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Long non-coding RNAs (lncRNAs) are nucleotide sequences that participate in different biological processes and are associated with different pathologies, including cancer. Long intergenic non-protein-coding RNA 662 (LINC00662) has been reported to be involved in different cancers, including colorectal, prostate, and breast cancer. However, its role in gallbladder cancer has not yet been described. In this article, we hypothesize that LINC00662 has an important role in the acquisition of aggressiveness traits such as a stem-like phenotype, invasion, and chemoresistance in gallbladder cancer. Here, we show that LINC00662 is associated with larger tumor size and lymph node metastasis in patients with gallbladder cancer. Furthermore, we show that the overexpression of LINC00662 promotes an increase in CD133+/CD44+ cell populations and the expression of stemness-associated genes. LINC00662 promotes greater invasive capacity and the expression of genes associated with epithelial-mesenchymal transition. In addition, the expression of LINC00662 promotes resistance to cisplatin and 5-fluorouracil, associated with increased expression of chemoresistance-related ATP-binding cassette (ABC) transporters in gallbladder cancer (GBC) cell lines. Finally, we show that the mechanism by which LINC00662 exerts its function is through a decrease in microRNA 335-5p (miR-335-5p) and an increase in octamer-binding transcription factor 4 (OCT4) in GBC cells. Thus, our data allow us to propose LINC00662 as a biomarker of poor prognosis and a potential therapeutic target for patients with GBC.
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Neoplasias de la Vesícula Biliar , Regulación Neoplásica de la Expresión Génica , MicroARNs , Factor 3 de Transcripción de Unión a Octámeros , ARN Largo no Codificante , Humanos , Neoplasias de la Vesícula Biliar/genética , Neoplasias de la Vesícula Biliar/patología , Neoplasias de la Vesícula Biliar/metabolismo , MicroARNs/genética , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Línea Celular Tumoral , Factor 3 de Transcripción de Unión a Octámeros/genética , Factor 3 de Transcripción de Unión a Octámeros/metabolismo , Femenino , Transición Epitelial-Mesenquimal/genética , Resistencia a Antineoplásicos/genética , Masculino , Invasividad Neoplásica , Cisplatino/farmacología , Persona de Mediana Edad , Células Madre Neoplásicas/metabolismo , Células Madre Neoplásicas/patología , Fluorouracilo/farmacología , Metástasis LinfáticaRESUMEN
BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are relatively rare but rank as the second most common pancreatic neoplasm. They can be functional, causing early metabolic disturbances due to hormone secretion, or non-functional and diagnosed later based on tumor size-related symptoms. Recent diagnoses of PNETs under 2 cm in size have sparked debates about their management; some practitioners advocate for surgical removal and others suggest observation due to the tumors' lower potential for malignancy. However, it is unclear whether managing these small tumors expectantly is truly safe. AIM: To evaluate poor prognostic factors in PNETs based on tumor size (> 2 cm or < 2 cm) in surgically treated patients. METHODS: This cohort study included 64 patients with PNETs who underwent surgical resection between 2006 and 2019 at a high-complexity reference hospital in Medellín, Colombia. To assess patient survival, quarterly follow-ups were conducted during the first year after surgery, followed by semi-annual consultations at the hospital's hepatobiliary surgery department. Qualitative variables were described using absolute and relative frequencies, and quantitative variables were expressed using measures of central tendency and their corresponding measures of dispersion. RESULTS: The presence of lymph node involvement, neural involvement, and lymphovascular invasion were all associated with an increased risk of mortality, with hazard ratios of 5.68 (95%CI: 1.26-25.61, P = 0.024), 6.44 (95%CI: 1.43-28.93, P = 0.015), and 24.87 (95%CI: 2.98-207.19, P = 0.003), respectively. Neural involvement and lymphovascular invasion were present in tumors smaller than 2 cm in diameter and those larger than 2 cm in diameter. The recurrence rates between the two tumor groups were furthermore similar: 18.2% for tumors smaller than 2 cm and 21.4% for tumors larger than 2 cm. Patient survival was additionally comparable between the two tumor groups. CONCLUSION: Tumor size does not dictate prognosis; lymph node and lymphovascular involvement affect mortality, which highlights that histopathological factors-rather than tumor size-may play a role in management.
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In December 2022 the US Food and Drug Administration (FDA) removed the requirement that drugs in development must undergo animal testing before clinical evaluation, a declaration that now demands the establishment and verification of ex vivo preclinical models that closely represent tumor complexity and that can predict therapeutic response. Fortunately, the emergence of patient-derived organoid (PDOs) culture has enabled the ex vivo mimicking of the pathophysiology of human tumors with the reassembly of tissue-specific features. These features include histopathological variability, molecular expression profiles, genetic and cellular heterogeneity of parental tissue, and furthermore growing evidence suggests the ability to predict patient therapeutic response. Concentrating on the highly lethal and heterogeneous gastrointestinal (GI) tumors, herein we present the state-of-the-art and the current methodology of PDOs. We highlight the potential additions, improvements and testing required to allow the ex vivo of study the tumor microenvironment, as well as offering commentary on the predictive value of clinical response to treatments such as chemotherapy and immunotherapy.
