificity, respectively. While colloidal gold is currently the most-used label, other detection systems are being developed. Carbon nanoparticles (CNPs) demonstrate outstanding features to improve the sensitivity of this technology by producing an increased contrast in the paper background. Based on the necessity of sensitivity improvement, the aim of this work is a comparative study, in terms of analytical performance, between commercial streptavidin gold nanoparticles (streptAv-AuNPs) and avidin carbon nanoparticles (Av-CNPs) in a nucleic acid lateral flow assay. The visual LOD of the method was calculated by serial dilution of the DNA template, ranging from 0.0 to 7 pg µL-1/1.5 × 104 CFU mL-1). The LFA achieved visual detection of as low as 2.2 × 10-2 pg µL-1 using Av-CNPs and 8.4 × 10-2 pg µL-1 using streptAv-AuNPs. These LODs could be obtained without the assistance of any instrumentation. The results demonstrate that CNPs showed an increased sensitivity, achieving the nanomolar range even by visual inspection. Furthermore, CNPs are the cheapest labels, and the suspensions are very stable and easy to modify.

Unconventional quantum vortex matter state hosts quantum oscillations in the underdoped high-temperature cuprate superconductors.

A central question in the underdoped cuprates pertains to the nature of the pseudogap ground state. A conventional metallic ground state of the pseudogap region has been argued to host quantum oscillations upon destruction of the superconducting order parameter by modest magnetic fields. Here, we use low applied measurement currents and millikelvin temperatures on ultrapure single crystals of underdoped [Formula: see text] to unearth an unconventional quantum vortex matter ground state characterized by vanishing electrical resistivity, magnetic hysteresis, and nonohmic electrical transport characteristics beyond the highest laboratory-accessible static fields. A model of the pseudogap ground state is now required to explain quantum oscillations that are hosted by the bulk quantum vortex matter state without experiencing sizable additional damping in the presence of a large maximum superconducting gap; possibilities include a pair density wave.

Pacientes con dolor pélvico crónico intervenidas por laparoscopia en el Hospital Universitario de Santander, 2010-2013 / Patients with chronic pelvic pain intervened by laparoscopy in the University Hospital of Santander, 2010-2013

Resumen Introducción: El dolor pélvico crónico es un problema importante por su frecuencia y morbilidad, tiene una prevalencia del 3.8%, es considerado una de las principales indicaciones para histerectomía y realización de laparoscopia. Por otro lado, es adecuado seleccionar las pacientes que se beneficien de una laparoscopia. Objetivo: Describir las características clínicas, hallazgos intraoperatorios, y complicaciones quirúrgicas de las pacientes con diagnóstico de dolor pélvico crónico a quienes se les realizó laparoscopia diagnóstica y/o terapéutica, en el Hospital Universitario de Santander, entre los meses de junio 2010 a diciembre de 2013. Materiales y métodos: Se realizó un estudio retrospectivo descriptivo y de corte transversal. El plan de análisis se realizó en el software STATA 12.0 con un nivel de significancia del 5%. Resultados: La población fue conformada por 41 mujeres, el enfoque terapéutico inicial realizado fue analgésico (55,3%), en menor proporción hormonal (29%), sin embargo, en el 70% de los casos se inició un tratamiento combinado, al no presentar respuesta en ninguna de las pacientes se realizó procedimiento quirúrgico, encontrando como principales causas de dolor pélvico crónico, masas anexiales 51,2% y adherencias densas 41,5%. Conclusiones: Se debe hacer una mejor aproximación diagnóstica para utilizar de manera óptima los recursos disponibles, finalmente se evidencia como la laparoscopia es de gran utilidad para el manejo de endometriosis y síndrome adherencial. MÉD.UIS.2020;33(2):25-32.

