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OBJECTIVE: To determine if cystoscopy could be safely performed without a urine culture by analyzing 2 prospectively cohorts of patients undergoing outpatient cystoscopy, 1 without urine culture and the other cohort screened and treated for ASB as per protocol. We aim to report the rate of symptomatic UTI and the rate of urinary sepsis within 30 days of cystoscopy. METHODS: All patients who underwent cystoscopy between 2021 and 2022 were invited to participate. Patients were prospectively recruited in a 2:1 ratio. Cohort A: patients who did not require urine culture before cystoscopy. Cohort B: patients who were required to have sterile urine before the procedure. Primary endpoint was the occurrence of symptomatic UTI ≤ 30 days after cystoscopy. RESULTS: A total of 461 patients were recruited, 316 for cohort A and 145 for cohort B. Fifteen patients had symptomatic UTIs between both groups, 8 in Cohort A and 7 in Cohort B. The overall rate of symptomatic UTI was 3.2%, 2.5% for Cohort A and 4.8% for Cohort B. We had only 1 case of urinary sepsis in Cohort B. The RR for developing UTI in cohort B was 1.91 in the univariate model and 1.74 in the multivariate analysis. CONCLUSION: Routine urine culture before outpatient cystoscopy is unnecessary. In asymptomatic patients, subsequent UTIs are rare and can be easily treated. Avoiding routine urine culture helps prevent misuse of antibiotics, reduce cancellation rates, and ease the burden of patients that get cancelled because of ASB. The low risk of symptomatic UTI after the procedure must be discussed with the patient.
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Cistoscopia , Infecções Urinárias , Humanos , Cistoscopia/efeitos adversos , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Urinálise , Antibacterianos/uso terapêutico , Pacientes AmbulatoriaisRESUMO
Purpose: GreenLight XPS Laser System (GL-XPS) photoselective vaporization of the prostate (PVP) is not only noninferior to transurethral resection of the prostate, but also with shorter rates of hospital stay and length of catheterization. Scarce literature has been published about the feasibility and safety of performing GL-XPS PVP in an outpatient setting. Our aim is to report our 7-year experience with outpatient GL-XPS PVP. Methods: Medical charts of all patients who underwent GL-XPS PVP between 2013 and 2020 were reviewed. Patients were discharged after careful monitoring in the recovery room and the catheter was removed either at home or at a scheduled hospital visit. We used the Shapiro-Wilk test to assess for normal distribution, and the evaluation of homoscedasticity was performed with the SD test. For qualitative variables, the comparison between groups was carried using the chi-square test and for the quantitative variables we used the nonparametric Mann-Whitney U test. Results: A total of 537 patients were treated, 517 in an outpatient basis. Median age was 68 years (interquartile range [IQR] 62-76), median prostate volume 50 cc (IQR 40-70). 22.8% were on anticoagulants or antiplatelet therapy. Median operative time was 100 minutes (IQR 75-125), length of hospital stay 5 hours (IQR 4-6.45), mean length of catheterization 48 hours (SD 14.92). Readmission rate within 90 days of surgery was 11.7%, 58 (10.8%) for surgical-related complications. Median time for readmission was 4 days (IQR 2-24). Immediate readmission (within 10 days) was recorded in 7.6% of patients, urinary retention was the main cause. No significant differences were found trying to find perioperative predictors for readmission. Conclusions: Our experience suggests that outpatient GL-XPS PVP could be performed safely with a predefined outpatient pathway, with a low readmission and complication rate. (IRB number CEI-521).
