Interest in Cardiothoracic Surgery Among the American College of Osteopathic Surgeons' Medical Students.

BACKGROUND: As more integrated cardiothoracic (CT) surgical residency programs are developed, there is increased interest in factors influencing specialty selection during undergraduate medical education. This study aimed to nationally assess interests and perceptions of CT surgery from medical students pursuing surgery and factors influencing such interests. METHODS: Active members of the American College of Osteopathic Surgeons - Medical Student Section were invited to complete an original survey. Means and 95% confidence intervals were calculated and graphed for questions using Likert scale responses. The comparison of mean responses for students in preclinical versus clinical years was assessed by a Kruskal-Wallis non-parametric ANOVA. Differences between response proportions were assessed via Bonferroni Comparison of Column Proportions. RESULTS: There were 306 surveys completed. Interest in CT surgery was indicated by 10.24% of respondents with preclinical students comprising 84.3% of those responses. Most students interested in CT surgery experienced certain factors including clinical exposure (78.4%), shadowing (81.8%), volunteering (57.1%), and significant personal/life events (86.2%) before medical school. Preclinical students noted exposure to CT surgery during preclinical years would further increase their interest when compared to clinical students (µ=4.12 versus µ=3.51, P<0.000). Importantly, clinical students feel significantly less supported by their school to pursue CT surgery compared to preclinical students (µ=2.45 versus µ=3.40, P<0.000). CONCLUSIONS: All factors establishing interest in CT surgery occurred before students entered medical school and during preclinical years. While there are negative perceptions associated with CT surgery, these may be ameliorated with increased support and resources for CT surgery during the preclinical years.

Building Interest in Cardiothoracic Surgery at an Osteopathic Medical School: Results of an Institutional Study and a Guide for Medical Schools.

Objective A previous study at this institution revealed a connection between interest group involvement and specialty interest while identifying the negative perceptions of cardiothoracic (CT) surgery. This study aimed to build interest and ameliorate the negative perceptions of CT surgery by exposing pre-clinical students to the field through engaging events. Methods Students at a US osteopathic institution who attended CT surgery committee events were invited to complete an online survey after each event. Associations between the number of events attended and ranked responses to survey questions were assessed by two-tailed Spearman correlations. Statistical comparisons in ranked responses between the events attended and the survey questions were assessed by a two-way analysis of variance (ANOVA). Pre-clinical students actively enrolled at the institution during the 2022-2023 academic year were eligible for inclusion. Results There were 83 surveys completed over seven events. There was a significant association between the number of events a student attended and their perception of CT surgeon's work/life balance with a correlation coefficient of .258 (P=0.019) and whether CT surgeons have time for their families with a correlation coefficient of .235 (P=0.035). Residents and medical student events as well as wet lab events increased interest the most and helped students feel equipped to apply for CT surgery. Conclusions While negative perceptions associated with CT surgery exist, these may be ameliorated with more exposure to the field. Unique events that expose pre-clinical students to multiple facets of CT surgery, including physicians and trainees in the field, as well as offering hands-on activities, may increase interest in the field and further pursuit of the field during clinical years.

Assessing interest in cardiothoracic surgery at an osteopathic medical school: Results of an institutional survey.

Objective: Cardiothoracic surgery is a surgical subspecialty that attracts few medical students. As integrated surgical residency programs continue to grow in number, there is increased interest in what factors influence specialty selection during undergraduate medical education. Previous institutional studies have studied allopathic medical schools affiliated with academic institutions. This study aimed to assess the interest and perception of cardiothoracic surgery at an osteopathic institution. Methods: Active medical students at a US osteopathic institution were invited to complete an original online survey. Means and 95% confidence intervals were calculated and graphed for questions using Likert scale responses. Comparison of mean responses for preclinical versus clinical students was assessed by a Kruskal-Wallis nonparametric analysis of variance. Results: There were 166 surveys (22%) completed, and interest in cardiothoracic surgery was indicated by 7.8% of respondents. Work/life balance, personality of cardiothoracic surgeons, and lack of family time were negative factors associated with cardiothoracic surgery. Clinical exposure, shadowing, mentorship, and significant personal/life events before medical school were strong factors in establishing students' interest in cardiothoracic surgery. Preclinical students noted exposure to cardiothoracic surgery would further increase their interest when compared with clinical students (µ = 3.39 vs µ = 2.69, P = .008). Conclusions: All factors that established interest in cardiothoracic surgery occurred before students entered medical school. Although there are negative perceptions associated with cardiothoracic surgery, these may be ameliorated with more exposure to the field. Further research is needed to explore how early exposure in preclinical years of medical school affects students' perceptions and ultimate interest in cardiothoracic surgery.

