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1.
J Food Sci Technol ; 57(5): 1856-1865, 2020 May.
Article in English | MEDLINE | ID: mdl-32327796

ABSTRACT

In this work the preparation of a hummus pastes from a Mexican variety of chickpea (Blanco Sinaloa, BS) was investigated. With this purpose, the nutritional and functional properties of the raw chickpea were evaluated, which revealed a content of protein, fiber and lipids of 19, 1.6 and 10.3%, respectively. Meanwhile the values of hydration capacity, water absorption index, water solubility index, emulsifying activity and foam capability were 0.65 g/seed, 2.26 g/g, 22.3%, 40.7% and 29.2%, respectively. Based on these results this variety of chickpea was considered suitable for the target application. The preparation of the paste was done by further sterilization of the paste promoted a decreased on the activity of lipoxygenase (68%) and starch content (40%). The rheological characterization of the hummus paste showed that the sterilization induced the formation of a tridimensional structure, due to the gelatinization of the starch and protein denaturation. Moreover, the linear viscoelastic zone shifted to higher values of strain (%γ), whereas the storage modulus (G') increased in about two orders of magnitude. The results of frequency sweeps showed that the paste exhibits a solid-like behavior (weak gel). Measurements of shear rate of the paste (unsterilized and sterilized) revealed that the shear viscosity exhibited a shear thickening behavior and a thixotropic behavior.

2.
Med Oral Patol Oral Cir Bucal ; 24(1): e84-e88, 2019 Jan 01.
Article in English | MEDLINE | ID: mdl-30573713

ABSTRACT

BACKGROUND: Cancer of the oral cavity combined with oropharyngeal cancer is the sixth leading cause of death for cancer worldwide. Surgery remains the standard treatment for this disease in early clinical and locally advanced stages. Numerous studies have shown that laser management is useful for premalignant lesions in the oral cavity; however, there is no conclusive evidence that its use is appropriate in cancer of the oral cavity and that results are comparable with traditional surgery. The objective of this study is to determine cancer control after wide local resection with CO2 laser for oral malignant neoplasms. MATERIAL AND METHODS: Retrospective study in patients with tumors of the oral cavity who were considered for surgical resection with CO2 laser from January 2006-December 2015. Demographic data, treatment modalities, histopathological diagnosis and clinical stage variables were obtained. All resections were done with the use of the microspot. Patients with cancer of the tongue were not included because a specific protocol for these patients does exist in our institution. RESULTS: There were twenty patients, 10 male and 10 female with a average age of 58 years (range: 20-92 years). Mean age was 53.5 years for females and 63 years for males. Twelve (60%) patients are alive and disease free and four (20%) were lost free of disease. CONCLUSIONS: CO2 laser is an acceptable surgical method for the management of small lesions in the oral cavity. We cannot rule out that small lesions of the oral cavity with positive neck could be managed in this manner, adding treatment to the neck, producing an adequate local regional control. However, this hypothesis requires additional studies.


Subject(s)
Lasers, Gas/therapeutic use , Mouth Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Oral Surgical Procedures/methods , Retrospective Studies , Young Adult
3.
Med Oral Patol Oral Cir Bucal ; 21(4): e425-30, 2016 Jul 01.
Article in English | MEDLINE | ID: mdl-27031071

ABSTRACT

BACKGROUND: Mucosal melanoma (MM) of head and neck (H&N) is a rare entity with a quite poor prognosis. Ballantyne's staging system has been commonly used since 1970. In the 7th edition of the AJCC Staging Manual a new chapter for the staging of TNM Classification system for mucosal melanoma (MM) of the head and neck (H&N) has been introduced to reflect the particularly aggressive biological behavior of this neoplasm. The aim of this study was to analyze and compare among Ballantyne's staging system vs TNM H&N in terms of overall survival (OS) and disease-free survival (DFS) in a consecutive population of patients with MM in a cancer centre. MATERIAL AND METHODS: Descriptive analysis of demographic, clinical and pathological variables of MM of the Head & Neck were performed. We compared the survival curves for both systems according to the Kaplan-Meier method using the Log-rank test. RESULTS: An up-staging migration effect from Ballantyne's localized disease to moderate-ly and very advanced disease according to AJCC staging system. The 5-year DFS and OS for Ballantyne's Localized Disease and AJCC Stage III were 31% and 36% vs. 47% and 50%, respectively. For locoregional disease the 5-year DFS / OS were 5% / 10% for Ballantyne's system vs. 13.8% / 17.8% and 0 / 0% for AJCC Stages IVA and IVB, respectively. CONCLUSIONS: In this series, the TNM staging system for MM of the H&N predicted the prognosis of the disease when comparing with Ballantyne's system.


