Heart failure among Indigenous and non-Indigenous Australians in remote Central Australia.

BACKGROUND: There is a paucity of data on the burden of heart failure (HF) in Central Australia, the most populous Indigenous region in the country. AIMS: To characterize Indigenous and non-Indigenous Australians with HF in Central Australia. METHODS: Consecutive patients with HF and reduced ejection fraction <50% were included for the period 2019 to 2021. Clinical, echocardiographic and major adverse cardiovascular events (MACE) data were collected. RESULTS: Four hundred twenty-four patients with HF were included (70% Indigenous, 59% male; follow-up 2.2 ± 0.5 years). Indigenous Australians were younger (53 ± 15 vs 68 ± 13 years, P < 0.001) with higher rates of rheumatic heart disease (18% vs 1%, P < 0.001), diabetes (63% vs 33%, P < 0.001) and severe chronic kidney disease (CKD; 32% vs 7%, P < 0.001). HF was more prevalent among Indigenous (138 [95% confidence interval (CI), 123-155] per 10 000) compared with non-Indigenous Australians (53 [95% CI, 44-63] per 10 000), particularly among younger individuals and females. There were similar HF aetiologies between groups. Guideline-directed medical therapy (GDMT) was suboptimal and similar between the groups: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (64% vs 67%, P = 0.47) and ß-blockers (68% vs 71%, P = 0.47). Indigenous Australians had a significantly higher rate of MACE (54% vs 28%, P < 0.001) and death from any cause (24% vs 13%, P = 0.013). CONCLUSIONS: HF is more than two times as prevalent among Indigenous Central Australians, particularly among younger individuals and females. Despite similar HF aetiologies and GDMT, MACE and mortality outcomes are higher in Indigenous individuals with HF. These data have implications for efforts to close the Indigenous gap in morbidity and mortality.

Longitudinal Study of the Mental Health, Resilience, and Post-Traumatic Stress of Senior Nursing Students to Nursing Graduates during the COVID-19 Pandemic.

This study analyzed changes in the psychological health of students who were in the final year of their nursing degree during the COVID-19 pandemic and later served as nursing professionals in hospitals. Methods: A prospective longitudinal study was conducted over two periods of time (the first in April 2020 and the second 6 months later, in December 2020) with 296 students for a T0 baseline (rate response 68.83%) and 92 students for a T1 post-test sample (response rate 31.08%). The data were electronically collected using the Hospital Anxiety and Depression Scale, the Life Satisfaction Questionnaire, the Resilience Scale, and a post-traumatic stress questionnaire. The mean age of the sample participants was 24.17 years (SD = 5.51), and 89.11% were female. During the pandemic, 14.11% of students showed scores that indicated depression, and 32.61% showed scores that indicated anxiety. In December 2020, 86.5% of the participants were working as nurses, and the percentages of those with anxiety (12%) and depression (4.3%) were significantly lower than in the first sample period. A total of 20.7% of the participants had post-traumatic stress. High scores for resilience were significantly associated with better quality of life and lower levels of anxiety, depression, and post-traumatic stress. Conclusions: Although the percentages of participants with anxiety and depression decreased, they still presented with mental health problems.

Flapjack: Data Management and Analysis for Genetic Circuit Characterization.

Characterization is fundamental to the design, build, test, learn (DBTL) cycle for engineering synthetic genetic circuits. Components must be described in such a way as to account for their behavior in a range of contexts. Measurements and associated metadata, including part composition, constitute the test phase of the DBTL cycle. These data may consist of measurements of thousands of circuits, measured in hundreds of conditions, in multiple assays potentially performed in different laboratories and using different techniques. In order to inform the learn phase this large volume of data must be filtered, collated, and analyzed. Characterization consists of using this data to parametrize models of component function in different contexts, and combining them to predict behaviors of novel circuits. Tools to store, organize, share, and analyze large volumes of measurement and metadata are therefore essential to linking the test phase to the build and learn phases, closing the loop of the DBTL cycle. Here we present such a system, implemented as a web app with a backend data registry and analysis engine. An interactive frontend provides powerful querying, plotting, and analysis tools, and we provide a REST API and Python package for full integration with external build and learn software. All measurements are associated with circuit part composition via SBOL (Synthetic Biology Open Language). We demonstrate our tool by characterizing a range of genetic components and circuits according to composition and context.