Abstract Introduction: Chronic pelvic pain is a major problem due to its frequency and morbidity; it has a prevalence of 3.8%, it is considered one of the main indications for hysterectomy and laparoscopy. On the other hand, it is appropriate to select the patients who benefit from a laparoscopy. Objective: To describe the clinical characteristics, intraoperative findings, and surgical complications of patients with a diagnosis of chronic pelvic pain who underwent diagnostic and / or therapeutic laparoscopy at the University Hospital of Santander between the months of June. 2010 to December 2013. Materials and methods: A descriptive and cross-sectional retrospective study was carried out. The analysis plan was carried out in the STATA 12.0 software with a significance level of 5%. Results: The population was made up of 41 women, the initial therapeutic approach was analgesic (55.3%), in a lower hormonal proportion (29%), however, in 70% of the cases, a combined treatment was started, as there was no response in none of the patients a surgical procedure was performed, finding 51.2% adnexal masses and 41.5% dense adhesions as the main causes of chronic pelvic pain. Conclusions: A better diagnostic approach must be made to optimally use the available resources. Finally, laparoscopy is very useful for the management of endometriosis and adherent syndrome. MÉD.UIS.2020;33(2):25-32.

Contrast induced nephropathy in patients with primary percutaneous coronary intervention with or without metabolic syndrome / Nefropatía inducida por contraste en pacientes con intervención coronaria percutánea primaria con o sin síndrome metabólico

Abstract: Contrast induced nephropathy (CIN) is defined as the absolute increment of serum creatinine ≥ 0.5 mg/dL or an increment more than 25% of basal creatinine, without any other identified cause, within 48 hours after contrast media administration. Objective: Determine the CIN risk in patients with Acute Coronary Syndrome (ACS) with or without metabolic syndrome (MetS) treated with primary percutaneous coronary intervention (PCI). Material and methods: A prospective, observational, longitudinal and comparative study, in patients with ACS admitted to the Coronary Care Unit or Intensive Care Unit. PCI was performed with a serum creatinine (sCr) of ≤ 1.2 mg/dL prior intervention. Serum creatinine determinations were conducted 24-48 hours post PCI. The statistical test for analysis of free distribution quantitative variables was performed with Mann Whitney U test, and for qualitative variables Chi square test (χ2). Likelihood-ratio and confidence interval of 95% with p = 0.05. Results: 420 patients with infarction code were studied, 323 men (76.9%), 97 women (23.1%), with ages between 56-70 years. They were divided into 2 groups: group A 176 (41.9%) with MetS and group B 244 (58%) without MetS. CIN was present in 43 patients (10.2%) group A and in 29 (6.9%) group B. RR: 2.05, CI 95% 1.33-3.15, p = 0.0012. Conclusions: MetS is a risk factor (RF) for the development of CIN in patients with ACS who undergo PCI. Therefore, this syndrome should be kept in mind for an early detection and prevention of the development of CIN.

Resumen: La nefropatía inducida por contraste (NIC) se define como el incremento absoluto de creatinina sérica ≥ 0.5 mg/dL o un incremento del 25% de la creatinina basal, sin otra causa identificada, en un periodo de 48 horas posterior a la exposición al medio de contraste. Objetivo: Determinar el riesgo de NIC en pacientes con síndrome coronario agudo (SCA) con y sin síndrome metabólico (SM) tratados con intervencionismo coronario percutáneo (ICP). Material y métodos: Estudio prospectivo, observacional, longitudinal, comparativo, en pacientes con SCA admitidos a la Unidad de Cuidados Coronarios o a la Unidad de Cuidados Intensivos. La ICP fue realizada con creatinina sérica (Crs) previa ≤ 1.2 mg/dL. Las determinaciones de creatinina sérica se efectuaron 24-48 horas postICP. Para el análisis de las variables cuantitativas se utilizó la prueba de U de Mann-Whitney y para variables cualitativas, prueba de Chi cuadrada (χ2) con nivel de significancia e intervalos de confianza del 95% con p = 0.05. Resultados: 420 pacientes de código infarto fueron estudiados, 323 hombres (76.9%), 97 mujeres (23.1%) con edades de 56 a 70 años. Se dividieron en dos grupos: grupo A 176 (41.9%) con SM, grupo B, 244 (58%) sin SM. Se presentó NIC en 43 pacientes (10.2%) del grupo A y en 29 (6.9%) del grupo B. RR: 2.05, IC 95% 1.33-3.15, p = 0.0012. Conclusiones: El SM es un factor de riesgo (FR) para desarrollar NIC en pacientes con SCA sometidos a ICP. Por lo tanto, debe tenerse en cuenta para la detección temprana y prevención de NIC.

