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PURPOSE: To evaluate the benefit of targeted antibiotic prophylaxis (TAP) based on rectal swab culture in comparison with standard empiric antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided needle biopsy of the prostate (TRUS-BP), as well as to assess rate of fecal carriage of Fluoroquinolone-resistant Enterobacterales FQRE. PATIENTS AND METHODS: We prospectively analyzed data that randomized 157 patients within two groups: (G1) TAP according to rectal swab performed 10 days before PB; (G2): empirical antibiotic prophylaxis with ciprofloxacin. Prevalence of FQRE digestive carriage and risk factors were investigated. Incidence of infectious complications after (TRUS-BP) in each group was compared. RESULTS: G2 included 80 patients versus 77 in G1. There was no difference between the two groups regarding age, diabetes, prostate volume, PSA, number of biopsy cores, and risk factors for FQRE. In G2, the prevalence of FQRE digestive carriage was 56.3% all related to E. coli species. In the case of digestive carriage of FQRE, TAP according to the rectal swab culture with third-generation cephalosporins was performed in 73.3%. Patients with FQRE had history of FQ use within the last 6 months in 17.8% (p = 0.03). Rate of febrile urinary tract infection after PB was 13% in G1 and 3.8% in G2 (p = 0.02). CONCLUSIONS: Incidence of FQ resistance in the intestinal flora of our local population was prevalent. Risk factor for resistance was the use of FQ within the last 6 months. TAP adapted to rectal swab, mainly with third-generation cephalosporins, significantly reduced the rate of infectious complications after (TRUS-BP).
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Profilaxis Antibiótica , Próstata , Recto , Humanos , Masculino , Estudios Prospectivos , Recto/microbiología , Próstata/patología , Anciano , Persona de Mediana Edad , Antibacterianos/uso terapéutico , Ciprofloxacina/uso terapéutico , Ciprofloxacina/administración & dosificación , Infecciones Urinarias/prevención & control , Infecciones Urinarias/microbiología , Infecciones Urinarias/epidemiología , Biopsia Guiada por Imagen/efectos adversos , Biopsia Guiada por Imagen/métodosRESUMEN
Keratinizing squamous metaplasia of the renal pelvis is a rare lesion of the upper urinary tract that can occur in the context of chronic aggression to the urothelium, potentially leading to a secondary pyeloureteral junction syndrome. We report the case of a 43-year-old patient discovered intraoperatively in relation to a renal pelvis stone causing a pyeloureteral junction syndrome. The extemporaneous histological examination ruled out a malignant process, and we performed a pyeloplasty according to KUSS-ANDERSON technique. This pathology should be recognized by the urologist for appropriate management. Treatment is conservative, with extended follow-up to detect recurrences or carcinomatous degenerations.
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With about 110 cases reported in literature, juxtaglomerular cell tumors are rare. We report a 25 years old patient who was admitted in neurology for a hemorrhagic stroke secondary to a cerebral aneurysm rupture due to high blood pressure. Etiological investigations showed a solid mass of the left kidney. A radical nephrectomy was realized and pathological examination and immunohistochemical profile concluded to juxtaglomerular cell tumor. The originality of this observation is based on the mode of presentation of a rare renal tumor by a malignant high blood pressure.
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Prostate cancer (PCa) in the second most common cancer in men worldwide. It commonly metastasizes to the bone, lymph nodes, liver and lungs. Synchronous or metachronous testicular metastasis is a rare finding, generally diagnosed incidentally after bilateral orchidectomy for hormonal management in patients with advanced PCa, or at autopsy. We report a case of a 55-year-old male, presenting a PCa and who developed a single testicular metastasis treated by radical orchidectomy, while he was under hormonotherapy.
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Paratesticular leiomyoma is an extremely rare benign tumour. It is often asymptomatic. It is sometimes difficult to distinguish leiomyomas from malignant testicular tumours, which leads to radical orchidectomy, despite its benign nature. Magnetic resonance imaging can be helpful to make conservative management of this lesion.
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Refugees are a vulnerable, growing population who confront a myriad of traumas leading to their forced migration. Although psychiatric illnesses of resettled refugees are well-documented, there is a paucity of studies characterizing their neurological disease profiles. This study aimed to characterize the frequency and range of neurological disorders in a sample of resettled refugees receiving care at a community health center in Massachusetts, U.S.A. We performed a retrospective medical record review of adult (≥ 18 years) resettled refugees between May 2001 and December 2012 at a community health center in Northeast Massachusetts. Sociodemographic and clinical characteristics pertaining to neuropsychiatric health were collected from medical records using a standardized data extraction tool. Group comparisons between those with and without neurological illness and associated sociodemographic and psychiatric characteristics were evaluated using χ2 and independent samples two-tailed t-tests. In our sample (n = 779), 53.3% (n = 415) were male and 48.8% (n = 380) were from the African continent. The mean age was 33.2 ± 12.4 years (range 18-85). 36.8% were diagnosed with at least one neurological disorder and 18.1% with more than one neurological illness. The most common diagnoses were headaches (28.3%), sleep disorders (11.2%), cognitive impairment/ dementia (5.5%), and head trauma (5.5%). Exploratory analyses revealed that participants with neurological illness were more likely to be older (p < .001), female (p = .002), and diagnosed with co-morbid psychiatric diagnoses (p < .001) than those without neurological illness. Neurological disorders frequently co-occur with psychiatric comorbidities among U.S. resettled adult refugees. Standard refugee health assessments should incorporate screening and treatment for neurological illnesses.
