Topology Regulated Background Extraction (TRBE) method for eye fundus images.

One of the initial steps in the preprocessing of digital fundoscopy images is the identification of pixels containing relevant information. This can be achieved through different approaches, one of them is implementing background extraction, reducing the set of pixels to be analyzed later in the process. In this work, we present a background extraction method for digital fundoscopy images based on computational topology. By interpreting binarized images as cubical complexes and extracting their homological groups in 1 and 2 dimensions we identify a subset of luminescence values that can be used to binarize the original grayscale image, obtaining a mask to achieve background extraction. This method is robust to noise and suboptimal image quality, facilitating the analytical pipeline in the context of computer aided diagnosis approaches. This method facilitates the segmentation of the background of a digital fundoscopy image, which allows further methods to focus on pixels with relevant information (eye fundus). This tool is best suited to be implemented in the preprocessing stages of the analytical pipeline by computational ophthalmology specialists.•It is robust to noise and low-quality images.•Output provides an ideal scenario for down-the-line analysis by facilitating only relevant pixels in a digital fundoscopy.

Performance, Effectiveness, and Efficiency of Honeybees as Pollinators of Coffea arabica (Gentianales, Rubiaceae).

Studies in crop plants analyzing floral biology in conjunction with effectiveness and efficiency of pollinators on pollen transfer and fruit formation are not common, although they are essential to provide better management actions. On this base, we selected a farm in Bahia, Brazil, to study pollination on coffee plants (Coffea arabica L.). Specifically, we want to analyze if nectar traits influence visitor's performance throughout flower lifetime and if honeybees (Apis mellifera scutellata Lepeletier, 1836) are effective and efficient for coffee pollination comparing fertilization and fructification among four experimental treatments: open (OP), wind (WP), cross (HCP), and single-visit bee pollination (SVBP). We found that honeybees collect both nectar and pollen from coffee flowers and transfer pollen on stigmas even after one visit. No differences were found among treatments regarding the number of pollen grains transferred on the stigmas (effectiveness). OP flowers showed a comparative lower efficiency (pollen tubes and fruit set) probably due to pollination failure as those flowers have a higher variability on the number of deposited pollen grains. Two of the treatments (HCP and SVBP) showed higher fertilization (measuring tubes until the end of the style). Pollen loads seem to be limited by a peak of pollen transference by pollinators, followed by the stabilization in the number of pollen grains deposited per stigma. Thus, reproduction of the coffee can be limited by the quality of pollen grains moved by pollinators instead of quantity. Management strategies should focus on monitoring bee density on plants for increasing pollen quality transfer on flowers trough maintaining the adequate proportions of seminatural habitats and/or the number of hives on agricultural fields according to the flowering of the crop.

Prospective comparison among three intrarectal anesthetic treatments combined with periprostatic nerve block during transrectal ultrasonography-guided prostate biopsy.

BACKGROUND: Recent trends in prostate biopsy analgesia suggest a combination anesthetic to provide better pain relief than periprostatic nerve block (PPNB) alone. This study aimed to demonstrate the efficacy and safety of three intrarectal local anesthesia (IRLA) combined with PPNB in patients undergoing transrectal ultrasonography (TRUS)-guided prostate biopsy. METHODS: In this prospective, randomized study, 120 prostate biopsy patients were equally divided into four IRLA groups: group 1 (placebo) received simple lubrication; group 2 received 2% lidocaine gel; group 3 received 100 mg indomethacin suppository and group 4 received 5% prilocaine/lidocaine (EMLA) cream. PPNB with 2% lidocaine was applied in all groups. A ten-point visual analog scale evaluated both pain associated with the probe insertion and pain associated with prostate sampling. Adverse effects or complications due to anesthesia during and after the procedure were documented. RESULTS: Compared with group 1, groups 3 and 4 had significantly lower pain scores at both probe insertion and prostate sampling while group 2 showed no significant differences at both pain scores. Moreover, group 4 showed significantly lower pain scores at probe insertion compared to group 3, while no significant difference was observed at prostate sampling. Mild complications were observed in all groups with no significant difference in the incidence of complications between groups. CONCLUSION: Intrarectal application of EMLA cream is a more efficient pain reduction than either 2% lidocaine gel or 100 mg indomethacin suppository when applied combined with PPNB. This combination represents an effective option of pain relief for patients undergoing TRUS-guided prostate biopsy.

