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INTRODUCTION AND OBJECTIVE: The implementation of Enhanced Recover After Surgery (ERAS) multimodal rehabilitation protocols in radical cystectomy has shown to improve outcomes in hospital stay and complications. The aim of this analysis is to evaluate the impact of laparoscopic surgery on radical cystectomy within a multimodal rehabilitation program. MATERIAL AND METHODS: The study was carried out in a third level center between 2011 and 2020 including patients with bladder cancer submitted to radical cystectomy according to an ERAS (Enhanced Recovery After Surgery) protocol and the Spanish Multimodal Rehabilitation Group (GERM) with 20 items to be fulfilled. RESULTS: A total of 250 radical cystectomies were performed throughout the study period, 42.8% by open surgery (OS) and 57.2% by laparoscopic surgery (LS). The groups are comparable in demographic and clinical variables (pâ¯>â¯0.05). Operative time was longer in the LS group (248.4⯱â¯55.0 vs. 286.2⯱â¯51.9â¯min; pâ¯<â¯0.001). However, bleeding was significantly lower in the LS group (417.5⯱â¯365.7 vs. 877.9⯱â¯529.7 cc; pâ¯<â¯0.001), as was the need for blood transfusion (33.6% vs. 58.9%; pâ¯<â¯0.001). Postoperative length of stay (11.5⯱â¯10.5 vs. 20.1⯱â¯17.2 days; pâ¯<â¯0.001), total and major complications were also significantly lower in this group (LS). The readmission rate was lower in the LS group but not significantly (36.4% vs. 29.4%; pâ¯=â¯0.237). The difference between 90-day mortality in both groups was not statistically significant (2.8% LS vs. 4.3% OS; pâ¯=â¯0.546). The differences were maintained in the multivariate models. CONCLUSIONS: Laparoscopic surgery within a multimodal rehabilitation program increases operative time but significantly decreases intraoperative bleeding, transfusion requirements, postoperative length of stay, and complications.
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Cistectomía , Laparoscopía , Neoplasias de la Vejiga Urinaria , Humanos , Cistectomía/rehabilitación , Cistectomía/métodos , Masculino , Laparoscopía/rehabilitación , Femenino , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/rehabilitación , Anciano , Resultado del Tratamiento , Persona de Mediana Edad , Recuperación Mejorada Después de la Cirugía , Estudios Retrospectivos , Complicaciones Posoperatorias/epidemiología , Protocolos Clínicos , Tiempo de Internación/estadística & datos numéricos , Terapia CombinadaRESUMEN
BACKGROUND: This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes. MATERIALS AND METHODS: Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data. RESULTS: The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2 = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2 = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2 = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2 = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73). CONCLUSIONS: Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.
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Implantes Dentales , Humanos , Estudios Transversales , Implantes Dentales/efectos adversos , Calidad de Vida , Proyectos Piloto , Prótesis Dental de Soporte Implantado , DolorRESUMEN
The denim textile industry represents an important productive sector. It generates wastewater with low biodegradability due to the presence of persistent pollutants, which can produce toxic and carcinogenic compounds; therefore, wastewater treatment reduces risks to aquatic life and public health. This paper presents a review of 172 papers regarding textile industry wastewater treatment for the removal of contaminants, especially indigo dyes used in the denim industry, in the context of green technologies. The physicochemical characteristics of textile wastewater, its environmental and health impacts, and the permissible limit regulations in different countries were reviewed. Biological, physicochemical and advanced oxidation processes for the removal of indigo dyes were reviewed. The goal of this study was to analyze the characteristics of green technologies; however, the research does not clearly demonstrate an effect on energy consumption savings, carbon footprint decreases, and/or waste generation. Advanced oxidation processes showed the highest color removal efficiency (95 and 97% in synthetic or real wastewater, respectively). Photocatalysis and Fenton reactions were the most efficient processes. None of the revised works presented results regarding upscaling for industrial application, and the results should be discussed in terms of the guidelines and maximum permissible limits established by international legislation. New technologies need to be developed and evaluated in a sustainable context with real wastewater.
