Resultados a largo plazo de la rehabilitación del piso pélvico en pacientes con incontinencia fecal / Long-term results of pelvic floor rehabilitation in patients with fecal incontinence

Resumen Introducción: La rehabilitación del piso pélvico es frecuentemente indicada a los pacientes con incontinencia fecal. Su efectividad a corto plazo ha sido demostrada. Sin embargo, sus resultados en el largo plazo son controversiales. Objetivo: Nuestro objetivo es evaluar los resultados funcionales y calidad de vida a largo plazo de los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico. Materiales y Método: Estudio cuasi-experimental. Se incluyeron los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico entre 2007-2014 en nuestro centro, sin necesidad de cirugía. Se midió el puntaje funcional de Wexner y de calidad de vida (FIQLS) antes (T1) y después del tratamiento (T2). Se realizó encuesta vía correo electrónico para obtener dichos puntajes entre 3-10 años posterior al tratamiento (T3). Resultados: De 215 pacientes, 182 cumplían criterios de inclusión. 96 (52,8%) de ellos respondieron la encuesta en T3. La mediana de seguimiento fue de 4,5 (3-10) años. La edad promedio al tiempo del estudio fue de 60,8 ±13,1 años. 88,4% fueron mujeres. La mediana del puntaje funcional fue 16 (6-20) en T1 y 7 (0-18) en T2, p = 0,000. La calidad de vida mejoró significativamente en sus 4 dimensiones entre T1 y T2. En T3, ambos puntajes presentaron mejores promedios que en T1, p = 0,000. No hubo asociación entre el tiempo de seguimiento y el resultado funcional en T3. Conclusión: Los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico mejoran significativamente su funcionalidad y calidad de vida. El beneficio disminuye en el tiempo, pero persiste mejor que previo al tratamiento.

Introduction: Pelvic floor rehabilitation is often indicated as first-line therapy for patients with fecal incontinence. Its short-term effectiveness has been demonstrated in these patients. However, long-term results are controversial. Aim: Our objective is to evalúate long-term functionality and quality of life in patients with fecal incontinence treated with pelvic floor rehabilitation. Materials and Method: Quasi- experimental study conducted at a single tertiary care center. We included patients with fecal incontinence treated by pelvic floor rehabilitation at our center between 2007-2014 who did not require surgery. Wexner functional score and quality of life using FIQLS were measured pre (T1) and post-treatment (T2). Poste - riorly, an-e-mail survey was conducted to retrieve scores three to 10 years after treatment (T3). Results: Of the 215 patients, 182 met the inclusion criteria. 96 (52.8%) patients responded at T3 and were therefore included. The median follow-up period was of 4.5 years (3-10). The mean age at the time of the study was 60.8 ± 13.1 years and 88.4% were women. The median Wexner score was 16 (6-20) in T1 and 7 (0-18) in T2, (p = 0.000). Quality of life improved significantly in its four dimensions when comparing T1 and T2. In T3, Wexner and the quality of life scores were significantly lower than T2. However, in T3, both scales had better means than T1, (p = 0.000). There was no association between the follow-up time and the functional result in T3. Conclusions: Patients with fecal incontinence treated by pelvic floor rehabilitation improve their functionality and quality of life significantly. This benefit decreases over time but remains above its baseline.

Hipoacusia sensorioneural unilateral: Revisión de los manejos posibles en nuestra realidad nacional / Unilateral sensorineural hearing loss: Review of possible management in our national reality

