RESUMEN
OBJECTIVES: Chronic pancreatitis produces disabling pain and loss of pancreatic endocrine/exocrine function. Almost half of the patients will need surgery during the course of the disease. Certain conditions, such as extrahepatic portal hypertension or cavernous transformation of the portal vein, can increase the risk of morbidity and mortality. These complications must be borne in mind in the design of the surgical treatment of chronic pancreatitis. This study is a systematic review on the coexistence of chronic pancreatitis and extrahepatic portal hypertension/cavernous transformation in patients undergoing pancreatic surgery. METHODS: We conducted an unlimited search updated on 10 December 2017, which yielded 535 results. We selected 11 articles. RESULTS: Main indication for surgery was intractable pain. Presence of extrahepatic portal hypertension and/or cavernous transformation increased intraoperative bleeding and general postoperative morbidity, though the increase in general morbidity was less when the different postoperative complications were analyzed individually. Case series showed a higher mortality in patients with extrahepatic portal hypertension. CONCLUSION: Little is known about the presence of extrahepatic portal hypertension in patients undergoing pancreatic surgery for chronic pancreatitis. More studies are needed in order to standardize criteria for vascular involvement in patients with chronic pancreatitis, in order to select the surgical technique and, if necessary, to establish contraindications, in this subgroup of patients.
Asunto(s)
Hipertensión Portal/etiología , Pancreatectomía , Pancreatitis Crónica/complicaciones , Pancreatitis Crónica/cirugía , Vena Porta/anomalías , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Humanos , Pancreatectomía/mortalidad , Pancreatitis Crónica/mortalidad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Factores de Riesgo , Resultado del TratamientoRESUMEN
Interpretation of variants of unknown significance (VUS) in genetic tests is complicated in ethnically diverse populations, given the lack of information regarding the common spectrum of genetic variation in clinically relevant genes. Public availability of data obtained from high-throughput genotyping and/or exome massive parallel sequencing (MPS)-based projects from several thousands of outbred samples might become useful tools to evaluate the pathogenicity of a VUS, based on its frequency in different populations. In the case of the Mexican and other Latino populations, several thousands of samples have been genotyped or sequenced during the last few years as part of different efforts to identify common variants associated to common diseases. In this report, we analyzed Mexican population data from a sample of 3985 outbred individuals, and additional 66 hereditary breast cancer patients were analyzed in order to better define the spectrum of common genomic variation of the BRCA1 and BRCA2 genes. Our analyses identified the most common genetic variants in these clinically relevant genes as well as the presence and frequency of specific pathogenic mutations present in the Mexican population. Analysis of the 3985 population samples by MPS identified three pathogenic mutations in BRCA1, only one population sample showed a BRCA1 exon 16-17 deletion by MLPA. This resulted in a basal prevalence of deleterious mutations of 0.10% (1:996) for BRCA1 and 11 pathogenic mutations in BRCA2, resulting in a basal prevalence of deleterious mutations of 0.276% (1:362) for BRCA2, combined of 0.376% (1:265). Separate analysis of the breast cancer patients identified the presence of pathogenic mutations in 18% (12 pathogenic mutations in 66 patients) of the samples by MPS and 13 additional alterations by MLPA. These results will support a better interpretation of clinical studies focused on the detection of BRCA mutations in Mexican and Latino populations and will help to define the general prevalence of deleterious mutations within these populations.
Asunto(s)
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias de la Mama/genética , Mutación , Femenino , Genética de Población , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , México , Tasa de MutaciónRESUMEN
We theoretically studied the influence of an infinite set of waveguides on the evanescent field of Bloch waves at the surface of a one-dimensional photonic crystal (PC) excited by a TE Gaussian beam undergoing total internal reflection. The set of waveguides is regarded as a periodic inhomogeneous medium with period a. Numerical results are presented for the case in which a is greater than λ, which is the wavelength used to excite the surface mode. When the waveguide tip is very close to the surface of the PC, a fraction of the surface wave is reflected by the tip, producing an interference pattern that can be observed in the near field. In this case, the system simulates scanning tunneling optical microscopy in 2D geometry, and an image of the field distribution of the surface mode is obtained by quantifying the flux energy throughout the waveguide.