Características y resultados de la ingestión de cuerpos extraños en niños / Characteristics and outcomes of foreign body ingestion in children

Introducción: La ingestión de un cuerpo extraño (CE) es un accidente frecuente en el hogar en la edad pediátrica; su manejo oportuno por especialistas puede evitar complicaciones a corto y largo plazo. Objetivo: Describir características y complicaciones de los CE en el tubo digestivo en población pediátrica. Material y métodos: Estudio transversal, retrospectivo y prospectivo. Se incluyeron pacientes con diagnóstico de ingestión de un CE desde enero de 1971 a diciembre de 2016. Se recabaron características generales de los pacientes, tipo de objeto, métodos de extracción y complicaciones. Se realizó análisis descriptivo. Resultados: Durante 45 años, se extrajeron 2637 CE localizados en faringe (n= 118), esófago (n= 2410), estómago (n= 103) e intestino (n= 6). Predominaron en el sexo masculino (50,9%); 74% fueron en menores de 5 años. El 57% llegó en las primeras 24 horas; sialorrea, disfagia y vómito fueron los principales síntomas y un 16% estaba asintomático. La radiografía permitió localizar el CE en el 93%; el más ingerido fue la moneda (78%); la localización más común fue el tercio superior del esófago (79%); el 86% se extrajo con endoscopio rígido y las complicaciones se presentaron en el 7,8% de los casos. Conclusiones: La ingestión de un CE predomina en menores de 5 años, y los metales son los más frecuentes. La radiografía simple es el estudio de elección, que permite realizar el diagnóstico y la extracción es por vía endoscópica con endoscopio rígido o flexible según la experiencia del endoscopista.

Introduction: Foreign body (FB) ingestion is a common home accident during childhood; a timely management by the specialists may help prevent complications in the short and long term. Objective: To describe the characteristics and complications of FB ingestion located in the gastrointestinal tract in the pediatric population. Material and methods: Two phases, retrospective, and prospective study. Patients diagnosed with FB ingestion between January 1971 and December 2016 were included. The general characteristics of patients, FB type, removal method, and complications were registered. A descriptive analysis was performed. Results: Over 45 years, 2637 FBs were removed from the pharynx (n= 118), the esophagus (n= 2410), the stomach (n= 103), and the intestines (n= 6). Male patients predominated (50.9%); 74% were younger than 5 years. Besides, 57% arrived within the first 24 hours; ptyalism, dysphagia, and vomiting were the main symptoms; 16% of patients had no symptoms. It was possible to locate the FB using an X-ray in 93% of cases; the most common FBs were coins (78%); the most frequent location was the upper third of the esophagus (79%); 86% of FBs were removed using a rigid endoscope, and complications were observed in 7.8% of patients. Conclusions: FB ingestion predominated among children younger than 5 years; metal objects were the most common ones. A plain X-ray is the test of choice for diagnosis; removal is usually done with a rigid or flexible endoscope, depending on the endoscopist's experience.

[Characteristics and outcomes of foreign body ingestion in children] / Características y resultados de la ingestión de cuerpos extraños en niños

INTRODUCTION: Foreign body (FB) ingestion is a common home accident during childhood; a timely management by the specialists may help prevent complications in the short and long term. OBJECTIVE: To describe the characteristics and complications of FB ingestion located in the gastrointestinal tract in the pediatric population. MATERIAL AND METHODS: Two phases, retrospective, and prospective study. Patients diagnosed with FB ingestion between January 1971 and December 2016 were included. The general characteristics of patients, FB type, removal method, and complications were registered. A descriptive analysis was performed. RESULTS: Over 45 years, 2637 FBs were removed from the pharynx (n= 118), the esophagus (n= 2410), the stomach (n= 103), and the intestines (n= 6). Male patients predominated (50.9%); 74% were younger than 5 years. Besides, 57% arrived within the first 24 hours; ptyalism, dysphagia, and vomiting were the main symptoms; 16% of patients had no symptoms. It was possible to locate the FB using an X-ray in 93% of cases; the most common FBs were coins (78%); the most frequent location was the upper third of the esophagus (79%); 86% of FBs were removed using a rigid endoscope, and complications were observed in 7.8% of patients. CONCLUSIONS: FB ingestion predominated among children younger than 5 years; metal objects were the most common ones. A plain X-ray is the test of choice for diagnosis; removal is usually done with a rigid or flexible endoscope, depending on the endoscopist's experience.