La hipoacusia unilateral (HUL) definida como la pérdida auditiva de cualquier grado en un solo oído tiene prevalencias en edad escolar de 3% a 6%. La etiología es desconocida en la mayoría de los casos, pero destacan las anormalidades anatómicas severas a diferencia de las hipoacusias bilaterales, lo que le otorga importancia al estudio de imágenes. También se recomienda realizar evaluación oftalmológica. El impacto de la HUL se observa en la localización sonora, reconocimiento del habla, desarrollo del lenguaje, desempeño social y conducta, pero por sobre todo en el rendimiento académico. En este sentido es relevante mencionar que además de existir mayor probabilidad de repitencia de curso, es necesario mayor apoyo educacional individualizado para evitar dicha repitencia o lograr mismo éxito académico que un normoyente. En relación al diagnóstico aún faltan normas o protocolos, siendo éste un desafío en las zonas donde no hay screening universal. Se discute la importancia de las encuestas para realizar evaluaciones y seguimiento en estos casos. Finalmente se abordan las estrategias de intervención disponibles, además de un plan individualizado considerando al niño, su familia y sus expectativas, particularmente se discuten las características o factores a tomar en cuenta en el momento de la adaptación, para así lograr un tratamiento tendiente al éxito.

Unilateral hearing loss (UHL) defined as hearing loss of any degree in only one ear has a school-age prevalence of 3% to 6%. The etiology is unknown in most cases, but severe anatomical abnormalities stand out as opposed to bilateral hearing loss, which gives importance to the study of images. Ophthalmological evaluation is also recommended. The impact of UHL is observed in sound localization, speech recognition, language development, social performance and behavior, but above all in academic performance. In this sense, it is relevant to mention that in addition to having a higher probability of repeating the course, it is necessary to have more individualized educational support to avoid this repetition or achieve the same academic success as a normal listener. Regarding the diagnosis, there are still missing norms or protocols, this being a challenge in areas where there is no universal screening. The importance of surveys to carry out evaluations and follow-up in these cases is discussed. Finally, the available intervention strategies are discussed, in addition to an individualized plan considering the child, his family and his expectations, particularly, the factors to be taken into account at the time of adaptation, in order to achieve a success treatment.

Transmisión vertical de hepatitis B: importancia de incorporar el cribado en el control prenatal en Chile / Vertical transmission of hepatitis B: the importance of incorporating screening during pregnancy in Chile

Resumen La transmisión vertical de hepatitis B es responsable de 50% de las infecciones en el mundo e implica 90% de riesgo de evolucionar a hepatitis crónica y sus complicaciones. La inmunoprofilaxis postparto (inmunoglobulina más vacuna) es la medida de prevención más efectiva. Sin embargo, puede existir fracaso a pesar de dicha intervención, debido a factores como alta carga viral o la presencia de HBeAg en la madre, los que sólo pueden evitarse si se hace el diagnóstico y tratamiento durante la gestación. En Chile, en el año 2019 se incorporó la vacunación en los recién nacidos, pero no existe aún cribado durante el embarazo, a diferencia de los países desarrollados. En los últimos años se ha experimentado un aumento acelerado de inmigración proveniente principalmente de América latina y el Caribe, con prevalencias altas en algunos de ellos. Chile debiese avanzar prontamente hacia el cribado de hepatitis B en embarazo.

Abstract Half of cases of hepatitis B around the world are produced from vertical transmission; and 90% of them can evolve to chronic hepatitis and their long term complications. Postpartum immunoprophylaxis (immunoglobulin and vaccine) is the most effective preventive measure. However, despite this prophylaxis, vertical transmission is possible if the mother presents a high viral load or e-antigen. This risk can be reduced only if screening during pregnancy and treatment if needed, are incorporated. In 2019, vaccination for hepatitis B in newborn was incorporated in Chile, but not yet prenatal screening, unlike developed countries. Chile has experienced a growth in immigration from Latin America and Caribbean, some countries with high endemicity included. Prenatal screening in Chile should be promptly incorporated.

NOD1 rs2075820 (p.E266K) polymorphism is associated with gastric cancer among individuals infected with cagPAI-positive H. pylori.

