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Thermographic image analysis is a subfield of diagnostic image processing aimed at detecting breast abnormalities in women at an early stage. It is a developing field of research and its effectiveness and scope require scientific assessment to be determined. An open-access dataset has been created for the scientific community to test and develop techniques for computational detection of normal and abnormal breast conditions from thermograms. This dataset is a valuable resource for researchers due to the scarcity of publicly available datasets of breast thermographic images. It includes thermographic images of the female chest area in three capture positions: anterior, left oblique and right oblique. The data set comes from 119 women ranging from 18 to 81 years of age. A table is attached to the dataset with the diagnosis of breast pathology, showing that 84 patients had benign pathology and 35 patients had malignant pathology. The diagnoses of women with healthy breast pathology are not included.
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Objective: Superior eyelid endoscopic transorbital approach (SETOA) is nowadays gaining progressive application in neurosurgical scenarios. Both anatomic and clinical reports have demonstrated the possibility of taking advantage of the orbital corridor as a minimally invasive route to reach anterior and middle cranial fossae and manage selected surgical lesions developing in these areas. The aim of this paper is to further shed light on other anatomic regions of the skull base as seen from a transorbital perspective, namely, the posterior cranial fossa and tentorial area, describing technical feasibility and steps in reaching this area through an extradural-transtentorial approach and providing quantitative evaluations of the "working area" obtained through this route. Material and methods: Four cadaveric heads (eight sides) were dissected at the Laboratory of Surgical Neuroanatomy (LSNA) of the University of Barcelona, Spain. A stepwise dissection of the transorbital approach to the tentorial area was described. Qualitative anatomical descriptions and quantitative analyses of working were evaluated by using pre- and postdissections CT and MRI scans, and three-dimensional reconstructions were made using Amira software. Results: With the endoscopic transorbital approach, posterior cranial fossa dura was reached by an extradural middle cranial fossa approach and drilling of the petrous apex. After clipping the superior petrosal sinus, the tentorium was divided and cut. An endoscope was then introduced in the posterior cranial fossa at the level of the tentorial incisura. Qualitative analysis provided a description of the tentorial and petrosal surfaces of the cerebellum, middle tentorial incisura, cerebellopontine fissures, and, after arachnoid dissection, by a 30° endoscopic visualization, the posterior aspect of the cerebellomesencephalic fissure. Quantitative analysis of the "working area" obtained after bone removal was also provided. Conclusions: This anatomic qualitative and quantitative study sheds light on the anatomy of the posterior cranial fossa contents, such as the tentorial area and incisura, as seen through a transorbital perspective. The first aim of the article is to enrich the anatomical knowledge as seen through this relatively new corridor and to provide quantitative details and insights into the technical feasibility of reaching these regions in a surgical scenario.
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OBJECTIVE: To identify nonalcoholic steatohepatitis (NASH) and liver stiffness in Mexican subjects with different body mass index (BMI). METHODS: A cross-sectional study was conducted in 505 adults. Risk for NASH was defined as the presence of one or more of the following biochemical and metabolic parameters (BMPs): fasting glucose ≥100 mg/dl, triglycerides (TG) ≥150 mg/dl, homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.5, aspartate aminotransferase (AST) >54 IU/L and alanine aminotransferase (ALT) >42 IU/L. Body mass index measurement and nutritional assessment were performed by standard procedures. Liver fibrosis stage was determined by liver stiffness measurement using transitional elastography (TE) or by liver biopsy (LB). RESULTS: Risk for NASH was 57% (290/505). Most BMPs values incremented by BMI category. Among 171 at-risk patients, 106 subjects were evaluated by TE and 65 subjects by LB. Abnormal liver stiffness (≥6.0 kPa) was prevalent in 54% (57/106) of the cases, whereas by LB, 91% (59/65) of patients with obesity had NASH and liver fibrosis. Furthermore, liver fibrosis was prevalent in 46% (6/13) in normal weight individuals, whereas 4.6% (3/65) of patients with a BMI ≥ 35 kg/m2 showed no histopathological abnormalities. Overall, 67.8% (116/171) of the patients had abnormal liver stiffness or NASH. The normal weight patients with liver damage consumed relatively a higher fat-rich diet compared to the other groups whereas the remaining subgroups shared a similar dietary pattern. CONCLUSION: Young patients with overweight and obesity showed a high prevalence of altered BMPs related to abnormal liver stiffness assessed by TE and NASH by LB. Early diagnostic strategies are required to detect the risk for NASH and avoid further liver damage in populations with a rising prevalence of obesity by defining the risk factors involved in the onset and progression of NASH.
