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The sensitivity of circularly polarized x-ray resonant magnetic scattering (CXRMS) to chiral asymmetry has been demonstrated. The study was performed on a 2D array of Permalloy (Py) square nanomagnets of 700 nm lateral size arranged in a chess pattern, in a square lattice of 1000 nm lattice parameter. Previous x-ray magnetic circular dichroism photoemission electron microscopy (XMCD-PEEM) images on this sample showed the formation of vortices at remanence and a preference in their chiral state. The magnetic hysteresis loops of the array along the diagonal axis of the squares indicate a non-negligible and anisotropic interaction between vortices. The intensity of the magnetic scattering using circularly polarized light along one of the diagonal axes of the square magnets becomes asymmetric in intensity in the direction transversal to the incident plane at fields where the vortex states are formed. The asymmetry sign is inverted when the direction of the applied magnetic field is inverted. The result is the expected in the presence of an unbalanced chiral distribution. The effect is observed by CXRMS due to the interference between the charge scattering and the magnetic scattering.
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BACKGROUND AND OBJECTIVE: Body dysmorphic disorder (BDD) is a mental disorder that is difficult to diagnose, causes a lot of suffering and is more prevalent in dermatology patients than in the general population. Our objective was to screen for possible cases of BDD in patients with acne and to determine the prevalence according to DSM-IV and DSM-5 criteria, as well as to analyse the relationship between dermatological and sociodemographic variables. METHODS: A total of 245 patients diagnosed with acne in 11 dermatological centres in Spain were included in the study by members of the Aragon Psychodermatology Research Group and Spanish Research Group of Psychiatric Dermatology. We used the Body Dysmorphic Disorder Questionnaire (BDDQ) as a screening tool. RESULTS: In our sample, we obtained a prevalence for BDD of 10.6% (95% CI: 7.6-13.6%). The prevalence was the same with DSM-IV or DSM-5 criteria. Possible cases of BDD were predominantly women (P = 0.021), and 56% had non-inflammatory lesions vs. 30% of negative patients (P = 0.002). Positive patients as possible cases of BDD spent more than two hours on average a day worrying about their appearance. Most people only worried about one part of their body (86%), and in 95% of the cases, the part of their body that worried them was the face. The three most frequent compulsive behaviours in patients who screened positive for BDD were mirror checking (90.7%), camouflaging (79.1%) and using make-up (72.1%). CONCLUSIONS: As a consequence of the high prevalence of possible cases of BDD in patients with acne observed in our study, there is a need for dermatologists to screen for BDD so that they can be referred to a mental health unit to confirm the diagnosis and be offered treatment to reduce the progression of psychosocial deterioration and the development of comorbid disorders.
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Acne Vulgar/complicações , Transtornos Dismórficos Corporais/psicologia , Acne Vulgar/psicologia , Adolescente , Adulto , Transtornos Dismórficos Corporais/complicações , Transtornos Dismórficos Corporais/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Espanha/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: Chronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension). OBJECTIVE: The present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching. MATERIAL AND METHODS: We compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals. RESULTS: Significant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges. CONCLUSIONS: These psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment.
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Homens/psicologia , Neurodermatite/psicologia , Inventário de Personalidade , Mulheres/psicologia , Cognição , Estudos Transversais , Emoções , Feminino , Fricção , Humanos , Relações Interpessoais , Masculino , Motivação , Neurodermatite/terapia , Prurido/etiologia , Prurido/psicologia , Espanha , Estresse Psicológico/etiologia , Inquéritos e QuestionáriosRESUMO
The exchange bias of antiferromagnetic-ferromagnetic (AFM-FM) bilayers is found to be strongly dependent on the ferromagnetic spin configuration. The widely accepted inverse proportionality of the exchange bias field with the ferromagnetic thickness is broken in FM layers thinner than the FM correlation length. Moreover, an anomalous thermal dependence of both exchange bias field and coercivity is also found. A model based on springlike domain walls parallel to the AFM-FM interface quantitatively accounts for the experimental results and, in particular, for the deviation from the inverse proportionality law. These results reveal the active role the ferromagnetic spin structure plays in AFM-FM hybrids which leads to a new paradigm of the exchange bias phenomenon.