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In this paper, breast cancer patients were monitored throughout their chemotherapy treatments (CHT), with blood serum sample Raman spectroscopy and multivariate analysis, approximately for a year. First of all, we discriminate between healthy and clinically diagnosed breast cancer patients. Breast cancer detection in terms of sensitivity and specificity were 87.14% and 90.55% respectively. Although no shifts of peaks in mean spectrum of samples from breast cancer patients were found with respect to the mean spectrum from control patients, some peaks did show clear differences in intensity, the greatest disparities found at 509, 545, 1063, 1103, 1338, 1556, 1083 and 1449 cm- 1 are associated with amino acids and phospholipid, 1246 and 1654 cm- 1, corresponding to amide III and I, respectively. Other peaks of interest encountered at 450, 661, 890, 917 and 1405 cm- 1 are associated to glutathione. Then, 6 breast cancer patients were monitored during their chemotherapy treatments, the results were in complete correspondence with their medical records, enabling a detailed study of the evolution of each patient's cancer. A special interest arose in the possible correlation between the intensity of Raman peak, 450 cm- 1, corresponding to glutathione and evolution of cancer throughout CHT, i.e., glutathione appears to be a good candidate as breast cancer biomarker. The results confirmed that Raman spectroscopy and PCA are, not only a good support to current breast cancer detection techniques, but could also be excellent techniques to monitor more efficiently breast cancer patients undergoing CHT, using blood serum samples which are a lot less invasive than other methods.
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Neoplasias de la Mama , Espectrometría Raman , Humanos , Femenino , Espectrometría Raman/métodos , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/diagnóstico , Biomarcadores de Tumor , Análisis de Componente Principal , GlutatiónRESUMEN
The growing use of biomaterials with different therapeutic purposes increases the need for their physiological understanding as well as to seek its integration with the human body. Chronic inflammatory local pathologies, generally associated with infectious or autoimmunity processes, have been a current therapeutic target due to the difficulty in their treatment. The recent development of biomaterials with immunomodulatory capacity would then become one of the possible strategies for their management in local pathologies, by intervening in situ, without generating alterations in the systemic immune response. The treatment of periodontal disease as an inflammatory entity has involved the use of different approaches and biomaterials. There is no conclusive, high evidence about the use of these biomaterials in the regeneration of periodontitis sequelae, so the profession keeps looking for other different strategies. The use of biomaterials with immunomodulatory properties could be one, with a promising future. This review of the literature summarizes the scientific evidence about biomaterials used in the treatment of periodontal disease.
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The aims of the present study were to comprehensively assess all the published cases on dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) in the literature in English and describe the clinical, imaging, and therapeutic variables for this condition. An electronic search was undertaken in March 2020 using PubMed/MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases. Eligibility criteria included publications with sufficient information to confirm the diagnosis. In addition, we have presented the case report of a 13-year-old boy with DMCCF, who was treated with craniectomy, arthroplasty, and reconstruction with a resorbable osteosynthesis material obtaining favourable and functional results. A total of 72 cases reported in English, including ours, were analysed and discussed. Most of the patients were female (n= 49) with a mean (range) age of 23.4 (5-72) years, the most affected condyle was the right (n= 42), the main aetiology was a motor vehicle accident, and half of the patients had intracranial lesions. Open treatment was performed in the majority with condylar surgery that included condylotomy and condylectomy. Temporomandibular joint arthroplasty was performed with bone, osteosynthesis material, and flap rotation. Timely treatment before four weeks was performed in most of the cases and, despite this, the persistence of the deviation was observed in more than a third of cases, with functional and neurosensorial sequelae. The present study allows an update of the characteristics of DMCCF and gives a current vision of how to manage this rare and complex fracture.