Introducción: La ingestión de un cuerpo extraño (CE) es un accidente frecuente en el hogar en la edad pediátrica; su manejo oportuno por especialistas puede evitar complicaciones a corto y largo plazo. Objetivo: Describir características y complicaciones de los CE en el tubo digestivo en población pediátrica. Material y métodos: Estudio transversal, retrospectivo y prospectivo. Se incluyeron pacientes con diagnóstico de ingestión de un CE desde enero de 1971 a diciembre de 2016. Se recabaron características generales de los pacientes, tipo de objeto, métodos de extracción y complicaciones. Se realizó análisis descriptivo. Resultados: Durante 45 años, se extrajeron 2637 CE localizados en faringe (n= 118), esófago (n= 2410), estómago (n= 103) e intestino (n= 6). Predominaron en el sexo masculino (50,9%); 74% fueron en menores de 5 años. El 57% llegó en las primeras 24 horas; sialorrea, disfagia y vómito fueron los principales síntomas y un 16% estaba asintomático. La radiografía permitió localizar el CE en el 93%; el más ingerido fue la moneda (78%); la localización más común fue el tercio superior del esófago (79%); el 86% se extrajo con endoscopio rígido y las complicaciones se presentaron en el 7,8% de los casos. Conclusiones: La ingestión de un CE predomina en menores de 5 años, y los metales son los más frecuentes. La radiografía simple es el estudio de elección, que permite realizar el diagnóstico y la extracción es por vía endoscópica con endoscopio rígido o flexible según la experiencia del endoscopista.

Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in non-metastatic breast cancer patients from a Hispanic population.

BACKGROUND: High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been associated with poor prognosis in certain tumors. Nevertheless, few data exist regarding these prognostic variables in breast cancer patients from Hispanic populations. In this study, we aimed to determine the prognostic value of these two estimates and to establish the best cutoff to categorize patients according to their risk. MATERIALS AND METHODS: We retrospectively reviewed 172 consecutive breast cancer patients treated in our center. Pre-treatment NLR and PLR, as well as clinical variables were collected from medical records. Univariate and multivariate Cox regression analyses were performed to assess the relationship between NLR, PLR, overall survival (OS) and disease free survival (DFS), adjusted for potential confounders. The best cut-off point was determined based on the maximization of the Log-rank test statistic. RESULTS: Median follow-up time was 71.3 months. The optimal cut-off for NLR and PLR was 3 and 250, respectively. In univariate analysis, a NLR 3 was associated with poor DFS (Hazard Ratio (HR): 3.92; 95% Confidence Interval (CI): 1.98-7.77; p < 0.001) and reduced OS (HR: 4.20; 95% CI: 2.10-8.38; p < 0.001). Similarly, a PLR 250 was associated with worse DFS (HR: 5.01; 95% CI: 2.33-11.1; p < 0.001) and poorer OS (HR: 5.35; 95% CI: 2.43-11.76; p < 0.001). However, after adjustment for potential confounders, only the PLR was independently associated with worse outcomes. CONCLUSIONS: A NLR greater than 3 and a PLR greater than 250 were associated with worse OS and DFS in Hispanic patients with breast cancer.

Magnetic phase diagram of underdoped YBa2Cu3O y inferred from torque magnetization and thermal conductivity.

Strong evidence for charge-density correlation in the underdoped phase of the cuprate YBa2Cu3O y was obtained by NMR and resonant X-ray scattering. The fluctuations were found to be enhanced in strong magnetic fields. Recently, 3D charge-density-wave (CDW) formation with long-range order (LRO) was observed by X-ray diffraction in [Formula: see text] 15 T. To elucidate how the CDW transition impacts the pair condensate, we have used torque magnetization to 45 T and thermal conductivity [Formula: see text] to construct the magnetic phase diagram in untwinned crystals with hole density p = 0.11. We show that the 3D CDW transitions appear as sharp features in the susceptibility and [Formula: see text] at the fields [Formula: see text] and [Formula: see text], which define phase boundaries in agreement with spectroscopic techniques. From measurements of the melting field [Formula: see text] of the vortex solid, we obtain evidence for two vortex solid states below 8 K. At 0.5 K, the pair condensate appears to adjust to the 3D CDW by a sharp transition at 24 T between two vortex solids with very different shear moduli. At even higher H (41 T), the second vortex solid melts to a vortex liquid which survives to fields well above 41 T. de Haas-van Alphen oscillations appear at fields 24-28 T, below the lower bound for the upper critical field [Formula: see text].