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Neoplasias Gastrointestinales , Estados Unidos , Animales , Humanos , Neoplasias Gastrointestinales/tratamiento farmacológico , Neoplasias Gastrointestinales/metabolismo , Organoides/metabolismo , Organoides/patología , Microambiente TumoralRESUMEN
This paper investigates the hemp limecrete mechanical and microstructural performance of a new sustainable and environmental friendly building material. Several studies have investigated the hemp limecrete focusing on the non-structural applications. The newly developed hemp limecrete consists of high mechanical and microstructural properties. The specimens were prepared with varying lengths and proportions of hemp fibers with lime and tested for compressive strength, flexural strength, thermal conductivity and microstructural analysis like SEM and EDS. The study found that the optimal fiber content for making mortars was between 2 and 4%. This conclusion was reached after analyzing the influence of fiber length and ratio on the properties of the mortars. The dry unit weight decreased when the fiber content was higher than 4%. In terms of strength, the study found that the flexural strength of the hemp limecrete improved with an increase in fiber ratio, but the compressive strength decreased. However, with 2% hemp fiber, compressive strengths of 3.48 MPa and above were obtained. The study also highlighted the good thermal insulation properties and dimensional stability of hemp limecrete. These findings have important implications for the use of hemp limecrete as a sustainable building material. The results suggest that hemp limecrete has the potential to be a viable alternative to conventional concrete in specific applications, particularly in areas where environmental sustainability is a priority.
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MicroRNAs (miRNAs) constitute a subclass of non-coding RNAs that exert substantial influence on gene-expression regulation. Their tightly controlled expression plays a pivotal role in various cellular processes, while their dysregulation has been implicated in numerous pathological conditions, including cancer. Among cancers affecting women, breast cancer (BC) is the most prevalent malignant tumor. Extensive investigations have demonstrated distinct expression patterns of miRNAs in normal and malignant breast cells. Consequently, these findings have prompted research efforts towards leveraging miRNAs as diagnostic tools and the development of therapeutic strategies. The aim of this review is to describe the role of miRNAs in BC. We discuss the identification of oncogenic, tumor suppressor and metastatic miRNAs among BC cells, and their impact on tumor progression. We describe the potential of miRNAs as diagnostic and prognostic biomarkers for BC, as well as their role as promising therapeutic targets. Finally, we evaluate the current use of artificial intelligence tools for miRNA analysis and the challenges faced by these new biomedical approaches in its clinical application. The insights presented in this review underscore the promising prospects of utilizing miRNAs as innovative diagnostic, prognostic, and therapeutic tools for the management of BC.
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Background: Fexofenadine emerged as one of the most representative second generation histamine H1 antagonist drugs since the 1990s, with an outstanding efficacy and appreciable safety for the treatment of allergic patients. While allergic rhino-conjunctivitis represents the most frequent atopic disease globally, an update of fexofenadine efficacy and safety on this entity was proposed as a surrogate of allergic condition. Methods: Double blind, placebo controlled, randomized clinical trials investigating the efficacy and safety of fexofenadine for the treatment of Allergic Rhinitis were searched in 5 major global databases. Eligibility criteria and characteristics, risk of bias, and validity assessment, data extraction and heterogeneity evaluation are described. Primary outcome selected corresponded to 12-reflective and instantaneous total symptom scores (TSS), besides morning instantaneous TSS and the frequency of reported adverse events (AEs); analysis was planned on the intention-to-treat population.Standardized mean differences of scoring systems were analyzed, and Cochran's Q statistic test and the I2 test were assessed for heterogeneity. Results: From the initial 83 identified records, 12 eligible studies were selected. In the evaluated patients, individuals receiving fexofenadine (1910) showed a significant reduction of TSS compared with those who received placebo (1777), change from baseline: standardized mean difference (SMD) -0.33; 95% CI-0.47 to -0.18, p < 0.0001. Morning instantaneous TSS also demonstrated lower symptoms (change from baseline: SMS -1.42; 95% CI -2.22 to -0.62, p = 0.0005). Heterogeneity was found across selected studies.Frequency of AEs was similar compared to placebo (OR = 1.04; 0.88-1.21), with no detection of heterogeneity across these 12 studies. Conclusions: According to this new evidence, fexofenadine maintains its beneficial profile on signs and symptoms of patients with allergic conditions, as well as its attributes as one of the major candidates for an ideal antihistamine medication (including special conditions such as pregnancy and pre-school age), providing support to its over-the-counter condition in several countries.
