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1.
Ophthalmologie ; 121(1): 27-35, 2024 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-37815541

RESUMEN

BACKGROUND: The handling of fireworks regularly leads to a variety of injuries affecting the periocular region. Due to the COVID-19 lockdown and a sales ban on consumer fireworks for the private sector the number of injuries massively decreased; however, a considerable increase was registered again at the last New Year festivities. The aim of this work was to present the extent and spectrum of such injuries in a maximum care center. METHODS: As part of the nationwide survey of firework-associated eye injuries in emergency care eye clinics and hospitals, data from the MHH Eye Hospital in Hannover were compiled over the period of 3 days (30.12.2022-01.01.2023) and evaluated with respect to gender, age, severity, injury pattern, type of fireworks and treatment. RESULTS: Of a total of n = 25 injured patients, n = 19 (76%) were male. Most patients presented on New Year's Day (n = 14, New Year's Eve: n = 9; 30.12.2022: n = 2), with the majority of cases presenting with mild injuries with irritation and erosion of the ocular surface (n = 15; 60%). Of the patients four sustained moderate to severe injuries with bulbar contusion, hyphema, and sometimes iris base tears (16%). Of the patients six suffered severe, mainly open, eye injuries (24%), two of which required primary evisceration. Ignition of fireworks batteries revealed the highest risk of serious injury, affecting mainly males 31-40 years of age. Children up to 12 years of age generally sustained only minor injuries, although there were exceptions as there were among adolescents. The person who caused the fireworks injury was affected in about 52% of the cases; in 48% the victim of the accident was a bystander. In cases of complex injuries, under certain conditions only surgical exploratory diagnostics could lead to the correct diagnosis and best possible care. CONCLUSION: The extent of firework injuries is manifold and the consequences including blindness are considerable. The burden on physicians on duty on New Year's Eve and New Year's Day was enormous, as with the permission of private fireworks a large number of patients had to be cared for via the emergency room, some of whom required complex surgical care. To prevent serious eye injuries, targeted education about the risks of private fireworks and possibilities to increase safety should be intensified.


Asunto(s)
Traumatismos por Explosión , COVID-19 , Lesiones Oculares , Niño , Adolescente , Humanos , Masculino , Femenino , Traumatismos por Explosión/epidemiología , Universidades , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Lesiones Oculares/epidemiología
2.
J Dairy Sci ; 107(5): 2954-2967, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38101741

RESUMEN

The use of veterinary drugs is of similar importance to that of human drugs in addressing health challenges. In this context, pharmaceuticals and their metabolites inevitably enter soil and water in unknown quantities. Therefore, this study collects and analyzes drug data from 2020 for 50 dairy farms located in Germany. The most frequently used substance group is antibiotics (40.13%), followed by antiphlogistics (18.86%), antiparasitics (13.09%), and hormones (9.29%). Treatment frequencies record the number of days per year on which an average animal on a farm was treated with a substance. The calculated values range from 0.94 to 21.69 d/yr and are distributed heterogeneously across farms. In this study, on average, a cow was treated on 6 d in 2020: 2.34 d with antibiotics, 1.07 d with antiphlogistics, 0.76 d with antiparasitics, and 0.41 d with hormones. In addition to individual farm management practices, other factors are related to treatment frequency. Farms with a veterinary care contract used more hormonal substances than farms without a care contract. In addition, higher milk yield coincides with more frequent treatments with antiphlogistic or hormonal substances. Other related factors include grazing, longevity, farm size, and use of a claw bath. Our study represents an important first step in describing the amounts and determinants of veterinary drugs used in livestock farming. Such insights on magnitudes and farm parameters are essential to estimate potential environmental effects and derive strategies to reduce veterinary drug use.


