Impact of colloids or crystalloids in renal function assessed by NGAL and KIM-1 after hysterectomy: randomized controlled trial.

BACKGROUND: Hydroxyethyl starches are colloids used in fluid therapy that may reduce volume infusion compared with crystalloids, but they can affect renal function in critical care patients. This study aims to assess renal effects of starches using renal biomarkers in the perioperative setting. METHODS: This prospective, controlled, randomized study compared Hydroxyethyl starch 6% (HES) with Ringer's lactate (RL) in hysterectomy. Each episode of mean arterial pressure (MAP) below 60 mmHg guided the fluid replacement protocol. The RL group received 300 mL bolus of RL solution while the HES group received 150 mL of HES solution. All patients received RL (2 mL.kg-1.h-1) intraoperatively to replace insensible losses. Blood and urine samples were collected at three time points (preoperatively, 24 hours, and 40 days postoperatively) to assess urinary NGAL and KIM-1, as primary outcome, and other markers of renal function. RESULTS: Seventy patients were randomized and 60 completed the study. The RL group received a higher crystalloid volume (1,277 ± 812.7 mL vs. 630.4 ± 310.2 mL; p = 0.0002) with a higher fluid balance (780 ± 720 mL vs. 430 ± 440 mL; p = 0.03) and fluid overload (11.7% ± 10.4% vs. 7.0% ± 6.3%; p = 0.04) compared to the HES group. NGAL and KIM-1 did not differ between groups at each time point, however both biomarkers increased 24 hours postoperatively and returned to preoperative levels after 40 days in both groups. CONCLUSION: HES did not increase renal biomarkers following open hysterectomy compared to RL. Moreover, HES provided better hemodynamic parameters using less volume, and reduced postoperative fluid balance and fluid overload.

[Perianal cutaneous amebiasis. Report of two cases]. / Amibiasis cutánea perianal. Informe de dos casos.

Perianal cutaneous amebiasis is a rare entity, with 0.03% to 0.07% reported incidence. We present two cases of perianal cutaneous amebiasis, both in male patients. Diagnosis was established by biopsy, with demonstration of Entamoeba histolytica trophozoites. Treatment with metronidazol was performed with good outcome. Although incidence of perianal cutaneous amebiasis is low, this entity must be kept in mind when painful atypical ulcers appear in this region. Diagnosis must be confirmed by identification of the parasite and treatment must be established with antiamebic extra-luminal drugs.

Nitrogen (protein) determination in single seeds by nuclear reactions.

In this work, a brief review on nuclear reaction methods aimed at nitrogen assessment in organic matter is given, followed by a detailed application using a deuteron beam and (d,p) and (d,α) induced reactions on 14N to determine nitrogen content in single seeds This study covers the analysis of five wheat and four maize stable varieties, which showed up good (linear) correlation coefficients in comparison with corresponding Kjeldahl nitrogen analysis for each species. This method of analysis turns out to be a fast and non-destructive technique for protein determination in cereals, besides its extendibility to other plant products for human nutrition.

Particle swarm optimization for network-based data classification.

Complex networks provide a powerful tool for data representation due to its ability to describe the interplay between topological, functional, and dynamical properties of the input data. A fundamental process in network-based (graph-based) data analysis techniques is the network construction from original data usually in vector form. Here, a natural question is: How to construct an "optimal" network regarding a given processing goal? This paper investigates structural optimization in the context of network-based data classification tasks. To be specific, we propose a particle swarm optimization framework which is responsible for building a network from vector-based data set while optimizing a quality function driven by the classification accuracy. The classification process considers both topological and physical features of the training and test data and employing PageRank measure for classification according to the importance concept of a test instance to each class. Results on artificial and real-world problems reveal that data network generated using structural optimization provides better results in general than those generated by classical network formation methods. Moreover, this investigation suggests that other kinds of network-based machine learning and data mining tasks, such as dimensionality reduction and data clustering, can benefit from the proposed structural optimization method.