BACKGROUND: Helicobacter pylori is detected by pathogen recognition receptors including toll-like receptors (TLR) and nucleotide-binding oligomerization domain (NOD)-like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. RESULTS: A case-control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal-type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41-5.13, p = 0.0026). The association was not statistically significant in diffuse-type gastric cancer cases (OR = 1.26, 95% CI 0.63-2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80-3.36, p = 0.0019), in particular for intestinal-type gastric cancer cases (OR = 7.16, 95% CI 2.40-21.33, p = 4.1 × 10- 4) but not among diffuse-type gastric cancer cases (OR = 3.39, 95% CI 1.13-0.10, p = 0.03). CONCLUSIONS: NOD1 rs2075820 increases the risk of intestinal-type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.

NOD1 rs2075820 (p.E266K) polymorphism is associated with gastric cancer among individuals infected with cagPAI-positive H. pylori

BACKGROUND: Helicobacter pylori is detected by pathogen recognition receptors including toll-like receptors (TLR) and nucleotide-binding oligomerization domain (NOD)-like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. RESULTS: A case-control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal-type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41-5.13, p = 0.0026). The association was not statistically significant in diffuse-type gastric cancer cases (OR = 1.26, 95% CI 0.63-2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80-3.36, p = 0.0019), in particular for intestinal-type gastric cancer cases (OR = 7.16, 95% CI 2.40-21.33, p = 4.1 × 10- 4) but not among diffuse-type gastric cancer cases (OR = 3.39, 95% CI 1.13-0.10, p = 0.03). CONCLUSIONS: NOD1 rs2075820 increases the risk of intestinal-type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.

Polymorphisms PSCA rs2294008, IL-4 rs2243250 and MUC1 rs4072037 are associated with gastric cancer in a high risk population.

Genetic variants are considered risk factors for gastric cancer. To date, 61 polymorphisms have been identified as associated with this disease. The aim of the present study was to analyze the association of some of those polymorphisms with GC in Chile. We performed a case-control study including 310 gastric cancer cases and 311 controls to assess the association of 36 single-nucleotide polymorphisms genotyped by Global Screening Array (GSA). Three polymorphisms was significantly associated: PSCA rs2294008 (allele model, OR = 1.49, 95%CI 1.17-1.88, P = 1.08 × 10-3), IL-4 rs2243250 (allele model, OR = 1.28, 95%CI 1.01-1.62, P = 0.04), and MUC1 rs4072037 (allele model, OR = 0.78, 95%CI 0.61-0.99, P = 0.04).PSCA rs2294008, IL-4 rs2243250 and MUC1 rs4072037 are associated with gastric cancer in Chile. It suggests that those polymorphisms could be used as biomarkers to assess the genetic risk for this cancer outside of the previously studied populations, not only for East Asians and Caucasians populations.

Comparison of nasal and olfactory functions between two surgical approaches for the treatment of concha bullosa: a randomised clinical trial.

OBJECTIVE: Concha bullosa may be associated with paranasal sinus infections and nasal obstruction. Middle concha mucosa membranes have olfactory neurofibrils. This study investigated the impact of routinely used concha bullosa surgery techniques - crushing and lateral laminectomy - on nasal and olfactory functions. METHODS: Forty-three adult patients who had undergone surgery for a symptomatic concha bullosa completed the odour test, nasal obstruction visual analogue scale, 22-item Sino-Nasal Outcome Test, and peak nasal inspiratory flow test, pre-operatively and three months post-operatively. The pre- and post-operative results within and between the two treatment groups were compared. RESULTS: Intragroup comparison of mean pre- versus post-treatment changes revealed statistically significant findings for the nasal obstruction visual analogue scale, Sino-Nasal Outcome Test, peak nasal inspiratory flow and olfaction tests (all p < 0.05). However, there were no statistically significant changes when comparing the scores between the groups (intergroup comparison). CONCLUSION: Lateral laminectomy and crushing in concha bullosa surgery have no negative effects on olfactory function. Concha bullosa surgery provides positive outcomes regarding nasal complaints in symptomatic patients.