Asunto(s)
Drogas Veterinarias , Bovinos , Animales , Femenino , Humanos , Granjas , Drogas Veterinarias/metabolismo , Industria Lechera , Leche/metabolismo , Antibacterianos/metabolismo , Antiparasitarios/metabolismo , Hormonas/metabolismo
3.
Acta Parasitol ; 68(1): 194-207, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36542296

RESUMEN

PURPOSE: The diversity of larval digenetic trematodes can provide information on one or more intermediate hosts prior to maturation into the definitive host; on host activity and distribution; and in some cases, on environmental perturbations. In this context, the goal of the present study was to analyse the trematode larvae found in adult amphibians collected from the Argentinian Chaco Region. Few studies have been reported on the systematics of larval digeneans in amphibians. METHODS: A total of 167 specimens of frogs (Leptodactylus macrosternum, Leptodactylus latinasus, Lepidobatrachus laevis, Lepidobatrachus llanensis and Lysapsus limellum) and toads (Rhinella bergi) were examined for larval digeneans. Frogs and toads were collected in two Argentinian ecoregions (Dry Chaco and Humid Chaco); between June 2002 and December 2019. Morphology of each taxon was studied in detail using light microscopy and scanning electron microscopy (SEM). RESULTS: Fourteen different taxa of the families Diplostomidae (Alariinae gen sp., Didelphodiplostomum sp., Pharingostomoides sp. and Tylodelphys sp.), Proterodiplostomidae (Heterodiplostomum lanceolatum), and Strigeidae (Strigea spp.) were found infecting the body cavity, mesentery, muscle, fluid in the spinal cord canal, and cranial cavity of amphibians. All species are described and illustrated, and their life cycles are briefly discussed. CONCLUSION: These infections provide new information on the morphology, morphometry, and composition of the diversity of mesocercariae and metacercariae in amphibians, thus contributing to the knowledge of potential intermediate hosts. In addition, our results serve as an indicator of parasite and host biodiversity in different ecoregions of the Gran Chaco.


Asunto(s)
Trematodos , Infecciones por Trematodos , Humanos , Animales , Infecciones por Trematodos/veterinaria , Infecciones por Trematodos/parasitología , Larva , Anuros/parasitología , Biodiversidad , Bufonidae
4.
Arch Gynecol Obstet ; 304(3): 783-790, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33585986

RESUMEN

BACKGROUND: Molecular profiling of breast cancer (BC) classifies several intrinsic subtypes based on different patterns of gene expression. Multigene assays estimate the risk of recurrence and help to select high-risk patients for adjuvant chemotherapy. However, these tests are associated with significant costs. Immunohistochemistry (IHC) offers a surrogate classification for molecular subtypes by determining estrogen (ER) and progesterone receptors (PR), human epidermal growth factor (Her2neu), as well as the proliferation marker Ki67. Core needle biopsy (CNB) is well established in BC diagnosis and allows a pre-operative assessment of biomarkers. The aim of this study was to analyze the concordance of these markers between CNB and surgical specimens to assess whether re-testing of the surgical specimen is mandatory. MATERIALS AND METHODS: Within a 3-year period, patients with primary BC and paired samples of CNB and surgical specimens were analyzed retrospectively. Concordance rates of ER, PR, Her2neu, Ki67, and the surrogate classification for molecular subtypes were calculated using the Landis and Koch agreement grades. RESULTS: Out of 2254 patients with primary breast cancer, 1307 paired specimens without pre-operative treatment were available for analysis Concordance rates for ER, PR, Her2neu, and Ki67 status showed substantial-to-almost perfect agreement grades (κ = 0.91, 0.75, 0.89, and 0.61, respectively). Though substantial concordance was also found for the subtype classification (κ = 0.70), the molecular subtype changed in 18.5% of patients based on the testing of the surgical specimen, mainly from luminal A-like to luminal B-like. CONCLUSIONS: Though the concordance rates for single markers were convincing, a significant proportion of the molecular subtypes differed between CNB and the surgical specimen. Re-testing of PR and Ki67 is mandatory to ensure optimal treatment decisions. Further research is necessary to define safe, efficient, and cost-effective predictive models in adjuvant breast cancer therapy.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Biopsia con Aguja Gruesa/métodos , Neoplasias de la Mama/patología , Mama/metabolismo , Carcinoma/patología , Antígeno Ki-67/metabolismo , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/química , Mama/química , Mama/patología , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/cirugía , Carcinoma/química , Carcinoma/cirugía , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estudios Retrospectivos
5.
J Surg Oncol ; 123(4): 1092-1098, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33333589