Subject(s)
Head and Neck Neoplasms/pathology , Melanoma/pathology , Neoplasm Staging , Disease-Free Survival , Humans , Prognosis , Retrospective Studies
5.
Clin Exp Allergy ; 42(2): 265-74, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22093077

ABSTRACT

BACKGROUND: Racial disparities persist in early childhood wheezing and cannot be completely explained by known risk factors. OBJECTIVE: To evaluate the associations of genetic ancestry and self-identified race with early childhood recurrent wheezing, accounting for socio-economic status (SES) and early life exposures. METHODS: We studied 1034 children in an urban, multi-racial, prospective birth cohort. Multivariate logistic regression was used to evaluate the association of genetic ancestry as opposed to self-identified race with recurrent wheezing (>3 episodes). Sequential models accounted for demographic, socio-economic factors and early life risk factors. Genetic ancestry, estimated using 150 ancestry informative markers, was expressed in deciles. RESULTS: Approximately 6.1% of subjects (mean age 3.1 years) experienced recurrent wheezing. After accounting for SES and demographic factors, African ancestry (OR: 1.16, 95% CI: 1.02-1.31) was significantly associated with recurrent wheezing. By self-reported race, hispanic subjects had a borderline decrease in risk of wheeze compared with African Americans (OR: 0.44, 95% CI: 0.19-1.00), whereas white subjects (OR: 0.46, 95% CI: 0.14-1.57) did not have. After further adjustment for known confounders and early life exposures, both African (OR: 1.19, 95% CI: 1.05-1.34) and European ancestry (OR: 0.84, 95% CI: 0.74-0.94) retained a significant association with recurrent wheezing, as compared with self-identified race (OR(whites) : 0.31, 95% CI: 0.09-1.14; OR(hispanic) : 0.47, 95% CI: 0.20-1.08). There were no significant interactions between ancestry and early life factors on recurrent wheezing. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to self-identified race, African ancestry remained a significant, independent predictor of early childhood wheezing after accounting for early life and other known risk factors associated with lung function changes and asthma. Genetic ancestry may be a powerful way to evaluate wheezing disparities and a proxy for differentially distributed genetic and early life risk factors associated with childhood recurrent wheezing.


Subject(s)
Black or African American/genetics , Environmental Exposure/adverse effects , Respiratory Sounds/genetics , Respiratory Sounds/immunology , Boston/epidemiology , Boston/ethnology , Child , Child, Preschool , Female , Genetic Markers , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Risk Factors , Social Class , White People/genetics
7.
Physiol Res ; 71(4): 457-475, 2022 Aug 31.
Article in English | MEDLINE | ID: mdl-35770469

ABSTRACT

Irisin is a myokine secreted during exercise. It has drawn the attention of researchers as it regulates several effects of exercise that are considered beneficial. It has also been proposed as a therapeutic tool to treat metabolic disorders. In recent years, the effect of different types of training on circulating irisin has been studied in large populations. An overall beneficial result has been shown, however, the outcome of the investigations has raised some controversy. Herein we evaluated the existing literature on the effects of different types of training on the circulating irisin levels in healthy subjects and in those displaying different metabolic condition. We conducted queries in the PubMed and Web of Science databases for literature published between January 2010 and January 2021. Thirty-seven original articles were retrieved and they were included in this review. Any letter to the editor, meta-analyses, reviews, and systematic review articles were excluded. From these 37 articles, 19 of them reported increased levels of circulating irisin. The interventions encompassed aerobic, resistance, combined, circuit, and interval training types. Such increase of circulating irisin was reported for healthy subjects and for those displaying different metabolic condition. A training that is steadily kept with a moderate to high intensity, including that characterized by brief highly intense intervals, were distinguishable from the rest. Nevertheless, the training effectiveness as evaluated by the increased circulating irisin levels depends on the subject's metabolic condition and age.


