Improving assessment of alcohol treatment barriers among Latino and White adults with an alcohol use disorder: Development of the barriers to specialty alcohol treatment scale.

INTRODUCTION: The present study's aims were two-fold. First, we sought to validate a novel measure to assess barriers to specialty alcohol treatment among White and Latino individuals with an alcohol use disorder (AUD): The Barriers to Specialty Alcohol Treatment (BSAT) scale. Second, we sought to demonstrate that the BSAT scale could be used to explain Latino-White disparities in barriers to alcohol treatment. METHODS: In 2021, we recruited an online national sample of 1200 White and Latino adults with a recent AUD. Participants completed an online questionnaire that included the BSAT items. Confirmatory and exploratory factor analyses were conducted to validate the BSAT. Multiple group analyses across race/ethnicity and language were also performed using the final model. RESULTS: The final model consisted of 36 items across 7 factors that reflect barriers related to low problem recognition, recovery goals, low perceived treatment efficacy, cultural factors, immigration-related concerns, low perceived social support, and logistical barriers. The final model's factor structure and factor loadings held up across race/ethnicity and language. The top endorsed barriers were low problem recognition, recovery goals, low perceived social support, logistical issues, and low perceived treatment efficacy. Compared to Whites, Latinos were more likely to report perceived lack of social support, logistical barriers, low perceived treatment efficacy, cultural barriers, and immigration-related concerns as barriers. CONCLUSION: Findings provide empirical support for the validity of the BSAT scale, which offers improved measurement of specialty alcohol treatment barriers and can be used to explore Latino-White disparities in a future study.

Knowledge, attitudes, and behavior regarding antibiotics, antibiotic use, and antibiotic resistance in students and health care professionals of the district of Barranquilla (Colombia): A cross-sectional survey.

Objective: To evaluate the knowledge, attitudes and behavior regarding antibiotics, use of antibiotics, and antibiotic resistance in students and health care professionals of the district of Barranquilla, Colombia. Study design: Descriptive, cross-sectional. Methods: A sample of 399 respondents was selected, that included health professionals and medical students from 12 health institutions in the district of Barranquilla (Colombia), using an established stratified sampling method. Each of the respondent professionals completed a survey that included 43 items in the Likert scale. A descriptive analysis of the study variables was performed using the software SPSS version 25. Results: Most of the respondents were women (64.4%), aged between 26 and 35 years (47.6%); 28.8% were nurses and 26.1% general practitioners, with ≤10 years of professional experience (63.4%). Overall, the survey revealed that the participants had considerable knowledge about antibiotic use (89.5%-98% correct answers) and the spread of antibiotic resistance (67.4%-89% correct answers). Approximately 74% of the respondents agreed or fully agreed with the questions related to the management of infections and the provision of advice. Conclusions: The present study revealed that most of the health care professionals surveyed had a good knowledge about antibiotic use, although strategies must be developed to strengthen knowledge regarding the spread of antibiotic resistance. Likewise, it is important to identify opportunities for improvement related with access to the guidelines and/or materials necessary to treat infections and to provide advice on antibiotic use and antibiotic resistance.

Subacute Meckel's diverticulum perforation.

Meckel's diverticulum is the most common intestinal congenital defect, its prevalence is 0.2%-4.0% and it occurs more commonly in children younger than 2-year old with intestinal bleeding and abdominal pain. Perforation in the elderly is very rare with no more than 35 articles reported worldwide. Here we report the case of a 62-year-old man who was admitted to hospital with a history of acute abdominal pain with a 20-day onset. The patient was treated with laparotomy and 30 cm ileal resection was performed for an 8×5 cm perforated ileum tumour at 50 from ileocecal valve with a side-to-side mechanical anastomosis for reconstruction. Having morbidity Clavien-Dindo scale I in postsurgical and good outcome in 6-month follow-up. Meckel's diverticulum is an infrequent pathology in paediatric and even rarer in adult population, however, it is always important to keep in mind how to act when is seen either as a finding or as a complication.