Relevant Tools for Tackling Interoperability Problems on Heterogeneous Electronic Health Record Systems: An Exploratory Research / Herramientas Relevantes para Abordar Problemas de Interoperabilidad en Sistemas de Expedientes Clínicos Electrónicos Heterogéneos: una Investigación Exploratoria

Abstract: Patients' medical records have been originally based on paper and since 1865 the medical field recognized the need to improve the means for storing and retrieving disperse information. Electronic Health Records (EHR) systems face similar problems, with interoperability being one of them, it defined by IEEE standard glossary of software engineering terminology as: the ability among information systems to exchange data. Mainly, two perspectives of interoperability emerge: a) syntactic, which refers to the ability of an information system to import and validate grammar, as well as a set of construction rules utterances created by another system; and b) semantic, the ability to exchange data among systems and understand it in the same way, regardless of the source system, also called Semantic Interoperability on Information and Communication Technologies or SIICT. The use of standards, vocabularies and terminologies is a common practice for sharing data among heterogeneous EHR systems in order to face interoperability problems. This heterogeneity starts with the manner to collect and store data. This paper presents to e-health practitioners and researches relevant tools used to achieve interoperability in heterogeneous EHR systems, as well as challenges and future trends to manage EHRs with the intention to achieve SIICT.

Resumen: Los registros clínicos de pacientes se basaron en papel originalmente, desde el año de 1865 se reconoció en el entorno medico la necesidad de mejorar los medios para el almacenamiento y recuperación de información dispersa. Los Sistemas de Expediente Clínicos Electrónicos (ECE) enfrentan problemas similares, siendo uno de estos problemas, la interoperabilidad. La cual es definida por "IEEE standard glossary of software engineering terminology" como: la habilidad de intercambiar datos entre sistemas de información, donde dos perspectivas de interoperabilidad emergen: a) sintáctica, la cual se refiere a la habilidad de un sistema de información de importar y validar la gramática de datos, así como de un conjunto de reglas de expresiones creadas por otro sistema; y b) semántica, como la habilidad de intercambiar datos entre sistemas y de entenderlos de la misma forma, independientemente del sistema fuente, llamando a esto como Interoperabilidad Semántica sobre Tecnologías De La Información y Comunicación (ISTIC). El uso de estándares, vocabularios y terminologías es una práctica común para poder compartir datos entre sistemas ECE con el fin de enfrentar problemas de interoperabilidad. Esta heterogeneidad se da desde la forma en cómo se colecta y almacenan los datos. Este artículo presenta a los profesionales de salud e investigadores de e-salud acerca de herramientas relevantes utilizadas para lograr la interoperabilidad de sistemas ECE heterogéneos, así como retos y futuras tendencias para administrar sistemas ECE con la intención de lograr ISTIC.

Angiomatosis quística exclusiva del abdomen sin afectación ósea o de partes blandas / No disponible

No disponible

Linfoma de Burkitt de localización única en el tiroides / No disponible

No disponible

[Biological factors involved in the genesis of incisional hernia]. / Factores biológicos implicados en la génesis.

In the context of a surgically treated abdominal wall pathology, eventration of the wall, or incisional hernia, is one of the most prevalent complications. Despite numerous improvements over the years in suture materials and closure techniques, the incidence of incisional hernia has not diminished. Several general factors can influence the wound healing process after a laparotomy, but there are also biological factors that depend on the individual patient that can to a great extent explain the un-changing incidence of this pathology. Thus, different types of collagen, certain enzymes such as metalloproteinases and factors such as smoking have been attributed a role in the appearance of incisional hernia. These features suggest the need for a biomaterial to strengthen laparotomy closures, especially midline closures, in high-risk patients and/or in those where wound healing is compromised.