RESUMEN

BACKGROUND AND OBJECTIVES: To compare the detection rates of sentinel lymph nodes after converting the tracer technique from blue dye to indocyanine green (ICG). METHODS: Patients with uterine or cervical cancer were enrolled for sentinel lymph node (SLN) dissection. A total of 109 consecutive patients were analyzed and compared to a historical cohort of 109 consecutive patients with the sentinel blue dye technique. SLNs were analyzed by ultrastaging. RESULTS: The bilateral mapping rate of sentinel nodes was significantly higher with the ICG (78%; n = 85) compared to the blue dye tracer (61%; n = 67; p = .006). Neither the mean number of SLN nor the rate of low volume metastases showed significant differences between both cohorts. In the subgroup of endometrial cancer patients, the number of systematic lymph node dissection (LND) was significantly lower in the ICG cohort compared to the blue dye cohort (9% vs. 28%, p = .001). CONCLUSIONS: ICG improved the detection rate of pelvic SLN compared to blue dye and may be considered as the superior technique. In clinical practice, the rate of systematic LND further decreased after incorporating SLN mapping with ICG. Reliable safety data are still pending.


Asunto(s)
Colorantes/farmacocinética , Neoplasias de los Genitales Femeninos/patología , Verde de Indocianina/farmacocinética , Colorantes de Rosanilina/farmacocinética , Ganglio Linfático Centinela/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Neoplasias de los Genitales Femeninos/diagnóstico por imagen , Neoplasias de los Genitales Femeninos/cirugía , Humanos , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Ganglio Linfático Centinela/diagnóstico por imagen , Ganglio Linfático Centinela/cirugía , Biopsia del Ganglio Linfático Centinela , Distribución Tisular
6.
Urologe A ; 59(5): 565-572, 2020 May.
Artículo en Alemán | MEDLINE | ID: mdl-32103288

RESUMEN

INTRODUCTION: Robot-assisted simple prostatectomy (RASP) is a relatively new minimally invasive procedure for surgical treatment to manage symptomatic, therapy-refractory benign prostate hyperplasia (BPH) in prostate volumes >80 cm3. Thus, postoperative morbidity based on Clavien-Dindo and hematological parameters in RASP and open simple prostatectomy (OSP) procedures are examined. PATIENTS AND METHODS: We retrospectively reviewed a total of 78 patients: 39 patients underwent RAPS and 39 OSP. The following parameters were statistically evaluated and compared: age, PSA value, prostate volume, ASA score, duration of hospital stay, operative time, Hb decrease on postoperative (po) day 1 and in the 5 five po days, CRP peak in the first 5 po days and transfusion rate. RESULTS: The comparison between RASP and standard OSP showed no significant differences regarding the mean patient age (73 vs. 74 years; p =0.54), PSA values (7.7 vs. 10.7 ng/ml; p =0.17), ASA score (2.2 vs. 2.3; p =0.26) and prostate volume (130 vs. 113 cm3; p =0.07). Patients in the RAPAE group had statistically significant longer surgery (178 vs. 110 min; p =<0.01) with a significantly smaller decrease in Hb on po day 1 (1.9 vs. 3.3 g/dl; p ≤0.01) and in the first 5 po days (2.4 vs. 4.2 g/dl; p ≤0.01), lower need for preserved blood (3% vs. 26%; p =0.01) and number of blood bags (0.1 vs. 1.3; p =0.01), a lower po Clavien-Dindo score (0.44 vs. 1.23; p =0.003) and lower CRP values (52 vs. 104 mg/l; p ≤0.01) in the first 5 po days. CONCLUSION: RASP is a safe procedure that offers the advantage of reduced blood loss and blood bag consumption and rare complications due to the minimally invasive surgical method. The OSP group showed an increased occurrence of complications due to bleeding, leading to prolonged hospitalization and significantly increased need for blood transfusion. The lesser increase of CRP in RASP group is a result of the lower invasiveness of the robot-assisted procedure.