Subject(s)
Diabetes Mellitus, Type 2 , Metabolic Syndrome , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/therapy , Exercise/physiology , Fibronectins/metabolism , Humans , Metabolic Syndrome/diagnosis , Metabolic Syndrome/therapy , Overweight
8.
Allergy ; 66(11): 1442-8, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21819409

ABSTRACT

BACKGROUND: It has been hypothesized that vitamin D deficiency (VDD) contributes to the development of food sensitization (FS) and then food allergy. However, the epidemiological evidence is conflicting. We aim to examine whether cord blood VDD is associated with FS and whether such association can be modified by genetic variants in a prospective birth cohort. METHODS: This study included 649 children who were enrolled at birth and followed from birth onward at the Boston Medical Center. We defined VDD as cord blood 25(OH)D < 11 ng/ml, and FS as specific IgE ≥ 0.35 kUA/l to any of eight common food allergens in early childhood. We genotyped potentially functional single-nucleotide polymorphisms (SNPs) in 11 genes known to be involved in regulating IgE and 25(OH)D concentrations. Logistic regressions were used to test the effects of VDD on FS individually and jointly with SNPs. RESULTS: Among the 649 children, 44% had VDD and 37% had FS. When examined alone, VDD was not associated with FS. When examined jointly with SNPs, a significant interaction between IL4 gene polymorphism (rs2243250) and VDD (p(interaction) = 0.003, p(FDR) = 0.10) was found: VDD increased the risk of FS among children carrying CC/CT genotypes (OR = 1.79, 95%CI: 1.15-2.77). Similar but weaker interactions were observed for SNPs in MS4A2 (rs512555), FCER1G (rs2070901), and CYP24A1 (rs2762934). When all four SNPs were simultaneously considered, a strong gene-VDD interaction was evident (p(interaction) = 9 × 10(-6) ). CONCLUSIONS: Our data demonstrate that VDD may increase the risk of FS among individuals with certain genotypes, providing evidence of gene-vitamin D interaction on FS.


Subject(s)
Food Hypersensitivity/epidemiology , Food Hypersensitivity/genetics , Interleukin-4/genetics , Polymorphism, Single Nucleotide , Vitamin D Deficiency/epidemiology , Vitamin D/blood , Adult , Child, Preschool , Cohort Studies , Female , Food Hypersensitivity/diagnosis , Food Hypersensitivity/etiology , Humans , Incidence , Infant , Infant, Newborn , Male , Prospective Studies , Risk Factors , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/genetics
9.
P R Health Sci J ; 38(3): 148-155, 2019 09.
Article in English | MEDLINE | ID: mdl-31536627

ABSTRACT

OBJECTIVE: To perform an epidemiologic profile of pancreatic cancer (PC) in Puerto Rico (PR) with data gathered from 2001 to 2015. METHODS: Using data from the PR Central Cancer Registry we estimated incidence and mortality rates and trends of PC in PR, and performed survival analyses. We also compared the age-standardized incidence and mortality rates of PC in people in PR with those of Hispanics, non-Hispanic whites, and non Hispanic blacks in the United States (US). RESULTS: From 2011 to 2015, 7.8 per 100,000 persons were diagnosed with PC in PR; higher rates were observed in men than in women (9.2 vs. 6.7 per 100,000, respectively) and in persons 65 years old and older (42.7 per 100,000 persons). For the same period, 6.7 per 100,000 persons died from PC; men and persons 65 years and older had higher mortality rates. Incidence and mortality trends of PC in PR increased from 2001-2015 (annual percent change [APC] = 3.8% and 1.9%, respectively (p<0.05). Lower risk of being diagnosed with and dying from PC was seen in PR than in members of several racial/ethnic groups in the US. The median survival time for PC cases diagnosed in PR during the period of 2008 to 2012 was 5.3 months. CONCLUSION: We observed increasing mortality rates and low survival in PC patients in PR. Research on access and response to treatment is needed to elucidate the reasons for the observed results and have a positive impact on PC burden and survival.


Subject(s)
Black or African American/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Pancreatic Neoplasms/epidemiology , White People/statistics & numerical data , Aged , Female , Humans , Incidence , Male , Middle Aged , Puerto Rico/epidemiology , Registries , Survival Rate
11.
Mucosal Immunol ; 11(3): 932-946, 2018 05.
Article in English | MEDLINE | ID: mdl-29346349