Randomized clinical trial with topical diltiazem for post-hemorrhoidectomy wound healing. / Ensayo clínico aleatorizado con diltiazem tópico para la cicatrización de heridas posthemorroidectomía.

Anal sphincter spasm contributes to the delay in surgical wound healing after hemorrhoidectomy. A prospective, experimental, randomized, double-blind trial was conducted on two groups of patients that underwent closed hemorrhoidectomy. There were 26 patients in each group. Group A received topical diltiazem in the anal region three times a day. Group B received a placebo. Cicatrization time was documented for 6 weeks through digital photography. Mean healing time for the group treated with diltiazem was 3.19 weeks (22.33±0.884 days) and 3.92 weeks (27.44±1.130 days) for the control group (p=0.012 95% CI). At week three, the wounds in 73.07% of the patients in the diltiazem group had healed, compared with 46.15% of the patients in the control group.

Surgical Technique Notes of Arterial Vascular Reconstruction During Kidney Transplantation: Personal Experience and Literature Review.

BACKGROUND: Arterial vascular anomalies in patients undergoing kidney transplantation (KT) are correlated with a higher incidence of early surgical complications, potentially causing graft loss. Arterial reconstruction allows patients to overcome these surgical challenges, thus minimizing the risk of poor outcomes. The aim of the present study is to retrospectively investigate the safety and effectiveness of the multiple arterial reconstruction technique with a Teflon patch in case of an unavailable aortic patch: to do so, surgical complications, graft function, and patient survival were evaluated. METHODS: During the period January 2009 to August 2016, 202 adult deceased-donor KTs were performed at our center. Group A (n = 27; reconstruction of multiple arteries) and Group B (n = 175; control group) were compared. RESULTS: No differences were observed between the 2 groups in terms of early postoperative course, with no vascular complication observed in Group A. No vascular patch infections were reported, nor longer cold ischemia time rates. Similarly, long-term survival rates were similar between the 2 groups. CONCLUSIONS: The Teflon-patch arterial reconstruction technique appears to be safe and effective, with an acceptable balance of benefits and potential risks of using a prosthetic material. Studies based on larger series are needed to further validate this approach.

Phenotype and Variant Spectrum in the LAMB3 Form of Amelogenesis Imperfecta.

Amelogenesis imperfecta (AI) is a heterogeneous group of inherited disorders characterized by abnormal formation of dental enamel, either in isolation or as part of a syndrome. Heterozygous variants in laminin subunit beta 3 ( LAMB3) cause AI with dominant inheritance in the absence of other cosegregating clinical features. In contrast, biallelic loss-of-function variants in LAMB3 cause recessive junctional epidermolysis bullosa, characterized by life-threatening skin fragility. We identified 2 families segregating autosomal dominant AI with variable degrees of a distinctive hypoplastic phenotype due to pathogenic variants in LAMB3. Whole exome sequencing revealed a nonsense variant (c.3340G>T, p.E1114*) within the final exon in family 1, while Sanger sequencing in family 2 revealed a variant (c.3383-1G>A) in the canonical splice acceptor site of the final exon. Analysis of cDNA from family 2 revealed retention of the final intron leading to a premature termination codon. Two unerupted third molar teeth from individual IV:5 in family 2 were subject to computerized tomography and scanning electron microscopy. LAMB3 molar teeth have a multitude of cusps versus matched controls. LAMB3 enamel was well mineralized but pitted. The architecture of the initially secreted enamel was abnormal, with cervical enamel appearing much less severely affected than coronal enamel. This study further defines the variations in phenotype-genotype correlation for AI due to variants in LAMB3, underlines the clustering of nonsense and frameshift variants causing AI in the absence of junctional epidermolysis bullosa, and highlights the shared AI phenotype arising from variants in genes coding for hemidesmosome proteins.