Effect of somatotropin on survival and diameter of bovine preantral follicles / Efeito da somatotropina na sobrevivência e no diâmetro de folículos pré-antrais de bovinos

The aim of this study was to evaluate the effect of Recombinant bovine somatotropin (rbST) on survival and diameter of bovine preantral ovarian follicles (PAOF) cultured in vitro. Ovaries were collected from adult cows and fragments of ovarian cortex were immediately fixed (non-cultured control) or cultured in vitro in α-MEM+ alone or containing 10, 50, 100 or 1,000ng/mL rbST. The fragments were processed for Classical Histology and Transmission Electron Microscopy. After one and seven days of culture, the percentage of normal follicles in the non-cultured control was superior (P< 0.05) to the follicles cultured in α-MEM+ alone or with different rbST concentrations. The oocyte and follicular mean diameter did not increase during the culture for one and seven days, both in media containing rbST and in the medium without this hormone. The only medium in which there was no reduction in follicular diameter with the time of culture was the medium without rbST. Ultrastructural damage in PAOF cultured in vitro was found. It is concluded that the use of rbST at different concentrations in in situ culture of bovine preantral follicles has no beneficial effects on survival and growth of bovine PAOF.(AU)

O objetivo deste trabalho foi avaliar o efeito da somatotropina recombinante bovina (rbST) sobre a sobrevivência e o diâmetro de folículos ovarianos pré-antrais (FOPA) bovinos cultivados in vitro. Ovários foram coletados de vacas adultas e fragmentos do córtex ovariano foram imediatamente fixados (controle não cultivado) ou cultivados in vitro em α-MEM + sozinho ou contendo 10, 50, 100 ou 1.000ng/mL de rbST. Os fragmentos foram processados para histologia clássica e microscopia eletrônica de transmissão. Após um e sete dias de cultivo, o percentual de folículos normais no controle não cultivado foi superior (P<0,05) aos cultivados em α-MEM + sozinho ou acrescido de diferentes concentrações de rbST. Os diâmetros médios oocitário e folicular não aumentaram durante o cultivo por um e sete dias, tanto nos meios contendo rbST, como no meio sem esse hormônio (α-MEM + ). O único meio em que não houve redução no diâmetro folicular com o tempo de cultivo foi o sem rbST. Verificaram-se ainda danos ultraestruturais em FOPA cultivados in vitro. Conclui-se que o uso de rbST em diferentes concentrações no cultivo in situ de folículos pré-antrais bovinos não tem efeitos benéficos na sobrevivência e no crescimento de FOPA bovinos.(AU)

Trichospilus diatraeae (Hymenoptera: Eulophidae): development and reproduction in Lepidoptera palm oil pests / Trichospilus diatraeae (Hymenoptera: Eulophidae): desenvolvimento e reprodução em lepidópteros-praga da palma de óleo

Abstract Brazil is a leading palm oil producer, but the defoliating caterpillars Opsiphanes invirae Hübner Brassolis sophorae L. (Lepidoptera: Nymphalidae) can reduce the productivity of this crop. The aim of this study was to evaluate the development and reproduction of the parasitoid Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) in pupae of these oil palm defoliators. Ten O. invirae or B. sophorae pupae with up to two days old were exposed each to 30 T. diatraeae females for 48 hours. Parasitism and emergence of the progeny of T. diatraeae were similar in pupae of both Lepidoptera defoliators. The life cycle of this parasitoid was shorter in O. invirae (21.50 ± 0.42 days) pupae than with those of B. sophorae (27.60 ± 1.80 days). The number of the progeny (669.00 ± 89.62) and dead immature (217.13 ± 58.18) of T. diatraeae were higher in B. sophorae pupae than in those of O. invirae with 447.83 ± 51.52 and 13.50 ± 5.23, respectively. The sex ratio and female and male longevity of T. diatraeae emerged from these hosts were similar. The reproductive traits, especially the number of individuals (offspring) of T. diatraeae were better with B. sophorae pupae than with those of O. invirae.