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A second-generation surveillance system of people infected with human immunodeficiency virus (HIV) has been implemented in Spain. Behavioural and clinical data were collected between 2002 and 2011 through an annual one-day, cross-sectional survey in public hospitals, including all in- and outpatients receiving HIVrelated care on the survey day. Mean age increased over time (from 38.7 years in 2002 to 43.8 years in 2011) and 68.4% of the 7,205 subjects were male. The proportion of migrants increased from 6.1% to 15.9%, while people who inject or used to inject drugs (PWID and Ex-PWID) decreased and men who have sex with men (MSM) and heterosexuals increased. Unprotected intercourse at last sex increased among MSM and PWID/Ex-PWID. Patients receiving antiretroviral treatment increased significantly from 76.0% to 88.2% as did those with CD4 T-cell counts ≥350 (from 48.2% to 66.9%) and viral copies <200 (from 47.0% to 85.2%). HIV-infected people with hepatitis C virus RNA decreased from 36.0% in 2004 to 29.9% in 2011, while those with HBsAg remained stable at around 4.4%. Implementation of a low-cost, sustainable system for second-generation surveillance in people living with HIV is feasible. In Spain, the information obtained has helped to define and refine public health policy and document treatment effectiveness.
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Infecções por HIV/epidemiologia , Comportamentos Relacionados com a Saúde , Hepatite C/epidemiologia , Vigilância da População/métodos , Comportamento Sexual , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Inquéritos Epidemiológicos , Hepatite C/transmissão , Heterossexualidade/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Espanha/epidemiologiaRESUMO
Controlling the magnetic ground states at the nanoscale is a long-standing basic research problem and an important issue in magnetic storage technologies. Here, we designed a nanostructured material that exhibits very unusual hysteresis loops due to a transition between vortex and double pole states. Arrays of 700 nm diamond-shaped nanodots consisting of Py(30 nm)/Ru(tRu)/Py(30 nm) (Py, permalloy (Ni80Fe20)) trilayers were fabricated by interference lithography and e-beam evaporation. We show that varying the Ru interlayer spacer thickness (tRu) governs the interaction between the Py layers. We found this interaction mainly mediated by two mechanisms: magnetostatic interaction that favors antiparallel (antiferromagnetic, AFM) alignment of the Py layers and exchange interaction that oscillates between ferromagnetic (FM) and AFM couplings. For a certain range of Ru thicknesses, FM coupling dominates and forms magnetic vortices in the upper and lower Py layers. For Ru thicknesses at which AFM coupling dominates, the magnetic state in remanence is a double pole structure. Our results showed that the interlayer exchange coupling interaction remains finite even at 4 nm Ru thickness. The magnetic states in remanence, observed by magnetic force microscopy (MFM), are in good agreement with corresponding hysteresis loops obtained by the magneto-optic Kerr effect (MOKE) and micromagnetic simulations.
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The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.
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COVID-19 , Cetilpiridínio , Antissépticos Bucais , SARS-CoV-2 , Eliminação de Partículas Virais , Humanos , Pessoa de Meia-Idade , Cetilpiridínio/uso terapêutico , Cloretos , Método Duplo-Cego , Antissépticos Bucais/uso terapêutico , Proteínas do Nucleocapsídeo , RNA Viral , Eliminação de Partículas Virais/efeitos dos fármacosRESUMO
BACKGROUND AND OBJECTIVES: Positive immunostaining for the tumor suppressor protein p16 is associated with the presence of mucosal or αsubtypes of human papillomavirus (HPV) in cervical and genital squamous cell carcinoma (SCC). The aim of this study was to determine whether p16 immunostaining is also associated with mucosal HPV in extragenital SCC. MATERIAL AND METHODS: Paraffin sections of lesions located in the genital region (8 genital warts, 3 intraepidermal SCCs, and 7 invasive SCCs) and extragenital area (29 intraepidermal SCCs corresponding to Bowen disease and 10 invasive SCCs) were stained for p16 by immunohistochemistry. Mucosal HPV was detected by polymerase chain reaction (PCR). RESULTS: In the genital area, p16 immunostaining was negative in genital warts and positive in all 3 intraepidermal SCCs and 2 invasive SCCs (29%). Mucosal HPV was detected in 6 genital warts and 2 intraepidermal SCCs (100% after exclusion of 3 lesions that could not be analyzed by PCR) and in the 2 invasive SCCs that were positive for p16. In the extragenital area, 19 intraepidermal SCCs (95%) and 2 invasive SCCs (20%) were immunopositive for p16. Mucosal HPV was detected in 4 intraepidermal SCCs (p16 immunopositive) and 1 invasive SCC (p16 immunonegative). In intraepidermal SCCs, p16 immunostaining facilitated the identification of dermal microinfiltration or invasion of normal skin appendages. CONCLUSIONS: According to our results, unlike in genital SCCs, p16 immunopositivity is independent of the presence of HPV in extragenital SCCs. Compared with intraepidermal SCCs, the absence of p16 protein in invasive SCCs in the extragenital area would indicate progression of the disease.