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Terapia a Laser , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Idoso , Humanos , Terapia a Laser/efeitos adversos , Lasers , Masculino , Pacientes Ambulatoriais , Próstata/cirurgia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , VolatilizaçãoRESUMO
For decades, sodium/iodide symporter NIS-mediated iodide uptake has played a crucial role in the radioactive ablation of thyroid cancer cells. NIS-based gene therapy has also become a promising tool for the treatment of tumors of extrathyroidal origin. But its applicability has been hampered by reduced expression of NIS, resulting in a moderated capacity to accumulate 131I and in inefficient ablation. Despite numerous preclinical enhancement strategies, the understanding of NIS expression within tumors remains limited. This study aims at a better understanding of the functional behavior of exogenous NIS expression in the context of malignant solid tumors that are characterized by rapid growth with an insufficient vasculature, leading to hypoxia and quiescence. Using subcutaneous HT29NIS and K7M2NIS tumors, we show that NIS-mediated uptake and NIS expression at the plasma membrane of cancer cells are impaired in the intratumoral regions. For a better understanding of the underlying molecular mechanisms induced by hypoxia and quiescence (separately and in combination), we performed experiments on HT29NIS cancer cells. Hypoxia and quiescence were both found to impair NIS-mediated uptake through mechanisms including NIS mis-localization. Modifications in the expression of proteins and metabolites involved in plasma membrane localization and in energy metabolism were found using untargeted proteomics and metabolomics approaches. In conclusion, our results provide evidence that hypoxia and quiescence impair NIS expression at the plasma membrane, and iodide uptake. Our study also shows that the tumor microenvironment is an important parameter for successful NIS-based cancer treatment.
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Introducción La disfunción eréctil se ha reconocido como una complicación de la prostatectomía radical. El entrenamiento de los músculos del piso pélvico puede ser una opción terapéutica, sin embargo, existe poca evidencia sobre el efecto del entrenamiento en la función eréctil. Objetivo Describir el efecto de la rehabilitación de la musculatura de piso pélvico en la función eréctil en hombres > 40 años con disfunción eréctil después de prostatectomía radical. Métodos Estudio retrospectivo basado en la revisión de historias clínicas de pacientes con disfunción eréctil después de prostatectomía radical, sometidos a un protocolo de rehabilitación con ejercicios de músculos de piso pélvico, biofeedback y electroestimulación. La función eréctil se evaluó por el índice internacional de la función eréctil (IIEF-5). La presión de los elevadores del ano se midió con el equipo Myomed134 y la fuerza muscular con la escala modificada de Oxford. Resultados Se incluyeron 13 hombres con edad promedio de 63,2 ± 8 años, sin historia de consumo de tabaco y con índice de masa corporal de 24,9 ± 2,6 kg/m2. Antes de la intervención, se encontraron 10 casos con disfunción severa y 3 de leve a moderada, según el cuestionario IIEF-5. Después de la intervención, se encontró mejoría en 11 pacientes en la función eréctil: 7 con mejoría completa, 4 con disfunción eréctil leve. En 2 casos no se presentó mejoría. Conclusión El estudio muestra que el efecto del entrenamiento de la musculatura de piso pélvico es beneficioso en la recuperación de la función eréctil después de prostatectomía radical.
Introduction Erectile dysfunction has been recognised as a complication of radical prostatectomy. The training of the pelvic floor muscles can be a therapeutic option for these patients; however, there is little evidence on the effect of this training in erectile function. Objective To describe the effect of physical rehabilitation of pelvic floor muscles in men over 40 years old with erectile dysfunction as a result of radical prostatectomy. Methods A retrospective study was conducted based on a review of medical records of patients with erectile dysfunction after radical prostatectomy and following a rehabilitation protocol including pelvic floor muscles exercises, biofeedback, and electrostimulation. Erectile function was assessed by the modified Oxford scale, the international index of erectile function (IIEF-5), and the pressure, in cmH2O, of the levator ani muscle. Results The study included 13 men with a mean age of 63.2 ± 8.0 years. None of them had a smoking history, and the mean body mass index was 24.9 ± 2.6. Before the intervention, there were 10 cases with severe dysfunction according to the IIEF-5, 3 cases with mild to moderate dysfunction. After the intervention, the erectile function improved in 11 patients (7 with complete improvement and 4 with mild erectile dysfunction). Two patients showed no improvement. Conclusion The study suggests that the effect of the pelvic floor muscles training is beneficial in the recovery of erectile function after radical prostatectomy.