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Luxaciones Articulares , Cóndilo Mandibular , Adolescente , Adulto , Anciano , Artroplastia , Fosa Craneal Media/cirugía , Femenino , Humanos , Luxaciones Articulares/cirugía , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Persona de Mediana Edad , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVES: Radical cystectomy with urinary diversion associated with extended pelvic lymphadenectomy continues to be the treatment of choice in muscle invasive bladder cancer. Sixty-four percent of patients submitted to this procedure present postoperative complications, with urinary infection being responsible in 20-40% of cases. The aim of this project is to assess the rate of urinary infection as a cause of re-admission after cystectomy, and to identify protective and predisposing factors for urinary infection in our environment. Finally, we will evaluate the outcomes after the establishment of a prophylactic antibiotic protocol after removal of ureteral catheters. MATERIAL AND METHODS: Retrospective descriptive study of cystectomized patients in the Urology Service of the Hospital Clínico Universitario of Zaragoza, from January 2012 to December 2018. A urinary tract infection (UTI) prevention protocol after catheter removal is established for all patients since October 2017. RESULTS: UTI is responsible for 54.7% of readmissions, with 55.1% of these being due to UTI after removal of ureteral catheters. Of the patients who received with prophylaxis, 9.5% presented UTIs after withdrawal, compared to 10.6% in the group of patients without prophylaxis. The patient who is re-admitted for UTI after withdrawal has a mean catheter time of 24.3±7.2 days, compared to 24.5±7.4 days for patients in the group without UTI (P=.847). CONCLUSIONS: The type of urinary diversion performed is not related to the rate of urinary infection. The regression model does not identify antibiotic prophylaxis, nor catheter time, as independent factors of UTI after catheter removal.
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Derivación Urinaria , Infecciones Urinarias , Profilaxis Antibiótica , Cistectomía/efectos adversos , Humanos , Estudios Retrospectivos , Derivación Urinaria/efectos adversos , Infecciones Urinarias/epidemiologíaRESUMEN
INTRODUCTION: Multiple sclerosis (MS) is a chronic, demyelinating, autoimmune disease of the central nervous system causing neuroinflammation. Experimental autoimmune encephalitis (EAE) is a model of the disease. MS is classically treated with interferon beta (IFN-ß) and glatiramer acetate (GA). Melatonin (MLT) has been reported to modulate immune system responses. The aim of the present study is to analyse the effects of MLT administration in comparison with the first-line treatments for MS (IFN-ß and GA). METHODS: EAE was induced in male Sprague-Dawley rats; the animals subsequently received either IFN-ß, GA, or MLT. Cerebrospinal fluid (CSF) samples were analysed by multiplex assay to determine the levels of proinflammatory cytokines. The neurological evaluation of EAE was also recorded. RESULTS: All immunised animals developed EAE. We evaluated the first relapse-remission cycle, observing that IFN-ß and GA had better results than MLT in the clinical evaluation. Neither EAE nor any of the treatments administered modified CSF IL-1ß and IL-12p70 concentrations. However, IFN-ß and MLT did decrease CSF TNF-α concentrations. CONCLUSIONS: Further studies are needed to evaluate the molecular mechanisms involved in the behaviour of MLT in EAE, and to quantify other cytokines in different biological media in order for MLT to be considered an anti-inflammatory agent capable of regulating MS.