Impact of colloids or crystalloids in renal function assessed by NGAL and KIM-1 after hysterectomy: randomized controlled trial

Abstract Background Hydroxyethyl starches are colloids used in fluid therapy that may reduce volume infusion compared with crystalloids, but they can affect renal function in critical care patients. This study aims to assess renal effects of starches using renal biomarkers in the perioperative setting. Methods This prospective, controlled, randomized study compared Hydroxyethyl starch 6% (HES) with Ringer's lactate (RL) in hysterectomy. Each episode of mean arterial pressure (MAP) below 60 mmHg guided the fluid replacement protocol. The RL group received 300 mL bolus of RL solution while the HES group received 150 mL of HES solution. All patients received RL (2 mL.kg−1.h−1) intraoperatively to replace insensible losses. Blood and urine samples were collected at three time points (preoperatively, 24 hours, and 40 days postoperatively) to assess urinary NGAL and KIM-1, as primary outcome, and other markers of renal function. Results Seventy patients were randomized and 60 completed the study. The RL group received a higher crystalloid volume (1,277 ± 812.7 mL vs. 630.4 ± 310.2 mL; p= 0.0002) with a higher fluid balance (780 ± 720 mL vs. 430 ± 440 mL; p= 0.03) and fluid overload (11.7% ± 10.4% vs. 7.0% ± 6.3%; p= 0.04) compared to the HES group. NGAL and KIM-1 did not differ between groups at each time point, however both biomarkers increased 24 hours postoperatively and returned to preoperative levels after 40 days in both groups. Conclusion HES did not increase renal biomarkers following open hysterectomy compared to RL. Moreover, HES provided better hemodynamic parameters using less volume, and reduced postoperative fluid balance and fluid overload.

Resveratrol inhibits rhabdomyosarcoma cell proliferation.

Rhabdomysarcoma is the most common soft tissue tumour in children under the age of 15. Although the introduction of multimodal treatment programmes, including chemotherapy, radiation therapy and excision have increased the overall survival, the chemotherapeutic agents currently used for the treatment of rhabdomyosarcoma exhibit considerable toxicity. The aim of this study was to investigate the effects and possible mechanism(s) of action of resveratrol on human embryonal rhabdomyosarcoma (RD) cells. Resveratrol is a natural polyphenolic compound produced in a number of edible plants and has received considerable attention as a potential chemopreventive and/or chemotherapeutic agent against various types of cancers. In the present study, resveratrol was shown to inhibit cell proliferation of RD cells in a dose-dependent manner with an IC50 of 48.1 micromol/l and induce an arrest in the S/G2 phase of the cell cycle. As evident from immunocytochemical data, resveratrol treatment increased the size of the RD cells. Furthermore, resveratrol treatment resulted in a significant downregulation of cyclin B expression as demonstrated by western blot analyses. In conclusion, the present study shows that resveratrol exerts a strong inhibition of rhabdomyosarcoma cell proliferation in part by arresting cells in S/G2 phase of the cell cycle. These findings warrant further investigation to establish potential use of resveratrol as a relatively non-toxic chemotherapeutic agent for the treatment of rhabdomyosarcoma.

Virtualización de contenidos académicos en entornos de aprendizaje a distancia / Virtualization of academic content in distance learning environments

El objetivo del presente trabajo es el describir la virtualización de contenidos académicos en entornos virtuales de aprendizaje con tecnologías educativas y el desarrollo de materiales didácticos digitales, imágenes, documentos, contenidos interactivos, videos multimedia, actividades interactivas, evaluación y otros. Se plantea conceptualizaciones de tecnología educativa, estrategias de enseñanza y aprendizaje, entorno virtual de aprendizaje, estructura del aula virtual, competencias digitales. Finalmente, se incide en los elementos que componen y los pasos que se requieren en el proceso de virtualización del plan de estudios y/o los contenidos de la materia para coadyuvar en la formación académica y en la apertura de escenarios activos, colaborativos, interactivos virtuales entre docentes y estudiantes.