Health-Related Quality of Life in Levothyroxine-Treated Hypothyroid Women and Women without Hypothyroidism: A Case-Control Study.

The use of levothyroxine is not always related to the elimination of the symptoms of hypothyroidism. The aim of this study is to compare the health-related quality of life (HRQOL) of a group of hypothyroid women under levothyroxine treatment with that of a group of non-hypothyroid women. METHODOLOGY: A case-control study was performed. We used convenience sampling. The case group consisted of 152 levothyroxine-treated hypothyroid women; the control group consisted of 238 women without hypothyroidism disorders. All of the participants were euthyroid according to the clinical practice guidelines. We used as instruments the Short Form-12 questionnaire (SF-12v1) and a sociodemographic questionnaire. RESULTS: Hypothyroid women scored significantly lower in HRQOL in SF-12v1 mental and physical components than the control group (mental component summary: 41.23 ± 12.12 vs. 46.45 ± 10.22, p < 0.001; physical component summary: 49.64 ± 10.16 vs. 54.75 ± 5.76, p < 0.001). body mass index (BMI) and age showed an influence on the physical component (p < 0.001 in both variables). Adjusted for age and BMI, hypothyroidism was still related to worse scores (p < 0.001). CONCLUSION: Despite being euthyroid, women with hypothyroidism showed a poorer quality of life than women without hypothyroidism. Health professionals need to assess the HRQOL of women with hypothyroidism. Further research on HRQOL and hypothyroidism is needed.

Lisch nodules and iris mammillations in two siblings with familial legius syndrome.

Legius syndrome is characterized by numerous café-au-lait macules and intertriginous freckling, but typically lacks the distinctive tumor manifestations of neurofibromatosis type 1. We report two siblings with Legius syndrome and Lisch nodules illustrating the importance of eye surveillance in these patients.

Sexual Function in Levothyroxine-Treated Hypothyroid Women and Women without Hypothyroidism: A Case-Control.

Background: Levothyroxine is the most common treatment to normalize thyroid hormones levels and to reduce primary hypothyroidism symptoms. Aim: To assess sexual function in women with levothyroxine-treated hypothyroidism and women without hypothyroidism. Methods: A case-control study was performed with 152 women with levothyroxine-treated hypothyroidism and 238 women without hypothyroidism. An online survey was used to collect socio-demographic data and the answers to the Women Sexual Function (WSF) questionnaire. Results: Women with levothyroxine-treated hypothyroidism showed a higher prevalence of sexual dysfunction than women in the control group (31.60% vs. 16.40%), furthermore the presence of hypothyroidism increased the risk of sexual dysfunction (p = 0.002, OR: 2.29 (1.36-3.88)). The most affected domains were 'desire' (p < 0.001), 'arousal' (p = 0.003) and 'penetration pain' (p = 0.020). In hypothyroid women, age increased the risk of sexual dysfunctions (p = 0.009, OR: 1.07 (1.01-1.12)), however when age was adjusted (ANCOVA) the sexual dysfunction remained in women with hypothyroidism in all domains. Conclusions: Hypothyroidism is associated with an increase in the prevalence of sexual dysfunction even if treated with levothyroxine and thyroid-stimulating hormone (TSH) levels are normalized. Relevance to clinical practice: Sexual function in hypothyroid women should be assessed before and after starting the treatment.

Mood Disorders in Levothyroxine-Treated Hypothyroid Women.

Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28-3.38) and depression (OR = 3.13, IC = 1.45-6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.

Demulsification of crude oil-in-water emulsions by means of fungal spores.

The present feature describes for the first time the application of spores from Aspergillus sp. IMPMS7 to break out crude oil-in-water emulsions (O/W). The fungal spores were isolated from marine sediments polluted with petroleum hydrocarbons. The spores exhibited the ability to destabilize different O/W emulsions prepared with medium, heavy or extra-heavy Mexican crude oils with specific gravities between 10.1 and 21.2°API. The isolated fungal spores showed a high hydrophobic power of 89.3 ± 1.9% and with 2 g of spores per liter of emulsion, the half-life for emulsion destabilization was roughly 3.5 and 0.7 h for extra-heavy and medium crude oil, respectively. Then, the kinetics of water separation and the breaking of the O/W emulsion prepared with heavy oil through a spectrofluorometric technique were studied. A decrease in the fluorescence ratio at 339 and 326 nm (I339/I326) was observed in emulsions treated with spores, which is similar to previously reported results using chemical demulsifiers.