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Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia , Diafragma da Pelve , Recuperação de Função Fisiológica , Disfunção Erétil , Terapêutica , Biorretroalimentação Psicológica , Exercício Físico , Força MuscularRESUMO
Introducción: las tecnologías de la información y la comunicación (TICs) han modificado la forma en que el conocimiento es transmitido y asimilado. En la educación médica son consideradas fundamentales para la optimización del proceso enseñanza-aprendizaje, por favorecer la apropiación e integración del conocimiento, y apoyar las actividades presenciales en el aula. Una efectiva aplicación de estas herramientas requiere la identificación de las temáticas de más difícil comprensión para los estudiantes, permitiendo un direccionamiento preciso de su uso para la solución de los problemas de aprendizaje. Métodos: se identificó el tópico de Bioquímica con mayor dificultad y se diseñó una herramienta virtual con diapositivas animadas, dibujos y gráficas que lo abordara. Los estudiantes recibieron orientaciones conceptuales que prepararon y discutieron con el profesor; posteriormente, accedieron a la herramienta para reforzar el estudio independiente. Se evaluó la eficacia de la herramienta al comparar los resultados de las evaluaciones antes y después de aplicarla y se evaluó la actitud de los estudiantes frente a su uso. Resultados: el índice de dificultad global identificó el metabolismo de compuestos nitrogenados como un tema crítico. La implementación de la herramienta aumentó el éxito en las evaluaciones intrasemestrales e intersemestrales. La actitud de los estudiantes frente al uso de la herramienta fue favorable, la consideraron útil para reforzar sus conocimientos y mejorar su formación académica. Conclusión: el uso orientado de las tecnologías de la información y la comunicación TICs en la educación superior favorece el proceso de autoaprendizaje y plantea la necesidad de una mayor integración e implementación estructurada y adaptada de este tipo de herramientas al entorno estudiantil(AU)
Introduction: Information and communication technologies (ICTs) have modified the way knowledge is transmitted and assimilated. In medical education, they are considered fundamental for the optimization of the teaching-learning process, to favor the appropriation and integration of knowledge, and to support classroom activities. An effective application of these tools requires the identification of the most difficult topics for students, allowing to precisely address their use for the solution of learning problems. Methods: The Biochemistry topic with more difficulties was identified and a virtual tool was designed with animated slides, drawings and graphs that would address it. Students received conceptual guidance that they prepared and discussed with the professor. Later on, they accessed the tool to reinforce homework. The efficacy of the tool was evaluated on comparing the results of the evaluations before and after applying it and evaluated the students' attitude towards their use. Results: The global difficulty index identified the metabolism of nitrogen compounds as a critical issue. The implementation of the tool increased the success in the intra- and inter-semester quizzes. The students' attitude towards the use of the tool was favorable, they considered it useful to reinforce their knowledge and to improve their academic training. Conclusion: The use of the information and communication technologies in higher education favors the process of self-learning and raises the need for a greater integration or structured and adapted implementation of this type of tools to the students' environment(AU)
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Bioquímica/métodos , Disseminação de Informação , Educação MédicaRESUMO
P-glycoprotein (Pgp) and breast cancer resistance protein (BCRP) are ATP binding cassette (ABC) transporters that are overexpressed in different drug-resistant cancer cell lines. In this study, we investigated whether doxorubicin promotes Pgp and/or BCRP expression to induce drug resistance in colon cancer cells under hypoxic conditions. We analyzed HIF-1α activity via ELISA, Pgp, and BCRP expression by qRT-PCR and the relationship between doxorubicin uptake and ABC transporter expression via confocal microscopy in HT-29WT and HT-29 doxorubicin-resistant colon cancer cells (HT-29DxR). These cells were treated with doxorubicin and/or CoCl2 (chemical hypoxia), and reactive oxygen species inductors. We found that the combination of chemically induced hypoxia and doxorubicin promoted Pgp mRNA expression within 24 h in HT-29WT and HT-29DxR cells. Both doxorubicin and CoCl2 alone or in combination induced Pgp and BCRP expression, as demonstrated via confocal microscopy in each of the above two cell lines. Thus, we surmised that Pgp and BCRP expression may result from synergistic effects exerted by the combination of doxorubicin-induced ROS production and HIF-1α activity under hypoxic conditions. However, HIF-1α activity disruption via the administration of E3330, an APE-1 inhibitor, downregulated Pgp expression and increased doxorubicin delivery to HT-29 cells, where it served as a substrate for Pgp, indicating the existence of an indirect relationship between Pgp expression and doxorubicin accumulation. Thus, we concluded that Pgp and BCRP expression can be regulated via cross-talk between doxorubicin and hypoxia, promoting drug resistance in HT-29 WT, and HT-29DxR cells and that this process may be ROS dependent. J. Cell. Biochem. 118: 1868-1878, 2017. © 2017 Wiley Periodicals, Inc.