Identificación de alteraciones moleculares en pacientes Venezolanos con diagnóstico de leucemia linfoblástica aguda / Identification of molecular alterations in Venezuelan patients with acute lymphoblastic leukemia diagnosis

La Leucemia Linfoblástica Aguda (LLA) es la neoplasia más frecuente en edad pediátrica. En los últimos años, entre el 15 y 20% de los pacientes fracasan en el tratamiento. Conocimientos en citogenética y biología molecular repercuten de manera importante en la determinación del pronóstico y del esquema de tratamiento adecuado. En Venezuela existe un conocimiento limitado en cuanto a la genética molecular de esta alteración onco-hematológica. El objetivo del trabajo fue evaluar las alteraciones genéticas más frecuentes en pacientes venezolanos con diagnóstico clínico de leucemia linfoblástica aguda. Se realizó un estudio transversal, descriptivo y prospectivo de 2006 a 2014, en el que se evaluaron las translocaciones ETV6/RUNX1, MLL/AF4, TCF3/PBX1, BCR/ABL1, así como las mutaciones en los genes PAX5 y FLT3 mediante el uso de diferentes tipos de PCR. Ciento treinta pacientes con diagnóstico clínico de leucemia linfocítica aguda fueron incluidos en el estudio. Se identificaron alteraciones moleculares en 56 pacientes (43,1%), en los que observamos la presencia de una o varias alteraciones en conjunción en un mismo paciente. Las alteraciones identificadas fueron t(12;21) (11,5%), t(4;11) (8,5%), t(1;19) (10%), t(9;22) (20,8%), ITD-FLT3 (14,8%), mutación P80S (4,2%) y S77del (4,2%) en el gen PAX5. La prevalencia de BCR/ ABL, es una de las más altas que ha sido descrita hasta ahora en casos de LLA donde la mayor parte de la población está conformada por pacientes pediátricos. Estos resultados representan el primer estudio molecular de la LLA en Venezuela, sentando las bases para el diagnóstico y seguimiento de la enfermedad en su población.

Acute Lymphoblastic Leukemia (ALL) is the most common neoplasm in pediatric age. In recent years, between 15 and 20% of patients failed in their treatments. Knowledge on cytogenetics and molecular biology has an important impact on the determination of the prognosis and the appropriate treatment scheme. In Venezuela there is limited knowledge regarding the molecular genetics of this onco-hematological alteration. The aim of this work was to evaluate the most frequent genetic alterations in Venezuelan patients with a clinical diagnosis of acute lymphoblastic leukemia. A cross-sectional, descriptive and prospective study was carried out from 2006 to 2014, in which the translocations ETV6/RUNX1, MLL/AF4, TCF3/PBX1, BCR/ABL1, as well as mutations in the PAX5 and FLT3 genes were evaluated through the use of different types of PCR. One hundred and thirty patients with a clinical diagnosis of acute lymphocytic leukemia were included in the study. Molecular alterations were identified in 56 patients (43.1%), in which we observed the presence of one or several alterations in conjunction in the same patient. The alterations identified were t(12; 21) (11.5%), t(4; 11) (8.5%), t(1; 19) (10%), t(9; 22) (20.8%), ITD-FLT3 (14.8%), P80S mutation (4.2%) and S77del (4.2%) in the PAX5 gene. The prevalence of BCR/ABL is one of the highest described so far in cases of ALL where most of the population is made up of pediatric patients. These results represent the first molecular study of ALL in Venezuela, laying the foundations for the diagnosis and monitoring of the disease in its population.

Xenotransplantation of human adipose-derived stem cells in the regeneration of a rabbit peripheral nerve.