Behavior of Tamarixia triozae Females (Hymenoptera: Eulophidae) Attacking Bactericera cockerelli (Hemiptera: Triozidae) and Effects of Three Pesticides on This Parasitoid.

The parasitism and host feeding behavior of Tamarixia triozae (Burks) (Hymenoptera: Eulophidae) females on Bactericera cockerelli (Sulc) (Hemiptera: Triozidae) fourth instars that have infested tomato (Lycopersicon esculentum Miller) leaflets are described and quantified. Females took approximately 31.14 ± 4.39 min to search for their first suitable host. The recognition and handling times for oviposition were 2.66 ± 0.18 and 4.26 ± 0.39 min, respectively. T. triozae parasitized 4.66 ± 0.61 nymphs in a period of 6 h. The parasitoid explored and probed its host by walking along the margins of its body while antennating and repeatedly introducing the ovipositor beneath the nymph. The handling times before and during host feeding were 8.42 ± 0.67 and 8.29 ± 0.60 min, respectively. T. triozae females consumed 1.00 ± 0.00 B. cockerelli nymph after parasitizing 3.3 ± 0.48 nymphs. EPA-a refined soybean oil-imidacloprid, and abamectin caused between ~70 and 100% T. triozae adult mortality after a 48-h contact treatment with fresh pesticide residue and a 47-91% decrease (abamectin > imidacloprid > EPA) in adult emergence when parasitized B. cockerelli fourth instars were directly sprayed. These data suggest that the use of these insecticides in combination with T. triozae in integrated pest management programs should be carefully evaluated.

Two new species of Zospeum Bourguignat, 1856 from the Basque-Cantabrian Mountains, Northern Spain (Eupulmonata, Ellobioidea, Carychiidae).

Two new species of the genus Zospeum Bourguignat, 1856 are described from caves in the Sierra de Aitzgorri (Gipuzkoa) and the Sierra Salvada (Burgos) in Northern Spain. The taxa Zospeumvasconicum sp. n. and Zospeumzaldivarae sp. n. have recently, without a formal name, been included in a molecular study of worldwide members of the Carychiidae. In the present paper, the shell morphology and variation of these species is described and illustrated.

Hearing loss in Mexican children treated with cisplatin.

OBJECTIVE: Cisplatin is widely used to treat a variety of pediatric solid tumors. One of the most severe and debilitating adverse drug reactions experienced by patients who receive cisplatin therapy is permanent bilateral hearing loss. The aim of this study was to evaluate the incidence and risk factors for cisplatin-induced hearing loss in Mexican pediatric patients. METHODS: Detailed medical and drug histories, including use of cisplatin as well as other drugs known to cause hearing loss, were collected from patient medical records. Results of audiology tests on pediatric patients with solid tumors were collected at baseline, during treatment and at the end of cisplatin chemotherapy. Hearing loss was classified according to the Common Terminology Criteria for Adverse Events. Bivariate and multivariate analyses were performed using survival curves. RESULTS: Fifty-nine pediatric patients, median age 11 years (range, 3-17 years) were included in the study. The incidence of cisplatin-induced hearing loss was 56%. Individual risk factors including age (< 5 years), male sex, and concomitant medications were not associated with an increased risk of cisplatin-induced hearing loss. Patients with a diagnosis of osteosarcoma and a cumulative cisplatin dose greater than 400 mg/m(2) were at higher risk of hearing loss compared with all other tumor and cumulative dose combinations (HR = 2.47 [95% CI, 1.043-5.831]). CONCLUSIONS: Cumulative dose and tumor type are associated with an increased risk of cisplatin-induced hearing loss. Further research is required to characterize fully the interindividual variation in hearing loss in Mexican patients.

Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab.

BACKGROUND: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. MATERIAL AND METHOD: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of follow-up. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and c2 tests. RESULTS: At follow-up, C-C displayed significantly higher systolic (125 ± 10 vs. 114 ± 8) and diastolic (81 ± 8 vs. 72 ± 7) blood pressure, serum glucose (96 ± 13 vs. 86 ± 10), triglycerides (177 ± 61 vs. 129 ± 34), total (183 ± 43 vs. 148 ± 34) and LDL-cholesterol (100 ± 22 vs. 87 ± 25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4 ± 20.6 vs. 70.6 ± 17.0, p=.004). AR frequency was lower in ESW-C. CONCLUSIONS: Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C.