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Inmunomodulación , Melatonina , Esclerosis Múltiple , Animales , Acetato de Glatiramer/uso terapéutico , Interferón beta , Masculino , Melatonina/uso terapéutico , Ratones , Esclerosis Múltiple/tratamiento farmacológico , Ratas , Ratas Sprague-DawleyRESUMEN
The Mediterranean fruit fly Ceratitis capitata is a globally invasive pest, often controlled with the sterile insect technique (SIT). For the SIT, mass-rearing of the target insect followed by irradiation are imperatives. Sterile males are often less able to inhibit female remating and transfer less number of sperm, and even irradiation could affect male reproductive organs, with consequences for their ability to inhibit female remating. On the other hand, male age could affect their ability to modulate female response after mating. Here, we evaluated the quality of the genetic sexing strain Vienna-8-tsl mass-reared in Bioplanta San Juan, Argentina, under laboratory conditions, with regard to: (i) the ability of sterile males irradiated at 100 or 140 Gy to inhibit female remating, in the same day and at 24 h of first copulation; (ii) the ability of 3, 4 or 5 day-old sterile males to inhibit female remating at 24 h of first copulation, and (iii) the effect of a reduction in irradiation doses on the number of sperm stored by females and reproductive organ size in virgin males. Sterile males were better able than wild males to inhibit female remating in the same day of first copulation and as able as wild males 1 day after first copulation. Male age did not affect their ability to inhibit female receptivity. Number of sperm stored by females, testes size and ectodermal accessory glands size were not affected by male identity, while sterile 100 Gy males had larger mesodermal accessory glands than control lab males. A reduction in irradiation dose does not impact any variable measured, except for percentage of sperm-depleted females: females mated with sterile 100 Gy males had lower probabilities to store sperm. The results showed here are very encouraging for tsl Vienna 8 strain reared in Argentina and are discussed in comparison with previous studies in C. capitata female remating with dissimilar results.
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Ceratitis capitata/efectos de la radiación , Control de Insectos/métodos , Control Biológico de Vectores/métodos , Conducta Sexual Animal/efectos de la radiación , Espermatozoides/efectos de la radiación , Animales , Argentina , Femenino , Genitales/crecimiento & desarrollo , Genitales/efectos de la radiación , Masculino , Tamaño de los Órganos/efectos de la radiación , Dosis de Radiación , Espermatozoides/fisiologíaRESUMEN
Male broodstock (Litopenaeus vannamei, 36 ± 7 g, n = 600) reproductive performance, spermatophores and reproductive tract melanization, prostaglandin concentrations and biochemical composition were evaluated after including 3.8% Ulva clathrata meal in the diet (dry base) of a commercial hatchery during 45 days. Males fed Ulva had less melanized spermatophores (120 compared with 233, P < 0.01), less bacteria in the ductus deferens (P < 0.01), more sperm cells in testicles (P < 0.05), and increased courtship activity (839 compared with 689, P < 0.01), with no effect on mortality. Ulva-fed males had more arachidonic acid (20:4n-6) in the spermatophores (P < 0.05) but this did not affect the prostaglandin concentrations in response to diet. Males fed Ulva had more carotenoids in the hepatopancreas (0.08 ± 0.02 compared with 0.01 ± 0.01 mg/g, P < 0.05), and phenolic compounds in hepatopancreas (6.1 ± 0.7 compared with 1.8 ± 0.7 mg eq. phloroglucinol/g, P < 0.05) and muscle (0.4 ± 0.3 compared with 0.2 ± 0.1 mg eq. phloroglucinol/g, P < 0.05). Males fed the Ulva also had a lesser carbohydrate content in the hepatopancreas (P < 0.01) and muscle (P < 0.01). In conclusion, supplementing fresh maturation diets with a small dose of dried Ulva allowed for improvement of reproductive performance and to decrease melanization in spermatophores and the male reproductive tract.
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Melaninas/metabolismo , Penaeidae/fisiología , Pigmentación/fisiología , Espermatogonias/fisiología , Ulva/metabolismo , Alimentación Animal , Animales , Acuicultura , Masculino , Conducta Sexual Animal , Testículo/fisiologíaRESUMEN
The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries of varied size, population, and socio-economic development. In the last decade, great improvements have been made in the diagnosis and treatment of MM. Applying these advances in real life is a challenge in our region. Local data regarding MM standards of care and outcomes are limited. A survey was carried out among hematologists from 15 Latin American countries to describe access to MM diagnostic and prognostic tests and the availability of effective care options. This study provides real-world data for MM in our region, highlighting striking differences between public and private access to essential analyses and therapeutic options.
