Limited utility of routine bone scintigraphy in the staging of patients with hepatocellular carcinoma: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: The most widely used staging system for hepatocellular carcinoma (HCC) is the Barcelona Liver Clinic Cancer (BCLC) system, which considers tumor burden, performance status, and liver function. Tumor burden is assessed with cross sectional imaging of the abdomen and chest, controversy surrounds the routine use of bone scintigraphy (BS) for detecting extrahepatic metastases. This study evaluated the role of BS in staging HCC in Mexican patients. PATIENTS AND METHODS: Retrospective cross-sectional study of all adults with HCC at a Mexican referral center from 2000 to 2018. Staging included abdominal computed tomography (CT) or magnetic resonance imaging, chest CT, and BS. The main outcome was the impact of BS on staging and/or therapy plans. RESULTS: Among 238 patients, 2 with fibrolamellar variant and 44 with incomplete data were excluded. Median age was 66 years, 84 % had cirrhosis, and the predominant etiology was hepatitis C virus (43 %). BCLC stages were distributed as follows: A (14 %), B (7 %), C (68 %), and D (11 %). Extrahepatic disease was present in 18 %; only 8 % patients had a positive BS. Among the positive cases, 4 were true positives, but they did not alter staging or therapy plans. CONCLUSIONS: Routine BS in HCC staging demonstrated low yield, with a notable rate of false positives. Considering the implications of extrahepatic disease, BS may be justified for liver transplant candidates outside conventional criteria. Our study highlights the limited role of BS in early-stage HCC and advocates for a more selective utilization.

Roux-en-Y partial volvulus in biliary-digestive reconstruction in children.

Various complications occur after a biliary-digestive reconstruction. Volvulus of a segment of the biliodigestive loop has not been described. Two patients who underwent biliodigestive bypass, years later, began with sudden and intense abdominal pain, associated with a volvulus with necrosis of a segment of this biliodigestive loop. This complication occurred many years after the initial correction, and manifested with sudden abdominal pain without impaired liver function, as occurred in these patients.

Diversas complicaciones pueden ocurrir después de una reconstrucción biliodigestiva. El vólvulo de un segmento del asa biliodigestiva no ha sido descrito. Dos pacientes operados de derivación biliodigestiva, años después iniciaron con dolor abdominal súbito e intenso, asociado a un vólvulo con necrosis de un segmento de la asa interpuesta. Se ha descrito el vólvulo de toda el asa interpuesta, pero no el de solo una pequeña porción de esta. La complicación ocurrió muchos años después de la corrección inicial y se manifiesto con dolor abdominal súbito sin deterioro de la función hepática, como sucedió en estos pacientes.

Fixed dental prosthesis on six zirconia implants for an anterior maxillary rehabilitation: case report with 10-year follow-up.

This article reports a case of maxillary rehabilitation with an implant-supported fixed partial denture on six zirconia implants. A female patient with impacted maxillary canines attended our dental clinic seeking a metal-free maxillary restoration. After the extraction of both impacted maxillary canines and the placement of autogenous bone graft, six one-piece zirconia implants with conical abutments were placed in the anterior maxillary region. Two zirconia fixed dental prosthesis with porcelain veneering, separated at the mid-line, were placed on these zirconia implants. The ten-year follow-up monitored the adequate evolution of both implants and restorations with no signs of peri-implant disease.

mTOR Inhibition Enhances Delivery and Activity of Antisense Oligonucleotides in Uveal Melanoma Cells.

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. Owing to a lack of effective treatments, patients with metastatic disease have a median survival time of 6-12 months. We recently demonstrated that the Survival Associated Mitochondrial Melanoma Specific Oncogenic Non-coding RNA (SAMMSON) is essential for UM cell survival and that antisense oligonucleotide (ASO)-mediated silencing of SAMMSON impaired cell viability and tumor growth in vitro and in vivo. By screening a library of 2911 clinical stage compounds, we identified the mammalian target of rapamycin (mTOR) inhibitor GDC-0349 to synergize with SAMMSON inhibition in UM. Mechanistic studies revealed that mTOR inhibition enhanced uptake and reduced lysosomal accumulation of lipid complexed SAMMSON ASOs, improving SAMMSON knockdown and further decreasing UM cell viability. We found mTOR inhibition to also enhance target knockdown in other cancer cell lines as well as normal cells when combined with lipid nanoparticle complexed or encapsulated ASOs or small interfering RNAs (siRNAs). Our results are relevant to nucleic acid treatment in general and highlight the potential of mTOR inhibition to enhance ASO and siRNA-mediated target knockdown.