Design of a new rotating drum bioreactor operated at atmospheric pressure on the bioremediation of a polluted soil.

This paper reports the effect of the operation and design characteristics of rotating drum bioreactors (RDBs) aerated by natural convection and applied to the treatment of a soil highly polluted with weathered total petroleum hydrocarbons (TPH) (55,000 +/- 2,600 mg/kg). The parameters studied were length to diameter ratio (L/D), rotating speed (N) and lifter type. The highest TPH removal (59.6 +/- 0.7%) was obtained with the RDB of the lowest L/D ratio (1.5). Removals diminished by 27, 36 and 56%, with a ratio increment of 2.1, 3.1 and 5.1, respectively. Increment of the N, at an optimal value and lifter change from straight to helicoidal showed an improvement on the TPH removal of 20 and 30%, respectively. According to these results, slurry surface renewal through the variation of the N and the change of slurry flow was able to improve TPH removal in RDBs operated by natural convection.

Influence of azadirachtin and methoxyfenozide on life parameters of Spodoptera littoralis (Lepidoptera: Noctuidae).

Effects on adult longevity, fecundity and fertility, as well as long-term effects on progeny were determined through oral exposure of Spodoptera littoralis (Boisduval) (Lepidoptera: Noctuidae) adults to azadirachtin and methoxyfenozide. Both compounds reduced adult longevity by 2.3 d at the higher concentrations tested, but no significant differences were observed between sexes. Fecundity and fertility were significantly affected for both insecticides, although this effect was only dose-dependent for azadirachtin. The progeny from adults treated with azadirachtin or methoxyfenozide were only affected in percentage of pupation of eggs that successfully hatched, but no effects were observed in adult emergence of individuals that successfully pupated for either insecticide. In the second part of this study, each sex was exposed separately to methoxyfenozide by topical application or ingestion. Adult fecundity was more affected when moths were treated by ingestion than when treated topically, with a mean number eggs laid per female of 343 +/- 89 and 932 +/- 79, respectively. Finally, azadirachtin applied to pepper plants showed a significant oviposition deterrence activity on S. littoralis adults. However, when fecundity was scored for one additional day in females that had been previously exposed to pepper, Capsicum annum L., plants treated with this insecticide, the number of eggs laid per female did not differ significantly from that of controls. The effects of azadirachtin and methoxyfenozide on S. littoralis suggest changes in population dynamics of this pest in crops treated with these insecticides.

Use of non-absorbable polypropylene mesh for the treatment of spontaneous renal graft rupture.

Renal graft rupture (RGR) is a life-threatening complication of kidney transplantation (KT), frequently associated with rejection and acute tubular necrosis. RGR repair with the use of suture, and corsetage with various materials (including synthetic glue, polyglactin absorbable hemostatic mesh, and lyophilized human dura), is indicated in non-severe cases. However, the employment of non-absorbable synthetic mesh had not been previously reported. Here, a case of a KT from cadaveric donor with RGR associated with acute rejection is reported. The graft was salvaged with the employment of a non-absorbable polypropylene mesh. Six months after KT, the patient remains asymptomatic with normal renal function. To the best of our knowledge, this is the first report of the use of a non-absorbable polypropylene mesh to repair a RGR. In a setting in which economical restrictions are important, the use of non-absorbable synthetic mesh may represent a good option of treatment.

Use of non-absorbable polypropylene mesh for the treatment of spontaneous renal graft rupture / Uso de una malla no absorbible de polipropileno para el tratamiento de la ruptura espontánea de injerto renal

Renal graft rupture (RGR) is a life-threatening complication of kidney transplantation (KT), frequently associated with rejection and acute tubular necrosis. RGR repair with the use of suture, and corsetage with various materials (including synthetic glue, polyglactin absorbable hemostatic mesh, and lyophilized human dura), is indicated in non-severe cases. However, the employment of non-absorbable synthetic mesh had not been previously reported. Here, a case of a KT from cadaveric donor with RGR associated with acute rejection is reported. The graft was salvaged with the employment of a non-absorbable polypropylene mesh. Six months after KT, the patient remains asymptomatic with normal renal function. To the best of our knowledge, this is the first report of the use of a non-absorbable polypropylene mesh to repair a RGR. In a setting in which economical restrictions are important, the use of non-absorbable synthetic mesh may represent a good option of treatment.