Estrategias educativas y tecnología digital en el proceso enseñanza aprendizaje / Educational strategies and digital technology in the teaching learning process

El objetivo del presente trabajo es describir las estrategias educativas y su integración con las tecnologías digitales para el fortalecimiento del proceso enseñanza aprendizaje de docentes y estudiantes. Se abordan diferentes investigaciones, enfoques y conceptualizaciones desarrollados por otras investigaciones; además, se describen las estrategias de enseñanza pre-instruccionales, co-instruccionales y postinstruccionales entre las cuales resaltan los objetivos, organizadores previos, mapas mentales y conceptuales, ilustraciones, analogías y otros; por otra parte, se enfoca en las estrategias que el estudiante emplea en su formación académica como ser el ensayo, elaboración, organización, comprensión, apoyo y aprendizaje significativo. Por otro lado, se destaca las nuevas tecnologías digitales, los recursos de Internet orientadas a la educación y las miradas concernientes a reducir la brecha digital en el contexto educativo. Por último, se enfatiza en la integración de las estrategias educativas y las nuevas tecnologías de información y comunicación disponibles, y como éstas conllevan a la apertura de nuevos escenarios activos de interrelación e interacción entre docentes y estudiantes.

Cardiovascular disease risk factors in 2 distinct ethnic groups: Indian and Pakistani compared with American premenopausal women.

BACKGROUND: Although people from the Indian subcontinent have high rates of cardiovascular disease (CVD), studies of such in Indian and Pakistani women living in the United States are lacking. OBJECTIVE: This study accounted for variability in serum lipid (total cholesterol and triacylglycerol) and lipoprotein [LDL cholesterol, lipoprotein(a), and HDL cholesterol] concentrations in Indian and Pakistani compared with American premenopausal women in the United States. Body composition, regional fat distribution, dietary intake, and energy expenditure were compared between groups. DESIGN: The 2 groups were 47 Indian and Pakistani and 47 American women. Health was assessed via medical history, physical activity, body composition (via anthropometry and dual-energy X-ray absorptiometry), dietary intake (via 7-d food records), and serum lipids. RESULTS: Serum total cholesterol, triacylglycerol, LDL cholesterol, lipoprotein(a), the ratio of total to HDL cholesterol, and the ratio of LDL to HDL cholesterol were greater (P <0.03), whereas HDL-cholesterol values were lower (P = 0.011) in Indians and Pakistanis than in Americans. Multiple regression analysis indicated that approximately 18% of the variance in total cholesterol (P = 0.0010) and LDL cholesterol (P = 0.0009) was accounted for by ethnicity, energy expenditure, and the ratio of the sum of central to the sum of peripheral skinfold thicknesses. Ethnicity, sum of central skinfold thicknesses, ratio of polyunsaturated to saturated fat, and monounsaturated fat intake accounted for approximately 43% of the variance in triacylglycerol concentration (P < 0.0001). Monounsaturated fat, percentage body fat, and alcohol intake accounted for approximately 26% of variance in HDL cholesterol. Ethnicity contributed approximately 22% of the 25% overall variance in lipoprotein(a). CONCLUSIONS: Results suggest that these Indian and Pakistani women are at higher CVD risk than their American counterparts, but that increasing their physical activity is likely to decrease overall and regional adiposity, thereby improving their serum lipid profiles.

Deguelin inhibits the growth of colon cancer cells through the induction of apoptosis and cell cycle arrest.

As previously demonstrated, deguelin [(7aS, BaS)-13, 13a-dihydro-9,10-dimethoxy-3,3-dimethyl-3H-bis[1]benzo-pyrano[3,4-b:6',5'-e]pyran-7(7aH)-one mediates anti-proliferative properties in a variety of cell types. In the present study, deguelin was found to suppress the growth of HT-29 colon cancer cells with an IC(50) of 4.32 x 10(-8) M. The cells were arrested in the G1-S-phase of the cycle. Investigations of G1/S regulatory proteins by Western blot analyses showed an upregulation of p27, and decreased expression levels of cyclin E and CDK4. Furthermore, by 24 h, exposure to deguelin resulted in an increase in the hypophosphorylated form of Rb. Since hypophosphorylated pRb binds to and inactivates E2F1, additional studies were performed and downregulation of E2F1 was observed after 24 h of treatment with deguelin. These results are consistent with the observation that deguelin arrested cells in the G1-S- phase. In addition, based on ethidium bromide/acridine orange staining, detection of digoxigenin-labelled genomic 3'-OH DNA ends, and DNA laddering, it was found that deguelin exerts its growth inhibitory effects via the induction of apoptosis. Based on these data, the potential of deguelin to serve as a cancer chemotherapeutic agent for colon cancer may be suggested.