HDAC1 regulates the chromatin landscape to control transcriptional dependencies in chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) is a quiescent B-cell malignancy that depends on transcriptional dysregulation for survival. The histone deacetylases are transcriptional regulators whose role within the regulatory chromatin and consequence on the CLL transcriptome is poorly characterized. Here, we profiled and integrated the genome-wide occupancy of HDAC1, BRD4, H3K27Ac, and H3K9Ac signals with chromatin accessibility, Pol2 occupancy, and target expression signatures in CLL cells. We identified that when HDAC1 was recruited within super-enhancers (SEs) marked by acetylated H3K27 and BRD4, it functioned as a transcriptional activator that drove the de novo expression of select genes to facilitate survival and progression in CLL. Targeting HDACs reduced BRD4 and Pol2 engagement to downregulate the transcript and proteins levels of specific oncogenic driver genes in CLL such as BLK, a key mediator of the B-cell receptor pathway, core transcription factors such as PAX5 and IKZF3, and the antiapoptotic gene, BCL2. Concurrently, HDAC1, when recruited in the absence of SEs, repressed target gene expression. HDAC inhibition reversed silencing of a defined set of protein-coding and noncoding RNA genes. We focused on a specific set of microRNA genes and showed that their upregulation was inversely correlated with the expression of CLL-specific survival, transcription factor, and signaling genes. Our findings identify that the transcriptional activator and repressor functions of HDACs cooperate within the same tumor to establish the transcriptional dependencies essential for survival in CLL.

Cancer Stem Cells in Tumor Microenvironment of Adenocarcinoma of the Stomach, Colon, and Rectum.

Gastrointestinal adenocarcinomas are one of the world's deadliest cancers. Cancer stem cells and the tissue microenvironment are highly regulated by cell and molecular mechanisms. Cancer stem cells are essential for maintenance and progression and are associated with resistance to conventional treatments. This article reviews the current knowledge of the role of the microenvironment during the primary establishment of gastrointestinal adenocarcinomas in the stomach, colon, and rectum and its relationship with cancer stem cells. We also describe novel developments in cancer therapeutics, such as targeted therapy, and discuss the advantages and disadvantages of different treatments for improving gastrointestinal cancer prognosis.

Antioxidant and Antimicrobial Activity of Rosemary (Rosmarinus officinalis) and Garlic (Allium sativum) Essential Oils and Chipotle Pepper Oleoresin (Capsicum annum) on Beef Hamburgers.

The inclusion of natural ingredients to preserve meat and meat products has increased in recent years. This study evaluated rosemary (REO) and garlic essential oils (GEO) as well as chipotle pepper oleoresin (CPO), alone or in combination, as preservatives on beef hamburgers (BH). Six treatments were evaluated: T1 (control, without additives), T2 (GEO 1%), T3 (REO 1%), T4 (CPO 0.5%), T5 (GEO 1% + CPO 0.5%) and T6 (REO 1% + CPO 0.5%). The microbiological quality, physicochemical characteristics, sensory evaluation, and lipid oxidation of hamburgers were evaluated. REO, GEO and CPO limited the growth of aerobic microorganisms, S. aureus, Salmonella spp., B. thermosphacta, moulds and yeasts, lactic acid bacteria and coliforms (p < 0.05); however, this effect depended on time. Furthermore, lipid oxidation decreased significantly (p < 0.5) in all treatments, except for T5 (GEO 1% + CPO 0.5%). Regarding sensory acceptance, consumers preferred BH with GEO in terms of colour, odour, flavour and overall appearance (p < 0.05). It is concluded that REO, GEO and CPO, alone or in combination, improve microbiological quality and inhibit the lipid oxidation of BH.