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Accesibilidad a los Servicios de Salud , Mieloma Múltiple , Práctica Privada , Práctica de Salud Pública , Encuestas y Cuestionarios , Estudios Transversales , América Latina/epidemiología , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/epidemiología , Mieloma Múltiple/terapiaRESUMEN
GronOR is a program package for non-orthogonal configuration interaction calculations for an electronic wave function built in terms of anti-symmetrized products of multi-configuration molecular fragment wave functions. The two-electron integrals that have to be processed may be expressed in terms of atomic orbitals or in terms of an orbital basis determined from the molecular orbitals of the fragments. The code has been specifically designed for execution on distributed memory massively parallel and Graphics Processing Unit (GPU)-accelerated computer architectures, using an MPI+OpenACC/OpenMP programming approach. The task-based execution model used in the implementation allows for linear scaling with the number of nodes on the largest pre-exascale architectures available, provides hardware fault resiliency, and enables effective execution on systems with distinct central processing unit-only and GPU-accelerated partitions. The code interfaces with existing multi-configuration electronic structure codes that provide optimized molecular fragment orbitals, configuration interaction coefficients, and the required integrals. Algorithm and implementation details, parallel and accelerated performance benchmarks, and an analysis of the sensitivity of the accuracy of results and computational performance to thresholds used in the calculations are presented.
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Using bacterial artificial chromosome-double transgenic mice expressing tdTomato in D1 receptor-medium spiny neurons (MSNs) and enhanced green fluorescent protein in D2 receptor-MSNs, we have studied changes in spine density and perisomatic GABAergic boutons density in MSNs of both the D1R and D2R pathways, in an experimental model of parkinsonism (mouse injected with 6-hydroxydopamine in the medial forebrain bundle), both in the parkinsonian and dyskinetic condition induced by L-DOPA treatment. To assess changes in perisomatic GABAergic connectivity onto MSNs, we measured the number of contacts originated from parvalbumin (PV)-containing striatal "fast-spiking" interneurons (FSIs), the major component of a feed-forward inhibition mechanism that regulates spike timing in MSNs, in both cell types as well as the number of vesicular GABA transporter (VGAT) contacts. Furthermore, we determined changes in PV-immunoreactive cell density by PV immunolabeling combined with Wisteria floribunda agglutinin (WFA) labeling to detect FSI in a PV-independent manner. We also explored the differential expression of striatal activity-regulated cytoskeleton-associated protein (Arc) and c-Fos in both types of MSNs as a measure of neuronal activation. Our results confirm previous findings of major structural changes in dendritic spine density after nigrostriatal denervation, which are further modified in the dyskinetic condition. Moreover, the finding of differential modifications in perisomatic GABAergic connectivity and neuronal activation in MSNs suggests an attempt by the system to regain homeostasis after denervation and an imbalance between excitation and inhibition leading to the development of dyskinesia after exposure to L-DOPA.