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Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/metabolismo , Hipóxia Celular/fisiologia , Neoplasias do Colo/metabolismo , Doxorrubicina/farmacologia , Proteínas de Neoplasias/metabolismo , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/genética , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/genética , Hipóxia Celular/genética , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Neoplasias do Colo/genética , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/genética , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/metabolismo , Ensaio de Imunoadsorção Enzimática , Células HT29 , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Microscopia Confocal , Proteínas de Neoplasias/genética , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/genética , Espécies Reativas de Oxigênio/metabolismoRESUMO
Introducción: la permanencia de los estudiantes en Medicina implicó el desarrollo de estrategias dirigidas a disminuir la deserción académica. El Programa de Fortalecimiento académico de la Universidad del Rosario, ha contribuido a este logro a partir del acompañamiento de los estudiantes en su aprendizaje. Objetivo: analizar el éxito y la calidad académicos de estudiantes de Medicina que reingresaron a la carrera luego de cursar y aprobar un Programa de Fortalecimiento Académico diseñado para reforzar las asignaturas que causaron la pérdida del cupo. Métodos: estudio tipo censo que incluyó a todos los estudiantes inscritos (n = 113) en las asignaturas de refuerzo en Bioquímica del Programa, desde el primer semestre del 2008 al segundo del 2012. Resultados: el mayor número de inscritos al Programa se presentó en las asignaturas de refuerzo en Bioquímica I y II: 42 por ciento (n = 58) y el 50 por ciento (n = 56). El 58 por ciento (n = 66) de los estudiantes que aprobaron el Programa obtuvieron el reingreso al pregrado y permanecieron activos en la carrera de Medicina. El 18 por ciento de los que permanecieron en la Universidad, superó el parámetro de buena calidad académica, con notas ≥ 4,0 una vez cursaron las asignaturas. Conclusiones: desde el ámbito de la Bioquímica, el Programa ha contribuido a la permanencia estudiantil en la carrera de Medicina, acorde con el reto de las políticas públicas. La pérdida del cupo por bajo rendimiento académico del 21,8 por ciento (n = 87) de estudiantes que reingresaron al pregrado, indica la orientación de acciones que incidan en factores como el aislamiento social, problemas familiares o de salud, y la orientación vocacional(AU)
Introduction: The retention of students in Medicine involves development of strategies aimed at reducing academic desertion. Academic Support Program of the Universidad del Rosario, has contributed to this achievement from accompanying students in their learning. Objective: The aim of this study was to analyze the success and quality in academic promotion of students from Health Sciences at the University of Rosario, who entered the Strengthening Program, and previously lost their enrollment in Medicine because Biochemistry subjects. Methods: Census study that includes all students enrolled in the program (113) with reinforcement in Biochemistry subjects from the first half of 2008 to second in 2012. Results: 58 percent (n = 66) of students remained and obtaining readmission to the University and active status likewise undergraduate students in the medical career. The highest number was registered in the subjects Biochemistry reinforcement I and II: 42 percent (n = 58) and 50 percent (n = 56) respectively. 18 percent of those who stayed in college, exceeded the parameter of good academic quality, with notes ≥ 4,0 in these subjects. Conclusions: Since Biochemistry context, the Strengthening Program has contributed to student retention in the medical career and also according to the challenge of public policy. The loss of quota for poor academic performance 21.8 percent (n = 87) of students who were readmitted to undergraduate indicates the orientation of activities influencing factors such as social isolation, family or health problems, and vocational guidance(AU)
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Humanos , Desempenho Acadêmico , Aprendizagem , Estudantes de Medicina , Universidades , Bioquímica/educaçãoRESUMO