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Absceso Abdominal , Cavidad Abdominal , Apendicitis , Peritonitis , Humanos , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control , Apendicitis/complicaciones , Apendicitis/tratamiento farmacológico , Apendicitis/cirugía , Antibacterianos/uso terapéutico , Peritonitis/cirugía , Peritonitis/complicaciones , Apendicectomía/efectos adversosRESUMEN
Gastric cancer (GC) represents ~10% of the global cancer-related deaths, increasingly affecting the younger population in active stages of life. The high mortality of GC is due to late diagnosis, the presence of metastasis and drug resistance development. Additionally, current clinical markers do not guide the patient management adequately, thereby new and more reliable biomarkers and therapeutic targets are still needed for this disease. RNA-seq technology has allowed the discovery of new types of RNA transcripts including long non-coding RNAs (lncRNAs), which are able to regulate the gene/protein expression of many signaling pathways (e.g., the PI3K/AKT/mTOR pathway) in cancer cells by diverse molecular mechanisms. In addition, these lncRNAs might also be proposed as promising diagnostic or prognostic biomarkers or as potential therapeutic targets in GC. This review describes important topics about some lncRNAs that have been described as regulators of the PI3K/AKT/mTOR signaling pathway, and hence, their potential oncogenic role in the development of this malignancy.
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Carcinoma , ARN Largo no Codificante , Neoplasias Gástricas , Humanos , Proteínas Proto-Oncogénicas c-akt/metabolismo , Neoplasias Gástricas/patología , Fosfatidilinositol 3-Quinasas/metabolismo , ARN Largo no Codificante/metabolismo , Serina-Treonina Quinasas TOR/genética , Serina-Treonina Quinasas TOR/metabolismo , BiomarcadoresRESUMEN
Introducción. La estenosis colorrectal benigna hace referencia a una condición anatómica caracterizada por una disminución del diámetro de la luz intestinal distal a la válvula ileocecal, ocasionando una serie de signos y síntomas de tipo obstructivo. Es una entidad poco frecuente, secundaria en la gran mayoría de veces a la realización de anastomosis intestinales al nivel descrito. El objetivo de esta investigación fue determinar la utilidad del stentcolónico en estenosis secundaria a patología colorrectal no neoplásica. Métodos. Estudio descriptivo de una cohorte de pacientes que desarrolló estenosis colorrectal de origen benigna confirmada por colonoscopía, en 3 hospitales de alta complejidad de la ciudad de Medellín, Colombia, entre los años 2007 y 2021. Resultados. Se incluyeron 34 pacientes con diagnóstico de estenosis colorrectal de origen benigno, manejados con stents metálicos autoexpandibles. La mediana de seguimiento fue de 19 meses y se obtuvo éxito clínico en el 73,5 % de los casos. La tasa de complicación fue del 41,2 %, dada principalmente por reobstrucción y migración del stent, y en menor medida por perforación secundaria a la colocación del dispositivo. Conclusión. Los stents metálicos autoexpandibles representan una opción terapéutica en pacientes con obstrucción colorrectal, con altas tasas de mejoría clínica en pacientes con patología estenosante no maligna. Cuando la derivación por medio de estoma no es una opción, este tipo de dispositivos están asociados a altas tasas de éxito clínico y mejoría de la calidad de vida de los pacientes
Introduction. Benign colorectal stenosis refers to an anatomical condition characterized by a decrease in the diameter of the intestinal lumen distal to the ileocecal valve, which might cause a series of obstructive signs and symptoms. It is a rare entity, caused in the vast majority of cases due to intestinal anastomosis at the described level. The purpose of this study is to determine the performance of colonic stents in the management of non-malignant colorectal strictures. Methods. Descriptive study of a cohort of patients who developed a benign colorectal stenosis confirmed by colonoscopy in three high-complexity hospitals in the city of Medellín, Colombia, between 2007 and 2021. Results. Thirty-four patients diagnosed with benign colorectal stenosis managed with self-expanding metal stents were included in the study. Median follow-up was 19 months, obtaining clinical success in 73.5% of cases, with a complication rate of 41.2%, mainly due to reobstruction and migration of the stent, and to a lesser extent due to perforation secondary to device placement.Conclusion. Self-expanding metallic stents represent a therapeutic option in patients with colorectal obstruction caused by non-malignant stenosing pathology. When diversion through a stoma is not an option, this type of device is associated with high rates of clinical success and improvement in the patients' quality of life
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Humanos , Enfermedades del Recto , Anastomosis Quirúrgica , Stents Metálicos Autoexpandibles , Recto , Colon , Constricción PatológicaRESUMEN
Objective: This study aimed to relate life satisfaction and psychological distress to coping with the perception of criminal danger in university students. Method: Three scales were used: The Life Satisfaction Scale, the K-10 Psychological Distress Scale, and the Coping with Perceived Danger Scale. A total of 370 university students participated, of whom 65.4% were female, and 13.8% had experienced crime in the previous two years. Result: A positive and statistically significant relationship was found between coping with perceived danger, such as cautious avoidance (r=0.274, p ≤ 0.00), preventive coping (r=0.344, p ≤ 0.00), and extreme avoidance (r=0.207, p ≤ 0.00), with psychological distress. These relationships were even stronger for victims of crime. Women show higher levels of psychological distress and more cautious, avoidant and extreme coping strategies in the face of danger compared to men. Finally, a negative and significant relationship was observed between psychological distress and life satisfaction. Conclusion: It appears that regardless of whether a person has been a victim of crime in the last two years, perceptions of danger and strategies of cautious and even extreme crime prevention are related.