RESUMEN
No disponible
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Humanos , Bancos de Tejidos , Encéfalo , Obtención de Tejidos y Órganos , Preservación de Órganos , Conocimientos, Actitudes y Práctica en Salud , Encuestas y CuestionariosAsunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Enfermedad de Darier/diagnóstico , Enfermedad de Darier/etiología , Enfermedad de Darier/patología , Enfermedad de Darier/terapia , Granuloma Anular/diagnóstico , Granuloma Anular/patología , Granuloma Anular/terapia , Enfermedad de Darier/clasificación , Enfermedad de Darier/complicaciones , Enfermedad de Darier/prevención & control , Granuloma Anular/clasificación , Granuloma Anular/complicaciones , Granuloma Anular/prevención & controlAsunto(s)
Enfermedad de Darier/diagnóstico , Adulto , Enfermedad de Darier/complicaciones , Enfermedad de Darier/tratamiento farmacológico , Enfermedad de Darier/genética , Enfermedad de Darier/patología , Genes Dominantes , Infecciones por VIH/complicaciones , Humanos , Queratinocitos/patología , Queratolíticos/uso terapéutico , Masculino , Persona de Mediana Edad , Ácidos Nicotínicos/uso terapéutico , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/genética , Terminología como AsuntoAsunto(s)
Tumor de Células Granulares/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Adulto , Biomarcadores de Tumor/análisis , Tumor de Células Granulares/química , Tumor de Células Granulares/patología , Tumor de Células Granulares/cirugía , Humanos , Masculino , Neoplasias Primarias Múltiples/química , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias de los Tejidos Blandos/química , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/cirugía , Tejido SubcutáneoAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Células de la Granulosa/clasificación , Células de la Granulosa/patología , Células de la Granulosa/fisiología , Biopsia/instrumentación , Biopsia/métodos , Biopsia , Histología/educación , Histología/instrumentaciónAsunto(s)
Lupus Eritematoso Cutáneo/complicaciones , Vitíligo/complicaciones , Adulto , Femenino , HumanosRESUMEN
No disponible
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Humanos , Femenino , Persona de Mediana Edad , Lupus Eritematoso Cutáneo/diagnóstico , Lupus Eritematoso Cutáneo/inmunología , Lupus Eritematoso Cutáneo/patología , Vitíligo/diagnóstico , Vitíligo/inmunología , Vitíligo/patología , Biopsia/instrumentación , Biopsia/métodos , Biopsia , Hipopigmentación/complicaciones , Hipopigmentación/diagnóstico , Hipopigmentación/inmunologíaRESUMEN
BACKGROUND: Although bariatric surgery is currently the most common practice for inducing weight loss in morbidly obese patients (BMI>40 kg/m2), its effect on the lipid content of adipose tissue and its lipases (lipoprotein lipase [LPL] and hormone-sensitive lipase [HSL]) are controversial. METHODS: We analyzed LPL and HSL activities and lipid content from plasma as well as subcutaneous (SAT) and visceral (VAT) adipose tissue of 34 morbidly obese patients (MO) before and after (6 and 12 months) Roux-en-Y gastric bypass surgery and compare the values with those of normal weight (control) patients. RESULTS: LPL activity was significantly higher in MO (SAT=32.9+/-1.0 vs VAT=36.4+/-3.3 mU/g tissue; p<0.001) than in control subjects (SAT=8.2+/-1.4 vs VAT=6.8+/-1.0 mU/g tissue) in both adipose depots. HSL activity had similar values in both types of tissue (SAT=32.8+/-1.6 and VAT=32.9+/-1.6 mU/g) of MO. In the control group, we found similar results but with lower values (SAT=11.9+/-1.4 vs VAT=12.1+/-1.4 mU/g tissue). Twelve months after surgery, SAT LPL activity diminished (9.8+/-1.4 mU/g tissue, p<0.001 vs morbidly obese), while HSL (46.6+/-3.7 mU/g tissue) remained high. All lipids in tissue and plasma diminished after bariatric surgery except plasma nonesterified fatty acids, which maintained higher levels than controls (16+/-3 vs 9+/-0 mg/dL; p<0.001, respectively). CONCLUSIONS: When obese patients lose weight, they lose not only part of the lipid content of the cells but also the capacity to store triacylglycerides in SAT depots.
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Derivación Gástrica , Lipoproteína Lipasa/sangre , Obesidad Mórbida/cirugía , Esterol Esterasa/sangre , Pérdida de Peso , Adulto , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Grasa Intraabdominal/metabolismo , Grasa Intraabdominal/patología , Metabolismo de los Lípidos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/fisiopatología , Grasa Subcutánea/metabolismo , Grasa Subcutánea/patología , Resultado del TratamientoRESUMEN
The objective of this in vivo study was to evaluate the performance of a laser fluorescence device in detecting dentinal caries in noncavitated occlusal surfaces. The sample included 102 first and second permanent molars, selected according to the criteria of Ekstrand et al. [Caries Res 1997;31:224-231]: 46 not suspected of having dentinal caries (score: 0-2) and 56 under suspicion (score: 3-4). Once measured by laser fluorescence, all were validated by fissurotomy (gold standard). To avoid ethical questions, the 46 teeth (score: 0-2) used were to serve as abutments for a fixed-fixed bridge. Visual inspection performed well, showing a sensitivity and specificity of 0.93 and 0.88, respectively. Laser fluorescence had an area under the receiver operating characteristic curve of A(z) = 0.85. The cutoff point with the highest sensitivity and specificity was 20, with a sensitivity and specificity of 0.89 and 0.75, respectively.