La ruptura del injerto renal (RIR) es una complicación del trasplante renal (TR) que amenaza la vida, y frecuentemente está asociada a rechazo y necrosis tubular aguda. La reparación de la RIR con el uso de sutura y ferulización con varios materiales (incluyendo pegamento sintético, mallas hemostáticas absorbibles de poliglactina y duramadre liofilizada humana) está indicada en los casos no graves. Sin embargo, el empleo de mallas no absorbibles no había sido informado previamente. Aquí se informa el caso de un TR proveniente de donador cadavérico con RIR asociada a rechazo agudo. El injerto fue rescatado con el empleo de una malla no absorbible de polipropileno. Seis meses después del TR el paciente se encuentra asintomático con función renal normal. Hasta donde tenemos conocimiento, éste es el primer informe del uso de una malla no absorbible de polipropileno para reparar una RIR. En un medio con importantes restricciones económicas, el uso de mallas sintéticas no absorbibles puede representar una buena opción de tratamiento.

Evaluación del funcionamiento de un tambor rotatorio aplicado a la biorremediación de un suelocontaminado con hidrocarburos

Entre los procesos de biorremediación, los biorreactores de tambor rotatorio son una alternativa promisoria para la restauración ad situ de suelos contaminados con hidrocarburos. Se estudió el efecto del número de mamparas, tipo de mampara y velocidad de rotación, en el proceso de remoción de hidrocarburos tratados en un biorreactor tipo tambor rotatorio abierto a la atmósfera, de 4l de capacidad. Se utilizó suelo intemperizado tipo migajón-limoso, con una concentración promedio de 50000mg/kg de hidrocarburos totales de petróleo (HTPs). De acuerdo a los resultados obtenidos y un análisis de varianza, la velocidad de rotación es la variable más significativa (contribución del 96% de la varianza) en el proceso de remoción de hidrocarburos, observándose una velocidad óptima de 10rpm, en el intervalo 5-20rpm. El nivel máximo promedio de remoción de HTPs fue de 65%, cuando se operó el reactor con 4 mamparas acanaladas y 10rpm. El número y tipo de mamparas no tuvo efecto significativo sobre la remoción de HTPs. De acuerdo con los niveles de remoción alcanzados, se considera que los reactores abiertos a la atmósfera podrían ser aplicados exitosamente en el campo a la remediación de suelos intemperizados y altamente contaminados, con la ventaja de que los tiempos de tratamiento son los más bajos.

Among bioremediation processes, the rotating drum bioreactor is a promising alternative for the ad situ restoration of soils polluted with hydrocarbons. The effects of number and type of baffles, as well as rotating speed, on the hydrocarbon removal process were examined in a soil treated in a rotating open drum of 4l. An aged silty-loam soil was used, containing 50000mg/kg of total hydrocarbon oil (HTP). The rotating speed was the variable with the greatest effect on the degradation process, and an optimal speed of 10rpm was identified in the interval 5-20rpm. The maximal percentage of HTP removal obtained was 65%, when the drum was operated with 4 baffles and 10rpm. The number and type of baffles did not have a significant effect over the implemented operational conditions. According to the results obtained, the open drums could be successfully applied, with lower treatment times, to the remediation of aged heavily contaminated soil.

Entre os processos de biorremediação, os bioreatores de tambor rotatório são uma alternativa otimista para a restauração ad situ de solos contaminados com hidrocarbonetos. Estudou-se o efeito do número de membranas, tipo de membranas e velocidade de rotação, no processo de remoção de hidrocarbonetos tratados em um biorreactor tipo tambor rotatório aberto à atmosfera, de 4lts de capacidade. Utilizou-se solo intemperizado tipo "migajon-limoso" (pastoso-limoso), com uma concentração média de 50.000 mg/kg de hidrocarbonetos totais de petróleo (HTPs). De acordo aos resultados obtidos e uma análise de variação, a velocidade de rotação é a variável mais significativa (contribuição do 96% da variação) no processo de remoção de hidrocarbonetos, observando-se uma velocidade ótima de 10 rpm, no intervalo 5-20 rpm. O nível máximo médio de remoção de HTPs foi de 65%, quando se operou o reator com 4 membranas acanaladas e 10 rpm. O número e tipo de membranas não teve efeito significativo sobre a remoção de HTPs. De acordo com os níveis de remoção alcançados, se considera que os reatores abertos à atmosfera poderiam ser aplicados exitosamente no campo à remediação de solos intemperizados e altamente contaminados, com a vantagem de que os tempos de tratamento são os mais baixos.