OBJECTIVE: Describe the psychometric properties of the Suicide Resilience Inventory (SRI-25), adapted to Spanish, in a student sample of adolescents and young adults from San Juan de Pasto, Colombia. METHODS: The SRI-25 was adapted to the Spanish language by means of a simple translation. This involved the participation of 573 schoolchildren and college/ university students between 10 and 25 years of age. RESULTS: In an exploratory factorial analysis by principal components, a structure of three factors was found to explain 52.83% of the variance. Factorial analysis was carried out by sex, educational level, and developmental stage. On this basis, it was confirmed that in all the groups, the items are weighted on the same factors as in the original test: namely, internal protection, emotional stability, and external protection. A Cronbach's alpha coefficient of 0.922 was obtained for the total test. Concerning the validity of the construct, the SRI-25 presented significant correlations with measurements of self-esteem, social support, problem-solving skills, reasons for living, depression, despair, and suicidal ideas. CONCLUSIONS: It was proved that the SRI-25 is a useful instrument for measuring resilience to suicide among adolescents and young people pursuing their education in San Juan de Pasto, Colombia.
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Suicídio/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Criança , Colômbia , Escolaridade , Humanos , Idioma , Análise de Componente Principal/métodos , Setor Privado , Psicometria , Setor Público , Fatores Sexuais , Estudantes/psicologia , Traduções , Adulto JovemRESUMO
OBJETIVO: Describir las propiedades psicométricas del Suicide Resilience Inventory (SRI-25), adaptado al español, en una muestra de adolescentes y jóvenes escolarizados de San Juan de Pasto, Colombia. MÉTODOS: Se adaptó el SRI-25 al idioma español por medio de una traducción simple. Se contó con 573 participantes, estudiantes de colegios y universidades, de 10 a 25 años de edad. RESULTADOS: En un análisis factorial exploratorio por componentes principales se encontró una estructura de tres factores que explican el 52,83 por ciento de la varianza. Se realizaron análisis factoriales según el sexo, el nivel educativo y la etapa evolutiva, a partir de los cuales se confirmó que en todos los grupos, los ítems cargan en los mismos factores de la prueba original, a saber: protección interna, estabilidad emocional y protección externa. Se obtuvo un coeficiente alfa de Cronbach de 0,922 para la prueba total. En cuanto a la validez de constructo, el SRI-25 presentó correlaciones significativas con medidas de autoestima, apoyo social, solución de problemas, razones para vivir, depresión, desesperanza e ideas suicidas. CONCLUSIÓN: Se comprobó que el SRI-25 es un instrumento útil para medir la resiliencia ante el suicidio en adolescentes y jóvenes escolarizados de San Juan de Pasto, Colombia.
OBJECTIVE: Describe the psychometric properties of the Suicide Resilience Inventory (SRI-25), adapted to Spanish, in a student sample of adolescents and young adults from San Juan de Pasto, Colombia. METHODS: The SRI-25 was adapted to the Spanish language by means of a simple translation. This involved the participation of 573 schoolchildren and college/ university students between 10 and 25 years of age. RESULTS: In an exploratory factorial analysis by principal components, a structure of three factors was found to explain 52.83 percent of the variance. Factorial analysis was carried out by sex, educational level, and developmental stage. On this basis, it was confirmed that in all the groups, the items are weighted on the same factors as in the original test: namely, internal protection, emotional stability, and external protection. A Cronbach's alpha coefficient of 0.922 was obtained for the total test. Concerning the validity of the construct, the SRI-25 presented significant correlations with measurements of self-esteem, social support, problem-solving skills, reasons for living, depression, despair, and suicidal ideas. CONCLUSIONS: It was proved that the SRI-25 is a useful instrument for measuring resilience to suicide among adolescents and young people pursuing their education in San Juan de Pasto, Colombia.