[Recurrent aneurysm of sinus of Valsalva, the world's first case report]. / Aneurisma del seno de Valsalva recidivante, reporte del primer caso mundial.

An aneurysm of the sinus of Valsalva is a rare cardiac anomaly (0.09% of cases in autopsy studies) . This article describes the case of a male patient, 58 years old with a history of smoking and surgery for the correction of sinus of Valsalva aneurysm 31 years before, with no record of approach or type of surgery. His condition began five months before his admission with atypical chest pain. Echocardiographic diagnosis of severe aortic regurgitation, finding recurrent aneurysm of sinus of Valsalva. Surgery was performed with primary closure of the defect and aortic valve replacement with mechanical prosthesis, issuing a favorable postoperative. We present a case of which there are no reports in the current literature.

Un aneurisma del seno de Valsalva es una anomalía cardiaca muy poco frecuente (0.09 % de casos en series de autopsia).1 Se presenta el caso de un paciente del sexo masculino, de 58 años con antecedente de tabaquismo, cirugía de corrección de aneurisma del seno de Valsalva hace 31 años, no hay registro de abordaje, ni del tipo de cirugía practicada. Su padecimiento se inició cinco meses previos a su ingreso con dolor torácico atípico. Diagnóstico por ecocardiograma de insuficiencia aórtica severa, hallazgo de aneurisma del seno de Valsalva recidivante. Se realizó cirugía con cierre primario del defecto y reemplazo valvular aórtico con prótesis mecánica, cursando con postoperatorio favorable. En este artículo presentamos un caso del cual no hay reportes en la literatura actual.

Prognosis impact of the lymph node ratio in patients with colon adenocarcinoma: a single-centre experience.

PURPOSE: Recently, the positive lymph node ratio (LNR) is considered a new prognostic parameter on survival and time to progression for patients with colon cancer. The aim of this study was to determine the prognostic impact of the LNR as an independent factor for overall survival (OS) and disease-free survival (DFS) in patients with colon cancer regardless of their clinical stage. METHODS: We retrospectively identified 85 consecutive patients diagnosed with colon adenocarcinoma treated in our centre during 2010. We categorized patients according to a LNR cutoff of 0.25. Three-year OS and DFS were determined according to the Kaplan-Meier method. A Cox proportional model was used to assess the influence of other prognostic variables on each outcome. RESULTS: After median follow-up of 34.8 months, neither median OS nor DFS has been reached by any of the subgroups. Nevertheless, patients with a LNR ≥ 0.25 exhibited a higher risk of death (hazard ratio, 3.10; 95 % confidence interval (CI), 1.38-7.01; log-rank test: p = 0.006) and a shorter interval without progression (hazard ratio, 6.59; 95 % CI, 1.96-22.15; log-rank test: p = 0.002.) than patients with LNR < 0.25. After adjusting for prespecifed variables, the impact of a LNR ≥ 0.25 was independently associated with OS (hazard ratio, 2.8; 95 % CI, 1.01-7.73; p = 0.04) and DFS (hazard ratio, 7.07; 95 % CI, 1.23-40.45; p = 0.03). CONCLUSIONS: LNR was independently associated with OS and DFS in patients with colon adenocarcinoma regardless of its clinical stage.

Abordaje integral del dolor pélvico crónico: revisión de la literatura / Comprehensive approach to chronic pelvic pain: literature review

El dolor pélvico crónico es una manifestación de muchas enfermedades y un síntoma muy frecuente en la consulta de ginecología. Para entender más completamente su presentación clínica, se explican los mecanismos neuroanatómicos y neurofisiológicos implicados y las causas más comúnmente diagnosticadas. Se resalta la necesidad de un abordaje multidisciplinario, ya que a pesar de su alta prevalencia no existe una clara aproximación de su abordaje primario en forma integral. El objetivo de este estudio es realizar una revisión de la literatura que permita definir los puntos más relevantes para el abordaje diagnóstico y terapéutico de esta patología. Se presentan los estudios disponibles y recomendados según la clínica de las pacientes, adicionalmente puntos clave y signos útiles para evaluar integralmente la consulta motivada por esta condición.