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Espinas Dendríticas/fisiología , Discinesias/fisiopatología , Red Nerviosa/fisiopatología , Animales , Cuerpo Estriado/metabolismo , Proteínas del Citoesqueleto/metabolismo , Femenino , Interneuronas/metabolismo , Levodopa , Ratones Endogámicos C57BL , Ratones Transgénicos , Proteínas del Tejido Nervioso/metabolismo , Oxidopamina , Parvalbúminas/metabolismo , Lectinas de Plantas/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Receptores N-Acetilglucosamina/metabolismoRESUMEN
BACKGROUND AND OBJECTIVE: Alcohol consumption is associated with enhanced TH2 immune responses. Objective: To investigate the frequency of false-positive results in serological tests for allergy in alcoholic patients. METHODS: A total of 138 alcoholic patients consecutively admitted to hospital underwent a panel of allergy tests that included serum total IgE, a multiallergen IgE test (UniCAP Phadiatop), and skin prick tests to relevant aeroallergens in the area, which were considered the standard reference for atopy. In selected cases with positive specific IgE (sIgE) to cross-reactive carbohydrate determinants (CCDs) on ImmunoCAP, we determined sIgE to hymenoptera venom components (ADVIA Centaur) and a microarray of 103 allergen components (ISAC). RESULTS: Increased serum total IgE (>170 IU/mL) was observed in 59/110 (54%) of nonatopic (skin prick test-negative) patients. The result of the multiallergen IgE test was positive in 46 nonatopic patients (42%). This finding was closely associated with high serum concentrations of total IgE and sIgE to CCDs. The vast majority of patients with positive CCD-sIgE showed positivity to glycosylated plant and hymenoptera allergen components on ISAC and ADVIA Centaur. Only 1 out of 26 patients with positive sIgE to CCD and hymenoptera venom developed honeybee venom allergy after a median follow-up of 166 months. Correlations between measurements of sIgE to CCD markers on ImmunoCAP, ADVIA Centaur, and ISAC were imperfect. CONCLUSIONS: Serological tests for allergy should be interpreted with caution in alcoholic patients, who frequently have increased levels of total IgE and CCD-sIgE and subsequent positivity of sIgE to glycosylated allergen components, irrespective of the method used.
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Alcoholismo/diagnóstico , Hipersensibilidad/diagnóstico , Inmunoglobulina E/sangre , Serología/métodos , Células Th2/inmunología , Adulto , Anciano , Alcoholismo/inmunología , Alérgenos/inmunología , Animales , Reacciones Cruzadas , Reacciones Falso Positivas , Femenino , Estudios de Seguimiento , Humanos , Himenópteros/inmunología , Hipersensibilidad/inmunología , Proteínas de Insectos/inmunología , Masculino , Persona de Mediana Edad , Pruebas Cutáneas , Ponzoñas/inmunologíaRESUMEN
BACKGROUND: The rotator cuff injury it is one of the most common causes of pain and functional disability of the shoulder with an annual reported incidence of 4.5 million cases in the United States. It is one of the leading causes of pain of shoulder in patients older than 60 years. In Mexico, there are no reports of the incidence or the results of arthroscopic repair of massive rotator cuff lesions alone or combined with other procedures. OBJECTIVE: To evaluate the clinical evolution of patients post-surgery of arthroscopic rotator cuff massive injury repair AR-RCMI alone or in combination with other techniques. METHODS: Evaluation of records of patients with AR-RCMI post-surgery, comparing the results of the scales: simple shoulder test and VAS before and after surgery with a follow up of 2.6 years. The combined procedures were acromioplasty, tenotomy of biceps or both. RESULTS: 65 patients with diagnosis of massive injury; with an average age of 62.8 years (SD ± 9. 42), 27.7% were men and 72.3% women. The evaluation was conducted in four groups: arthroscopic repair (AR); arthroscopic repair + biceps tenotomy (AR + BT); arthroscopic repair + acromioplasty (AR + A) and arthroscopic repair + biceps tenotomy + acromioplasty (AR + BTA). All groups showed significant reduction in pain: AR (-44.1%, p = 0.0001), AR + A (-36.9%, p = 0.001), AR + BT (-36.3%, p = 0.0001), AR + BT + A (-38.5%, p = 0.0001). All groups had significant improvement in function with the SST scale.