Factores biológicos implicados en la génesis / Biological factors involved in the genesis of incisional hernia

En el contexto de la patología quirúrgica de la pared abdominal, la eventración o hernia incisional sigue siendo una de las afecciones de mayor prevalencia. Su incidencia no ha disminuido en los últimos años a pesar de la mejora en los materiales de sutura y también en las técnicas de cierre. Existen factores de índole general que pueden interferir en el proceso cicatricial de las laparotomías, pero hay factores de tipo biológico dependientes del propio individuo que pueden explicar en gran parte la inalterable incidencia de esta afección. Así, los diferentes tipos de colágenos, determinadas enzimas, como las metaloproteinasas, y ciertos hábitos, como el tabaquismo, han sido implicados en la aparición de esta afección. Probablemente sea necesario en casos de riesgo y cicatrización comprometida realizar los cierres laparotómicos con algún material protésico de apoyo, especialmente en las laparotomías medias (AU)

In the context of a surgically treated abdominal wall pathology, eventration of the wall, or incisional hernia, is one of the most prevalent complications. Despite numerous improvements over the years in suture materials and closure techniques, the incidence of incisional hernia has not diminished. Several general factors can influence the wound healing process after a laparotomy, but there are also biological factors that depend on the individual patient that can to a great extent explain the un-changing incidence of this pathology. Thus, different types of collagen, certain enzymes such as metalloproteinases and factors such as smoking have been attributed a role in the appearance of incisional hernia. These features suggest the need for a biomaterial to strengthen laparotomy closures, especially midline closures, in high-risk patients and/or in those where wound healing is compromised (AU)

Papel de la cirugía en las metástasis del cáncer de mama / Role of surgery in metastases from breast cancer

Siempre se ha considerado que el cáncer de mama con metástasis a distancia es una enfermedad incurable y, consecuentemente, la paciente es candidata a recibir sólo tratamiento médico paliativo. Sin embargo, la obtención de mayores éxitos de supervivencia tras los nuevos regímenes terapéuticos en el cáncer de mama diseminado y la existencia de un 5% de enfermas con cáncer de mama metastásico confinado a un solo órgano sólido (estado oligometastásico) son dos aspectos determinantes en la introducción de la cirugía como parte integral en el tratamiento multidisciplinario de las metástasis hepáticas, pulmonares y óseas de origen mamario. Esta revisión actualiza las diferentes series publicadas centrando la discusión en dos aspectos: la selección de las candidatas ideales para la cirugía exerética de hígado, pulmón o partes óseas y la identificación de los factores pronósticos de recurrencia y/o supervivencia tras la extirpación de tales metástasis (AU)

Patients with distant metastases from breast cancer have always been considered terminally ill and as such candidates for palliative treatment only. However, due to new therapeutic modalities in oncology, survival in these patients has improved. Furthermore, in 5% of patients, metastasis from breast cancer is limited to a single solid organ (oligometastatic state). Because of these two factors, surgery is now being performed as a component of multidisciplinary treatment for hepatic, lung and bone metastases from a primary breast tumor. In the present article, we review the different published series, focussing discussion on two issues: selecting candidates for liver, lung or bone resection, and identifying prognostic factors for recurrence and/or survival following surgical excision of metastases to these sites (AU)

[Role of surgery in metastases from breast cancer]. / Papel de la cirugía en las metástasis del cáncer de mama.

Patients with distant metastases from breast cancer have always been considered terminally ill and as such candidates for palliative treatment only. However, due to new therapeutic modalities in oncology, survival in these patients has improved. Furthermore, in 5% of patients, metastasis from breast cancer is limited to a single solid organ (oligometastatic state). Because of these two factors, surgery is now being performed as a component of multidisciplinary treatment for hepatic, lung and bone metastases from a primary breast tumor. In the present article, we review the different published series, focussing discussion on two issues: selecting candidates for liver, lung or bone resection, and identifying prognostic factors for recurrence and/or survival following surgical excision of metastases to these sites.

Alpha1A-adrenoceptors predominate in the control of blood pressure in mouse mesenteric vascular bed.

1 The pressor action of the alpha1A-adrenoceptor agonist, A61603 (N-[5-(4,5-dihydro-1H-imidazol-2-yl)-2-hydroxy-5,6,7,8-tetrahydronaphthalen-1-yl] methanesulfonamide) or the alpha1-adrenoceptor agonist phenylephrine, and their blockade by selective alpha1-adrenoceptor antagonists in the mouse isolated mesenteric vascular bed were evaluated. 2 A61603 showed a approximately 235-fold higher potency in elevating perfusion pressure in mesenteric bed compared to phenylephrine. 3 The alpha1A-adrenoceptor selective antagonist RS 100329 (5-methyl-3-[3-[4-[2-(2,2,2,-trifluoroethoxy) phenyl]-1-piperazinyl] propyl]-2,4-(1H)-pyrimidinedione), displaced with high affinity agonist concentration-response curves to the right in a concentration-dependent manner. 4 The alpha1D-adrenoceptor selective antagonist BMY 7378 (8-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-8-azaspiro[4.5] decane-7,9-dione), did not displace A61603 nor did it block the phenylephrine-induced pressor response. 5 The alpha1B/D-adrenoceptor alkylating antagonist chloroethylclonidine (CEC), caused a rightward shift of the phenylephrine concentration-response curve and reduced its maximum response; however, CEC only slightly modified A61603 evoked contraction. 6 The results indicate that the isolated mouse mesenteric vascular bed expresses alpha1A-adrenoceptors and suggest a very discrete role for 1B-adrenoceptors.