The kidney transplant experience at Hospital de Especialidades, Centro Médico Nacional de Occidente, IMSS, Guadalajara México.

A total of 1,356 kidney transplants has been performed in the Hospital de Especialidades del Centro Médico Nacional de Occidente, IMSS, in Guadalajara Mexico, including 935 in the past 8 years. This represents an important increase of this activity in our country. Of the total transplants, 1,218 (90%) were from living donors and only 138 (10%) were from cadaveric donors, a number that we hope to increase. Most recipients were young adults, with an average age of 31 years old. The overall one-year graft and patient survival rates for living-donor kidney recipients were 90% and 82%, and for cadaveric kidney recipients they were 80% and 70%, respectively. Acute rejections occurred in 17% and chronic allograft nephropathy was diagnosed in 7% of our kidney transplant recipients. The main cause of patient death was infection, frequently invasive CMV. Cardiovascular complications were a relatively infrequent cause of death as has been seen in other international series. Hepatitis B and C have been widley studied. Hepatitis C is the most prevalent viral infection in our population. Both living and cadaveric donors in our series were young, which may explain the good results. We have had very few complications among living donors and no mortality. Two donors developed chronic renal insufficiency after the kidney donation (0.001%). This excellent safety record reflects the experience of our team. We hope to increase the number of cadaveric transplant donors with the renewed interest in enlarging the transplantation programs in Mexico while maintaining our high percentage of living donors in order to benefit more patients.

Risk factors for long-term graft loss in kidney transplantation: experience of a Mexican single-center.

BACKGROUND/AIM: There is not enough information regarding risk factors for renal graft loss in Mexico and Latin America. The aim of this study was to analyze risk factors associated with graft loss in our renal transplant (RT) population. METHODS: Clinical records of 326 patients with a first RT performed between August/76 and June/99 were reviewed. Clinical and laboratory variables were recorded, as well as the final patient and renal function status. STATISTICAL ANALYSIS: Survival analysis by Kaplan-Meier method; mortality risk by multivariate Cox's proportional hazard model. RESULTS: At the end of the study, 275 patients were alive, 30 were dead, 21 lost to follow-up; 65 patients (20%) had reinitiated dialysis. Patient survival at 1, 3, 5, 8, and 10 years was 92%, 86%, 81%, 77%, and 77%, respectively. Graft survival at 1, 3, 5, 8, and 10 years was 87%, 73%, 64%, 50%, and 47%, respectively. In the univariate analysis, the following were significantly associated (p < 0.05) with graft loss: acute rejection episodes, cadaveric donors, and HLA haplotype mismatches. In the multivariate analysis, only acute rejection (RR 2.12, p = 0.002) and a lower HLA haplotype matching (RR 0.37, p = 0.002) predicted graft loss. CONCLUSIONS: In Mexican population, graft survival was similar to the reported in developed countries. The main risk factors for long-term graft failure were acute rejection and HLA haplotype mismatching.

Adenocarcinoma mucinoso de la pelvis renal: informe de un caso / Mucinous adenocarcinoma of renal pelvis: report of a case

El adenocarcinoma de la pelvis renal es uno de los tumores más raros del aparato urinario. Hasta 1982 se habían informado de 36 casos en las publicaciones del mundo. Este es un informe del primer caso del estado de Michoacán, y segundo en México. Se hace referencia especial a las siguientes observaciones clínicas: frecuencia elevada de litiasis, presencia de hidronefrosis, cronicidad de los síntomas antes del diagnóstico, incapacidad para hacerlo con base en los estudios radiográficos preoperatorios con medio de contraste, propensión del tumor a implantarse en la porción distal del uréter y frecuencia elevada de recurrencias cuando ocurre diseminación operatoria. Es importante evitar la contaminación del campo operatorio con el contenido de riñón hidronefrótico, por lo que es necesario resecar la porción distal del uréter con un manguito de vejiga.