ANTECEDENTES: La lesión del manguito rotador (LMR) es una de las causas más comunes de dolor y discapacidad funcional del hombro con una incidencia anual reportada de 4.5 millones de casos en Estados Unidos. La LMR es una de las principales causas de dolor de hombro en pacientes mayores de 60 años. En México, no existen reportes de la incidencia ni de los resultados de la reparación artroscópica de las lesiones masivas de manguito rotador sola o combinada con otros procedimientos. OBJETIVO: Evaluar la evolución clínica de los pacientes postoperados de reparación artroscópica de lesión masiva del manguito rotador (RA-LMMR), sola o combinada con otras técnicas. MÉTODOS: Evaluación de expedientes de pacientes postoperados de RA-LMMR en la que se compararon los resultados de las escalas: simple shoulder test y EVA antes y después de la cirugía a un seguimiento promedio de 2.6 años. Los procedimientos combinados fueron acromioplastía, tenotomía de bíceps o ambas. RESULTADOS: 65 pacientes con diagnóstico de lesión masiva con edad promedio de 62.8 años (DE ± 9.42), 27.7% fueron hombres y 72.3% mujeres. La evaluación se realizó en cuatro grupos: reparación artroscópica (RA), reparación artroscópica + tenotomía del bíceps (RA + TB), reparación artroscópica + acromioplastía (RA + A) y reparación artroscópica + tenotomía del bíceps + acromioplastía (RA + TBA). Todos los grupos mostraron disminución significativa del dolor: RA (-44.1%, p = 0.0001), RA + A (-36.9%, p = 0.001), RA + TB (-36.3%, p = 0.0001), RA + TB + A (-38.5%, p = 0.0001). De igual forma todos los grupos mostraron mejoría significativa de la función evaluada con la escala SST.
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Artroscopía , Lesiones del Manguito de los Rotadores , Tenotomía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Manguito de los Rotadores , Lesiones del Manguito de los Rotadores/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Transcription factor STAT3 has a prominent innate immunity effect on cancer progression. We determined the regulation of STAT3 in the immunophenotype modulation of macrophages from M1 into M2 induced by the cell-culture supernatant of the Prostate-Cancer line PC3. METHODS: Monocytes-macrophages from healthy donors were cultured in the supernatant of PC3 cells, membrane proteins, and intracytoplasmic and phosphorylated STAT3 were measured using flow cytometry, while cytokines and growth factors were studied using luminescence. Cytotoxicity and nitric oxide were evaluated via colorimetric assays. RESULTS: The supernatant of PC3 prostate-tumor cells effectively induced macrophages toward an M2 profile, and the expression of phosphorylated STAT3 in the monocytes-macrophages notably increased, and mainly related to IL-10. In the group of monocytes-macrophages treated with a STAT3 inhibitor, the macrophages were induced toward an M1 phenotype. CONCLUSIONS: In this study, we showed that the secretion profile of PC3 prostate-cancer cells induces a change in macrophage phenotype from M1 into M2, and that the phenomenon is related to phosphorylation of transcription factor STAT3 and IL-10.
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Medios de Cultivo Condicionados/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Monocitos/inmunología , Factor de Transcripción STAT3/inmunología , Células Cultivadas , Humanos , Inmunofenotipificación , Interleucina-10/inmunología , Interleucina-10/metabolismo , Macrófagos/metabolismo , Masculino , Células PC-3 , Fosforilación/efectos de los fármacos , Neoplasias de la Próstata/inmunología , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/patología , Factor de Transcripción STAT3/metabolismoRESUMEN
Resumen: Antecedentes: La lesión del manguito rotador (LMR) es una de las causas más comunes de dolor y discapacidad funcional del hombro con una incidencia anual reportada de 4.5 millones de casos en Estados Unidos. La LMR es una de las principales causas de dolor de hombro en pacientes mayores de 60 años. En México, no existen reportes de la incidencia ni de los resultados de la reparación artroscópica de las lesiones masivas de manguito rotador sola o combinada con otros procedimientos. Objetivo: Evaluar la evolución clínica de los pacientes postoperados de reparación artroscópica de lesión masiva del manguito rotador (RA-LMMR), sola o combinada con otras técnicas. Métodos: Evaluación de expedientes de pacientes postoperados de RA-LMMR en la que se compararon los resultados de las escalas: simple shoulder test y EVA antes y después de la cirugía a un seguimiento promedio de 2.6 años. Los procedimientos combinados fueron acromioplastía, tenotomía de bíceps o ambas. Resultados: 65 pacientes con diagnóstico de lesión masiva con edad promedio de 62.8 años (DE ± 9.42), 27.7% fueron hombres y 72.3% mujeres. La evaluación se realizó en cuatro grupos: reparación artroscópica (RA), reparación artroscópica + tenotomía del bíceps (RA + TB), reparación artroscópica + acromioplastía (RA + A) y reparación artroscópica + tenotomía del bíceps + acromioplastía (RA + TBA). Todos los grupos mostraron disminución significativa del dolor: RA (-44.1%, p = 0.0001), RA + A (-36.9%, p = 0.001), RA + TB (-36.3%, p = 0.0001), RA + TB + A (-38.5%, p = 0.0001). De igual forma todos los grupos mostraron mejoría significativa de la función evaluada con la escala SST.