ABSTRACT

Integrin α4ß7 mediates the trafficking of leukocytes, including CD4+ T cells, to lymphoid tissues in the gut. Virus mediated damage to the gut is implicated in HIV and SIV mediated chronic immune activation and leads to irreversible damage to the immune system. We employed an immuno-PET/CT imaging technique to evaluate the impact of an anti-integrin α4ß7 mAb alone or in combination with ART, on the distribution of both SIV infected cells and CD4+ cells in rhesus macaques infected with SIV. We determined that α4ß7 mAb reduced viral antigen in an array of tissues of the lung, spleen, axillary, and inguinal lymph nodes. These sites are not directly linked to α4ß7 mediated homing; however, the most pronounced reduction in viral load was observed in the colon. Despite this reduction, α4ß7 mAb treatment did not prevent an apparent depletion of CD4+ T cells in gut in the acute phase of infection that is characteristic of HIV/SIV infection. However, α4ß7 mAb appeared to facilitate the preservation or restoration of CD4+ T cells in gut tissues at later stages of infection. Since damage to the gut is believed to play a central role in HIV pathogenesis, these results support further evaluation of α4ß7 antagonists in the study and treatment of HIV disease.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , Colon/virology , HIV Infections/immunology , HIV-1/physiology , Simian Acquired Immunodeficiency Syndrome/immunology , Simian Immunodeficiency Virus/physiology , Animals , Antibodies, Monoclonal/metabolism , Bacterial Outer Membrane Proteins , CD4-Positive T-Lymphocytes/virology , Cell Survival , Clonal Deletion , Disease Models, Animal , Humans , Integrins/immunology , Macaca , Receptors, Cell Surface , Viral Load
12.
Clin Transl Oncol ; 8(2): 119-23, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16632426

ABSTRACT

INTRODUCTION: Malignant sinonasal tumors are very rare in Mexico. They ussually present as advanced disease because it is extremely difficult to make an early diagnosis; in addition, its treatment is complicated by a variety of lesions. Surgical resection remains the mainstay of treatment, but its relative therapeutic value compared with alternative treatments is controversial. OBJECTIVE: We undertook a retrospective analysis in order to evaluate results of craniofacial resections for sinonasal tumors. MATERIALS AND METHODS: A total of 20 patients, 11 men and 9 women were considered, median age was 49 years (18-74). Eleven had received previous treatment elsewhere. In 13 patients tumor was limited to maxillo-ethmoid complex, but in 6 cases tumor involved anteroinferior aspect of sphenoid sinus, in 7 extended to the orbit, in 3 to dura and two to the brain. One had cervical metastases. Median tumoral size was 5.8 cm (1-10). RESULTS: Overall complication rate was 50%. Major surgical complications occurred in 4 patients (20%): one patient developed isolated cerebrospinal fluid leakage (CEFL), 1 developed deterioration of mental status, and two developed meningitis associated with CEFL. Late complications occurred in 30% of the patients. There was not any operative death. Eleven patients received postoperative radiotherapy. Fifteen patients recurred. There were 11 local relapses, although one associated with a regional relapse, and another with regional and distant relapse. There were four isolated regional fails and six isolated distant failures. Three year overall survival was 65%, and 3-year disease free survival was 50%. Patients without previous treatment median survival was 28.3 months, meanwhile with previous treatment was 18.2 months. CONCLUSIONS: Craniofacial resection is a safe and valuable tool in the treatment of advanced sinonasal tumors involving cranial base.


Subject(s)
Nose Neoplasms/surgery , Paranasal Sinus Neoplasms/surgery , Adolescent , Adult , Aged , Brain Neoplasms/secondary , Brain Neoplasms/surgery , Combined Modality Therapy , Dura Mater/surgery , Ethmoid Sinus/surgery , Female , Humans , Male , Maxillary Sinus Neoplasms/surgery , Meningeal Neoplasms/secondary , Meningeal Neoplasms/surgery , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local , Nose Neoplasms/radiotherapy , Orbital Neoplasms/secondary , Orbital Neoplasms/surgery , Paranasal Sinus Neoplasms/radiotherapy , Radiotherapy, Adjuvant , Retrospective Studies , Salvage Therapy , Sphenoid Sinus/surgery , Survival Analysis , Survival Rate , Treatment Outcome
13.
Microbiol Res ; 190: 19-26, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27393995