Sensitization to Aeroallergens in a Mexican Cohort with Allergic Conjunctivitis: A Cross-sectional Retrospective Study Conducted in Ángeles Puebla Hospital.

This study aims to evaluate the sensitization distribution of aeroallergens in patients with allergic conjunctivitis (AC) living in a temperate subhumid region and to describe the prevalence in a Mexican cohort. A total of 761 patient records were revisited, including the results of the skin prick test (SPT) for 45 aeroallergens. We found 292 patients with AC and a positive SPT in a 5-year period. The most frequent aeroallergens include dust mites (69.2% for Dermatophagoides pteronyssinus and 47.6% for Dermatophagoides farinae), trees (36% for cypress and 22.6% for ash), animals (33.9% for dogs and 26.7% for cats), and grasses (21.2% for Paspalum notalum and 19.9% for Poa pratensis). Among the studied population, a prevalence of 38.4% for the disease was calculated. House dust mites were responsible for most sensitizations found in the studied population. There is a high prevalence of AC in the selected cohort during the period studied.

Coordination copolymerization monitoring of ethylene and alfa-olefins by in-line Raman spectroscopy.

Copolymerizations of ethylene and alfa-olefins, using Ziegler-Natta or metallocene catalysts, testing two methods of co-monomer addition, through batch or dossing mode during the reactions, are reported in this work. Copolymerizations are monitored by in line Raman spectroscopy, comparing the effect of the kind of catalyst and the co-monomer addition modes on the chemical composition of the copolymers produced. The global co-monomer composition is determined by 13C NMR spectroscopy, compared with the monitoring by Raman spectroscopy along the reactions, where it is possible to define homogeneous or heterogeneous co-monomer distributions. Batch addition achieves higher incorporations of co-monomers, compared to dosed addition, where it is possible to determine the maximal co-monomer addition without affecting activities by transfer reactions. The incorporation mode of alfa-olefins in this type of reaction has been little reported, and until it is known, there is no rapid technique available to determine the uniformity of the co-monomer incorporations in real time. Copolymerization kinetics are also reported here and correlated to the addition method of the comonomers in both kinds of reactions. Homogeneous and heterogeneous co-monomer incorporations promoted by a single site catalyst (metallocene) or multisite system (Ziegler-Natta) is related to the homogeneous or heterogeneous co-monomer distributions detected by Raman spectroscopy, using each kind of catalytic system.

Long term follow-up of a full- arch rehabilitation with an implant-supported overdenture on four zirconia implants and a zirconia bar. A case report.

This clinical report describes a mandibular full-arch rehabilitation by means of an implant-supported overdenture on four zirconia implants. A female patient with an edentulous mandibular arch attended our dental clinic seeking a metal-free mandibular restoration. After oral and radiographic evaluation, four one-piece zirconia implants with conical abutments were placed in the intermentonian region. After a 3-month osseointegration period, an acrylic overdenture with plastic matrices was manufactured, supported by a zirconia bar cemented to the conical abutments of the zirconia implants. Radiographic and clinical follow-up after 12 years observed adequate implant evolution, without any signs of peri-implant disease. Maintenance events were principally the periodic replacement of the plastic matrices and prophylaxis. Key words:Zirconia implants, overdenture, full-arch rehabilitation, dental implants, case report.

Algorithm to filter the noise in the spectral intensity of ultrashort laser pulses.

We have developed an algorithm to filter the noise in the spectral intensity of ultrashort laser pulses. The filtering procedure consists of smoothing the noise by using the Savitzky-Golay filter, removing the offset, and using a super-Gaussian window to truncate the frequencies of the spectrum. We have modeled bandwidth-limited ultrashort pulses with Gaussian modulated frequencies to show the estimation of the carrier wavelength, reconstruction of the intensity pulse profile, and pulse duration after applying the algorithm. Theoretical results are presented for pulse durations between 5 fs and 100 fs with a carrier wavelength of 825 nm and three different amounts of signal-to-noise ratio (SNR): 30 dB, 20 dB, and 15 dB, normally found in experiments. The algorithm is also applied to an experimental spectral intensity from a homemade Ti:sapphire laser that produces pulses of about 20 fs at 825 nm at 100 MHz. We will show that using only a low-pass Fourier filter and removing offset is not enough to recover the spectral intensity when a large SNR is present, which may be the case when the ultrashort laser beam has been manipulated to compensate for the group velocity dispersion of an external optical system. In cases like this, the use of the Savitzky-Golay filter prior to the super-Gaussian filter improves the recovery of the carrier wavelength and the spectral intensity. We will also show that the algorithm presented in this paper is suitable for experimental analysis and requires limited user intervention.