Adipose tissue-derived mesenchymal stem cells (AdMSCs) are useful in the regeneration of neural tissues. Furthermore, xenotransplantation of human adipose tissue-derived mesenchymal stem cells (hAdMSCs) into animal models has already been tested and the results encouraged us to study peripheral nerve regeneration in rabbits, in order to test the feasibility of a xenotransplantation of hAdMSCs. ANIMALS AND METHOD: To promote end-to-end nerve fiber contacts of a 4-cm gap in the peroneal nerve of white New Zealand rabbits, an autologous vein conduit was used and three groups of animals were evaluated. In Group I, the gap was repaired with a vein conduit refilled with fibrin. Group II was similar, but the animals were treated with cyclosporine A. In Group III, a fibrin scaffold with hAdMSCs was placed inside the autologous vein conduit, and animals were treated with cyclosporine A. Neurofilament immunohistochemistry results showed 100% nerve regeneration at the vein guidance channel 90 days after the surgery in the hAdMSC-transplanted group but lesser neural regeneration in the neurofilaments of groups I and II. The analysis of variance (ANOVA) test showed statistically significant differences among all groups (p < 0.04). Group III exclusively tested positive for human monoclonal anti-mitochondrial antibody. Electron microscopy images showed tiny bundles, with a predominance of nonmyelinated axons. Myelinated axons caused irregular thickness of the myelin sheath, which was especially observed in group III. CONCLUSIONS: Xenotransplantation of hAdMSCs into a fibrin scaffold promoted nerve regeneration through a vein conduit that connected a 4-cm gap created at the peroneal nerve of rabbits. Animals treated with hAdMSCs presented negative inflammatory response at the regenerated nerve gaps, but it was demonstrated that hAdMSCs were incorporated to the new nerve creating neural tissue and endothelial cells. However, hAdMSCs required immunosuppression with cyclosporine A to achieve axonal regeneration.

[Metastatic collision tumour. A case report]. / Tumor metastásico de colisión. Informe de un caso.

BACKGROUND: Collision tumours are extremely rare. They are defined by the presence of two tumours of different histological origin in the same organ. CLINICAL CASE: A 71 year old female with history of a carcinoid tumour removed 20 years ago without any recurrence. The patient was admitted with intestinal occlusion symptoms secondary to a right flank abdominal tumour. An exploratory laparotomy was performed, removing the tumor and applying optimal debulking. The histopathological study reported bilateral ovary adenocarcinoma, as well as metastatic collision tumour of two histological types: well differentiated adenocarcinoma and a mixed malignant mesodermic Mullerian tumor. The patient was treated with adjuvant chemotherapy with poor results (death in 24 months). CONCLUSIONS: The presence of collision tumours is extremely rare. There are no statistics or specific treatment reported. Diagnosis is made with histopathology. At the moment, no similiar cases have been reported.

Positive association between vascular endothelial growth factor (VEGF) -2578 C/A variant and prostate cancer.

BACKGROUND: Vascular endothelial growth factor (VEGF) gene is an important angiogenesis regulator related to cancer development and progression. We evaluated the association between -2578 C/A (rs699947) VEGF polymorphism and PCa in Mexican subjects, to contribute to knowledge of VEGF role in genetic epidemiology of prostate cancer (PCa). OBJECTIVE: The aim of this study was to evaluate the association between -2578 C/A VEGF variant and PCa in Mexican population. METHODS: A total of 249 men (77 PCa cases and 172 controls) from the Northwestern region of Mexico were screened for the -2578 C/A VEGF variant. The polymorphism was determined by polymerase chain reaction-based restriction analysis. RESULTS: Genotype frequencies for C/C, C/A, and A/A, were 0.48, 0.49, 0.03 for cases and 0.41, 0.45, 0.14 for controls respectively. Genotype A/A of -2578 VEGF variant reduces the risk of PCa in an 84% among studied population (Odds Ratio 0.16; 95% CI: 0.04-0.71, P=0.007). C/C carriers showed an increased PCa risk of 6.1 times among the study population. CONCLUSIONS: Inheritance of -2578 A/A genotype of VEGF gene may modify PCa susceptibility risk in Mexican population.