[Stability of auditory thresholds during the first 5 weeks after stapedectomy]. / Estabilidad de los umbrales de audición durante las primeras 5 semanas post-estapedectomía.

To assess repeatability of audiological test performed every week during the first month post-stapedectomy, audiometry was performed to 21 patients with otosclerosis (mean age 37.8 years, S.D. 9.29), every week, during the 2 weeks prior to stapedectomy and during the first 5 weeks and at week 12 after stapedectomy. Repeatability of the audiological test was evaluated comparing the difference between the audiological evaluations performed before the surgery and the difference between each consecutive pair of audiological evaluations after the surgery, using Bland & Altman method and ANOVA, allowing for 5% of significance. Before the surgery, audiological thresholds, using head phones, were repeatable for low (125-500 Hz), mid (500-2000 Hz) and high (2000-8000 Hz) frequencies in 95% of the patients. After the surgery, repeatability of air conduction thresholds for the low frequency band was evident from the 2nd week, for the mid frequency band was evident from the 3rd week and for the high frequency band from the 4th week. The gain observed at week 5 after surgery was similar to the gain observed at week 12. In conclusion, in this study, stable air conduction auditory thresholds were obtained during the first month after stapedectomy.

Urbanization, the informal sector and migration: issues for research and cooperation.

Only recently have development studies begun to examine the complex set of relationships between urbanization, the growth of the informal sector, and internal migration in Latin America. This paper suggests that the economic crisis of the 1980s has resulted in significant changes in these phenomena and that 1 of the most important changes has been the growth of return international migration between Latin American countries. Also of importance are the continued migration flows to North America. The paper argues that the interconnectedness of these phenomena requires more multinational research efforts.

Competencias digitales y su integración con herramientas tecnológicas en educación superior / Digital competences and its integration with technological tools in higher education

Las competencias digitales son habilidades, destrezas aquellas que desarrolla el profesor universitario en su labor docente y el estudiante en su proceso de aprendizaje. Por otro lado, las nuevas tecnologías de información y comunicación han generado diferentes programas computaciones, herramientas tecnológicas gratuitas y de pago, el objetivo del presente trabajo es describir las competencias digitales existentes vinculadas con las nuevas tecnologías de información y comunicación, además, pretende identificar los ambientes flexibles, colaborativos, científicos, participativos y personalizados que se presentan con la integración de herramientas digitales. La integración y aplicabilidad de las competencias digitales integradas con las herramientas tecnológicas son determinantes en el desarrollo educativo, investigativo, profesional y otros

The digital competences are skills, skills that are developed by the university professor in his teaching work and the student in his learning process. On the other hand, the new information and communication technologies have generated different computer programs, free and paid technological tools, the objective of this work is to describe the existing digital competences linked to the new information and communication technologies, in addition, it aims to identify the flexible, collaborative, scientific, participative and personalized environments that are presented with the integration of digital tools. The integration and applicability of integrated digital competencies with the tools of technology are determining factors in educational, research, professional and other development

Evaluación cualitativa y cuantitativa de enseñanza aprendizaje combinado, sobre alimentación del menor de dos años / Qualitative and quantitative assessment of combined teaching learning process on feeding of children under two years of age