ABSTRACT

The aim of this study was to evaluate the capability of Lactobacillus reuteri NRRL 14171 and Lactobacillus casei Shirota to remove dietary acrylamide (AA) under simulated gastrointestinal conditions using a dynamic system. The effects of different AA levels or bacteria concentration on toxin removal by Lactobacillus strains were assessed. Thereafter, AA-removing capability of bacteria strains under either fasting or postprandial simulated gastrointestinal conditions was evaluated. Commercial potato chips were analyzed for their AA content, and then used as a food model. Average AA content (34,162µg/kg) in potato chips exceeded by ca. 34-fold the indicative values recommended by the EU. Toxin removal ability was dependent on AA content and bacterial cell concentration. A reduction on bacterial viability was observed in the food model and at the end of both digestive processes evaluated. However, bacteria survived in enough concentrations to remove part of the toxin (32-73%). Both bacterial strains were able to remove AA under different simulated gastrointestinal conditions, being L. casei Shirota the most effective (ca. 70% removal). These findings confirmed the risk of potato chips as dietary AA exposure for consumers, and that strains of the genus Lactobacillus could be employed to reduce the bioavailability of dietary AA.


Subject(s)
Acrylamide/metabolism , Gastrointestinal Tract/microbiology , Lacticaseibacillus casei/growth & development , Lacticaseibacillus casei/metabolism , Limosilactobacillus reuteri/growth & development , Limosilactobacillus reuteri/metabolism , Acrylamide/toxicity , Biotransformation , Food Contamination , Microbial Viability/drug effects , Models, Biological , Models, Theoretical , Solanum tuberosum
14.
Article in English | MEDLINE | ID: mdl-34368452

ABSTRACT

BACKGROUND & OBJECTIVE: Pancreatic cancer is an uncommon type of cancer worldwide. Nonetheless, even with early diagnosis, mortality rates are high. This study aims to perform an epidemiologic profile of pancreatic cancer in Puerto Rico (PR) from 1987-2010. METHODS: Using data from the Puerto Rico Central Cancer Registry, age-standardized incidence and mortality rates of pancreatic cancer in PR were compared with Hispanics, non-Hispanic Whites, and non-Hispanic Blacks in the United States of America (USA). Incidence and mortality trends of pancreatic cancer were estimated, and survival analyses were also performed. RESULTS: In 2005-2010, 5.8 per 100,000 persons were diagnosed with pancreatic cancer in PR and mortality rates were similar. Pancreatic cancer was more frequent in men (6.5 per 100,000 men) than women (5.2 per 100,000 women), and in persons older than 65 years (32.0 per 100,000 persons). Moreover, the median survival for the people diagnosed with pancreatic cancer in PR during 2006-2007 was 4 months and at the end of the third year after diagnosis, only 13% of the patients survived. Incidence trends of pancreatic cancer showed an increase for men (APC=13.0%, p<0.05) from 2006 to 2010, but not for women (APC=-0.4, p>0.05). However, mortality trends showed a slight decrease for men (APC=-1.0%, p<0.05), but not for women (APC=1.4, p>0.05) in the period of 1987 to 2010. Meanwhile, Puerto Ricans in comparison to other racial/ethnic groups living in the USA showed a lower risk for being diagnosed and of dying from pancreatic cancer. CONCLUSION: Our results highlight the need for additional research in pancreatic cancer, in order to have an impact in disease survival in PR.

15.
Clin Cancer Res ; 7(6): 1618-26, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11410498

ABSTRACT

PURPOSE: Transforming growth factor beta (TGF-beta) regulates cell growth and differentiation, in normal squamous epithelium, via specific TGF-beta receptors and intracellular signaling molecules (Smads). We have previously observed that TGF-beta type II receptor (TbetaR-II) expression decreases in squamous cell carcinomas as tumors become less differentiated and more biologically aggressive. However, a small fraction of tumors remain TbetaR-II positive. In this article, we examine the integrity of the other members of the TGF-beta-signaling machinery, the Smad proteins. EXPERIMENTAL DESIGN: Thirteen archived head and neck squamous cell carcinomas were selected from the files of the Pathology Department of the H. Lee Moffitt Cancer Center. Protein immunoexpression was quantitated by image analysis in the context of histopathological parameters. Mutation analysis of the MADR2/Smad2 gene was also performed. RESULTS: In both TbetaR-II-positive and TbetaR-II-negative tumors, expression of the non-TGF-beta-specific Smads (4, 6, and 7) was variable, whereas expression of the pathway-specific Smad2 was lost in 38% of the tumors. Expression of the activated, phosphorylated form of this molecule, Smad2-P, was lost in approximately 70% of the tumors. No abnormal mRNA expression and no mutations in the MADR2/Smad2 gene were observed. CONCLUSIONS: These results suggest that multiple defects in TGF-beta signaling, both at the receptor and postreceptor level, may play a role in the oncogenesis of head and neck squamous cell carcinoma.