Target Nanoparticles against Pancreatic Cancer: Fewer Side Effects in Therapy.

Pancreatic cancer is the most common lethal tumor in America. This lethality is related to limited treatment options. Conventional treatments involve the non-specific use of chemotherapeutical agents such as 5-FU, capecitabine, gemcitabine, paclitaxel, cisplatin, oxaliplatin, or irinotecan, which produce several side effects. This review focuses on the use of targeted nanoparticles, such as metallic nanoparticles, polymeric nanoparticles, liposomes, micelles, and carbon nanotubes as an alternative to standard treatment for pancreatic cancer. The principal objective of nanoparticles is reduction of the side effects that conventional treatments produce, mostly because of their non-specificity. Several molecular markers of pancreatic cancer cells have been studied to target nanoparticles and improve current treatment. Therefore, properly functionalized nanoparticles with specific aptamers or antibodies can be used to recognize pancreatic cancer cells. Once cancer is recognized, these nanoparticles can attack the tumor by drug delivery, gene therapy, or hyperthermia.

Behind the Adaptive and Resistance Mechanisms of Cancer Stem Cells to TRAIL.

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), also known as Apo-2 ligand (Apo2L), is a member of the TNF cytokine superfamily. TRAIL has been widely studied as a novel strategy for tumor elimination, as cancer cells overexpress TRAIL death receptors, inducing apoptosis and inhibiting blood vessel formation. However, cancer stem cells (CSCs), which are the main culprits responsible for therapy resistance and cancer remission, can easily develop evasion mechanisms for TRAIL apoptosis. By further modifying their properties, they take advantage of this molecule to improve survival and angiogenesis. The molecular mechanisms that CSCs use for TRAIL resistance and angiogenesis development are not well elucidated. Recent research has shown that proteins and transcription factors from the cell cycle, survival, and invasion pathways are involved. This review summarizes the main mechanism of cell adaption by TRAIL to promote response angiogenic or pro-angiogenic intermediates that facilitate TRAIL resistance regulation and cancer progression by CSCs and novel strategies to induce apoptosis.

Natural Oregano Essential Oil May Replace Antibiotics in Lamb Diets: Effects on Meat Quality.

A study was conducted to investigate the effect of oregano essential oil (OEO) and monensin sodium on the oxidative stability, colour, texture, and the fatty acid profile of lamb meat (m. Longissimus lumborum). Twenty Dorper x Pelibuey lambs were randomly divided into five treatments; control (CON), monensin sodium (SM, Rumensin 200® 33 mg/kg), a low level of OEO (LO, 0.2 g/kg dry matter (DM)), a medium level of OEO (MO, 0.3g/ kg DM), and a high level of OEO (HO, 0.4 g/kg DM). Dietary supplementation of OEO at any concentration lowered the compression strength in comparison with CON and SM. MO had the highest a* values (7.99) and fatty acid concentration (C16:1n7, C18:1n9c, C18:1n6c, C20:1n9, and C18:2n6c) during storage for 7 d at 3 °C. Lipid oxidation was not promoted (p > 0.05) by the moderated supplementation of oregano essential oil; however, OEO at 0.3 g/kg DM showed a slight lipid pro-oxidant effect. Dietary supplementation of MO and SM had the same effect on colour, tenderness, and the fatty acid profile of lamb (L. lumborum). It was demonstrated that oregano essential oil was beneficial for lambs feeding, and it could be a natural alternative to replace monensin in lamb diets with improvements in the quality of the meat.

Efficient anchoring of nanostructured cadmium selenide on different kinds of carbon nanotubes.

We report a method for the efficient anchoring of cadmium selenide (CdSe) nanoparticles on the surface of different types of multi-walled carbon nanotubes (purified, N-doped, O-doped and exfoliated). Characterization using different types of electron microscopies (SEM, STEM, and TEM), energy dispersive spectroscopy (EDS) and x-ray diffraction showed well anchored CdSe nanoparticles (NP) on the nanotube surfaces, NP shapes and sizes varied with temperature and other synthesis conditions, and formed with good yields. The method here reported does not require previous activation of the carbon nanotube surface by chemical functionalization, nor the use of organic solvents, and the reaction proceeded in aqueous solutions, making this process simpler and more environmentally friendly than others.