Resumo O Brasil é um dos principais produtores de óleo de palma, porém as lagartas desfolhadoras Opsiphanes invirae Hübner e Brassolis sophorae L. (Lepidoptera: Nymphalidae) podem comprometer a produtividade dessa cultura. O objetivo deste trabalho foi avaliar o desenvolvimento e aspectos reprodutivos do parasitoide Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) em pupas desses desfolhadores da palma de óleo. Dez pupas de O. invirae ou de B. sophorae com até dois dias de idade, foram expostas, cada uma, ao parasitismo por 30 fêmeas de T. diatraeae , por 48 horas. O parasitismo e a emergência da progênie de T. diatraeae foram semelhantes em pupas de ambas as espécies de lepidópteros desfolhadores da palma de óleo. O ciclo de vida desse parasitoide foi mais curto em pupas de O. invirae (21,50 ± 0,42 dias) que com as de B. sophorae (27,60 ± 1,80 dias). O número de progênie (669,00 ± 89,62) e de imaturos mortos (217,13 ± 58,18) de T. diatraeae foram maiores em pupas de B. sophorae que naquelas de O. invirae com 447,83 ± 51,52 e 13,50 ± 5,23, respectivamente. A razão sexual e a longevidade de fêmeas e machos de T. diatraeae emergidos desses hospedeiros foram semelhantes. As características reprodutivas, especialmente, o número de indivíduos (progênie) de T. diatraeae foram melhores com pupas de B. sophorae que com as de O. invirae .

Trichospilus diatraeae (Hymenoptera: Eulophidae): development and reproduction in Lepidoptera palm oil pests.

Brazil is a leading palm oil producer, but the defoliating caterpillars Opsiphanes invirae Hübner Brassolis sophorae L. (Lepidoptera: Nymphalidae) can reduce the productivity of this crop. The aim of this study was to evaluate the development and reproduction of the parasitoid Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) in pupae of these oil palm defoliators. Ten O. invirae or B. sophorae pupae with up to two days old were exposed each to 30 T. diatraeae females for 48 hours. Parasitism and emergence of the progeny of T. diatraeae were similar in pupae of both Lepidoptera defoliators. The life cycle of this parasitoid was shorter in O. invirae (21.50 ± 0.42 days) pupae than with those of B. sophorae (27.60 ± 1.80 days). The number of the progeny (669.00 ± 89.62) and dead immature (217.13 ± 58.18) of T. diatraeae were higher in B. sophorae pupae than in those of O. invirae with 447.83 ± 51.52 and 13.50 ± 5.23, respectively. The sex ratio and female and male longevity of T. diatraeae emerged from these hosts were similar. The reproductive traits, especially the number of individuals (offspring) of T. diatraeae were better with B. sophorae pupae than with those of O. invirae.

Síndrome de encefalopatía posterior reversible en lupus eritematoso sistémico / Reversible posterior encephalopathy syndrome in systemic lupus erythematosus

El síndrome de encefalopatía posterior reversible (PRES) es una condición reversible, poco conocida en el lupus eritematoso sistémico (LES) que puede semejar al lupus neuropsiquiátrico. Las manifestaciones de PRES son cefalea, convulsiones, alteración del nivel de conciencia y amaurosis. En la mayoría de los casos, la TC (tomografía computarizada) del cerebro muestra lesiones hipodensas en el lóbulo parieto-occipital. Aunque este síndrome es poco común, el reconocimiento rápido y preciso permite un tratamiento temprano con resultados favorables. Presentamos un caso clínico de una paciente con debut de LES posterior a episodio de eclampsia, y que durante el puerperio tardío presenta hipertensión sostenida asociada a convulsiones y deterioro del nivel de conciencia en contexto de PRES

Posterior reversible encephalopathy syndrome (PRES) is a poorly recognized and reversible condition in systemic lupus erythematosus (SLE) that could mimic neuropsychiatric lupus. The manifestations of PRES are headache, seizures, altered level of consciousness and blindness. In most cases, computed tomography of the brain shows hypodense lesions in the parieto-occipital lobe. Although this syndrome is rare, rapid and accurate recognition allows early treatment with favorable results. We present a case report of a patient with the onset of SLE following the episode of eclampsia, and who during the late puerperium presented sustained hypertension associated with seizures and deterioration of the level of consciousness in the context of PRES.