Characterization, antibiofilm and biocompatibility properties of chitosan hydrogels loaded with silver nanoparticles and ampicillin: an alternative protection to central venous catheters.

The purpose of this study was to generate novel chitosan hydrogels (CHs) loaded with silver nanoparticles (AgNPs) and ampicillin (AMP) to prevent early formation of biofilms. AgNPs and CHs were characterized by UV-Vis, DLS, TEM, rheology, FT-IR, Raman, and SEM. The antibiofilm effect of the formulations was investigated against four multidrug-resistant and extensively drug-resistant pathogens using a colony biofilm, a high cell density and gradients model. Also, their hemostatic properties and cytotoxic effect were evaluated. Rheology results showed that CHs with AgNPs and AMP are typical non-Newtonian pseudoplastic fluids. The CH with 25 ppm of AgNPs and 50 ppm AMP inhibited the formation of biofilms of Acinetobacter baumannii, Enterococcus faecium and Staphylococcus epidermidis, while a ten-fold increase of the antimicrobial's concentration was needed to inhibit the biofilm of the ß-lactamase positive Enterobacter cloacae. Further, CH with 250 ppm of AgNPs and 500 ppm AMP showed anticoagulant effect, and it was shown that all formulations were biocompatible. Besides to previous reports that described the bioadhesion properties of chitosan, these results suggest that AgNPs and AMP CHs loaded could be used as prophylactic treatment in patients with central venous catheter (CVC), inhibiting the formation of biofilms in their early stages, in addition to their anticoagulant effect and biocompatibility, those properties could keep the functionality of CVC helping to prevent complications such as sepsis and thrombosis.

'I'm going to look for you and take your kids': Reproductive justice in the context of immigration enforcement.

Prior research has shown that immigration law enforcement contributes to poor health outcomes-including reproductive health outcomes-among Latinos. Yet no prior research has examined how immigration enforcement might inhibit reproductive justice and limit individual's reproductive autonomy. We utilized data from an existing study that consisted of a partnership with a Latino community in Michigan in which an immigration raid resulted in multiple arrests and deportations midway through data collection. Using cross-sectional survey data (n = 192) where no one was re-interviewed, we used ordinal logistic regression to compare desired pregnancy timing of individuals surveyed prior to and after the raid to determine the impact of an immigration raid on desired timing of next pregnancy. We then used qualitative data-including 21 in-depth interviews and participant observation-collected in the community after the raid to contextualize our findings. Controlling for socio-demographic characteristics, we found that Latinos surveyed in the aftermath of the raid were more likely to report a greater desire to delay childbearing than Latinos surveyed before the raid occurred. Our qualitative data showed that an immigration raid has financial and psychological effects on immigrant families and that a raid may impact reproductive autonomy because people are fearful of these impacts. These finding suggest that current immigration enforcement efforts may influence reproductive decision-making, impede Latinos reproductive autonomy, and that family-friendly immigration policy reform is needed.

Low-energy/pulse response and high-resolution-CMOS camera for spatiotemporal femtosecond laser pulses characterization @ 1.55 µm.

In this work, we present a commercial CMOS (Complementary Metal Oxide Semiconductor) Raspberry Pi camera implemented as a Near-Infrared detector for both spatial and temporal characterization of femtosecond pulses delivered from a femtosecond Erbium Doped Fiber laser (fs-EDFL) @ 1.55 µm, based on the Two Photon Absorption (TPA) process. The capacity of the device was assessed by measuring the spatial beam profile of the fs-EDFL and comparing the experimental results with the theoretical Fresnel diffraction pattern. We also demonstrate the potential of the CMOS Raspberry Pi camera as a wavefront sensor through its a nonlinear response in a Shack-Hartmann array and for the temporal characterization of the femtosecond pulses delivered from the fs-EDFL through TPA Intensity autocorrelation measurements. The direct pulse detection and measurement, through the nonlinear response with a CMOS, is proposed as a novel and affordable high-resolution and high-sensitivity alternative to costly detectors such as CCDs, wavefront sensors and beam profilers @ 1.55 µm. The measured fluence threshold, down to 17.5 µJ/cm2, and pJ/pulse energy response represents the lowest reported values applied as a beam profiler and a TPA Shack-Hartmann wavefront sensor, to our knowledge.