Objetivo: El objetivo de este estudio fue relacionar la satisfacción con la vida y el malestar psicológico con el afrontamiento frente a la percepción de peligro delictual en universitarios. Método: Se utilizaron tres escalas, la escala de satisfacción con la vida, la escala de malestar psicológico k-10, y la escala de afrontamiento frente a la percepción de peligro. Participaron 370 estudiantes universitarios, de los cuales un 65,4% son mujeres y un 13,8% han sufrido un delito en los últimos 2 años. Resultados: Se encontró una relación positiva, con un tamaño del efecto pequeño entre el afrontamiento frente la percepción de peligro, como evitación prudente (r=0,274, (p ≤ 0,00), afrontamiento preventivo (r=0,344, p ≤ 0,00) y evitación extrema (r=0,207, p ≤ 0,00) con malestar psicológico. En víctimas de delitos, estas relaciones se hacen más fuertes. Las mujeres muestran un mayor malestar psicológico, así como también estrategias de afrontamiento frente al peligro más prudentes, preventivas y extremas que los hombres. Por último, se observa una relación negativa y significativa entre malestar psicológico y satisfacción con la vida. Conclusión: Se videncia que independiente de que, si la persona es víctima de un delito en los últimos dos años, la percepción de peligro y las estrategias llevadas a cabo para prevenir el delito de forma prudente e incluso extrema, se relacionan entre sí.
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The close relationship between the microbiota and allergic diseases has been known for several years, particularly food allergy. Although the best studied microbiota is that related to bacteria, viruses, parasites and fungi are also constituents of this, although their role is not definitively clarified. The microbial world interacts with the human body constantly, we are in daily contact with an infinite and innumerable number of varieties of microbes in our environment, some of them can pass through the body without causing any harm, while others generate undesirable risk for the body. health. Alteration of the original composition of the microbiota (dysbiosis) is associated with food allergy. This dysbiosis is related to changes in habits, method of termination of pregnancy (birth or cesarean section), replacement of breastfeeding or interruption at an early age; decrease in family size; loss of contact with farm animals or pets; inappropriate prescription or abuse of antibiotics. The transition from a diet based exclusively on milk to one with solid foods is associated with a drastic increase in microbial diversity. Immunomodulatory components of the microbiota (cell surface polysaccharides), dietary factors (vitamin A), and production of secondary metabolites (short-chain fatty acids and secondary bile acid metabolites) promote differentiation of the RORγt+ cell population Treg. ILC3 produces IL-2, which plays a decisive role in maintaining intestinal homeostasis.
La estrecha relación entre la microbiota y las enfermedades alérgicas es conocida desde hace varios años, particularmente la alergia alimentaria. Aunque la microbiota mejor estudiada es la relacionada con las bacterias, también son constitutivas de esta los virus, parásitos y hongos, aun con un rol no definitivamente esclarecido. El mundo microbiano interactúa con el cuerpo humano constantemente, estamos en contacto diario con una cantidad infinita e innumerable de variedades de microbios en nuestro entorno, algunos de ellos pueden pasar a través del cuerpo sin causar ningún daño, mientras que otros generan riesgo indeseable para la salud. La alteración de la composición original de la microbiota (disbiosis) se asocia con alergia alimentaria. Esta disbiosis se relaciona con los cambios de hábito, vía de finalización del embarazo (parto o cesárea), sustitución de la lactancia o interrupción en edades tempranas; disminución del tamaño de las familias; pérdida de contacto con animales de granja o mascotas; prescripción inadecuada o abuso de antibióticos. La transición de una dieta basada exclusivamente en leche a otra con alimentos sólidos se asocia con aumento drástico en la diversidad microbiana. Los componentes inmunomoduladores de la microbiota (polisacáridos de la superficie celular), los factores dietéticos (vitamina A) y la producción de metabolitos secundarios (ácidos grasos de cadena corta y metabolitos secundarios de ácidos biliares) promueven la diferenciación de la población de células RORγt + Treg. La ILC3 produce IL-2, que desempeña un papel decisivo en el mantenimiento de la homeostasis intestinal.