INTRODUCCIÓN: la cátedra de pediatría con apoyo del Instituto de Investigación en Salud y Desarrollo de la UMSA, ha elaborado un módulo de enseñanza teórico práctico para brindar conocimiento científico actualizado sobre alimentación y nutrición del menor de dos años. Durante la última gestión universitaria se ha incursionado en la enseñanza virtual para incrementar el tiempo de lectura, y contar con mayor espacio para las actividades prácticas. MÁTERIALES Y MÉTODOS: el objetivo de este artículo es identificar las fortalezas y debilidades del proceso de enseñanza y aprendizaje (PEA) combinado; usando metodología cuantitativa (pre y post-prueba) y cualitativa (grupo focal). Se contó con un total de 39 estudiantes. La prueba de conocimientos post intervención tuvo un puntaje de 771 mayor que la previa (p=0,000 ((IC 95% 642,35 - 901,23); y se respondió en menor tiempo (-219,43 segundos p=0.0000 (IC 95% (146,98 ­ 291,88). Un 81% de estudiantes estaba en el límite o por encima de lo que se consideró mínimo adecuado de facilidades informáticas. El grupo focal evidencio dificultades en el portal virtual, como muchos pasos para el ingreso, la saturación del servicio y otras; se dieron múltiples sugerencias para mejorar el módulo. RESULTADOS: este estudio demuestra que además de adquirir conocimientos, los estudiantes se han involucrado en los diferentes aspectos PEA; en base a sus sugerencias se ha comenzado a realizar cambios incluyendo la introducción de herramientas digitales de uso colaborativo como Wiki. CONCLUSIÓN: se concluye que el PEA combinado aplicado en la catedra de pediatría de la UMSA mejora la adquisición de conocimientos y prácticas sobre lactancia materna y alimentación complementaria del menor de dos años.

INTRODUCTION: the pediatric department with the support of the Institute of Research in Health and Development of the UMSA has developed a practical and theoretical teaching module to provide updated scientific knowledge on food and nutrition for children under two years of age. During the last university year, virtual teaching has been introduced to increase reading time, and to have more space for practical activities. MATERIAL AND METHODS: the objective of this article is to identify the strengths and weaknesses of the combined Learning Teaching Process using quantitative (pre and post-test) and qualitative methodology (focus group); 39 students participated in the study. In the post-intervention knowledge test obtained a score of 771 higher than the one prior to intervention (p = 0.000 ((95% CI 642.35 - 901.23), and spent shorter time in answers (-219.43 seconds p = 0.0000 (95% CI % (146.98 - 291.88). A total of 81% of students were in the limit or above what was considered adequate or minimum computer facilities. The focus group evidenced difficulties in the virtual portal, as many steps for the entrance, the saturation of the service and others, multiple suggestions were given to improve the module. RESULTS: this study shows that in addition to acquiring knowledge, students have been involved in the different aspects of the Teaching Learning Process (TLP). Based on their suggestions, changes such as the introduction of collaborative digital tools (Wiki) have been made. CONCLUSIONS: the article concludes indicating that the combined TLP applied in the pediatric department of the UMSA improves the students' acquisition of knowledge and practices on breastfeeding and complementary feeding of the child two years.

Actions of vitamin D are mediated by the TLR4 pathway in inflammation-induced colon cancer.

Many chronic inflammatory diseases are associated with increased risk of developing cancer. In the colon, strong support for a link between chronic inflammation and cancer extends, in part, from population-based studies of persons with inflammatory bowel disease (IBD). Patients with IBD are at increased risk of developing colorectal cancer (CRC). The general consensus is that IBD results from the combined effects of genetics and environment factors known to affect the immune system. Vitamin D, an important regulator of the immune system, has been linked to IBD. Despite the strong potential reported for 1,25-dihydroxyvitamin D (1,25-OH)2D), its effects on calcium metabolism limits its application. Recently, less active vitamin D metabolites, cholecalciferol and 25-hydroxyvitamin D (25(OH)D), have gained considerable attention as promising agents against IBD-related colon cancer. Yet, their anti-proliferative properties and mechanism of action remain to be better defined. We present several signaling pathways commonly regulated by vitamin D compounds and highlight their regulation on TLR4. The efficacy of 25(OH)D and 1alpha-hydroxyviatmin D5 are evaluated using the azoxymethane (AOM)/dextran sodium sulfate (DSS)-induced IBD-related colon carcinogenesis model. In summary, vitamin D supplementation may provide a cost-effective approach to reduce IBD related colon cancer.