Abstract: Background: The rotator cuff injury it is one of the most common causes of pain and functional disability of the shoulder with an annual reported incidence of 4.5 million cases in the United States. It is one of the leading causes of pain of shoulder in patients older than 60 years. In Mexico, there are no reports of the incidence or the results of arthroscopic repair of massive rotator cuff lesions alone or combined with other procedures. Objective: To evaluate the clinical evolution of patients post-surgery of arthroscopic rotator cuff massive injury repair AR-RCMI alone or in combination with other techniques. Methods: Evaluation of records of patients with AR-RCMI post-surgery, comparing the results of the scales: simple shoulder test and VAS before and after surgery with a follow up of 2.6 years. The combined procedures were acromioplasty, tenotomy of biceps or both. Results: 65 patients with diagnosis of massive injury; with an average age of 62.8 years (SD ± 9. 42), 27.7% were men and 72.3% women. The evaluation was conducted in four groups: arthroscopic repair (AR); arthroscopic repair + biceps tenotomy (AR + BT); arthroscopic repair + acromioplasty (AR + A) and arthroscopic repair + biceps tenotomy + acromioplasty (AR + BTA). All groups showed significant reduction in pain: AR (-44.1%, p = 0.0001), AR + A (-36.9%, p = 0.001), AR + BT (-36.3%, p = 0.0001), AR + BT + A (-38.5%, p = 0.0001). All groups had significant improvement in function with the SST scale.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Artroscopía , Tenotomía , Lesiones del Manguito de los Rotadores/cirugía , Resultado del Tratamiento , Manguito de los Rotadores , Persona de Mediana EdadRESUMEN
Anterior cruciate ligament reconstruction is a demanding procedure; complications may arise at any of its stages. This is the report of three cases in which the tibial fixation devices (IntraFix and Bio-IntraFix) led to intraarticular lesions. The complications were detected in one of the cases while the patient was still in the operating room and in the remaining two during the follow-up. All the patients had a stable knee, but all of them sustained chondral lesions resulting from the inadequate placement of the implants used for tibial fixation. Several suggestions to avoid the complications stemming from these devices are provided.
La reconstrucción del ligamento cruzado anterior es un procedimiento exigente; las complicaciones pueden presentarse en cualquiera de sus etapas. Presentamos tres casos en los cuales los dispositivos para la fijación tibial (IntraFix y Bio-IntraFix) condicionaron lesiones intraarticulares. Las complicaciones fueron detectadas, en uno de los casos, mientras el paciente se encontraba aún en la sala de operaciones, y en los otros dos, durante el seguimiento. Todos los pacientes contaban con una rodilla estable, pero tuvieron lesiones condrales causadas por la inadecuada colocación de los implantes para la fijación tibial. Se exponen algunas sugerencias para evitar complicaciones con estos dispositivos.