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Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , Neoplasias dos Genitais Femininos/química , Neoplasias dos Genitais Femininos/patologia , Neoplasias dos Genitais Masculinos/química , Neoplasias dos Genitais Masculinos/patologia , Proteínas de Neoplasias/análise , Neoplasias Cutâneas/química , Neoplasias Cutâneas/patologia , Inibidor p16 de Quinase Dependente de Ciclina , Feminino , Humanos , Imuno-Histoquímica , MasculinoRESUMO
Despite the great interest in RNA therapeutics, the development of a successful gene delivery process is still a major challenge. We propose an efficient nucleic acid entrapment into the mesopores of biocompatible nanoscaled metal-organic frameworks. Their rapid cellular uptake together with RNA protection and release led to a relevant in vitro gene activity.
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Portadores de Fármacos , Técnicas de Transferência de Genes , Ferro , Estruturas Metalorgânicas , RNA , Linhagem Celular Tumoral , Portadores de Fármacos/química , Portadores de Fármacos/farmacocinética , Portadores de Fármacos/farmacologia , Humanos , Ferro/química , Ferro/farmacocinética , Ferro/farmacologia , Estruturas Metalorgânicas/química , Estruturas Metalorgânicas/farmacocinética , Estruturas Metalorgânicas/farmacologia , RNA/química , RNA/farmacocinética , RNA/farmacologiaRESUMO
OBJECTIVE: To evaluate the effects of a multidisciplinary obesity treatment programme on fecal microbiota composition and immunoglobulin-coating bacteria in overweight and obese adolescents and their relationship to weight loss. DESIGN: Longitudinal intervention study based on both a calorie-restricted diet (calorie reduction=10-40%) and increased physical activity (calorie expenditure=15-23 kcal/kg body weight per week) for 10 weeks. PARTICIPANTS: Thirty-nine overweight and obese adolescents (BMI mean 33.1 range 23.7-50.4; age mean 14.8 range, 13.0-16.0). MEASUREMENTS: BMI, BMI z-scores and plasma biochemical parameters were measured before and after the intervention. Fecal microbiota was analyzed by fluorescent in situ hybridization. Immunoglobulin-coating bacteria were detected using fluorescent-labelled F(ab')2 antihuman IgA, IgG and IgM. RESULTS: Reductions in Clostridium histolyticum and E. rectale-C. coccoides proportions significantly correlated with weight and BMI z-score reductions in the whole adolescent population. Proportions of C. histolyticum, C. lituseburense and E. rectale-C. coccoides dropped significantly whereas those of the Bacteroides-Prevotella group increased after the intervention in those adolescents who lost more than 4 kg. Total fecal energy was almost significantly reduced in the same group of adolescents but not in the group that lost less than 2.5 kg. IgA-coating bacterial proportions also decreased significantly in participants who lost more than 6 kg after the intervention, paralleled to reductions in C. histolyticum and E. rectale-C. coccoides populations. E. rectale-C. coccoides proportions also correlated with weight loss and BMI z-score reduction in participants whose weight loss exceeded 4 kg. CONCLUSIONS: Specific gut bacteria and an associated IgA response were related to body weight changes in adolescents under lifestyle intervention. These results suggest interactions between diet, gut microbiota and host metabolism and immunity in obesity.