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Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/epidemiologia , Adulto , Biópsia , Índice de Massa Corporal , Estudos Transversais , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Resistência à Insulina/fisiologia , Fígado/metabolismo , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade/metabolismo , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Prevalência , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: To report our experience in the management of chordoma and chondrosarcoma with extended endoscopic endonasal surgery. METHOD: We performed a retrospective analysis of a series of 14 patients with clival chordoma or chondrosarcoma who had extended endoscopic endonasal surgery from 2008 to 2016 performed by the same multidisciplinary team. RESULTS: We had fourteen patients (male/female 2:1), with a mean age of 49years for chordoma and 32 for chondrosarcoma. The most common clinical presentation was diplopia in 78.5% of cases, followed by dysphagia in 28.6%. Histologically, 71.4% were chordomas and 28.6% were chondrosarcomas. In addition, invasion of at least two thirds or more of the clivus was found in 81% of the cases; in 57.1% there was intradural invasion, and in 35.7% invasion of the sella turcica. In 42.8% of cases, the degree of resection was total and in 21.5% subtotal. The most common complication was CSF fistula, occurring in 28.6% of the cases, with only one case requiring surgery to repair it. Adjuvant treatment with Proton Beam was performed in 35.7% of cases and with conventional radiotherapy in 21.5%. Mean follow-up was 53.5months and tumour recurrence or progression was found in 21.5% of the cases, two of which had not received adjuvant treatment. There were no deaths. CONCLUSION: The extended endoscopic endonasal approach (EEEA) performed by an experienced team is a good alternative for the management of these lesions. Intradural invasion may be related to an increased risk of complications and worse clinical presentation, in addition to a lower rate of total resection.
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Condrossarcoma/cirurgia , Cordoma/cirurgia , Cirurgia Endoscópica por Orifício Natural , Neoplasias da Base do Crânio/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Endoscópica por Orifício Natural/métodos , Nariz , Estudos Retrospectivos , Adulto JovemRESUMO
Antecedentes: La diabetes tipo 2 es uno de los mayores problemas para los sistemas de salud de Latinoamérica. La expectativa de su incremento se basa en la alta prevalencia de las condiciones que preceden a la diabetes como la obesidad y la intolerancia a la glucosa, entre otras. Objetivo: Determinar los conocimientos, prácticas y actitudes en relación a su enfermedad de los pacientes con Diabetes Mellitus tipo 2 en la aldea El Nance, Campamento, Olancho, Octubre-Diciembre 2016. Métodos: Estudio descriptivo que incluyó todos los pacientes con Diabetes Mellitus tipo 2 de la aldea el Nance, Campamento, Olancho. Se realizó una encuesta previa y luego se brindó educación a cada paciente. Resultados: Se evaluaron 40 pacientes con diabetes mellitus tipo 2, en donde 62.5 % desconoce que es hipoglicemia, la mitad de ellos relaciona las complicaciones a diabetes mellitus tipo 2 . 32.5% de los pacientes no realiza actividad física semanal. La mitad de ellos no cuenta con glucómetro. 55% de los pacientes asistiría a sus citas médicas si supiera que estará mejor. Discusión: Los pacientes diabéticos tipo 2 de este estudio presentaron conocimientos adecuados acerca de los conceptos de la enfermedad, las complicaciones, y algunas prácticas, siendo similar a los resultados de estudios centroamericanos.
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Humanos , Atenção Primária à Saúde , Intolerância à Glucose/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Obesidade/complicaçõesRESUMO
OBJECTIVES: Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital. MATERIAL AND METHODS: A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015. A record was made of the data as regards surgical times, resection rates, histological diagnosis, hospital stay, and survival rates during follow-up. RESULTS: The study included 50 patients, with a mean age of 55 years (±13.7), a preoperative mean Karnofsky of 92 (being 81 post-operatively), and a mean follow-up of 10.5 months (±6.5). There were 26% re-operations due to recurrence. High-grade gliomas were reported in 56%, low-grade gliomas in 24%, and 20% "Other" tumours. Overall hospital stay was 10 days (±4.5). Depending on the histologiacl diagnosis, the "Others" group had a longer hospital stay. Overall, there were 52% complete removal, 18% of maximum removals, and 30% of partial removals. The overall survival rates during follow-up was 84%. CONCLUSIONS: iMRI is a safe and effective tool for brain tumour surgery. Its use allows an increase in resection rates, and minimises post-operative complications. Its implementation involves an increase in surgical time, which improves with the characteristic learning curve. More studies are needed to establish its role in the long-term survival of patients.