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Hipersensibilidad a los Alimentos , Probióticos , Simbióticos , Femenino , Embarazo , Animales , Humanos , Prebióticos , Cesárea , Disbiosis , Probióticos/uso terapéuticoRESUMEN
El asma es una enfermedad crónica de la vía aérea prevalente en nuestro país, con frecuente mal control. Algunos especialistas de la Asociación de Alergia e Inmunología Clínica y la Asociación Argentina de Medicina Respiratoria han realizado recomendaciones sobre el manejo y tratamiento del asma mediante la metodología de consenso RAND/UCLA Delphi modificada sobre la base de la evidencia científica (GRADE). Este documento provee recomendaciones basadas en la opinión de especialistas y fundamentada en evidencia científica seleccionada en cuanto a la importancia de mejorar la adherencia al tratamiento y seguimiento a través de diferentes estrategias. Así mismo, provee recomendaciones actualizadas en aspectos críticos del tratamiento del asma leve al grave. Se recomienda, para mejorar la adherencia, el uso de planes personalizados de manejo (1 °C), uso de herramientas a través de teléfonos móviles (1B) y educación (1 °C). Con respecto a la inmunoterapia sublingual solo debe ser indicada a pacientes con asociación con rinitis alérgica, asociada a ácaros y síntomas de asma a pesar del tratamiento adecuado con FEV1 > 70 % (1B). Se recomienda fuertemente en el asma leve (escalón 2 GINA) el uso de broncodilatadores de acción rápida asociados a corticoides inhalados a demanda (1A). En asma grave, se recomienda el uso de la triple terapia inhalada con anticolinérgicos de acción prolongada, beta 2 de acción prolongada y corticoides inhaladas (1B). El uso de biológicos en asma grave está fuertemente indicado en fenotipo T2 con dupilumab (1A), T2 alérgico con omalizumab (1A) y en el T2 eosinofílico con benralizumab, o mepolizumab, con sus características distintivas (1A).
Asthma is a common chronic airway disease in our country, although with high poor control. Some specialists of the Asociación de Alergia e Inmunología Clínica and Asociación Argentina de Medicina Respiratoria have made recommendations for management and treatment of asthma, using a RAND/UCLA modified Delphi consensus methodology, based on GRADE evidence. This document provides recommendations based on specialist opinions about different strategies to improve adherence. Besides, it provides recommendations about critical issues of mild to severe asthma treatment. It´s recommended to improve adherence, personalized control-based management plan (1 °C), mobile devices (1B) and education (1 °C). Sublingual immunotherapy must be prescribed only in patients with allergic rhinitis, mite associated, and persistent symptoms although appropriate treatment with FEV1 > 70 % (1B). Use of fast action bronchodilators associated with inhaled corticosteroids prn in mild asthma (GINA stage 2) has strong recommendation (1A). Use of triple inhaled therapy (long acting anticholinergics, long acting beta 2 agonists and inhaled corticosteroids) is recommended in severe asthma (1B). Biologics has strong recommendations severe asthma: in phenotype T2 with dupilumab (1A), in phenotype allergic T2 with omalizumab (1A) and phenotype eosinophilic T2 with benralizumab or mepolizumab with distinctive characteristic (1A).
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Introducción: Las lesiones raquídeas son frecuentes en hombres adultos jóvenes. Reconocer la cinemática ayuda a disminuir la tasa de diagnósticos tardíos, principalmente si hay trastornos de la conciencia. Las fracturas vertebrales pueden ser únicas o múltiples, y asociarse con lesiones extravertebrales. Los objetivos de este estudio fueron analizar la distribución de la lesión según el mecanismo de producción, caracterizar el cuadro neurológico, evaluar el patrón de lesión y la asociación con lesiones extra-vertebrales, y analizar el tratamiento. materiales y métodos: Estudio multicéntrico, prospectivo de pacientes con lesiones vertebrales postrauma, que ingresaron entre el 1 de julio de 2018 y el 30 de junio de 2020. Se analizaron los siguientes parámetros: edad, sexo, cinemática, cuadro neurológico, sector afectado, patrón de lesión, lesiones extravertebrales asociadas. Resultados: Se evaluó a 281 pacientes (60% hombres) con 400 lesiones vertebrales y 118 extravertebrales que, en 62 casos, conformaban un cuadro de politraumatismo; 147 con trauma por caída de altura y 98, por accidente de tránsito. El cuadro neurológico más observado fue ASIA E (8 casos), no determinado al ingreso. El sector T2-L5 fue el más afectado, en su mayoría, por lesiones por compresión. Las lesiones extravertebrales más frecuentes fueron el trauma de cráneo y de tórax; hubo un caso de SCIWORA y un óbito temprano. Conclusiones: Los sectores raquídeos más afectados fueron: el toracolumbar, el torácico y el lumbar; las lesiones suelen deberse a caídas de altura y suelen ser únicas, sin cuadro neurológico. El tratamiento se decide según la estabilidad y el cuadro neurológico. Nivel de Evidencia: IV