Polymorphisms in TWIST1 and ZEB1 Are Associated with Prognosis of Gastric Cancer Patients.

BACKGROUND/AIM: Epithelial-mesenchymal transition (EMT) program has been linked as a driver of metastatic dissemination by conferring migratory and invasive capacity to cancer cells. Gastric cancer (GC) patients with tumors expressing altered levels of EMT markers have low survival. This study aimed to assess if polymorphisms of CDH1, TWIST1, SNAIL2, ZEB1 and ZEB2 genes are associated with survival in GC patients. PATIENTS AND METHODS: A total of 153 individuals with diagnosis of GC were recruited in Santiago, Chile. All patients were genotyped using Infinium Global Screening Array (GSA). Twenty Tag SNPs of the studied genes were retrieved. RESULTS: Three SNPs were associated with survival: rs2526614 (TWIST1) (genotype CA + AA, adjusted HR=0.58, 95%CI=0.37-0.93), rs6953766 (TWIST1) (genotype GG, crude HR=2.02, 95%CI=1.06-3.82, adjusted HR=2.14, 95%CI=1.07-4.25), and rs431073 (ZEB1) (genotype AC + CC, crude HR=1.62, 95%CI=1.01-2.59, adjusted HR=1.96, 95%CI=1.18-3.25). CONCLUSION: To the best of our knowledge, this is the first study proposing a role of these SNPs in cancer prognosis. Their use as prognostic markers of GC survival warrants further investigation.

Childhood and adolescent lymphoma in Spain: incidence and survival trends over 20 years.

BACKGROUND: Lymphoma is the third most common malignancy in children (0-14 years) and the first in adolescents (15-19 years). This population-based study-the largest ever done in Spain-analyses incidence and survival of lymphomas among Spanish children and adolescents. PATIENTS AND METHODS: 1664 lymphoma cases (1983-2007) for incidence and 1030 for survival (1991-2005) followed until 31/12/2010, were provided by 11 cancer registries. Age-adjusted incidence rates (ASRw) to the world standard population were obtained; incidence trends were modelled using the Joinpoint programme, observed survival (OS) was estimated with Kaplan-Meier and trends tested with a log-rank test. Results are presented according to the International Classification of Childhood Cancer-3. RESULTS: In Spain, the ASRw0-14 for lymphomas was 17.5 per 1.000.000 child-years and 50.0 the specific rate for adolescents. Overall incidence increased significantly during 1983-1997 with no increases thereafter. Patients over 9 years old showed significant rising trends for all subtypes, except for Burkitt lymphoma (BL) in adolescents. During 2001-2005 (age 0-19 years), 5-year OS was 94 (90-98), 73 (64-83) and 86 (78-94) for Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) and BL, respectively. No improvement in survival was found. The incidence in Spain was higher than overall European rates, but within the range of that in Southern Europe. Comparing OS in Spain 1991-1995 and 2001-2005 with results for Europe of the Automated Childhood Cancer Information System (ACCIS) (1988-1997) and the European cancer registry-based study on survival and care of cancer patients (EUROCARE) (2000-2007), it was similar for HL and lower for NHL and BL. CONCLUSIONS: Systematic monitoring and analysis of lymphoma paediatric data would provide clinical and epidemiological information to improve the health care of these patients and the outcomes for these malignancies in Spain.

Polymorphisms in RAS/RAF/MEK/ERK Pathway Are Associated with Gastric Cancer.

