Starting a peritoneal carcinomatosis treatment program in a developing country: A prospective analysis.

BACKGROUND: Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has become a valuable treatment strategy for selected patients with peritoneal carcinomatosis (PC). In Chile, it is an emerging technique. The aim of this study is to describe our protocol and report our perioperative results. METHODS: A prospectively maintained database for patients undergoing exploratory surgery for PC was reviewed. Eligible patients were selected using the peritoneal cancer index in correlation with the primary tumor. Patients underwent HIPEC using mitomycin C. Clinical data and postoperative results were analyzed. RESULTS: Seventy-six patients underwent exploratory surgery. Most patients were female (55%) with a median age of 62 years (range, 25-83). Complete CRS and HIPEC were achieved in 53 patients. The most frequent primary tumor site was colon-rectum (49%). The median number of resected organs was 4 (range, 1-13). Overall 90-day incidence of major complications was 26%. After a median follow-up of 26 months, 44 patients (83%) in the resected group were alive with no evidence of disease. CONCLUSIONS: The PC treatment program at our institution has been established in a safe manner, with acceptable morbidity comparable to high-volume centers. A comprehensive preoperative evaluation, careful patient selection, and a cohesive team are necessary for successful results.

A blood spot method for detecting fumonisin-induced changes in putative sphingolipid biomarkers in LM/Bc mice and humans.

Fumonisins (FB) are mycotoxins found in maize. They are hypothesised risk factors for neural tube defects (NTDs) in humans living where maize is a dietary staple. In LM/Bc mice, FB1-treatment of pregnant dams induces NTDs and results in increased levels of sphingoid base 1-phosphates in blood and tissues. The increased level of sphingoid base 1-phosphates in blood is a putative biomarker for FB1 inhibition of ceramide synthase in humans. Collection of blood spots on paper from finger sticks is a relatively non-invasive way to obtain blood for biomarker analysis. The objective of this study was to develop and validate in an animal model, and ultimately in humans, a method to estimate the volume of blood collected as blood spots on absorbent paper so as to allow quantification of the molar concentration of sphingoid base 1-phosphates in blood. To accomplish this objective, blood was collected from unexposed male LM/Bc and FB1-exposed pregnant LM/Bc mice and humans and applied to two types of absorbent paper. The sphingoid base 1-phosphates, absorbance at 270 nm (A270), and total protein content (Bradford) were determined in the acetonitrile:water 5% formic acid extracts from the dried blood spots. The results show that in both mouse and human the A270, total protein, and blood volume were closely correlated and the volume of blood spotted was accurately estimated using only the A270 of the extracts. In mouse blood spots, as in tissues and embryos, the FB1-induced changes in sphingolipids were correlated with urinary FB1. The half-life of FB1 in the urine was short (<24 h) and the elevation in sphingoid base 1-phosphates in blood was also short, although more persistent than the urinary FB1.

Elaboración de harinas procesadas de semilla de gandul / Preparation of flour processed with pigeon pea seed

Pigeon pea is a legume grain of good production capacity and of a relatively high nutritive value, which has not been used in Latin America on the basis of the potential it offers. In this study experiments were conducted to learn about the possibility of processing pigeon pea to yield an intermediate flour with good functional characteristics for food product development. The intermediate pigeon pea flour was produced through a selection of a process to efficiently dehull the grain followed by a thermic process to improve its functional properties and nutritive value. The best dehulling process was subjecting the grain to a vapor treatment for five minutes, followed by a 2-hour dehydration of surface moisture with air at 60 degrees and dehulling with an 8-disc dehuller for 10 minutes. Yield was 84 per cent with 70.7 per cent dehulling efficiency. Pigeon pea flours were prepared by three thermic processes: pressure cooking at 15 lb (121 degrees C) for 5 and 10 minutes as a reference product; cooking and drying with a drum dryer at 120 degrees C and 4 rpm and by extrusion-cooking with the material with 18 and 21 per cent moisture at 270 and 300 degrees F, respectively. Process selection was based on the functional properties such as water absorption index, water solubility index, soluble nitrogen and viscosity, through chemical analysis of protein, available lysine and methionine and residual trypsin inhibitors, and through a biological evaluation of protein digestibility and quality. Both pressure cooking products had similar functional and chemical characteristics, however, the 5-minute cooked product has higher protein quality than the 10-minute product.(ABSTRACT TRUNCATED AT 250 WORDS)

Estandarización de personal en diagnóstico clínico de bocio: ¿Cómo evaluar la concordancia entre examinadores de la tiroides? / Personnel standarization in clinical diagnosis of goiter: ¿How to evaluate concordance between thyroid examiners?

El uso de las pruebas t de Student y Cochran para evaluar medidas de tendencia central, así como la prueba de F para evaluar la variabilidad, y el análisis de correlación, han sido usados en forma equivocada para evaluar concordancia entre examinadores del tiroides. En el presente artículo se presenta la prueba de Kappa intraclase (Bloch y Kraemer, 1989), así como la experiencia de su uso en Centroamérica para estandarizar a los examinadores del tiroides que participaron en las encuestas nacionales para determinar prevalencia de bocio en 1990