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Caries Dental/diagnóstico , Dentina/patología , Rayos Láser , Diente Molar/patología , Corona del Diente/patología , Adulto , Área Bajo la Curva , Biopsia , Esmalte Dental/patología , Fisuras Dentales/diagnóstico , Diagnóstico Diferencial , Fluorescencia , Dureza , Humanos , Curva ROC , Sensibilidad y Especificidad , Decoloración de Dientes/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: Although bariatric surgery is the most common procedure used to induce weight loss in morbidly obese patients, its effect on plasma satiety factors (leptin, ghrelin, and apolipoprotein (apo)-AIV) is controversial. The aim of this work was to analyze these parameters before and at different times after surgery. METHODS: Plasma was obtained from 34 patients before undergoing Roux-en-Y gastric bypass and during weight loss in the 12 months following surgery. RESULTS: Morbidly obese patients had significantly higher values (147%) of leptin than normal-weight (NW) persons, while their ghrelin levels were 46% less than NW. Apo-AIV levels had approximately the same value in both groups (obese and NW). During weight loss, leptin decreased by 75% and ghrelin increased by 78%. Both parameters reached values less than or near NW, respectively, at 1 year after surgery. During the first month after surgery, apo-AIV plasma levels decreased (47%) but later increased and finally returned to preoperative values. Apo-AIV levels were correlated negatively with leptin and positively with ghrelin. High-density lipoprotein (HDL) levels were positively correlated with those of ghrelin and apo-AIV. CONCLUSIONS: During weight loss, plasma leptin and ghrelin could be good markers of total fat decrease. Ghrelin could also indicate gastric mucous improvement, whereas apo-AIV could indicate the recovery of intestinal function. Changes produced in the HDL levels of morbidly obese patients during weight loss suggest a decreased risk of coronary disease.
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Apolipoproteínas A/sangre , Ghrelina/sangre , Leptina/sangre , Obesidad Mórbida/sangre , Pérdida de Peso/fisiología , Tejido Adiposo/metabolismo , Adulto , Biomarcadores/sangre , Femenino , Derivación Gástrica , Humanos , Insulina/sangre , Metabolismo de los Lípidos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/cirugía , Saciedad/fisiología , Delgadez/sangre , Factores de TiempoRESUMEN
No disponible
No disponible
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Humanos , Masculino , Anciano , Fibrosarcoma/complicaciones , Fibrosarcoma/diagnóstico , Epidermólisis Ampollosa/complicaciones , Epidermólisis Ampollosa/diagnóstico , Histiocitoma Fibroso Benigno/complicaciones , Histiocitoma Fibroso Benigno/diagnóstico , Úlcera Varicosa/diagnóstico , Insuficiencia Venosa/cirugía , Tomografía Computarizada de Emisión/métodos , Mastocitosis Cutánea/complicaciones , Úlcera Varicosa/cirugía , Insuficiencia Venosa/complicaciones , Insuficiencia Venosa/diagnóstico , Histiocitoma Fibroso Benigno/fisiopatología , Histiocitoma Fibroso Benigno/terapia , Células Gigantes/patología , Dermatitis/complicacionesRESUMEN
Cysts with an origin in a malignant tumour of the cervical region are rare. It is even more uncommon that the malignant tumour has its origin in a minor salivary gland as it is the malignant transformation of a pleomorphic adenoma. Some considerations are made regarding its localization, histopathology, diagnosis and therapeuthic attitude, as well as some advices to take into account in order to arrive to the diagnosis and correct treatment in similar cases to the one shown.
Asunto(s)
Adenocarcinoma/patología , Adenoma Pleomórfico/patología , Neoplasias de Cabeza y Cuello/patología , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales Menores/patología , Adenocarcinoma/cirugía , Adenoma Pleomórfico/cirugía , Anciano , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Neoplasias de las Glándulas Salivales/cirugía , Glándulas Salivales Menores/cirugíaRESUMEN
Los quistes con origen en un tumor maligno de la región cervical son poco frecuentes. Es aún más raro que el tumor maligno se origine en una glándula salival menor y sea la transformación maligna de un adenoma pleomorfo. Se hacen algunas consideraciones sobre su localización, histopatología, diagnóstico y actitud terapéutica, así como algunos consejos a tener en cuenta para llegar al diagnóstico y tratamiento correcto en casos similares al presentado
Cysts with an origin in a malignant tumour of the cervical region are rare. It is even more uncommon that the malignant tumour has its origin in a minor salivary gland as it is the malignant transformation of a pleomorphic adenoma. Some considerations are made regarding its localization, histopathology, diagnosis and therapeuthic attitude, as well as some advices to take into account in order to arrive to the diagnosis and correct treatment in similar cases to the one shown