Subject(s)
Carcinoma, Squamous Cell/metabolism , DNA-Binding Proteins/metabolism , Head and Neck Neoplasms/metabolism , Signal Transduction , Trans-Activators/metabolism , Transforming Growth Factor beta/metabolism , Aged , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Cell Differentiation , Cell Division , Cell Nucleus/metabolism , DNA Mutational Analysis , DNA-Binding Proteins/genetics , Enzyme Activation , Epithelium/metabolism , Female , Head and Neck Neoplasms/genetics , Head and Neck Neoplasms/pathology , Humans , Image Processing, Computer-Assisted , Immunohistochemistry , Male , Middle Aged , Mutation , Phosphorylation , Polymerase Chain Reaction , RNA, Messenger/metabolism , Receptors, Transforming Growth Factor beta/genetics , Receptors, Transforming Growth Factor beta/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Smad2 Protein , Smad6 Protein , Smad7 Protein , Trans-Activators/genetics
16.
J Neuroimmunol ; 37(1-2): 93-7, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1548378

ABSTRACT

Genetically epilepsy-prone (GEPR-9) rats exhibit decreased antibody plaque-forming cell responses following immunization. We examined the hypothesis that this immunosuppression was due to deficits in the number or proliferative responses of T-lymphocytes. Splenocyte responses to concanavalin A and pokeweed mitogen were significantly greater in GEPR-9 rats than controls. Flow cytometric analysis indicated that GEPR-9 rats possess an increase in T-cells associated with the T-helper phenotype. The increased proportion of T-helper cells in GEPR-9 rats may underlie their enhanced proliferative responses to T-cell mitogens. These results clearly indicate that the failure of the GEPR-9 rat to respond to a T-dependent antigen in vivo is not due to a lack of T-helper activity.


Subject(s)
Epilepsy/pathology , T-Lymphocytes/pathology , Animals , Cell Division/drug effects , Flow Cytometry , Leukocyte Count , Mitogens/pharmacology , Rats , Rats, Inbred Strains , Rats, Mutant Strains
17.
Behav Modif ; 23(3): 358-78, 1999 Jul.
Article in English | MEDLINE | ID: mdl-10467889

ABSTRACT

The validity of using rapidly alternating multiple schedules (RAMS) as a method for assessing and treating aggression and disruptive behavior was demonstrated by using the naturally occurring reinforces identified in the RAMS to develop treatments that were experimentally tested. The RAMS consists of a series of 2-minute components in which a naturally occurring consequence is applied contingent on the target's behavior, alternated with components in which the consequence is not applied, with no break between components. The aggressive and disruptive behaviors of four 2- to 11-year-old children were analyzed and treated in school and home settings. The RAMS analyses yielded clear results about the reinforcing function of naturally occurring consequences in all cases, and the treatments using the reinforcers identified in the RAMS were all effective. The possible uses of the RAMS as an efficient, ecologically and experimentally valid tool for clinical assessment are discussed.


Subject(s)
Aggression/psychology , Attention Deficit and Disruptive Behavior Disorders/therapy , Behavior Therapy , Reinforcement Schedule , Social Environment , Affective Symptoms/psychology , Affective Symptoms/therapy , Attention Deficit and Disruptive Behavior Disorders/psychology , Autistic Disorder/psychology , Autistic Disorder/therapy , Child , Child Day Care Centers , Child, Preschool , Education, Special , Female , Humans , Male , Outcome and Process Assessment, Health Care
18.
J Laryngol Otol ; 115(5): 388-92, 2001 May.
Article in English | MEDLINE | ID: mdl-11410131

ABSTRACT

The objective of this paper was to evaluate the potential utility of supracricoid partial laryngectomies (SCPLS) for non-squamous cell carcinoma of the larynx. To illustrate our management of such tumours we present a case series based on six patients. Local control was achieved in five patients, with the sixth being salvaged by total laryngectomy and post-operative radiation therapy. Three of the six patients died of distant metastases. We concluded that supracricoid partial laryngectomies should become part of the armamentarium of the otolaryngologist - head and neck surgeon for non-squamous cell carcinoma of the larynx.