Asunto(s)
Prostatectomía/métodos , Hiperplasia Prostática/cirugía , Procedimientos Quirúrgicos Robotizados , Robótica/métodos , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica , Humanos , Tiempo de Internación , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del Tratamiento
7.
Bioinformatics ; 34(19): 3399-3401, 2018 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29746618

RESUMEN

Motivation: The presence of terraces in phylogenetic tree space, i.e. a potentially large number of distinct tree topologies that have exactly the same analytical likelihood score, was first described by Sanderson et al. However, popular software tools for maximum likelihood and Bayesian phylogenetic inference do not yet routinely report, if inferred phylogenies reside on a terrace, or not. We believe, this is due to the lack of an efficient library to (i) determine if a tree resides on a terrace, (ii) calculate how many trees reside on a terrace and (iii) enumerate all trees on a terrace. Results: In our bioinformatics practical that is set up as a programming contest we developed two efficient and independent C++ implementations of the SUPERB algorithm by Constantinescu and Sankoff (1995) for counting and enumerating trees on a terrace. Both implementations yield exactly the same results, are more than one order of magnitude faster, and require one order of magnitude less memory than a previous thirrd party python implementation. Availability and implementation: The source codes are available under GNU GPL at https://github.com/terraphast. Supplementary information: Supplementary data are available at Bioinformatics online.


Asunto(s)
Filogenia , Programas Informáticos , Algoritmos , Biología Computacional
8.
BMC Res Notes ; 10(1): 579, 2017 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-29121982

RESUMEN

OBJECTIVE: Imaging biomarkers like HistoScanning™ augment the informative value of ultrasound. Analogue image-guidance might improve the diagnostic accuracy of prostate biopsies and reduce misclassifications in preoperative staging and grading. RESULTS: Comparison of 77 image-guided versus 88 systematic prostate biopsies revealed that incorrect staging and Gleason misclassification occurs less frequently in image-guided than in systematic prostate biopsies. Systematic prostate biopsies (4-36 cores, median 12 cores) tended to detect predominantly unilateral tumors (39% sensitivity, 90.9% specificity, 17.5% negative and 50% positive predictive values). Bilateral tumors were diagnosed more frequently by image-guided prostate biopsies (87.9% sensitivity, 72.7% specificity, 50% negative and 96.8% positive predictive values). Regarding the detection of lesions with high Gleason scores ≥ 3 + 4, systematic prostate and image-guided biopsies yielded sensitivity and specificity rates of 66.7% vs 93.5%, 86% vs 64.5%, as well as negative and positive predictive values of 71.2% vs 87%, and 83.3% vs 79.6%, respectively. Potential reason for systematic prostate biopsies missing the correct laterality and the correct Gleason score was a mismatch between the biopsy template and the respective pathological cancer localization. This supports the need for improved detection techniques such as ultrasound imaging biomarkers and image-adapted biopsies.


Asunto(s)
Biopsia Guiada por Imagen/normas , Estadificación de Neoplasias/normas , Neoplasias de la Próstata/diagnóstico , Ultrasonografía/métodos , Anciano , Anciano de 80 o más Años , Biomarcadores , Humanos , Masculino , Clasificación del Tumor , Neoplasias de la Próstata/cirugía , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
9.
Aktuelle Urol ; 47(5): 402-7, 2016 09.
Artículo en Alemán | MEDLINE | ID: mdl-27680192