Introduction: Spinal injuries are common among young adult men. Recognizing kinematics can help reduce the number of late diagnoses, especially if there are consciousness disorders. Vertebral fractures can be single or multiple, and they are often associated with extravertebral injuries. Objectives: To examine the distribution of the lesion based on the mechanism of production, to characterize the neurological condition, to evaluate the lesion pattern and its relationship with extravertebral lesions, and to analyze the treatment. materials and methods:This was a multicenter, prospective study of patients admitted with post-trauma vertebral injuries between July 1, 2018 and June 30, 2020. Age, gender, kinematics, neurological condition, affected sector, pattern of injury, and associated extravertebral injuries were all examined. Results: There were 281 patients (60% men) evaluated, with 400 vertebral and 118 extravertebral lesions. The causes were as follows: polytrauma in 62 cases, falls from great heights in 147 patients, and traffic accidents in 98. ASIA E was the most frequently observed neurological picture (8 cases), which was not determined at admission. The T2-L5 sector was the most affected, mostly by compression injuries. Head and chest trauma were the most common extravertebral injuries; there was one case of SCIWORA and one early death. Conclusions: The most commonly affected spinal sectors were thoracolumbar, thoracic, and lumbar; the injuries are typically caused by falls from great heights and, in general, are isolated, with no neurological injuries. The treatment is determined by the stability and neurological condition. Level of Evidence: IV
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Adulto , Traumatismos Vertebrales , Vértebras Torácicas , Fracturas de la Columna Vertebral , Vértebras LumbaresRESUMEN
BACKGROUND: Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin condition that is associated with detrimental effects on the lives of patients and their families, including an impact on quality of life (QOL). Studies about QOL on Latin American AD patients are scarce and have generally included few patients. OBJECTIVE: describing AD impact on the QOL in a large cohort in Argentina. METHODS: a structured web-based survey including 1,650 AD pediatric and adult patients was performed. RESULTS: according to retrieved data, AD symptoms onset started during childhood in most patients, but 20 % of participants reported that manifestations of AD were initially perceived during late adolescence and adulthood. Important differences were observed among country regions, with a shorter time-to-diagnosis in most populated and richer districts. Main affected domains included frustration, anger, mood alterations, stress, sleep alterations, routine alterations, pain and economic impact of AD. LIMITATIONS: biases inherent to survey design. CONCLUSIONS: we consider that our study contributes to a better understanding of AD in Argentina, as well as its physical, social and financial impact on affected patients.
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Dermatitis Atópica , Calidad de Vida , Adulto , Adolescente , Humanos , Niño , Argentina/epidemiología , Índice de Severidad de la Enfermedad , InternetRESUMEN
Variants in genes encoding for microRNAs have been associated with their deregulation in breast cancer (BC). Sequencing of microRNAs deregulated in BC was performed using DNA from Chilean patients with a strong family history and negative for mutations in BRCA1/BRCA2. Seventeen variants were identified, three of which were selected for a case-control association study: rs376491654 (miR-335), rs755634302 (miR-497), and rs190708267 (miR-155). For rs190708267 C>T, the heterozygous T allele was detected in four BC cases and absent in controls, while homozygous TT cases were not detected. Variants were modelled in silico, cloned in a plasmid, expressed in BC cell lines, and functional in vitro assays were performed. Overexpression of the miR-155-T allele increased mature miR-155-5p levels in both BC cell lines, suggesting that its presence alters pre-miR-155 processing. Moreover, BC cells overexpressing the miR-155-T allele showed increased proliferation, migration, and resistance to cisplatin-induced death compared to miR-155-C overexpressing cells. Of note, the 3'UTR of APC, GSK3ß, and PPP1CA genes, all into the canonical Wnt signaling pathway, were identified as direct targets. APC and GSK3ß mRNA levels decreased while PP1 levels increased. These results suggest a pathogenic role of the variant rs190708267 (miR-155) in BRCA 1/2 negative BC, conferring susceptibility and promoting traits of aggressiveness.
