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1.
Ann Chir Plast Esthet ; 69(5): 400-409, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39003221

RESUMEN

BACKGROUND: Some risk factors for breast reduction complications are well known but for others the results are contradictory in scientific literature. The choice between superior pedicle and superomedial pedicle as a risk factor has been rarely studied. We aim to better identify the risk factors for breast reduction complications, including the choice between these two pedicles, in order to better prevent their occurrence. METHODS: We performed a retrospective analysis of the medical records of patients who underwent a bilateral breast reduction from august 2020 to august 2023 in our center. Patient data were obtained and correlated with postoperative complications using statistical tests and a literature search was carried out to compare our results to the current evidence. RESULTS: We included 216 patients. The complication rate was 24.07%. The most frequent complication was wound dehiscence (17.59%), followed by partial Nipple-Areola-Complex necrosis or peroperative suffering requiring conversion to Nipple-Areola-Complex free graft (5.56%). Increased Body Mass Index, superomedial pedicle and resection weight ≥650g were associated with an increased probability of complication occurrence (P=0.048, P=0.005 and P=0.044). The superomedial pedicle and the resection weight ≥650g were associated with an increased probability of wound dehiscence (P=0.005 and P=0.037). The difference between the preoperative and the postoperative Sternal-Notch-Nipple distance was associated with an increased probability of partial Nipple-Areola-Complex necrosis or Nipple-Areola-Complex free graft (P=0.014). CONCLUSION: Correcting modifiable preoperative risk factors and mastering both techniques, enabling the surgeon to choose the one best suited to each patient's clinical situation, reduces the complication rate.


Asunto(s)
Mamoplastia , Complicaciones Posoperatorias , Humanos , Mamoplastia/métodos , Mamoplastia/efectos adversos , Femenino , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Factores de Riesgo , Adulto , Persona de Mediana Edad , Colgajos Quirúrgicos , Dehiscencia de la Herida Operatoria/etiología , Dehiscencia de la Herida Operatoria/prevención & control , Dehiscencia de la Herida Operatoria/epidemiología , Medición de Riesgo
2.
J Mater Sci Mater Med ; 34(8): 40, 2023 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-37515640

RESUMEN

The present work studies the effect of Mn doping on the crystalline structure of the Hap synthesized by the hydrothermal method at 200 °C for 24 h, from Ca(OH)2 and (NH4)2HPO4, incorporating MnCl2 to 0.1, 0.5, 1.0, 1.5 and 2.0 %wt of Mn concentrations. Samples were characterized by the X-Ray Diffraction technique, which revealed the diffraction peaks that corresponded to the hexagonal and monoclinic phase of the Hap; it was observed that the average size of crystallite decreased from 23.67 to 22.69 nm as the concentration of Mn increased. TEM shows that in all samples, there are two distributions of particle sizes; one corresponds to nanorods with several tens of nanometers in length, and the other in which the diameter and length are very close. FTIR analysis revealed absorption bands corresponding to the PO4-3 and OH- groups characteristic of the Hap. It was possible to establish a substitution mechanism between the Mn and the ions of Ca+2 of the Hap. From the Alamar blue test, a cell viability of 86.88% ± 5 corresponding to the sample of Hap at 1.5 %wt Mn was obtained, considered non-cytotoxic according to ISO 10993-5. It also evaluated and demonstrated the good osteoinductive properties of the materials, which were verified by histology and immunofluorescence expression of osteogenic markers. Adhesion, viability, biocompatibility and osteoinductive properties, make these materials candidates for future applications in bone tissue engineering with likely uses in regenerative medicine.


Asunto(s)
Durapatita , Nanotubos , Durapatita/química , Osteogénesis
9.
Parasitol Res ; 117(7): 2291-2298, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29777337

RESUMEN

Wildlife species are involved in the transmission of diverse pathogens. This study aimed to monitor raccoons (Procyon lotor), American minks (Neovison vison), and red foxes (Vulpes vulpes) as potential reservoirs in central Spain. Specifically, 200 spleen and fecal samples (from 194 raccoons, 3 minks, and 3 foxes) were analyzed molecularly by PCR/qPCR and sequencing for the presence of piroplasmids, Hepatozoon spp., Toxoplasma gondii, and Ehrlichia canis infections in the Community of Madrid (Spain). Biological samples were obtained in the years 2014, 2015, and 2016. No pathogen DNA was found in fecal samples. In contrast, analysis of raccoon spleen samples revealed that Toxoplasma was the most prevalent pathogen (prevalence 3.6 ± 2.6%), followed by Hepatozoon canis and E. canis (each with a prevalence of 2.57 ± 2.2%). Hepatozoon canis was also diagnosed in all three of the analyzed foxes. Analysis of yearly prevalence showed that tick-borne pathogens were less frequent in raccoon in 2015, a dry and warm year compared both to 2014 and 2016. These data suggest that fecal PCR assays are unsuitable for detection of DNA of non-erythrocytic pathogens. Furthermore, they demonstrate that the raccoon (an invasive species often living in proximity to domestic areas) and the red fox are putative reservoirs for pathogenic organisms in the Community of Madrid.