RESUMEN

BACKGROUND: The most frequent carcinoma in male patients is prostate cancer. D'Amico and colleagues (1998) set up a classification to assess the aggressiveness of prostate cancer growth and the risk of metastatic spread, taking into account the following parameters: PSA, Gleason Score (GS), and tumour spread (T). The combination of these parameters results in a classification of low-, intermediate- and high-risk patients.In the context of a larger heuristic study entitled "Low-Risk Prostate Cancer Patients: Significance And Importance Of Pelvic Lymphadenectomy in Localized Prostate Carcinomas", we observed the correlation of the parameters PSA, GS and T stage with the occurrence of lymph node metastases in low-risk-patients who underwent lymphadenectomy during radical prostatectomy. PATIENTS/MATERIALS AND METHODS: Due to a lack of evidence - none of the confirmed LR (low-risk=LR) patients was diagnosed with metastases - we set up a subclassification for LR patients for the following corridor transition zone between low-risk and high-risk patients (based on the D'Amico classification):PSA≤10 ng/ml and GS≤7a (c: 7a) and clinical stage T1a-T2c (c: T2b, T2c): The population consists of 288 prostate cancer patients (60 low-risk (LR) patients, 228 corridor (c) patients). We analysed the number and frequency of removed lymph nodes and lymph node metastases. Moreover, we analysed the population with a view to a postoperative GS upgrade. The results are based on heuristic methods. RESULTS: The situation regarding the data in the transition zone, i. e. in the corridor area, and in the verified low-risk range is very complicated:In total, 3 743 lymph nodes were removed in 288 patients (mean: 13 lymph nodes). Of these only 7 lymph nodes in 5 patients from the corridor group were metastatic. The overall number of removed lymph nodes in these 5 patients lies within a small interval [23,32]; 26 lymph nodes were removed on average. A postoperative Gleason Score upgrade was found in 20.14% of the whole patient population. CONCLUSION: A postoperative Gleason Score upgrade in every fifth patient shows a highly relevant preoperative undergrading in these patients, which may lead to inadequate treatment. An opening of the D'Amico classification to include a corridor category of patients could be an opportunity to minimise preoperative undergrading. In this context, pelvic lymphadenectomy must be considered, at least for corridor patients.


Asunto(s)
Escisión del Ganglio Linfático , Neoplasias de la Próstata/cirugía , Humanos , Ganglios Linfáticos/patología , Masculino , Clasificación del Tumor , Estadificación de Neoplasias , Pronóstico , Neoplasias de la Próstata/clasificación , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Riesgo , Tasa de Supervivencia
11.
Urologe A ; 55(2): 208-17, 2016 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-26678799

RESUMEN

BACKGROUND: Salvage extended pelvic lymph node dissection (salvage ePLND) in patients with prostate cancer (PCa) biochemical recurrence is an alternative to the commonly used androgen deprivation therapy (ADT) and/or chemotherapy. Small patient number, insufficient accuracy of contemporary imaging methods for lymph node relapse diagnostics, and the lack of prospective data present limiting factors for a wider application of salvage ePLND. The purpose of this publication is to review German and European data and studies on the subject of salvage ePLND and to discuss future perspectives. MATERIALS AND METHODS: We analyzed available studies up to October 2014 from Medline with the keywords "salvage lymph node dissection prostate cancer". RESULTS: A total of 51 publications since 1984 (up to October 2014) meeting the search criteria were found. Ten of these were studies that analyzed the results of salvage ePLND. Of these 10 studies, 6 originated from German clinics. Furthermore, among these 51 publications, there were 2 clinical case reports (1 from Germany) and 3 reviews (none from Germany). CONCLUSIONS: The available data show insufficient evidence-based validity. There have been no prospective studies and just one multicenter study. However, single-center retrospective studies have shown promising results. Salvage ePLND leads to biochemical remission, freedom from clinical recurrence, and probably also to renewed response to ADT in patients with castration-resistant PCa. Multicenter prospective studies should be conducted in Germany (where most of the available studies have been performed). The selection of patients should be analyzed in order to identify clear selection criteria for salvage ePLND.


Asunto(s)
Escisión del Ganglio Linfático/métodos , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/cirugía , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/cirugía , Terapia Recuperativa/métodos , Medicina Basada en la Evidencia , Humanos , Masculino , Resultado del Tratamiento
12.
Urologe A ; 55(5): 641-4, 2016 May.
Artículo en Alemán | MEDLINE | ID: mdl-26450095