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Neoplasias Encefálicas/cirurgia , Craniotomia/estatística & dados numéricos , Glioma/cirurgia , Imageamento por Ressonância Magnética/métodos , Neuronavegação/métodos , Adulto , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/mortalidade , Craniotomia/métodos , Feminino , Seguimentos , Glioma/diagnóstico por imagem , Glioma/mortalidade , Humanos , Período Intraoperatório , Estimativa de Kaplan-Meier , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Duração da Cirurgia , Complicações Pós-Operatórias/prevenção & controle , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
HOX transcription factors are evolutionarily conserved in many different species and are involved in important cellular processes such as morphogenesis, differentiation, and proliferation. They have also recently been implicated in carcinogenesis, but their precise role in cancer, especially in cervical cancer (CC), remains unclear. In this work, using microarray assays followed by the quantitative polymerase chain reaction (qPCR), we found that the expression of 25 HOX genes was downregulated in CC derived cell lines compared with nontumorigenic keratinocytes. In particular, the expression of HOXA9 was observed as down-modulated in CCderived cell lines. The expression of HOXA9 has not been previously reported in CC, or in normal keratinocytes of the cervix. We found that normal CC from women without cervical lesions express HOXA9; in contrast, CC cell lines and samples of biopsies from women with CC showed significantly diminished HOXA9 expression. Furthermore, we found that methylation at the first exon of HOXA9 could play an important role in modulating the expression of this gene. Exogenous restoration of HOXA9 expression in CC cell lines decreased cell proliferation and migration, and induced an epithelial-like phenotype. Interestingly, the silencing of human papilloma virus (HPV) E6 and E7 oncogenes induced expression of HOXA9. In conclusion, controlling HOXA9 expression appears to be a necessary step during CC development. Further studies are needed to delineate the role of HOXA9 during malignant progression and to afford more insights into the relationship between downmodulation of HOXA9 and viral HPV oncoprotein expression during cercical cancer development.
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Movimento Celular/genética , Proliferação de Células/genética , Regulação para Baixo/genética , Transição Epitelial-Mesenquimal/genética , Proteínas de Homeodomínio/genética , Neoplasias do Colo do Útero/genética , Linhagem Celular Tumoral , Colo do Útero/metabolismo , Colo do Útero/patologia , Metilação de DNA/genética , DNA Viral/genética , Éxons/genética , Feminino , Células HeLa , Humanos , Queratinócitos/metabolismo , Queratinócitos/virologia , Proteínas Oncogênicas Virais/genética , Papillomaviridae/genética , Neoplasias do Colo do Útero/virologiaRESUMO
BACKGROUND: The Linear Array® (LA) genotyping test is one of the most used methodologies for Human papillomavirus (HPV) genotyping, in that it is able to detect 37 HPV genotypes and co-infections in the same sample. However, the assay is limited to a restricted number of HPV, and sequence variations in the detection region of the HPV probes could give false negatives results. Recently, 454 Next-Generation sequencing (NGS) technology has been efficiently used also for HPV genotyping; this methodology is based on massive sequencing of HPV fragments and is expected to be highly specific and sensitive. In this work, we studied HPV prevalence in cervixes of women in Western Mexico by LA and confirmed the genotypes found by NGS. METHODS: Two hundred thirty three cervical samples from women Without cervical lesions (WCL, n = 48), with Cervical intraepithelial neoplasia grade 1 (CIN I, n = 98), or with Cervical cancer (CC, n = 87) were recruited, DNA was extracted, and HPV positivity was determined by PCR amplification using PGMY09/11 primers. All HPV- positive samples were genotyped individually by LA. Additionally, pools of amplicons from the PGMY-PCR products were sequenced using 454 NGS technology. Results obtained by NGS were compared with those of LA for each group of samples. RESULTS: We identified 35 HPV genotypes, among which 30 were identified by both technologies; in addition, the HPV genotypes 32, 44, 74, 102 and 114 were detected by NGS. These latter genotypes, to our knowledge, have not been previously reported in Mexican population. Furthermore, we found that LA did not detect, in some diagnosis groups, certain HPV genotypes included in the test, such as 6, 11, 16, 26, 35, 51, 58, 68, 73, and 89, which indicates possible variations at the species level. CONCLUSIONS: There are HPV genotypes in Mexican population that cannot be detected by LA, which is, at present, the most complete commercial genotyping test. More studies are necessary to determine the impact of HPV-44, 74, 102 and 114 on the risk of developing CC. A greater number of samples must be analyzed by NGS for the most accurate determination of Mexican HPV variants.
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Colo do Útero/virologia , Técnicas de Genotipagem/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Papillomaviridae/classificação , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , Adulto , Idoso , Feminino , Genótipo , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Epidemiologia Molecular/métodos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , PrevalênciaRESUMO
El presente estudio se llevó a cabo la determinación de la actividad inhibidora contra Mycobacterium smegmatis y Mycobacterium tuberculosis de extracto de plantas de uso medicinal en Guatemala. El propósito de este estudio fue determinar si existía correlación entre la acción inhibidora in vitro de extractos hexánicos, clorosfórmico, metanólicos y acuosos de las plantas: Sida acuta, Enterolobium cyclocarpum, Piper auritum, Stachytarpheta cayennensis y Ocimum micranthum, de una cepa de Mycobacterium smegmatis y una cepa multisensible, 3 de mediana resistencia y una multiresistencia y una multiresistencia de Mycobacterium tuberculosis.