Factores prediálisis asociados al deterioro de la filtración glomerular en pacientes dializados / Predialise factors associated with the deterioration of glomerular filtration in dialydated patients

El presente estudio tiene el propósito de identificar los factores predialíticos asociados a la enfermedad renal crónica terminal en pacientes hemodializados. Metodología Estudio descriptivo, observacional y transversal realizado en 180 pacientes hemodiálizados y 120 muestras de pacientes del Hospital Obrero N°1 de la Ciudad de La Paz Bolivia, desde enero a agosto de 2017. Entre estos, 72 pacientes (58.5%) eran varones, 51 (41.5%) mujeres; 101 (82,1%) de procedencia urbana y 22 (17.9%) rural; la media de edad fue 60 ± 14,8 años. Resultados De los factores asociados a enfermedad renal crónica, el 1,6% de pacientes fueron registrados como obesos, 48 (39%) pacientes fueron diabéticos tipo 2, 83 (67.5%) pacientes con diagnóstico previo y actual de Hipertensión Arterial Sistémica, 26(21.1%) pacientes con otras causas de ERCT, y 78 (63.4%) pacientes mayores de 60 años. Conclusión Los factores prediálisis asociados al deterioro de la tasa de filtración glomerular en pacientes dializados se deben en mayor frecuencia a la Hipertensión Arterial Sistémica seguida por Diabetes Mellitus tipo 2, pacientes mayores de 60 años y otras causas de enfermedad renal crónica. La comorbilidad de pacientes diabéticos tipo 2, que además padecen Hipertensión Arterial Sistémica, es estadísticamente significativa y duplica el riesgo de ERCT; las variables de Diabetes tipo 2 y edad mayor a 60 años reflejan una asociación significativa que triplica el riesgo de padecer ERCT.

The purpose of this study is to identify predialitic factors associated to end-stage renal disease (ESRD) in hemodialyzed patients. Methodology A descriptive, observational, cross-sectional study was conducted in 180 hemodialyzed patients and 120 patient samples at Hospital Obrero N° 1 of La Paz city Bolivia, from January to August 2017. 72 (58.5%) patients were male, 51 (41.5%) female, 101 (82.1%) from urban origin and 22 (17.9%) from rural, the average age was 60 years and standard deviation 14.8 years. Results According to factors associated with chronic kidney disease(CKD) 1.6% of patients presented obesity, 48 patients (39%) were Type 2 diabetes, 83 (67.5%)with previous and current diagnosis of Systemic Arterial Hypertension,26 (21.1%) patients with other causes of ESRD, and 78 (63.4%) patients older than 60 years. Conclusion Predialitic factors associated to the deterioration of glomerular filtration rate in dialyzed patients are frequently due to Systemic Arterial Hypertension followed by Diabetes Mellitus type 2, patients older than 60 years and other causes of CKD. The comorbidity of type 2 diabetic patients who present systemic arterial hypertension is statistically significant and doubles the risk for ESRD; moreover, both type 2 diabetes and having more than 60 years display a statistically significant association that triples the risk for ESRD.

Disease model discovery from 3,328 gene knockouts by The International Mouse Phenotyping Consortium.

Although next-generation sequencing has revolutionized the ability to associate variants with human diseases, diagnostic rates and development of new therapies are still limited by a lack of knowledge of the functions and pathobiological mechanisms of most genes. To address this challenge, the International Mouse Phenotyping Consortium is creating a genome- and phenome-wide catalog of gene function by characterizing new knockout-mouse strains across diverse biological systems through a broad set of standardized phenotyping tests. All mice will be readily available to the biomedical community. Analyzing the first 3,328 genes identified models for 360 diseases, including the first models, to our knowledge, for type C Bernard-Soulier, Bardet-Biedl-5 and Gordon Holmes syndromes. 90% of our phenotype annotations were novel, providing functional evidence for 1,092 genes and candidates in genetically uncharacterized diseases including arrhythmogenic right ventricular dysplasia 3. Finally, we describe our role in variant functional validation with The 100,000 Genomes Project and others.

Use of CPR in hemorrhagic shock, a dog model.