Does renal function improve after parathyroidectomy in primary hyperparathyroidism? / ¿Mejora la función renal tras la paratiroidectomía en el hiperparatirodismo primario?

INTRODUCTION: Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterised by hypercalcaemia and parathormone increase. Decreased glomerular filtration rate (<60ml/min) continues to be a parathyroidectomy (PTX) criterion in asymptomatic PHPT. The influence of PTX on renal function evolution is the subject of debate. OBJECTIVE: To analyse the clinical, laboratory and histological characteristics of patients undergoing PHPT, as well as renal function evolution after PTX. MATERIAL AND METHODS: Retrospective study of 297 patients diagnosed with PHPT and referred to surgery in a single centre between 1998 and 2016. Laboratory parameters were determined at baseline, one week and one year after PTX. RESULTS: The Incidence of PTX was 38 cases/million/year. Mean age was 60±14 years and 80.5% of the patients were female. Approximately 65.3% were asymptomatic. Nephrolithiasis was the most common clinical finding (33%), followed by bone involvement (29.5%). PTX indications were: clinical symptoms (34.7%), hypercalcaemia>11.2mg/dl (27%), nephrolithiasis (13%), low bone mass (12%), age<50 years (11%) and decreased glomerular filtration rate<60ml/min (2.3%). For diagnostic localisation, spect-MIBI had a sensitivity of 92% and cervical ultrasound of 70%. A total of 94.3% of PHPT cases were due to a parathyroid adenoma. After PTX, normalisation of PHPT-related parameters was observed. We found a significant increase in serum creatinine levels (0.81 vs 0.85mg/dl, P<.001) from the first week post-PTX until the end of the first year. The renal function was only found to be significant in patients with glomerular filtration rate>60ml/min (baseline serum creatinine levels 0.77mg/dl vs serum creatinine levels after one year 0.81mg/dl, P<.001). CONCLUSIONS: PHPT was asymptomatic in most patients who underwent surgery. Hypercalcaemia and nephrolithiasis were the most common indications of parathyroidectomy in asymptomatic patients. MIBI scan was the most useful localisation method. Surgical treatment of PHPT is followed by renal function impairment, which persists after the first week post-PTX.

Health Implications of an Immigration Raid: Findings from a Latino Community in the Midwestern United States.

Immigration raids exemplify the reach of immigration law enforcement into the lives of Latino community members, yet little research characterizes the health effects of these raids. We examined the health implications of an immigration raid that resulted in multiple arrests and deportations and occurred midway through a community survey of a Latino population. We used linear regression following principal axis factoring to examine the influence of raid timing on immigration enforcement stress and self-rated health. We controlled for age, sex, relationship status, years in the county in which the raid occurred, children in the home, and nativity. 325 participants completed the survey before the raid and 151 after. Completing the survey after the raid was associated with higher levels of immigration enforcement stress and lower self-rated health scores. Findings indicate the negative impact of immigration raids on Latino communities. Immigration discussions should include holistic assessments of health.

The need for genetic study to diagnose some cases of distal renal tubular acidosis. / Necesidad de estudio genético para el diagnóstico de algunos casos de acidosis tubular renal distal.

We describe the case of a young woman who was diagnosed with advanced kidney disease, with an incidental finding of nephrocalcinosis of unknown aetiology, having been found asymptomatic throughout her life. The genetic study by panels of known genes associated with tubulointerstitial disease allowed us to discover autosomal dominant distal renal tubular acidosis associated with a de novo mutation in exon 14 of the SLC4A1 gene, which would have been impossible to diagnose clinically due to the advanced nature of the kidney disease when it was discovered.