Selective agonists reveal alpha(1A)- and alpha(1B)-adrenoceptor subtypes in caudal artery of the young rat.

Multiple alpha(1)-adrenoceptors were evaluated in caudal artery of the young Wistar rat using selective agonists and antagonists. Arteries were exposed to the selective alpha(1A)-adrenoceptor agonist, A-61603 (N-[5-(4,5-dihydro-1H-imidazol-2-yl)-2-hydroxy-5,6,7,8-tetrahydronaphthalen-1-yl] methanesulfonamide) or to phenylephrine and to prazosin (alpha(1)-adrenoceptor antagonist), or the selective alpha(1A)-adrenoceptor antagonists 5-methylurapidil, RS 100329 (5-methyl-3-[3-[4-[2-(2,2,2,-trifluoroethoxy)phenyl]-1-piperazinyl]propyl]-2,4-(1H)-pyrimidinedione), RS 17053 (N-[2(2-cyclopropylmethoxy) ethyl]-5-chloro-alpha, alpha-dimethyl-1H-indole-3-ethanamide), and the selective alpha(1D)-adrenoceptor antagonist BMY 7378 (8-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-8-azaspiro[4.5] decane-7,9-dione). Results showed a 100-fold higher potency of A-61603 for the alpha(1)-adrenoceptor present in the artery, compared with phenylephrine. Prazosin displaced both agonists with high affinity, whereas 5-methylurapidil, RS 100329 and RS 17053 displaced A-61603 with high affinity, indicating the presence of alpha(1A)-adrenoceptors. The selective alpha(1A)-adrenoceptor antagonists blocked phenylephrine responses with low affinity, suggesting that phenylephrine activated a second receptor population in caudal artery. BMY 7378 antagonized with low affinity both A-61603 and phenylephrine-induced contractions, indicating absence of alpha(1D)-adrenoceptors in the vessel. The results suggest that functional alpha(1B)-adrenoceptors are present in caudal arteries of the young Wistar rat.

Cytochrome oxidase activity in splanchnic organs of portal hypertensive rats.

OBJECTIVE: Portal hypertension is characterized by hyperdynamic splanchnic circulation associated with the development of portosystemic portal collateral circulation. Since blood flow regulation mechanisms in the splanchnic organs can be metabolic, its metabolic capacity has been studied using the mitochondrial enzyme cytochrome C oxidase as histochemical marker. METHOD: Cytochrome oxidase was quantified with a histochemical technique in the liver, pancreas and small bowel of Wistar rats in the control group (n = 8) and in rats with portal hypertension by triple stenosing ligation of the portal vein (n = 9) at 28 days of evolution. RESULTS: All rats with portal hypertension develop portosystemic collateral circulation. In these animals, cytochrome oxidase activity increases (p < 0.01) in the liver (left lateral lobe, periportal zone: 91.81 +/- 5.18 vs. 86.03 +/- 2.82) exocrine pancreas (125.6 +/- 7.25 vs 117.57 +/- 6.43; p < 0.05) as well as in the mucosa (crypts) and duodenum serosa, jejunum and ileum while it decreases in the pericentral zone of the hepatic acinus and intestinal villi. CONCLUSION: Cytochrome oxidase is considered an endogenous marker of local tissular metabolic capacity, so that its increased activity in the small bowel mucosa, crypts, exocrine pancreas and visceral peritoneum may be a metabolic factor that induces splanchnic hyperdynamic circulation in short-term portal hypertensive rats.