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Bacteroides/isolamento & purificação , Clostridium/isolamento & purificação , Fezes/microbiologia , Imunoglobulinas/isolamento & purificação , Obesidade/microbiologia , Redução de Peso/fisiologia , Adolescente , Índice de Massa Corporal , Restrição Calórica , Feminino , Humanos , Imunoglobulina A/isolamento & purificação , Imunoglobulina G/isolamento & purificação , Imunoglobulina M/isolamento & purificação , Masculino , Atividade Motora/fisiologia , Obesidade/sangue , Obesidade/terapia , Redução de Peso/imunologiaRESUMO
The frequency of monoclonal gammopathy of undetermined significance (MGUS) is higher in patients with type I Gaucher disease (GD I) than in the general population. Although enzyme replacement therapy is effective in the control of the disease, its effect on MGUS is still controversial. We present the case of a 65-year-old woman with extensive GD I associated with IgM MGUS, in whom enzyme replacement therapy succeeded in eradicating the monoclonal component. This observation further supports the idea that enzyme replacement therapy decreases the chronic antigenic stimulation responsible for gammopathies in Gaucher disease.
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Terapia de Reposição de Enzimas , Doença de Gaucher/complicações , Doença de Gaucher/tratamento farmacológico , Glucosilceramidase/uso terapêutico , Imunoglobulina M/sangue , Gamopatia Monoclonal de Significância Indeterminada/etiologia , Gamopatia Monoclonal de Significância Indeterminada/imunologia , Idoso , Anticorpos Monoclonais/sangue , Feminino , Doença de Gaucher/imunologia , Glucosilceramidase/sangue , Glucosilceramidase/genética , Humanos , Proteínas Recombinantes/uso terapêuticoRESUMO
OBJECTIVE: Antibiotic prophylaxis (AP) and mechanical bowel preparation (MBP) previous to surgery have classically been regarded as important in colorectal surgery. The latter has recently been questioned. We evaluated opinion of Spanish surgeons about the use of these measures. METHOD: E-mail survey among all members of Spanish Coloproctologic Associations. RESULTS: Of 413 participants in the survey, 131 (31.7%) responded; 87% of surgeons used cathartics (70%), enemas (2%) or both (28%) for MBP. MBP was used 60% in right colon surgery, 90% in left colon and 99% in rectal surgery. Surgeons with more case load or those who specialized in colorectal surgery used significantly less MBP; 60% of the surgeons thought that MBP made surgery easier and reduced contamination; 35% thought that it decreased wound infection (WI) and 17% thought that it prevented anastomotic leaks. For 77%, it was regarded as useful or very useful. AP was used by 99.3% of surgeons including systemic alone in 86.2% and combined with oral in 16.8%. The first dose was given 2 h before surgery by 20.2% of the surgeons, at the anaesthetic induction by 78.3% and postoperatively by 1.5%; 43% used single dose only, 44.5% extended to 24 h and 12.5% for two or more days; 95% thought that AP reduced WI and 96% considered that it was useful. CONCLUSION: There is general agreement on AP. MBP remained a common practice among Spanish colorectal surgeons except for right colonic resection. Surgeons with more case load and specialization used it significantly less.
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Antibioticoprofilaxia/estatística & dados numéricos , Colo/cirurgia , Cirurgia Colorretal , Cuidados Pré-Operatórios/estatística & dados numéricos , Adulto , Anastomose Cirúrgica , Catárticos/uso terapêutico , Coleta de Dados , Enema/estatística & dados numéricos , Humanos , Internet , Pessoa de Meia-Idade , Médicos , Cuidados Pré-Operatórios/métodos , EspanhaRESUMO
Objective Evidence regarding perioperative care in colorectal surgery has recently increased, leading to changes in classical clinical procedures that make the perioperative period safer and shorter. This survey aimed to evaluate the opinions of Spanish colorectal surgeons on the perioperative management of their patients. Method Emailed surveys submitted to the members of Spanish Coloproctological Associations. Results One hundred and thirty-one (31.7%) of the 413 members participated in the study and responded thus: 21% use clinical pathways and 8% use fast track (FT); 36% use epidural analgesia in colonic surgery and 57% in rectal; 40% use warm air and 23% warm fluids to maintain intraoperative normothermia; 53% prescribe >/= 3000 ml. of iv fluids on the first postoperative day and 6.2%= 2000 ml; 43% never use nasogastric tubes. Oral intake was initiated by 23.5% on the first day, and by 50% when peristalsis began, with an earlier tendency in laparoscopic surgery; 43% believed oral intake reduces ileus, but 12% considered it dangerous. Board accreditation and experience in Coloproctology were significantly associated with a lesser use of nasogastric tubes and earlier feeding. Sixty-nine per cent considered FT reduces postoperative stay and 44% thought that it minimizes complications. Conclusion Spanish surgeons maintain a classical procedural policy, but show tendencies towards optimizing patients' care.