Factors associated with the frequency of died pigs during transport to aslaughterhouse / Factores asociados con la frecuencia de cerdos muertos durante el transportea una planta de beneficio / Fatores associados com a frequência de suínos mortos durante o transporte paraum matadouro

The objective of this study was to evaluate the effect of transportation time, type of truck (one, two or three decks), farm of origin, time of year, transporter and producer, on the mortality of fattening pigs and the pre-slaughter stage in which the deaths occur. A retrospective study was made in a Colombian slaughterhouse during 2012, 2013 and 2014, to collect information on 76286 pigs that belonged to 1554 lots of 76 producers. The mortality/year was 0.176%, 0.173% and 0.20% respectively. The highest mortality rates were observed in trucks with one deck, particularly when the transport time was ≤1 hour. A total of 55.4% of the deaths occurred in the trucks, 41% in the slaughterhouse pens, and 4.4% during unloading. The mean mortality was higher for producers marketing smaller lots. The results indicate that transportation times ≤1 hour, truck design, and the type of producers increased the mortality during transportation of fattening pigs.

El objetivo de este estudio fue evaluar el efecto del tiempo de transporte, el tipo de camión (un piso, dos pisos, tres pisos), la granja de origen, la época del año, el transportador y el productor, sobre la mortalidad de cerdos de ceba y la etapa del presacrificio en la cual sucede la muerte. Se hizo un estudio retrospectivo en una planta de beneficio colombiana durante los años 2012, 2013 y 2014, para recolectar la información de 76.286 cerdos, que correspondían a 1554 lotes de 76 productores. La mortalidad/año fue 0,176% 0,173% y 0,20%, con respecto a cada año. La mayor tasa de muertes se observó en los camiones de carrocería de un piso, en particular, cuando el tiempo de transporte fue ≤1h. El 55,4% de las muertes ocurrieron en el camión, el 41% en los corrales de la planta de beneficio, y el 4,4% durante el descargue. La mortalidad promedio fue mayor en los productores que comercializan lotes de menor tamaño. Los resultados indican que los tiempos de transporte <1h, el diseño del camión y el tipo de productor incrementan la mortalidad en el transporte de cerdos de ceba.

Neste estudo objetivou-se avaliar o efeito do tempo de transporte, tipo de caminhão (um, dois e três andares), fazenda de origem, época do ano, transportador e produtor, na mortalidade de suínos de engorda e estágio de préabate, em que ocorre a morte. Um estudo retrospectivo foi feita num abatedouro na Colômbia entre os anos 2012 a 2014, coletando informações de 76.286 suínos correspondentes a 1554 lotes de 76 produtores. A mortalidade/ano foi de 0,176%, 0,173% e 0,20% para cada ano. A maior taça de mortalidade foi observada nos caminhões de um andar, particularmente, quando o tempo de transporte foi <1h. O 55,4% das mortes ocorreram no caminhão, o 41% nos corrais do abatedouro e, o 4,4% durante o desembarque. A mortalidade promedia foi maior em produções com lotes de menor tamanho. Os resultados indicam que os tempos de transporte <1h, o tipo de caminhão e tipo de produtor incrementam a mortalidade de suínos de engorda.

Tracking stochastic resonance curves using an assisted reference model.

The optimal noise amplitude for Stochastic Resonance (SR) is located employing an Artificial Neural Network (ANN) reference model with a nonlinear predictive capability. A modified Kalman Filter (KF) was coupled to this reference model in order to compensate for semi-quantitative forecast errors. Three manifestations of stochastic resonance, namely, Periodic Stochastic Resonance (PSR), Aperiodic Stochastic Resonance (ASR), and finally Coherence Resonance (CR) were considered. Using noise amplitude as the control parameter, for the case of PSR and ASR, the cross-correlation curve between the sub-threshold input signal and the system response is tracked. However, using the same parameter the Normalized Variance curve is tracked for the case of CR. The goal of the present work is to track these curves and converge to their respective extremal points. The ANN reference model strategy captures and subsequently predicts the nonlinear features of the model system while the KF compensates for the perturbations inherent to the superimposed noise. This technique, implemented in the FitzHugh-Nagumo model, enabled us to track the resonance curves and eventually locate their optimal (extremal) values. This would yield the optimal value of noise for the three manifestations of the SR phenomena.

Grassroots responsiveness to human rights abuse: history of the Washtenaw Interfaith Coalition for Immigrant Rights.

The purpose of this article is to discuss how a community agency based in Washtenaw County, the Washtenaw Interfaith Coalition for Immigration Rights (WICIR), emerged in response to increasing punitive immigration practices and human rights abuses toward the Latino community. The article discusses how WICIR is engaged in advocacy, community education on immigration issues, and political action toward a more humane immigration reform. Detailed examples of human rights abuses and the WICIR activities described in response to the abuses serve as illustrations of social work advocacy, education, and policy formulation that affect the general public, policymakers, and law enforcement officials.