Lista de cotejo de Caprini modificada como una estrategia para la aplicación de un programa de seguridad del paciente en la prevención de la enfermedad tromboembólica / Modified Caprini's checklist as a strategy to apply a safety program for the patient in the prevention of thromboembolic disease

Objetivo: Evaluar si la lista de cotejo de Caprini modificada para la valoración de factores de riesgo en la enfermedad tromboembólica venosa es útil para la práctica quirúrgica cotidiana y evaluar el estado actual del conocimiento de la tromboprofilaxis. Sede: Encuentro Nacional de Cirujanos 2009, Hacienda de San Miguel Regla Hgo. Asociación Mexicana de Cirugía General, A.C. Diseño: Estudio prospectivo, transversal, comparativo, observacional. Análisis estadístico: Porcentajes como medida de resumen para variables cualitativas y chi cuadrada con corrección de Yates. Material y métodos: Se realizó un estudio con 93 líderes de opinión de la cirugía general de todo el país y se utilizó una presentación destacando los conocimientos y evidencias más importantes en tromboprofilaxis. Luego, en pequeños grupos, se presentaba un caso clínico típico y se aplicaba la lista de cotejo de Caprini modificada que se discutía en cada mesa de trabajo y para cada caso clínico durante 2 ó 3 minutos para dar respuesta, de acuerdo a la evidencia clínica. Este ejercicio se efectuó en cinco ocasiones con diversos casos, todos ellos quirúrgicos y con diferente magnitud de dificultad. Al final del ejercicio se efectuó una encuesta de percepción acerca de la adquisición del conocimiento, con dos preguntas, a fin de averiguar si el cirujano tiene presente, y con actualización continua, el tema y en una tercera pregunta se exploró si la herramienta es o no útil para su práctica diaria. Resultados: Se entregaron 93 cuestionarios, que correspondieron al 100% de los asistentes, 66 se resolvieron completos. El instrumento de cotejo proporcionado pareció un instrumento útil en el 97%. Se realizó una comparación entre las respuestas de las preguntas que exploraban si el participante habría obtenido conocimiento o sólo reafirmado el mismo. Encontramos una diferencia estadísticamente significativa, pues ante la primera pregunta más de la mitad de los encuestados indicaban que no habían obtenido nuevos conocimientos; sin embargo, al responder si la práctica realizada les habría hecho recordar dichos conocimientos la mayoría aceptó esta situación (P < 0.001) Conclusión: Debe mantenerse una educación médica continua sobre tromboprofilaxis y se acepta la lista de cotejo de Caprini modificada para la práctica cotidiana.

Objective: To assess whether the modified Caprini risk stratification list for the evaluation of risk factors in venous thromboembolic disease is useful for the daily surgical practice and to evaluate the current status of knowledge on thromboprophylaxis. Setting: National Meeting of General Surgeons-2009, Hacienda de San Miguel Regla, Hgo. Mexican Association of General Surgery, A.C. Design: Prospective, cross-sectional, comparative, observational study. Statistical analysis: Percentages as summary measure for qualitative variables and Yates' chi-square test. Material and methods: We performed a study with 93 opinion leaders in Surgery of the whole country, and a presentation was used to point out the knowledge and most important evidences regarding thromboprophylaxis. Thereafter, in small groups, a typical clinical case and the modified Caprini risk assessment list were presented and discussed in each working table and for each clinical case for 2 to 3 min to provide an answer, based on clinical evidence. This exercise was performed five times with diverse cases; all surgical in nature and with different grades of difficulty. At the end of the exercise, a perception interview was performed regarding knowledge acquisition with two questions, aimed at finding out if the surgeon is aware and is continuously updated on the subject, and a third question to explore whether the tool is or not useful for the surgeon's daily activity. Results: We delivered 93 questionnaires, corresponding to 100% of the attendants; 66 were solved completely. The validation tool seemed to be useful in 97%. A comparison was made between the questions exploring whether the participant had obtained new knowledge or had only up-dated it. We found statistically significant difference, since to the first question more than half of the surveyed participants indicated that they did not acquire new knowledge; however, when responding to whether the performed exercise had refreshed that knowledge, most responses were positive (P < 0.001). Conclusion: A continuous medical education on thromboprophylaxis must be maintained and it is accepted that the modified Caprini risk assessment list is useful for the daily practice.