INTRODUCTION: Cardiopulmonary resuscitation was designed for sudden cardiac events usually triggered by thrombotic phenomena. Despite this, it is routinely used in trauma resuscitations as per the American Heart guidelines. There is no data supporting the use of chest compressions in hemorrhagic shock. An evidence-based cardiopulmonary resuscitation (CPR) protocol has been developed for dogs. We sought to determine the effects and outcomes of chest compressions in hemorrhagic shock in a canine model. METHODS: Eighteen dogs were randomized to three treatment groups-chest compressions only after hemorrhagic shock (CPR), CPR with fluid resuscitation after hemorrhagic shock (CPR + FLU), and fluid resuscitation alone after hemorrhagic shock (FLU). Under anesthesia, dogs were hemorrhaged until pulse was lost; they were maintained pulseless for 30 minutes and then resuscitated over 20 minutes. Vital signs and laboratory values were recorded at determined intervals. Echocardiography was performed throughout the study. Upon termination of the study, kidney, liver, heart, and brain tissue histology was evaluated for end organ damage. Statistical significance was p < 0.05 with a Bonferroni correction for multiple comparisons. RESULTS: Blood loss and mean time to loss of pulse were similar between the groups. Dogs in the CPR group had significantly lower mean arterial pressure and higher pulse at all points compared to CPR + FLU and FLU (p < 0.05). Ejection fraction was lower in the CPR group at 5 and 10 minutes compared to the other groups (p < 0.05). Vital signs and laboratory results between CPR + FLU and FLU were equivalent. Two of six dogs in the CPR group died, while no dogs died in the CPR + FLU or FLU groups. Dogs in the CPR group were found to have more episodes of end organ damage. CONCLUSION: There was no benefit to chest compressions in the hypovolemic animals. Chest compressions in addition to fluid did not reverse signs of shock better than fluid alone. Further research is needed to define if there is a role of CPR in the trauma patient with hemorrhagic shock.

dsPIG: a tool to predict imprinted genes from the deep sequencing of whole transcriptomes.

BACKGROUND: Dysregulation of imprinted genes, which are expressed in a parent-of-origin-specific manner, plays an important role in various human diseases, such as cancer and behavioral disorder. To date, however, fewer than 100 imprinted genes have been identified in the human genome. The recent availability of high-throughput technology makes it possible to have large-scale prediction of imprinted genes. Here we propose a Bayesian model (dsPIG) to predict imprinted genes on the basis of allelic expression observed in mRNA-Seq data of independent human tissues. RESULTS: Our model (dsPIG) was capable of identifying imprinted genes with high sensitivity and specificity and a low false discovery rate when the number of sequenced tissue samples was fairly large, according to simulations. By applying dsPIG to the mRNA-Seq data, we predicted 94 imprinted genes in 20 cerebellum samples and 57 imprinted genes in 9 diverse tissue samples with expected low false discovery rates. We also assessed dsPIG using previously validated imprinted and non-imprinted genes. With simulations, we further analyzed how imbalanced allelic expression of non-imprinted genes or different minor allele frequencies affected the predictions of dsPIG. Interestingly, we found that, among biallelically expressed genes, at least 18 genes expressed significantly more transcripts from one allele than the other among different individuals and tissues. CONCLUSION: With the prevalence of the mRNA-Seq technology, dsPIG has become a useful tool for analysis of allelic expression and large-scale prediction of imprinted genes. For ease of use, we have set up a web service and also provided an R package for dsPIG at http://www.shoudanliang.com/dsPIG/.

SINE retrotransposons cause epigenetic reprogramming of adjacent gene promoters.