Chronic pelvic pain is a manifestation of many diseases and a frequent symptom in gynecology. To understand completely as the clinical presentation neuroanatomical and neurophysiological mechanisms involved and the most commonly diagnosed causes are explained. In addition, the need for a multidisciplinare approach is emphasized because, despite its high prevalence there is no clear approach to its primary approach comprehensively. The objective of this study is to review the literature to define the most relevant diagnostic and therapeutic approach to this condition. We propose available studies and good options according to clinic of the patients; additionally we comment key points and useful signs at the moment of an integral approach of this condition.

[Placental chorangioma: clinic-pathological approach of a case in Colombia]. / Corangioma placentario: enfoque clínico-patológico de un caso descrito en Colombia.

Chorangioma is a tumor of vascular origin placental, the most frequent among primary placental non-trophoblastic tumors; however, it is found in about 1% of placental pathology case studies. Chorangioma represents a benign neoplasm with proliferation of capillaries and villous stroma associated to multiple gestations, preeclampsia and birth defects in the fetus. This paper reports the case of a 38-year pregnant woman (29 gestation weeks). She had eleven pregnancies, nine deliveries and one abortion. During perinatal assessment patient showed severe polyhydramnios and acute fetal distress. The histopathologic examination of the placenta showed a mass with hemorrhagic areas. The microscopic examination revealed proliferation of small fetal capillary vessels and CD34-positive immunostain. Histopathological study of primary non-trophoblastic tumors should differentiate chorangiosis from other entities, as the chorangiomatosis and choriocarcinoma, and this study should report the presence or absence of mesenchymal dysplasia because it is associated with genetic diseases. This neoplasm is associated with processes of fetal-placental hypoxia that must be assessed in patients with a history of fetal growth restriction, preeclampsia and multiple gestations.

Liver nodules after portal systemic shunt surgery for extrahepatic portal vein obstruction in children.

BACKGROUND: Liver nodules have been reported after portal systemic shunt surgery (PSSS) in animal experiments or in humans with liver cirrhosis. The aim of our study was to assess the incidence of liver nodules after surgery for extrahepatic portal vein obstruction (EHPVO) in children without associated liver disease. METHODS: We retrospectively reviewed the charts of 45 children who had surgery from 1979 to 2005 for EHPVO in our institution, consisting of 38 PSSS and 7 portal reperfusion procedures (PRPs). We assessed the presence of liver nodules on ultrasonography. RESULTS: Of 45 patients, 7 (15%) had liver nodules during a median of 80 months of follow-up. All the nodules occurred after PSSS. Five nodules were subjected to biopsy; we found 2 liver cell adenomas and 3 focal nodular hyperplasias. CONCLUSIONS: In this study, liver nodules occurred in 18% of cases after PSSS for EHPVO in children and not after PRP. As many children have undergone PSSS throughout the world, the presence of liver nodules should be considered during the follow-up of those patients.

Caracterización de pacientes hospitalizados en Clínica Dávila por ley de urgencia, 2003 / Characterization of patients admitted to Clínica Dávila under the medical emergency law (ley de urgencia), 2003

Antecedentes: La Ley de Urgencia vigente ampara la vida en situaciones de riesgo, independiente de la capacidad de pago. Objetivo: Realizar seguimiento y conocer las características de los pacientes hospitalizados por concepto de Ley de Urgencia en Clínica Dávila durante 2003. Material y Método: Se aplicó una encuesta a los pacientes hospitalizados durante 2003 utilizando además la base de datos de Clínica Dávila para completar información. Resultados: La población total fue de 165 pacientes, de los cuales se aplicó efectivamente la encuesta a 102. La edad promedio fue de 61 años, distribuyéndose en 41.8 (%) hombres y 58.18% mujeres. Los diagnósticos principales correspondieron a enfermedades cardiovasculares (34,5%) neurológicas (20 por ciento), respiratorias (14.5%, infecciosas (7.2 (%)), Diabetes Mellitus descompensada (6%) y patología quirúrgica (9.6%). El control de patología crónica en la población estudiada -previo a la hospitalización- fue de 53.8 (%), siendo en un 44.8 (%) en consultorios de atención primaria. El control posterior al alta de la Clínica fue de 85.7 (%), en un 39.7 (%) en la misma Clínica. De los pacientes fallecidos posterior al alta, 72.72 (%) no estaba en control y la mediana de edad fue 77 años. Discusión: Estos resultados indican que los principales beneficiarios de la Ley de Urgencia fueron pacientes de la tercera edad con alguna enfermedad crónica cuyo control parece insuficiente. El traspaso de pacientes del sistema público al privado, así como el impacto de la atención otorgada por el nivel primario, son situaciones a estudiar para propender a optimizar los recursos.