RESUMEN

OBJECTIVE: Dynamic sentinel node biopsy (DSNB) has been recommended in the EAU guidelines for several years as a minimally invasive method for lymph node staging in patients with penile carcinoma and nonpalpable lymph nodes. However, due to the high methodological demands and the primarily unreliable results, this method is rarely used in Germany. The aim of this study was to establish the reliability and morbidity of this method. MATERIAL AND METHODS: The frequency of lymph node recurrent disease and complications were prospectively recorded in patients with initially nonpalpable inguinal lymph nodes and histologically negative sentinel lymph nodes. Quality criteria were the false negative rate (percentage of lymph node recurrence in negative procedures) and the morbidity rate. Inguinal regions with palpable lymph nodes and/or evidence of metastases were not considered. RESULTS: The study included 37 patients with histologically negative sentinel lymph nodes in 63 groins with nonpalpable inguinal lymph nodes. There were 21 T1(a/b) stages, 10 T2, and 6 T3 stages. Tumor differentiation was good in 4, moderate in 26, and poor in 7 patients. During a median follow-up of 52 months (range 1-131 months), we observed a bilateral lymph node recurrence in 1 patient and a conservatively managed prolonged lymphorrhea in another patient. Per inguinal region the false-negative rate was 3.2 % and the morbidity rate was 1.6 %; seen per patient the rates were both 2.7 %. CONCLUSIONS: DSNB is a reliable method of lymph node staging in patients with penile carcinoma and nonpalpable inguinal lymph nodes. The high degree of reliability in combination with the low morbidity justifies the higher methodical complexity of this method.


Asunto(s)
Neoplasias del Pene/diagnóstico , Neoplasias del Pene/patología , Biopsia del Ganglio Linfático Centinela , Adulto , Anciano , Anciano de 80 o más Años , Reacciones Falso Negativas , Estudios de Seguimiento , Ingle , Adhesión a Directriz , Humanos , Metástasis Linfática/patología , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Estudios Prospectivos , Reproducibilidad de los Resultados , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón Único
13.
Urologe A ; 54(11): 1596, 1598-601, 2015 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-25794587

RESUMEN

BACKGROUND: Modern imaging modalities improve prostate diagnostics. OBJECTIVES: This study was performed to determine the outcome characteristics of biopsy procedures using the results of HistoScanning(TM) analysis (HS) for identifying prostate cancer (PCa) in patients with perineal template-guided prostate biopsy. PATIENTS AND METHODS: A total of 104 consecutive men (mean age 69 years, mean PSA 9.9 ng/ml) underwent HS prior to the extended prostate biopsy procedure. Patients received a targeted transperineal (template-assisted) as well as a targeted transrectal prostate biopsy using HS projection reports supplemented by a standardized 14-core systematic transrectal prostate biopsy (Bx). The cancer detection rate was analyzed on the sector level and HS targeted results were correlated to biopsy outcome, sensitivity, specificity, predictive accuracy, negative predictive value (NPV) and positive predictive value (PPV). RESULTS: Of 104 patients, 44 patients (42%) were found to have PCa. Histology detected atypical small acinar proliferation in 3 patients (2.9%), high-grade prostatic intraepithelial neoplasia in 16 (15.4%), and chronic active inflammation in 74 (71.1%), respectively. The detection rate for each region was significantly higher in HS-targeted biopsies compared to Bx. The detection rate per patient was not significantly different, although a smaller number of regions were biopsied with the targeted approach. The overall sensitivity, specificity, predictive accuracy, NPV, and PPV on the sector level were 37.2, 85.6, 78.6, 88.7 and 30.8%, respectively. CONCLUSION: The use of HS analysis results in a higher detection rate of prostate cancer compared to common transrectal ultrasonography (TRUS)-guided Bx. This technique increases the informative value of TRUS imaging and improves the diagnostic impact at least in the targeted biopsy setting.


Asunto(s)
Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Ultrasonografía/métodos , Anciano , Humanos , Masculino , Reconocimiento de Normas Patrones Automatizadas/métodos , Perineo/diagnóstico por imagen , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
14.
Urologe A ; 53(11): 1671-80; quiz 1681-2, 2014 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-25316184

RESUMEN

Numerous surgical procedures are available for the treatment of stress urinary incontinence in women and men. On a par with classical therapy options (e.g. colposuspension and artificial sphincter prosthesis) suburethral tape procedures have become established as the minimally invasive standard of care. Regarding comorbidities and recurrent urinary incontinence, therapeutic procedures should be modified on an individual basis. It is crucial to involve patients in therapeutic decision-making and counseling should be given with respect to all conservative and operative alternatives.