Almost half of the human genome and as much as 40% of the mouse genome is composed of repetitive DNA sequences. The majority of these repeats are retrotransposons of the SINE and LINE families, and such repeats are generally repressed by epigenetic mechanisms. It has been proposed that these elements can act as methylation centers from which DNA methylation spreads into gene promoters in cancer. Contradictory to a methylation center function, we have found that retrotransposons are enriched near promoter CpG islands that stay methylation-free in cancer. Clearly, it is important to determine which influence, if any, these repetitive elements have on nearby gene promoters. Using an in vitro system, we confirm here that SINE B1 elements can influence the activity of downstream gene promoters, with acquisition of DNA methylation and loss of activating histone marks, thus resulting in a repressed state. SINE sequences themselves did not immediately acquire DNA methylation but were marked by H3K9me2 and H3K27me3. Moreover, our bisulfite sequencing data did not support that gain of DNA methylation in gene promoters occurred by methylation spreading from SINE B1 repeats. Genome-wide analysis of SINE repeats distribution showed that their enrichment is directly correlated with the presence of USF1, USF2, and CTCF binding, proteins with insulator function. In summary, our work supports the concept that SINE repeats interfere negatively with gene expression and that their presence near gene promoters is counter-selected, except when the promoter is protected by an insulator element.

Genome architecture marked by retrotransposons modulates predisposition to DNA methylation in cancer.

Epigenetic silencing plays an important role in cancer development. An attractive hypothesis is that local DNA features may participate in differential predisposition to gene hypermethylation. We found that, compared with methylation-resistant genes, methylation-prone genes have a lower frequency of SINE and LINE retrotransposons near their transcription start site. In several large testing sets, this distribution was highly predictive of promoter methylation. Genome-wide analysis showed that 22% of human genes were predicted to be methylation-prone in cancer; these tended to be genes that are down-regulated in cancer and that function in developmental processes. Moreover, retrotransposon distribution marks a larger fraction of methylation-prone genes compared to Polycomb group protein (PcG) marking in embryonic stem cells; indeed, PcG marking and our predictive model based on retrotransposon frequency appear to be correlated but also complementary. In summary, our data indicate that retrotransposon elements, which are widespread in our genome, are strongly associated with gene promoter DNA methylation in cancer and may in fact play a role in influencing epigenetic regulation in normal and abnormal physiological states.

Severe radiation therapy-related soft tissue toxicity in a patient with porphyria cutanea tarda: a literature review.

BACKGROUND: Some porphyrias are associated with cutaneous phototoxicity due to photoactivation of porphyrins, but whether ionizing radiation can have an additive effect is not clear. We report a case of severe radiation therapy-related toxicity in a patient with porphyria cutanea tarda and review the literature. METHODS: A 50-year-old man with porphyria cutanea was treated for lower lip squamous cell carcinoma with definitive radiation therapy. During radiation therapy, acute toxicity was of an expected onset and severity. Six months after treatment completion, he developed skin hypopigmentation, soft tissue fibrosis, and areas of painful denuded skin and crusting within the previous treatment field. RESULTS: Reports of 7 patients with porphyria receiving radiation therapy to at least 9 separate sites were reviewed, with only 1 previous report suggestive of increased radiation therapy-related toxicity. CONCLUSION: Based on this and 1 other report, caution is warranted when considering radiation therapy in patients with active porphyria.

Modification of the activity of an alpha-amylase from Bacillus licheniformis by several surfactants

The influence of different commercial surfactants on the enzymatic activity of a commercial alpha-amylase from Bacillus licheniformis (Termamyl 300 L) has been studied. As non-ionic surfactants, alkyl polyglycosides (Glucopon® 215, Glucopon® 600 and Glucopon® 650) were studied, as were fatty alcohol ethoxylates (Findet 1214N/23 and Findet 10/15), and nonyl phenol ethoxylate (Findet 9Q/21.5NF). Also, an anionic surfactant, linear alkyl benzene sulfonate (LAS) was assayed. In general, none of the non-ionic surfactants studied, except Findet 10/15, vary substantially the enzymatic activity. Findet 10/15 has the strongest hydrophobic character and reduces the enzymatic activity more significantly the greater its concentration. Regarding LAS, this surfactant significantly depressed enzymatic activity, presumably due to the electrostatic interactions caused by its anionic character.