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Colo/cirurgia , Assistência Perioperatória , Padrões de Prática Médica , Reto/cirurgia , Adulto , Procedimentos Clínicos , Coleta de Dados , Humanos , Tempo de Internação , Pessoa de Meia-Idade , EspanhaRESUMO
OBJECTIVES: Published data about the association between the consumption of sweetened soft-drinks (SSD) and obesity in childhood are controversial and still inconsistent. In addition, data are lacking in the Spanish population. The purpose of this study was therefore, to explore the cross-sectional association between body composition-related parameters and SSD consumption in Spanish adolescents. SUBJECTS AND METHODS: A representative sample of 1,523 adolescents (768 boys and 755 girls), with complete dietary data as well as anthropometric measurements, were included in this study. Weight, height, waist circumferences, and 6 skinfolds were measured, and BMI and percentage body fat were calculated. From a 24h dietary recall the subjects were grouped in 3 groups according to their SSD consumption: 1) Non-consumers (0 g of SSD consumption); 2) Moderate consumption (< 336 g/day of SSD, equivalent to the average SSD portion size); and 3) High consumption (> 336 g/day of SSD). RESULTS: 67% males and 75% females did not consume any SSD the day before the dietary recall interview. Males consumed more SSD than females. Regarding the association between SSD consumption and measures of obesity, no difference was observed between the three groups of SSD consumption in any of the anthropometric measurement, BMI or body fat. CONCLUSION: As no association was present between SSD consumption and obesity in our cross-sectional study we suggest that dietary patterns and habits as well as lifestyle factors such as physical activity should be present when examining cross-sectional or longitudinal relationships with obesity. Multidisciplinary intervention studies are crucial when trying to develop solutions against the increasing obesity epidemic.
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Bebidas/estatística & dados numéricos , Composição Corporal , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , EspanhaRESUMO
INTRODUCTION: Although the supine position created by Dr. Valdivia two decades ago to perform the procedure known as percutaneous nephrolitectomy (PNL) presents advantages against the prone position in some aspects concerning anesthesia and surgical ergonomy, its use has failed to spread widely among the urology community due to certain technical difficulties, a lower rate of calculi clearing and a higher rate of complications, in spite of the fact that the scarce comparative studies do not show enough data to support this opinion. The present study compares both positions considering the technical difficulties encountered, their effectiveness and their results and complications. MATERIAL AND METHODS: A series of 50 patients that underwent PCNL by prone position is compared retrospectively with another series of 54 patients that underwent consecutively PCNL by prone position. All procedures were performed under general anesthesia, the inferior calyx approach was the one used the most over the supracostal approach, and the sole tract over the multi-tract approach was predominant. Dilatation of the nephrostomy tract was done, in most of the cases, with a high-pressure balloon catheter. The stone surface treated was 399.93+/-58.2 mm2 for the supine group, and 416.36+/-46.54 mm2 for the prone one (p=0.456). The management of the stones was carried out by ultrasonic or ballistic fragmentation, and a small group of patients underwent direct stone removal. RESULTS: As far as demographic parameters and operative variables such as number of tracts performed, calyx election, type of tract dilatation and kind of energy used for fragmentation, both groups were homogeneous. In 3 cases of each group there was a failure to access the kidney. The rate of failure was 6%, and 5.56%, for the supine and prone groups, respectively (p=0.716). Average operating time was 74.55+/-25.54 and 91.82+/-24.82 minutes, respectively, p=0.123. A postoperative x-ray showed a stone-free rate of 76% for the supine group and 74% for the prone group, p=0.308. ESWL was the supplementary treatment for 12% of the patients in the supine group, and for 12.96% of the patients in the prone group p= 0.478, and a second procedure was performed on 4 (8%) patients in the supine group and on 3 (5.56%) in the prone one, p=0.697. Hospital stay was the same for both groups (5.89+/-4.7 for the supine group, and 5.5+/-4.09 for the prone one, p=0.694). As far as analgesia required, 6.89+/-4.87 was administered for the supine against 6.18+/-4.09 for the prone, p=0.580. The complications rate was very low for both groups and also very similar; one of the patients in the supine group suffered a lesion to the colon. CONCLUSION: Valdivia position is as feasible as the prone position for PCNL. Success rates, as far as stone clearing, and complications are similar for both positions.