Asunto(s)
Ehrlichia canis/aislamiento & purificación , Eucoccidiida/aislamiento & purificación , Zorros/microbiología , Zorros/parasitología , Visón/microbiología , Visón/parasitología , Mapaches/microbiología , Mapaches/parasitología , Toxoplasma/aislamiento & purificación , Animales , Animales Domésticos , Animales Salvajes/microbiología , Animales Salvajes/parasitología , Coccidiosis/epidemiología , Coccidiosis/veterinaria , Ehrlichia canis/genética , Ehrlichiosis/epidemiología , Ehrlichiosis/veterinaria , Eucoccidiida/genética , Epidemiología Molecular , Reacción en Cadena de la Polimerasa , España/epidemiología , Bazo/parasitología , Garrapatas , Toxoplasma/genética , Toxoplasmosis Animal/epidemiología
11.
Spinal Cord ; 54(9): 746-9, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26902463

RESUMEN

OBJECTIVES: No studies have reported sexual dysfunction in Mexican women with a spinal cord injury (SCI).The objective of the present study was to determine the association between sociodemographic factors and sexual dysfunction characteristics in Mexican females with SCI. METHODS: An observational, cross-sectional, descriptive study was conducted in different rehabilitation centers in Mexico City from July 2013 to November 2014. Adult females with a SCI without any gynecologic structural abnormalities, which by itself produced sexual dysfunction, were included. The Female Sexual Function Index (FSFI) was answered personally by all participants. Other variables such as AIS (American spinal injury association Impairment Scale), neurologic level, time since injury, age, relationship status, socioeconomic status, spasticity, use of antispasticity drugs, education level, antidepressant medication, Spinal Cord Independence Measure III score, offspring, work activities and neuropathic pain were considered. RESULTS: There is a high percentage of sexual dysfunction among Mexican woman with SCI (81.9%). Age range went from 18- to 78-year old (42.8±15.87-year old). Time since injury went from 2 to 708 months (65.16±117.65 months). The study showed a negative correlation between age and the FSFI questionnaire (correlation coefficient (CC)=-0.384, P<0.001).There was no significant difference between the means (analysis of variance) of the different groups for neurologic level, socioeconomic status, spasticity and education level. CONCLUSION: Results showed that the younger the person is, the better sexual function they have, and offspring decreased sexual function and work activities increased it. Some variables showed small comparative groups (use of antidepressives/antispastics and comorbilities), which may be the reason we could not see significative differences in the means.


Asunto(s)
Enfermedades de los Genitales Femeninos/epidemiología , Enfermedades de los Genitales Femeninos/etiología , Factores Socioeconómicos , Traumatismos de la Médula Espinal/complicaciones , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , México , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Traumatismos de la Médula Espinal/epidemiología , Estadística como Asunto , Adulto Joven
12.
Opt Express ; 23(7): 8261-71, 2015 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-25968664

RESUMEN

We have investigated the nonlinear optical response of low loss Si(0.6)Ge(0.4) / Si waveguides in the mid-infrared wavelength range from 3.25- 4.75µm using picosecond optical pulses. We observed and measured the three and four-photon absorption coefficients as well as the Kerr nonlinear refractive index. The dynamics of the spectral broadening suggests that, in addition to multiphoton absorption, the corresponding higher order nonlinear refractive phenomena also needs to be included when high optical pulse intensities are used at mid-infrared wavelengths in this material.

13.
Opt Express ; 23(25): 32202-14, 2015 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-26699010

RESUMEN

We characterize the nonlinear optical response of low loss Si(0.6)Ge(0.4) / Si waveguides in the mid-infrared between 3.3 µm and 4 µm using femtosecond optical pulses. We estimate the three and four-photon absorption coefficients as well as the Kerr nonlinear refractive index from the experimental measurements. The effect of multiphoton absorption on the optical nonlinear Kerr response is evaluated and the nonlinear figure of merit estimated providing some guidelines for designing nonlinear optical devices in the mid-IR. Finally, we compare the impact of free-carrier absorption at mid-infrared wavelengths versus near-infrared wavelengths for these ultra-short pulses.