Deficit auditivo en recién nacidos con factores de riesgo egresados del Hospital Nacional Carlos Alberto Seguín (HNCASE) entre enero del 2001 y marzo del 2002 / Auditory deficit in newborn children with factors of risk gone away from the National Hospital Carlos Alberto Seguín (HNCASE) between January, 2001 and March, 2002

Objetivo. Establecer la prevalencia de déficit auditivo entre los RN con factores de riesgo egresados del HNCASE durante el periodo de enero del 2001 y marzo del 2002, realizar un seguimiento de los pacientes con déficit auditivo. Métodos. RN egresados de la Unidad en el periodo comprendido entre enero del 2001 y marzo del 2002 que tuvieran factores de riesgo para déficit auditivo de acuerdo al Joint Comittee on Infant Hearing modificado por Meyer et al. Estadística: Para la determinación del Riesgo se utilizaron pruebas de regresión logística uni y multivariada. Diseño. Prospectivo, analítico de corte longitudinal Resultados. Se incluyeron 113 RN, con una edad gestacional promedio de 36.45 semanas y un peso promedio de 2,465 g, 50 de ellos eran de sexo masculino y 63 de sexo femenino. De ellos 29 tuvieron PEA anormales en el primer control (25.66%). El análisis de los resultados mediante la regresión logística multivariada nos muestra que el riesgo para déficit auditivo es mayor en la hipertensión pulmonar persistente (Odds Ratio 4.43), seguido de la meningitis (Odds Ratio 3.59) y el RCRJ (Odds Ratio 3.18). El seguimiento de 17 de los 29 pacientes con PEA anormales nos muestra que el 82.35% de ellos continúan PEA anormales en sus controles. Conclusiones. Los principales factores de riesgo para déficit auditivo en los RN egresados del Servicio de Neonatología del HNCASE son la Hipertensión pulmonar persistente, la Meningitis Bacteriana y el Retardo de Crecimiento Intrauterino. El seguimiento de los pacientes con PEA anormales demuestra que 17 de los 19 de los pacientes (82.35%) persisten con PEA anormales.

Objective. To determine hearing disorders in newborns at risk in the HNCASE between January 2001 to March 2002 and follow up of them. Settings. Prospective trial Methods. Enrollment criteria: Newborn at risk defined by the Joint Comittee on Infant Hearing, modified by Meyer et al. Statistic: Univariated analisis of risk factors and a multivariate analysis were used. Results. 113 infants were included. Mean gestational age was 36.45 weeks, birth weigth 2465g; 50 infants being male and 63 female; 29 (25.66%) exhibited patologfc Auditory brainstem Response. Persistent Pulmonary hypertension (Odds Ratio 4.43), meningitis (Odds Ratio 3.59) and intrauterine growth restriction (Odds Ratio 3.18) were significant risk factors. Follow up of 17 of the 29 infants revealed persistent in hearing loss in 14 (82.35%). Conclusion. Hearing screening in high-risk neonates revealed a total of 25,66% of infants with patologic Auditory Brainstem Response. Significant risk factors were Persistent Pulmonary hypertension, mengitis and intrauterine growth restriction. Follow up of the infants revealed 82.35% of persistent hearing loss.

Láser colecistoesclerosis colecistoscópica: estudio de factibilidad, efectividad y seguridad en un modelo experimental vivo / Cholecystoscopic gallblader laser-sclerosis feasibleness, effectiveness and safeness procedure in a live experimental model

Antecedentes: La Laser Colecistoesclerosis Colecistoscópica es un procedimiento diseñado para eliminar litos vesiculares, cerrar el meato cístico, destruir la mucosa vesicular e inducir a la atrofia vesicular definitiva a través de colecistoscopía operatoria endoluminal prescindiendo de la anestesia general. objetivo: Demostrar la factibilidad, efectividad y seguridad de la operación en un modelo experimental vivo. Lugar de aplicación: Instituto universitario de cirugía experimental. Material: Se operaron 4 cerdos. Método: Se registraron los problemas técnicos. Se evaluó el destino de las vesículas tratadas con sonografía postoperatoria y luego el sacrificio de los animales con estudio macro y microscópico de los remanentes vesiculares. Se registraron las complicaciones. Resultados: La operación pudo completarse en todos los casos aunque deben mejorarse aspectos técnicos. La vesícula biliar evolucionó hacia la atrofia en todos los casos. No se registraron complicaciones. Conclusiones: Aunque perfectible, el procedimiento parece factible, efectivo y seguro en el modelo experimental elegido. Quizá en un futuro cercano, el procedimiento pueda estar disponible para el uso clínico masivo, brindando especial beneficio a los pacientes con factores de riesgo anestésico elevado