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Neoplasias de la Mama , MicroARNs , Femenino , Humanos , Regiones no Traducidas 3' , Neoplasias de la Mama/metabolismo , Línea Celular Tumoral , Proliferación Celular/genética , Regulación Neoplásica de la Expresión Génica , MicroARNs/genética , MicroARNs/metabolismo , MutaciónRESUMEN
Introducción. En la actualidad, el trauma de recto continúa siendo una situación clínica compleja y temida por ser potencialmente mortal. Su detección y manejo temprano es la piedra angular para impactar tanto en la mortalidad como en la morbilidad de los pacientes. Hoy en día, aún existe debate sobre la aproximación quirúrgica ideal en el trauma de recto y las decisiones de manejo intraoperatorias se ven enormemente afectadas por la experiencia y preferencias del cirujano. Métodos. Se realizó una búsqueda de la literatura en las bases de datos de PubMed, Clinical Key, Google Scholar y SciELO utilizando las palabras claves descritas y se seleccionaron los artículos más relevantes publicados en los últimos 20 años; se tuvieron en cuenta los artículos escritos en inglés y español. Discusión. El recto es el órgano menos frecuentemente lesionado en trauma, sin embargo, las implicaciones clínicas que conlleva pasar por alto este tipo de lesiones pueden ser devastadoras para el paciente. Las opciones para el diagnóstico incluyen el tacto rectal, la tomografía computarizada y la rectosigmoidoscopía. El manejo quirúrgico va a depender de la localización, el grado de la lesión y las lesiones asociadas. Conclusión. El conocimiento de la anatomía, el mecanismo de trauma y las lesiones asociadas permitirán al cirujano realizar una aproximación clínico-quirúrgica adecuada que lleve a desenlaces clínicos óptimos de los pacientes que se presentan con trauma de recto.
Introduction. Currently, rectal trauma continues to be a complex clinical and potentially fatal situation. Its early detection and management is the cornerstone to avoid both mortality and morbidity of patients. Today there is still debate about the ideal surgical approach in rectal trauma, and intraoperative management decisions are greatly affected by the experience and preferences of the surgeon. Methods. A literature search was performed in the PubMed, Clinical Key, Google Scholar and SciELO databases using the keywords described. The most relevant articles published in the last 20 years were selected. Articles written in English and Spanish were considered.Discussion. The rectum is the organ less frequently injured in trauma; however, the clinical implications of overlooking this injury can be devastating for the patient. Options for diagnosis include digital rectal examination, computed tomography and rectosigmoidoscopy. Surgical management will depend on the location, degree of the injury and the associated injuries. Conclusion. Knowledge of the anatomy, the mechanism of trauma and the associated injuries will allow the surgeon to make an adequate clinical-surgical approach that leads to optimal clinical outcomes in patients presenting with rectal trauma.
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Humanos , Recto , Traumatismo Múltiple , Sigmoidoscopía , Heridas y Lesiones , Tomografía Computarizada por Rayos X , Cirugía Colorrectal , DiagnósticoRESUMEN
Introducción. La colelitiasis tiene una prevalencia del 15 % y el 21 % tendrá coledocolitiasis al momento de la colecistectomía, con 50 % de probabilidad de presentar complicaciones asociadas. Desde el advenimiento de la colecistectomía laparoscópica, el abordaje de la coledocolitiasis ha sido endoscópico, usualmente en un tiempo diferente al vesicular, sin embargo, los avances en laparoscopia han permitido explorar la vía biliar común por la misma vía, pudiendo realizar ambos procedimientos en el mismo tiempo de forma segura. Métodos. Se realizó una búsqueda de la literatura existente con relación al enfoque para el manejo de la colecisto-coledocolitasis en un paso comparado con dos pasos. Resultados. Existe evidencia que demuestra mayor efectividad del abordaje en dos pasos, con CPRE y posterior colecistectomía laparoscópica, sobre el abordaje en un paso, especialmente en la tasa de fuga biliar y de cálculos retenidos. El enfoque en un paso con exploración de vías biliares y colecistectomía laparoscópica en el mismo tiempo es seguro, con alta tasa de éxito, baja incidencia de complicaciones, menor estancia hospitalaria y costos. Conclusión. El abordaje laparoscópico en un solo paso es un procedimiento seguro y eficaz para el manejo de la colecisto-coledocolitiasis, con el beneficio de estancia hospitalaria menor, sin embargo, se requieren habilidades técnicas avanzadas en cirugía laparoscópica. En nuestro medio ya existe una infraestructura para el manejo híbrido con CPRE y colecistectomía laparoscópica, pudiéndose realizar ambos en el mismo tiempo, para reducir estancia y costos.
Introduction. Cholelithiasis has a prevalence of 15%, and 21% will have choledocholithiasis at the time of cholecystectomy, with a 50% probability of presenting associated complications. Since the advent of laparoscopic cholecystectomy, the approach to choledocholithiasis has been endoscopic, normative at a different time than the gallbladder; however, advances in laparoscopy have made it possible to explore the common bile duct by the same route, being able to perform both procedures in a single time safely. Methods. A search of the existing literature was performed regarding the one-step approach compared to the two-step approach for the management of cholelithiasis and choledocholithiasis. Results. There is evidence that demonstrates greater effectiveness of the two-step approach with ERCP and subsequent laparoscopic cholecystectomy over the one-step approach, especially in the rate of bile leak and the incidence of retained stones. The one-step approach with bile duct exploration and laparoscopic cholecystectomy at the same time is safe, with a high success rate, low incidence of complications, shorter hospital stay, and lower costs. Conclusion. The one-step laparoscopic approach is a safe and effective procedure for the management cholelithiasis and concomitant choledocholithiasis, with the benefit of a shorter hospital stay; however, advanced technical skills in laparoscopic surgery are required. In our environment there is already an infrastructure for hybrid management with ERCP and laparoscopic cholecystectomy, both of which can be performed at the same time to reduce hospital stay and costs.