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Nefrostomia Percutânea/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Estudos RetrospectivosRESUMO
We present two patients with a diagnosis of chronic lymphoproliferative syndrome, chronic lymphocytic leukemia B (CLL B) and lymphoplasmacytic non-Hodgkin's lymphoma (NHL), who developed chronic myeloproliferative syndrome: polycythemia vera (PV) and Philadelphia-positive chronic myeloid leukemia (CML) respectively, and a third patient with chronic myeloproliferative syndrome, polycythemia vera (PV), who developed an undefined immunophenotype cyclin D1-positive chronic lymphoproliferative syndrome. The cases included in literature are scarce, and it is not known whether some common mechanism can explain both processes' pathogeneses and the control mechanisms of one process over the other.
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Transtornos Linfoproliferativos/complicações , Transtornos Mieloproliferativos/complicações , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: with the widespread use of minimally invasive techniques, robot-assisted urologic surgery has become widely adopted. Despite their infrequency, visceral and gastrointestinal complications could be life-threatening. OBJECTIVES: To identify the main gastrointestinal injuries that occur in a robot-assisted urologic surgery. To know the overall incidence and how is their management. ACQUISITION OF THE EVIDENCE: Search in PubMed of articles related to visceral and gastrointestinal complications in robot-assisted urology surgery, written in English or Spanish. Relevant publications as well literature reviews and chapters from books were reviewed. SYNTHESIS OF THE EVIDENCE: Along with vascular injuries, visceral and gastrointestinal lesions are among most dangerous complications. A complete preoperative study to individualize each patient characteristics and the correct use of imaging could help us to avoid complications in the first place. To know all the risky steps in the different robotic urologic procedures will let us anticipate the damage. Knowledge of main and most dangerous injuries in the different abdominal and pelvic organs is fully recommended. Early diagnosis and evaluation of lesions will let us an acute management during surgery. Recognition delay could change a repairable injury into a life-threatening situation. CONCLUSIONS: Despite the undeniable benefits of robotic approach, there are minor and major gastrointestinal injuries that all urologic surgeons must know. Those related with trocar placement are especially important. Immediate diagnosis and management is mandatory.
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Gastroenteropatias/etiologia , Complicações Intraoperatórias/etiologia , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Vísceras/lesões , Sistema Digestório/lesões , Fístula do Sistema Digestório/etiologia , Eletrocoagulação/efeitos adversos , Gastroenteropatias/prevenção & controle , Humanos , Complicações Intraoperatórias/prevenção & controle , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/instrumentação , Instrumentos Cirúrgicos/efeitos adversos , Fístula Urinária/etiologia , Procedimentos Cirúrgicos Urológicos/instrumentaçãoRESUMO
The growing occurrence of drug resistant strains of unicellular prokaryotic parasites, along with insecticide-resistant vectors, are the factors contributing to the increased prevalence of tropical diseases in underdeveloped and developing countries, where they are endemic. Malaria, cryptosporidiosis, African and American trypanosomiasis and leishmaniasis threaten human beings, both for the high mortality rates involved and the economic loss resulting from morbidity. Due to the fact that effective immunoprophylaxis is not available at present; preventive sanitary measures and pharmacological approaches are the only sources to control the undesirable effects of such diseases. Current anti-parasitic chemotherapy is expensive, has undesirable side effects or, in many patients, is only marginally effective. Under this point of view molecular biology techniques and drug discovery must walk together in order to find new targets for chemotherapy intervention. The identification of DNA topoisomerases as a promising drug target is based on the clinical success of camptothecin derivatives as anticancer agents. The recent detection of substantial differences between trypanosome and leishmania DNA topoisomerase IB with respect to their homologues in mammals has provided a new lead in the study of the structural determinants that can be effectively targeted. The present report is an up to date review of the new findings on type IB DNA topoisomerase in unicellular parasites and the role of these enzymes as targets for therapeutic agents.