Asunto(s)
Cistectomía/métodos , Cistocele/cirugía , Salud del Hombre , Procedimientos de Cirugía Plástica/métodos , Cabestrillo Suburetral , Incontinencia Urinaria/cirugía , Salud de la Mujer , Femenino , Humanos , Masculino
15.
Urologe A ; 53(7): 1073-84; quiz 1085-6, 2014 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-25023244

RESUMEN

Urinary incontinence can affect men and women to the same degree. A differentiation is made between stress incontinence (i.e. urine discharge as a result of physical activities, sneezing or coughing), urge incontinence (i.e. strong urge to void with involuntary discharge of urine), mixed urinary incontinence and special forms. While men and women share the pathophysiology of urge-associated urinary incontinence, the multifactorial female urinary stress incontinence is in contrast to the stress incontinence in men which is almost exclusively caused by prostatectomy (postprostatectomy). The basic diagnostic procedure for urinary incontinence is largely non-invasive. Special diagnostic procedures are reserved for recurrences and preparation for operative measures. Therapy is oriented to the degree of suffering and patient compliance and incorporates conservative measures as first line therapy (e.g. lifestyle changes, bladder and continence training). Duloxetin is approved for the medicinal therapy of female urinary stress incontinence. The treatment of urge-associated urinary incontinence is primarily with anticholinergic agents. Alternatively, procedures for neuromodulation, a beta mimetic or injection therapy with botulinum toxin can be used in the future.


Asunto(s)
Antagonistas Colinérgicos/uso terapéutico , Técnicas de Diagnóstico Urológico , Terapia por Ejercicio/métodos , Conducta de Reducción del Riesgo , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/terapia , Diagnóstico por Imagen/métodos , Femenino , Humanos , Masculino , Neurotransmisores/uso terapéutico , Caracteres Sexuales
16.
J Nat Prod (Gorakhpur) ; 7: 155-161, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-27867280

RESUMEN

From the ethanol extract of the stem of Lecaniodiscus cupanioides Planch, two known compounds 1 and 2 were isolated and identified as triterpenoid saponins 3-O-[α-L-arabinofuranosyl- (1→3)-α-L-rhamnopyranosyl- (1→2)-α-L-arabinopyranosyl-]-hederagenin and 3-O- [α-L-arabinopyranosyl- (1→3)-α-L-rhamnopyranosyl (1→2)-α-L-arabinopyranosyl-]-hederagenin. The structures were established by physicochemical and spectroscopic investigations (MS and NMR) as well as comparison of literature data. The compound 1 exhibited anticancer activity against human colon carcinoma H-116, human lung carcinoma A-549 and human lung carcinoma HT-29 cell lines with IC50 5.0, 2.5 and 2.5µg/ml respectively and compound 2 exhibited similar activities with IC505.0, 5.0 and 2.5µg/ml respectively. This suggests that the isolated triterpenoid saponins may be considered as potential anticancer leads for further studies.

17.
Niger J Biotechnol ; 27: 1-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-28042193

RESUMEN

Perseaamericana Mill (Lauraceae) is a local medicinal plant used in Nigerian ethnomedicine as antimalarial. The aqueous decoction of the root part is a potent remedy against bacterial infections. Hence, the need to investigate the phytochemical and biological activities (antimicrobial and antiplasmodial) of the root back of Perseaamericana. Chromatographic and spectroscopic techniques were used in the identification and purification of metabolites, which were assayed for antimalarial and antimicrobial activities using Plasmodium falciparum and a panel of microorganisms. From the seeds of P. americana, five known 1, 2, 4-dihydroxy derivatives aliphatic alcohols, called avocadenols were isolated and identified by spectroscopic methods including 1D- and 2D NMR, and comparison with reported data in literature. Antifungal activity for 1, 2, 4-Trihydroxyheptadec-6-en-16-yne (5) (IC50< 8 µg/mL) against all the fungal strains and S. areus, and antimalarial activity for compounds 1, 2, 4-Trihydroxyheptadec-16-ene (1) and 1, 2, 4-tetrahydroxyheptadecane-6, 16-diene(2) (IC50 = 1.6 and 1.4 µg/mL for the D6 clone, respectively, and 2.1 and 1.4 µg/mL for the W2 clone, respectively) was observed. The fatty alcohols 1, 2, 4-tetrahydroxyheptadecane-6, 16-diene(2); 1, 2, 4-Trihydroxyheptadec-16-yne(3) and 1, 2, 4-Trihydroxyheptadecane(4) also exhibited promising in vitro antibacterial activity against a panel of pathogenic bacteria S. areus, methicillin resistant S. areus and E. coli at IC50 values of 21.1, 8, 200 µg/mL), (3.259, 86.32 µg/mL) and (17.18, 8.26 and 200 µg/mL), respectively. The results of this study provide evidence that the fatty alcohols are a promising class of antimalarial and antimicrobial agents.