Asunto(s)
Humanos , Conductos Biliares , Colelitiasis , Coledocolitiasis , Colecistectomía , Colangiopancreatografia Retrógrada Endoscópica , LaparoscopíaRESUMEN
Gallbladder cancer (GBC) is an aggressive neoplasm that in an early stage is generally asymptomatic and, in most cases, is diagnosed in advanced stages with a very low life expectancy because there is no curative treatment. Therefore, understanding the early carcinogenic mechanisms of this pathology is crucial to proposing preventive strategies for this cancer. The main risk factor is the presence of gallstones, which are associated with some environmental factors such as a sedentary lifestyle and a high-fat diet. Other risk factors such as autoimmune disorders and bacterial, parasitic and fungal infections have also been described. All these factors can generate a long-term inflammatory state characterized by the persistent activation of the immune system, the frequent release of pro-inflammatory cytokines, and the constant production of reactive oxygen species that result in a chronic damage/repair cycle, subsequently inducing the loss of the normal architecture of the gallbladder mucosa that leads to the development of GBC. This review addresses how the different risk factors could promote a chronic inflammatory state essential to the development of gallbladder carcinogenesis, which will make it possible to define some strategies such as anti-inflammatory drugs or public health proposals in the prevention of GBC.
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Introducción. La presencia de neumomediastino secundario a un trauma contuso es un hallazgo común, especialmente con el uso rutinario de la tomografía computarizada. Aunque en la mayoría de los casos es secundario a una causa benigna, la posibilidad de una lesión aerodigestiva subyacente ha llevado a que se recomiende el uso rutinario de estudios endoscópicos para descartarla. El propósito de este estudio fue determinar la incidencia de neumomediastino secundario a trauma contuso y de lesiones aerodigestivas asociadas y establecer la utilidad de la tomografía computarizada multidetector en el diagnóstico de las lesiones aerodigestivas. Métodos. Mediante tomografía computarizada multidetector se identificaron los pacientes con diagnóstico de neumomediastino secundario a un trauma contuso en un periodo de 4 años en un Centro de Trauma Nivel I. Resultados. Fueron incluidos en el estudio 41 pacientes con diagnóstico de neumomediastino secundario a un trauma contuso. Se documentaron en total tres lesiones aerodigestivas, dos lesiones traqueales y una esofágica. Dos de estas fueron sospechadas en tomografía computarizada multidetector y confirmadas mediante fibrobroncoscopia y endoscopia digestiva superior, respectivamente, y otra fue diagnosticada en cirugía. Conclusión. El uso rutinario de estudios endoscópicos en los pacientes con neumomediastino secundario a trauma contuso no está indicado cuando los hallazgos clínicos y tomográficos son poco sugestivos de lesión aerodigestiva.
Introduction.The presence of pneumomediastinum secondary to blunt trauma is a common finding, especially with the use of computed tomography. Although in most cases the presence of pneumomediastinum is secondary to a benign etiology, the possibility of an underlying aerodigestive injuries has led to the recommendation of the routine use of endoscopic studies to rule them out. The purpose of this study was to determine the incidence of pneumomediastinum secondary to blunt trauma and associated injuries and to establish the role of multidetector computed tomography in the diagnosis of aerodigestive injuries. Methods.Using multidetector computed tomography, patients with a diagnosis of pneumomediastinum secondary to blunt trauma were identified over a period of 4 years in a Level 1 Trauma Center. Results. Forty-one patients diagnosed with pneumomediastinum secondary to blunt trauma, were included in this study. Two airway ruptures were documented: two tracheal injuries and one esophageal injury. Two of them suspected on multidetector computed tomography and confirmed on bronchoscopy and esophagogastroduodenoscopy, respectively, and another was diagnosed in surgery. Conclusion.The routine use of endoscopic studies in patients with pneumomediastinum secondary to blunt trauma is not indicated when the clinical and tomographic findings are not suggestive of aerodigestive injury.
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Humanos , Tórax , Perforación del Esófago , Tráquea , Heridas y Lesiones , MediastinoRESUMEN
In pediatrics urgency room, one of the main causes of consultation are traumatological problems, including those caused by school accidents and car accidents. We analyzed the change in these causes during SARS-CoV-2 pandemics at a regional hospital in Talca, Chile . We saw a clear droop in traumatological consultations due to sanitary restrictions. This clearly shows the impact that sanitary restrictions had on population behavior