The RAS/RAF/MEK/ERK pathway regulates certain cellular functions, including cell proliferation, differentiation, survival, and apoptosis. Dysregulation of this pathway leads to the occurrence and progression of cancers mainly by somatic mutations. This study aimed to assess if polymorphisms of the RAS/RAF/MEK/ERK pathway are associated with gastric cancer. A case-control study of 242 gastric cancer patients and 242 controls was performed to assess the association of 27 single nucleotide polymorphisms (SNPs) in the RAS/RAF/MEK/ERK pathway genes with gastric cancer. Analyses performed under the additive model (allele) showed four significantly associated SNPs: RAF1 rs3729931 (Odds ratio (OR) = 1.54, 95%, confidence interval (CI): 1.20⁻1.98, p-value = 7.95 × 10-4), HRAS rs45604736 (OR = 1.60, 95% CI: 1.16⁻2.22, p-value = 4.68 × 10-3), MAPK1 rs2283792 (OR = 1.45, 95% CI: 1.12⁻1.87, p-value = 4.91 × 10-3), and MAPK1 rs9610417 (OR = 0.60, 95% CI: 0.42⁻0.87, p-value = 6.64 × 10-3). Functional annotation suggested that those variants or their proxy variants may have a functional effect. In conclusion, this study suggests that RAF1 rs3729931, HRAS rs45604736, MAPK1 rs2283792, and MAPK1 rs9610417 are associated with gastric cancer.

Testicular cytology by fine needle aspiration in domestic cats.

In cases where semen collection in tom-cats is not possible, FNA of testes is the alternative to evaluate sperm production. Although this technique for the diagnosis of fertility problems has been well discussed in other mammals (men, dogs, stallions), data for domestic cats are limited. Therefore, the aim of this study was to verify the reliability of FNA using needles of small diameters (22G and 29G) in testes of domestic cats of different ages to assess the spermatogenesis status and to present description of germ cells and Sertoli cells for cytological examinations. Thirty-four mixed breed cats aged between four months and two years presented for neutering to a Veterinary Hospital were used in this study. Under general anesthesia, testicular measures and FNA were followed by orchiectomy and imprints of the parenchyma of testes and epididymides. Cats were assigned into 3 groups: (G1) 10 cats aged less than 6 months, (G2) 14 cats aged between 6 months and one year and (G3) 10 cats aged more than one year. Cats weighted between 1.5 and 6.0 kg. The mean testicular volume (TV cm3) was 0.55 (G1), 1.18 (G2) and 2.66 (G3). Hemorrhages in the needle path were observed in more than 70% of testes. Few samples (4/68) were excluded due to blood contamination. All germ cells and Sertoli cells were identified and quantified in imprint and FNA smears. Incomplete spermatogenesis was observed in cats aged less than 6 months using both techniques (FNA and imprint); therefore, testicular FNA should not be recommended for cats at this age. Complete spermatogenesis was found in 64% of cats aged from 6 months up to one year and in all cats aged more than one year. There were no differences of Sertoli cell Index (SEI) and Spermatic Index (SI) between FNA and imprints of cats older than 6 months. In conclusion, FNA using needles of small diameter in the testes of domestic cats is viable, reliable and can be used as a tool for the analysis of the spermatogenesis status of cats older than 6 months, mainly in cases in which semen collection is not possible.

¿Son los antipsicóticos efectivos para prevenir el delirium postoperatorio? / Are antipsychotics effective for the prevention of postoperative delirium?

INTRODUCCIÓN: Los antipsicóticos se han propuesto como una medida farmacológica para la profilaxis del delirium postoperatorio. No obstante, su real utilidad clínica y seguridad no han sido demostrados. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos 16 revisiones sistemáticas que en conjunto incluyeron ocho estudios primarios, todos correspondientes a ensayos aleatorizados. Concluimos que el uso de antipsicóticos profilácticos disminuye la incidencia de delirium postoperatorio, pero no hace diferencia en el tiempo de hospitalización y podría aumentar la mortalidad.

INTRODUCTION: Antipsychotics have been proposed as a pharmacological alternative to prevent postoperative delirium. Nonetheless, their actual clinical benefits and harms are a matter of debate. METHODS: To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the chosen systematic reviews, reanalyzed the data from the primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified 16 systematic reviews that included eight primary studies, all were randomized trials. We concluded the use of prophylactic antipsychotics reduces the incidence of postoperative delirium, but has no effect on the duration of hospital stay and might increase mortality.