Lipoma de válvula ileocecal / Ileum cecal valve lipoma

Se presenta un paciente con lipoma de la válvula ileocecal, efectuándose una revisión bibliográfica y discutiéndose metodología diagnóstica y táctica quirúrgica. (AU)

Lipoma de válvula ileocecal / Ileum cecal valve lipoma

Se presenta un paciente con lipoma de la válvula ileocecal, efectuándose una revisión bibliográfica y discutiéndose metodología diagnóstica y táctica quirúrgica.

Necrosis pancreática: aspectos clínicos y terapéuticos / Pancreatic necrosis: clinical and therapeutical aspects

Se analizan retrospectivamente 22 pacientes portadores de necrosis pancreática. De los exámenes complementarios por imágenes, la tomografía computada es la más útil para el diagnóstico y evaluación de la extensión de la necrosis pancreática y peripancreática. Si bien la presente serie favorecería la indicación de necrosectomía y cierre primario del abdómen abierto, el número de pacientes y la imposibilidad ética de realizar estudios "randomizados", impiden conclusiones definitivas. La mortalidad global fue del 54% y las causas más importantes, fallas multiorgánicas y sepsis. Se estima que la alta mortalidad se debe a demora en el diagnóstico, debridamiento incompleto e insuficiente apoyo nutricional.

Necrosis pancreática: aspectos clínicos y terapéuticos / Pancreatic necrosis: clinical and therapeutical aspects

Se analizan retrospectivamente 22 pacientes portadores de necrosis pancreática. De los exámenes complementarios por imágenes, la tomografía computada es la más útil para el diagnóstico y evaluación de la extensión de la necrosis pancreática y peripancreática. Si bien la presente serie favorecería la indicación de necrosectomía y cierre primario del abdómen abierto, el número de pacientes y la imposibilidad ética de realizar estudios "randomizados", impiden conclusiones definitivas. La mortalidad global fue del 54% y las causas más importantes, fallas multiorgánicas y sepsis. Se estima que la alta mortalidad se debe a demora en el diagnóstico, debridamiento incompleto e insuficiente apoyo nutricional. (AU)

Ulcera péptica antral postsección y reanastomosis antrofundica en la rata: puesta de manifiesto de un probable centro neuroendócrino antrofúndico / Post-seccional antral peptic ulcer and antrofundic re-anastomosis in rats: manifestation of a probable antrofundic neuroendocrine enter

La sección y reanastomosis antrofúndica (ARAF) desencadena, en ratas Wistar macho, verdaderas úlceras pépticas antrales. Se inician a los 20 días. Son de evolución progresiva, penetrando todas a las paredes gástricas. Entre los 7 y 8 meses involucran órganos vecinos (bazo, hígado, páncreas) y generan una gran reacción inflamatória de los ganglios peripancreáticos. La úlcera péptica antral se induce sea que se seccionen o no los nervios de la curvatura menor gástrica y se efectúe o no una piloroplastia concomitante. La hemisección gástrica, sea anterior o posterior, desencadena la úlcera péptica solamente en el mismo lado de la interrupción antrofúndica. En todas estas situaciones, salvo en los casos de piloroplastia concomitante, se comprueba un marcado y significativo incremento del índice gástrico (g/Kg) pero no del pancreático. En la serie de STAF con sección nerviosa en la curvatura menor y sin piloroplastia, el porcentaje de úlceras antrales pépticas es del 56%. Se postula la probable existencia, a nivel antrofúndico, de un centro neuroendócrino. Su anulación o pertubación por el procedimiento de sección y reanatomosis podría generar la úlcera antral y demás cambios histológicos (aumento de las células "G", hiperplasia de las células parietales y de las ECL y "A-like") por una o varias vías hipotéticas: 1. Acción directa, anulando la normal función bloqueadora de la somatostatina sobre las células "G" y/o célulkas parietales. 2. Pertubando o anulando el efecto de bomba motora del antro gástrico y, de esta manera, favoreciendo el reflujo duodenogástrico con todos los efectos deletéreos conocidos de la bilis en el antro, sobre todo en medio ácido. 3. Modificando en sentido inverso la sensibilidad, por un lado, de la masa de células "G" y, por el otro, de las células parietales, ECL y "A-like". La depresión de la sensibilidad fúndica induciría la hiperplasia de las células "G", la hipersecreción de gastrina y, a posteriori, todos los efectos secretorios y tróficos característicos de ésta...