Subject(s)
Adenocarcinoma/surgery , Laryngeal Neoplasms/surgery , Laryngectomy/methods , Adult , Aged , Fatal Outcome , Female , Humans , Male , Middle Aged , Retrospective Studies
19.
Rev. cir. (Impr.) ; 71(4): 307-317, ago. 2019. tab
Article in Spanish | LILACS | ID: biblio-1058277

ABSTRACT

INTRODUCCIÓN: Una de las vías de acceso a la cavidad abdominal es la laparotomía media, siendo uno de los riesgos más temidos las complicaciones postoperatorias, las cuales pueden disminuirse con difusión de una adecuada técnica quirúrgica. OBJETIVO: Generar un consenso de expertos con pasos clave para realizar una laparotomía media supra-infraumbilical, a través de la metodología Delphi. MATERIALES Y MÉTODO: Por medio de una revisión de la literatura se extrajo el detalle de 37 pasos considerados en el procedimiento, organizado en secciones de preparación, apertura y cierre, siendo evaluados por un grupo de cirujanos de 7 hospitales docentes de Chile, mediante una encuesta online. RESULTADOS: El consenso se alcanzó en dos rondas, con 28 de los 37 pasos extraídos de la literatura, considerados importantes o muy importantes para la enseñanza de la técnica. Discusión: De los 28 pasos identificados como importantes, existe un alto grado de acuerdo para la preparación y apertura de una laparotomía, a diferencia del cierre en el cual no se observa una preferencia clara entre el cierre en una o varias capas entre el peritoneo y la fascia, debiendo analizarse en cada caso específico. CONCLUSIÓN: La identificación de 28 pasos estandarizados constituye un aporte en los programas de formación de residentes y en el desarrollo de modelos de simulación adecuados para la replicación del procedimiento. El aprendizaje correcto de la técnica basado en evidencia es fundamental para disminuir el riesgo de complicaciones asociadas, especialmente en el postoperatorio.


INTRODUCTION: Traditionally, the main surgical technique to access the abdominal cavity has been midline incision laparotomy, being postoperative complications a main concern. Proper teaching-learning methods could help improving the success of this procedure. AIM: Establish an expert's consensus throughout the Delphi Methodology regarding the main steps that need to be considered in a midline laparotomy. MATERIALS AND METHOD: Literature review was conducted, 37 steps were identified and grouped in 3 sections; preparation of the skin, opening incision, and closure. These steps were evaluated online by surgeons of 7 teaching hospitals in Chile. RESULTS: Consensus was reached in two rounds, 28 of the 37 steps were identified as important or very important for the procedure. DISCUSSION: There is a high level of agreement in steps related to preparation of the skin and opening incision. However, there is not a consensus regarding closure of the peritoneum and fascia in one or more layers, being a case to case decision. CONCLUSIONS: Establishment of 28 standardized steps constitutes a contribution to resident teaching programs and the development of simulation materials as an active learning strategy. Satisfactory learning outcomes have a direct impact in the success of the procedure and a lower rate of complications.


Subject(s)
Humans , Delphi Technique , Consensus , Laparotomy/education , Laparotomy/methods , Surgical Procedures, Operative/education
20.
Arch Soc Esp Oftalmol ; 88(4): 130-3, 2013 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-23597641

ABSTRACT

OBJECTIVES: To evaluate the fluctuations in 24h mean intraocular pressure (IOP) when switching prostaglandin analogues in patients with glaucoma. METHODS: Fourteen patients with primary open angle glaucoma were evaluated with monthly 24-hour IOP curves, using a monthly switching pattern of prostaglandin analogues and brinzolamide during 3 years of follow-up. RESULTS: Average IOP and average fluctuation (peak to through difference) were significantly higher with brinzolamide than with any of the analogues. There was no significant difference in either parameter with the different prostaglandin analogues, regardless of the order in which they were evaluated, or even if a month on brinzolamide was intercalated between the analogues. CONCLUSIONS: Brinzolamide was less effective than prostaglandin analogues in reducing 24-hour mean IOP and its fluctuations. Switching analogues had no significant effect on mean IOP or mean IOP fluctuations.


Subject(s)
Intraocular Pressure/drug effects , Prostaglandins, Synthetic/pharmacology , Sulfonamides/pharmacology , Thiazines/pharmacology , Female , Glaucoma, Open-Angle/drug therapy , Glaucoma, Open-Angle/physiopathology , Humans , Male , Middle Aged , Monitoring, Physiologic , Prostaglandins, Synthetic/therapeutic use , Sulfonamides/therapeutic use , Thiazines/therapeutic use , Time Factors
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