Background: The Medical Emergency Law which is currently in force protects life at-risk, irrespectively of the solvency of the patient. Purpose: To carry out a follow-up and to know the characteristics of patients admitted to Clínica Dávila under the protection of the Medical Emergency Law, during 2003. Materials and Methods: A survey was implemented within all inpatients admitted during 2003. Information data was completed with Clínica Dávila database. Results: The total population of inpatients under the protection of the Law was 165. A total of 102 patients were effectively surveyed. Patient mean age was 61; 41.8% were males while 58.18% were female. The main diagnoses were cardiovascular diseases (34,5%), neurological disorders (20%), respiratory diseases (14.5%), infectious diseases (7.2%), decompensated Diabetes Mellitus (6%) and surgical pathologies (9.6%). Among the study population, 53.8% of patients were under control for chronic diseases prior to admission; 44.8% of such controls were carried out at primary care outpatient facilities. After discharge, 85.7% of the study population carried out regular controls, in 39.7% of the cases, within the same admission Hospital. A total of 72.72% of the patients deceased after discharge was not undergoing any control, and the median age of such population was 77. Discussion: The results indicate that the main beneficiaries of the Medical Emergency Law were senior patients with a chronic disease who wouldn’t be undergoing a sufficient control of their condition. Transfer of patients from the public to the private health system, as well as the impact of the medical assistance delivered by the primary care level are situations that need further research to aim at optimizing the resources available.

Aislamiento y caracterización de macrófagos- células espusas a partir de aorta de un modelo de ateroesclerosis en conejo hipercolesterolémico / Isolation and characterization of macrophages-foam cells from aorta of hypercholesterolemic rabbit

Actualmente existe suficiente evidencia que sustenta que la ateroesclerosis es una patología en la cual están involucrados no sólo procesos de desequilibrio y aumento de lípidos, sino también procesos inflamatorios mediados por macrófagos-células espumosas. Estos hallazgos han sido encontrados en estudios llevados a cabo con animales de experimentación. Con el propósito de racionalizar la utilización de animales y de proponer un modelo biológico alterno en el que se puedan estudiar los mecanismos de patogenicidad que involucren tipos celulares relacionados con la ateroesclerosis, en el presente trabajo se estandarizó una técnica de aislamiento y cultivo de macrófagos-células espumosas, así como, los procedimientos para caracterizar los cultivos establecidos mediante la detección de esterasas no específicas. Para el análisis de la expresión de estas enzimas, se utilizó una técnica histoquímica y electroforesis en gel de poliacrilamida en condiciones no denaturantes. En la literatura revisada, este último método no ha sido empleado para evidenciar expresión de esterasas no específicas en leucocitos. El modelo biológico aportado por este trabajo puede ser usado para estudiar respuestas de los macrófagos activados y células espumosas relacionadas con la ateroesclerosis.

[Isolation and characterization of macrophages-foam cells from aorta of hypercholesterolemic rabbit]. / Aislamiento y caracterización de macrófagos-células espumosas a partir de aorta de un modelo deateroesclerosis en conejo hipercolesterolémico.

Evidence has accumulatd to support the hypothesis that atherosclerosis involves lipid imbalance as well as inflammatory responses mediated by macrophage and foam cells. These findings have been based on animal models. To rationalize animal use and to propose an alternative biological model, a technique was standardized for macrophage-foam cell isolation and culture. The cultures were characterized by non-denaturing polyacrylamide gel electrophoresis (PAGE) of nonspecific esterases and histochemical staining. This method has not been applied previously for the characterization of the non specific esterases from leucocytes. The biological model presented here can be used to study macrophage-foam cell responses related to atherosclerosis.