18.
Mar Pollut Bull ; 75(1-2): 8-20, 2013 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-23932477

RESUMEN

The Great Barrier Reef (GBR) region of Queensland, Australia, encompasses a complex and diverse array of tropical marine ecosystems of global significance. The region is also a World Heritage Area and largely within one of the world's best managed marine protected areas. However, a recent World Heritage Committee report drew attention to serious governance problems associated with the management of ports and shipping. We review the impacts of ports and shipping on biodiversity in the GBR, and propose a series of guiding principles to improve the current governance arrangements. Implementing these principles will increase the capacity of decision makers to minimize the impacts of ports and shipping on biodiversity, and will provide certainty and clarity to port operators and developers. A 'business as usual' approach could lead to the GBR's inclusion on the List of World Heritage in Danger in 2014.


Asunto(s)
Conservación de los Recursos Naturales , Arrecifes de Coral , Política Ambiental , Navíos , Biodiversidad , Queensland
20.
Neuroscience ; 250: 60-9, 2013 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-23827309

RESUMEN

Abnormal plasticity in the cortico-basal ganglia-thalamocortical loop has been suggested to represent a key factor in the pathophysiology of dystonia. In a model of primary paroxysmal dystonia, the dt(sz) mutant hamster, previous experiments have shown a strongly increased long-term potentiation (LTP) in comparison to non-dystonic control hamsters. These basal changes, i.e. in the absence of dystonia, were found in young animals at an age of 5 weeks, when the age-dependent dystonia in dt(sz) mutant reaches highest severity. In the present study we examined in corticostriatal slices (1) whether the increases in synaptic plasticity can be modulated by stressful stimuli which induce dystonic episodes in young mutant hamsters, and (2) whether increases of LTP persist after spontaneous remission of dystonia in animals older than 10 weeks. The present data show that in slices of young mutant hamsters the extent of LTP was not influenced by the presence of dystonia: In comparison to age-matched control hamsters, LTP was increased in mutant hamsters independent of preceding stressful stimulation. After remission of dystonia, i.e., in older dt(sz) mutant hamsters >10 weeks, only LTP could be elicited, while in preparations from age-matched control hamsters, either LTP or long-term depression developed, depending on previous behavioral challenge. We conclude that in mature brain, corticostriatal connections have the potential for changes in metaplasticity, while in dt(sz) mutant hamsters this metaplasticity is persistently infringed even though stress-inducible dystonic symptoms are lost.


Asunto(s)
Corteza Cerebral/fisiología , Distonía/fisiopatología , Neostriado/fisiología , Plasticidad Neuronal/genética , Plasticidad Neuronal/fisiología , Envejecimiento/fisiología , Animales , Conducta Animal/fisiología , Cricetinae , Distonía/genética , Trastornos Distónicos/fisiopatología , Distrofina/genética , Fenómenos Electrofisiológicos , Potenciales Evocados/fisiología , Femenino , Potenciación a Largo Plazo/genética , Potenciación a Largo Plazo/fisiología , Masculino , Mesocricetus , Mutación/genética , Neuronas Aferentes/fisiología , Terminales Presinápticos/fisiología , Remisión Espontánea , Estrés Psicológico/psicología
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