16.
Artículo en Inglés | MEDLINE | ID: mdl-38636827

RESUMEN

INTRODUCTION AND OBJECTIVES: Lung cancer is the second type of cancer with the second highest incidence rate and the first with the highest mortality rate in the world. Machine learning through the analysis of imaging tests such as positron emission tomography/computed tomography (PET/CT) has become a fundamental tool for the early and accurate detection of cancer. The objective of this study was to propose an image analysis architecture (PET/CT) ordered in phases through the application of ensemble or combined machine learning methods for the early detection of lung cancer by analyzing PET/CT images. MATERIAL AND METHODS: A retrospective observational study was conducted utilizing a public dataset entitled "A large-scale CT and PET/CT dataset for lung cancer diagnosis." Various imaging modalities, including CT, PET, and fused PET/CT images, were employed. The architecture or framework of this study comprised the following phases: 1. Image loading or collection, 2. Image selection, 3. Image transformation, and 4. Balancing the frequency distribution of image classes. Predictive models for lung cancer detection using PET/CT images included: a) the Stacking model, which used Random Forest and Support Vector Machine (SVM) as base models and complemented them with a logistic regression model, and b) the Boosting model, which employed the Adaptive Boosting (AdaBoost) model for comparison with the Stacking model. Quality metrics used for evaluation included accuracy, precision, recall, and F1-score. RESULTS: This study showed a general performance of 94% with the Stacking method and a general performance of 77% with the Boosting method. CONCLUSIONS: The Stacking method proved to be a model with high performance and quality for lung cancer detection when analyzing PET/CT images.


Asunto(s)
Neoplasias Pulmonares , Aprendizaje Automático , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias Pulmonares/diagnóstico por imagen , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Estudios Retrospectivos , Masculino
17.
Comput Methods Programs Biomed ; 257: 108407, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39276668

RESUMEN

BACKGROUND AND OBJECTIVE: Only about 14% of eligible EU citizens finally participate in colorectal cancer (CRC) screening programs despite it being the third most common type of cancer worldwide. The development of CRC risk models can enable predictions to be embedded in decision-support tools facilitating CRC screening and treatment recommendations. This paper develops a predictive model that aids in characterizing CRC risk groups and assessing the influence of a variety of risk factors on the population. METHODS: A CRC Bayesian Network is learnt by aggregating extensive expert knowledge and data from an observational study and making use of structure learning algorithms to model the relations between variables. The network is then parametrised to characterize these relations in terms of local probability distributions at each of the nodes. It is finally used to predict the risks of developing CRC together with the uncertainty around such predictions. RESULTS: A graphical CRC risk mapping tool is developed from the model and used to segment the population into risk subgroups according to variables of interest. Furthermore, the network provides insights on the predictive influence of modifiable risk factors such as alcohol consumption and smoking, and medical conditions such as diabetes or hypertension linked to lifestyles that potentially have an impact on an increased risk of developing CRC. CONCLUSION: CRC is most commonly developed in older individuals. However, some modifiable behavioral factors seem to have a strong predictive influence on its potential risk of development. Modeling these effects facilitates identifying risk groups and targeting influential variables which are subsequently helpful in the design of screening and treatment programs.

18.
Rev Gastroenterol Mex (Engl Ed) ; 89(2): 265-279, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38789310

RESUMEN

Gastroesophageal reflux (GER) is a frequent normal phenomenon in children of any age. It is more common in infants, in whom the majority of episodes are short-lived and cause no other symptoms or complications, differentiating it from gastroesophageal reflux disease (GERD). The diagnosis and management of GER and GERD continue to be a challenge for the physician. Therefore, the aim of the Asociación Mexicana de Gastroenterología was to adapt international documents to facilitate their adoption by primary care physicians, with the goal of standardizing quality of care and reducing the number of diagnostic tests performed and inappropriate medication use. The ADAPTE methodology was followed, and the recommendations were approved utilizing the Delphi strategy. The executive committee carried out the review of the guidelines, position papers, and international reviews that met the a priori quality criteria and possible applicability in a local context. The recommendations were taken from those sources and adapted, after which they were approved by the working group. The consensus consists of 25 statements and their supporting information on the diagnosis and treatment of GER and GERD in infants. The adapted document is the first systematic effort to provide an adequate consensus for use in Mexico, proposing a practical approach to and management of GER and GERD for healthcare providers.


Asunto(s)
Reflujo Gastroesofágico , Reflujo Gastroesofágico/terapia , Reflujo Gastroesofágico/diagnóstico , Humanos , Lactante , México , Consenso , Técnica Delphi
19.
Pulm Pharmacol Ther ; 25(2): 193-9, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22366196

RESUMEN

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airway obstruction and increased cholinergic tone. The global initiative for chronic obstructive lung disease (GOLD) guidelines recommend long-acting anticholinergics for COPD maintenance treatment. Aclidinium bromide is a novel, long-acting muscarinic antagonist developed for the treatment of COPD. A phase I, randomized, single-blind, multiple-dose clinical trial was conducted to assess the safety and pharmacokinetics (PK) of multiple doses of twice-daily (BID) aclidinium in healthy subjects. Thirty healthy male and female subjects received aclidinium 200 µg, 400 µg, 800 µg, or placebo twice daily for 7 days. Subjects were randomized to 1 of 3 cohorts and 10 subjects in each cohort were randomized (8:2) to either aclidinium or placebo groups. Safety was assessed via adverse events (AEs), laboratory evaluations, vital signs, and ECGs. Plasma samples were obtained at multiple time points throughout the study and analyzed for aclidinium and its inactive acid and alcohol metabolites using a fully validated method of liquid chromatography coupled with tandem mass spectrometry. A total of 9 treatment-emergent AEs were reported (1, placebo; 3, aclidinium 400 µg; 5, aclidinium 800 µg), all of which were mild in severity. No serious AEs were reported. There were no clinically meaningful changes in laboratory parameters or vital signs. PK parameters on Day 7 following BID dosing of aclidinium showed that steady state was achieved for aclidinium and its metabolites. On Days 1 and 7, maximum plasma concentrations (Cmax) of aclidinium were generally observed at the first PK time point (5 min postdose) and rapidly declined, with plasma concentrations generally less than 10% of Cmax by 6 h postdose in all aclidinium groups. Mean effective t(½) after the evening dose on Day 7 ranged from 4.6 to 7.0 h for aclidinium 400 µg and 800 µg, similar to the terminal t(½) observed on Day 1 (4.5-5.9 h). Exposure for aclidinium and both metabolites increased with increasing dose, with the increase in exposure being less than dose proportional between the 400 µg and 800 µg doses. Overall, all doses of aclidinium were safe and well tolerated throughout the study. Pharmacokinetic steady state was reached for aclidinium and both metabolites within the 7-day treatment period for all doses tested. Aclidinium bromide exhibited time-independent PK following dosing to steady state, indicating that similar concentration versus time profiles will occur after repeated administration at the same dose and frequency.


Asunto(s)
Antagonistas Muscarínicos/administración & dosificación , Tropanos/administración & dosificación , Adolescente , Adulto , Cromatografía Liquida , Estudios de Cohortes , Relación Dosis-Respuesta a Droga , Femenino , Semivida , Humanos , Masculino , Persona de Mediana Edad , Antagonistas Muscarínicos/efectos adversos , Antagonistas Muscarínicos/farmacocinética , Método Simple Ciego , Espectrometría de Masas en Tándem , Factores de Tiempo , Tropanos/efectos adversos , Tropanos/farmacocinética , Adulto Joven
20.
Radiologia ; 54(4): 321-35, 2012.
Artículo en Español | MEDLINE | ID: mdl-22284561

RESUMEN

The presence of hyperintense punctiform images in the white matter in T2 weighted magnetic resonance (MR) sequences is a very common finding and is occasionally a diagnostic challenge for the radiologist. The present article attempts, using an anatomical approach to the brain circulation, as well as from histopathology correlation studies, to simplify the task of interpreting these images from the description of the three main patterns of hyperintense punctiform images in the white matter: vascular pattern, which corresponds to microvascular lesions; perivascular pattern, which represents inflammatory disease of which the paradigm is multiple sclerosis; and a non-specific pattern, which has to be a microvascular disease. From the various semiological elements in the MR images, a predominant pattern can be determined in each case and, in this way, helps in the differential diagnosis.


Asunto(s)
Encefalopatías/patología , Leucoencefalopatías/patología , Imagen por Resonancia Magnética , Neuroimagen , Algoritmos , Encefalopatías/fisiopatología , Circulación Cerebrovascular , Diagnóstico Diferencial , Humanos , Leucoencefalopatías/fisiopatología
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