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Refugiados , Trastornos del Sueño-Vigilia , Trastornos por Estrés Postraumático , Adulto , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/diagnóstico , Refugiados/psicología , Estudios Retrospectivos , Massachusetts/epidemiologíaRESUMEN
Upper tract urothelial carcinoma presents 5% of urothelial cancers. The most frequent revealing symptom gross haematuria. Vaginal metastasis is rare revealing condition. The combination on these two symptoms should recall the diagnosis of this neoplasm. Biopsy of the vaginal mass can make the histologic diagnosis easily.
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Marine natural products have displayed numerous advantageous effects on biological activities, including antioxidants and cytotoxicity. The total lipids, carotenoids, chlorophyll a and b content, total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity of methanolic crude extract of the green seaweed Halimeda opuntia were all measured in this study. The TPC of the extracts was determined according to the Folin-Ciocalteu method, yielding a result of 55.04 ± 0.98 mg GAE/g of extract. As determined by the aluminium chloride colorimetric method, the TFC of the extract was 40.02 ± 0.02 mg QE/g of extract. Antioxidant activity was determined by using a 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay with different concentrations that ranged between 200 and 1000 µg/mL, noted H. opuntia as the highest in DPPH reduction (63.61 %) at 1000 µg/mL concentration. Total antioxidant capacity (TAC) of the extract was 57.36 ± 0.004 mg AAE/g extract at concentration of 1.0 mg/mL. The cytotoxic activity of this seaweed was pre-screened against a panel of cell lines including estrogen receptor-positive human breast adenocarcinoma (MCF-7), estrogen negative human breast adenocarcinoma (MDA-MB-231), human colorectal adenocarcinoma (HT-29), human hepatocellular carcinoma (HepG2), and mouse embryonic fibroblast (3T3) using the MTT assay. The content of total lipids in H. opuntia was 1.60 ± 0.002 %. Total carotenoids were 115.57 ± 0.98 µg/g, while chlorophyll a and b were 148.73 ± 2.60 µg/g and 290.83 ± 9.46 µg/g, respectively. In terms of cytotoxicity activity, methanolic extract of H. opuntia was found to be highly cytotoxic to MCF-7 cells, with an IC50 of 25.14 ± 1.02 g/mL, and slightly less so to 3T3 cells (IC50 65.23 ± 0.25 µg/mL). This study's findings suggest that natural pigments (carotenoids and chlorophyll), phytochemicals like phenolic and flavonoid compounds found in this species may play an important role and could be used as a natural cancer treatment.
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INTRODUCTION: Clean Intermittent Catheterization (CIC) is the method of choice for bladder emptying in patients having bladder emptying disorders, acquired or pharmacologically induced, whether it is neurologically related or not. The aim of this study is to assess the theoretical and practical knowledge of general practitioners (GP) on CIC. MATERIALS: Observational prospective study (anonymous online questionnaire) was conducted with 224 GP between March and April 2020. Each physician had to complete a questionnaire about the definition of CIC, its indications and usage, the indications of urine culture, antibiotic therapy, and the complications of this method of drainage. RESULTS: Only 18.3% of GP that took part in the study gave an exact definition of CIC. As to the importance of it, 67.9% responded that it protects the upper urinary tract and 37.1% that it prevents urinary tract infections (UTI). Fifty-two per cent of physicians were unaware of the regular frequency at which it should carry out a day. Fifty eight percent prescribed sterile gloves and 57.1% an antiseptic. UTI was considered as the main complication of CIC by 87.1% of physicians and 35.7% requested a systematic urine culture for patients under CIC. For patients with an asymptomatic bacteriuria, 65.6% of GP prescribed antibiotic therapy. CONCLUSION: GP need to improve their knowledge of SIP, its framework, indications, modalities, and the way to deal with colonization or urinary tract infection. This will improve the management of impacted patients.
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Médicos Generales , Cateterismo Uretral Intermitente , Enfermedades de la Vejiga Urinaria , Vejiga Urinaria Neurogénica , Infecciones Urinarias , Antibacterianos/uso terapéutico , Encuestas de Atención de la Salud , Humanos , Cateterismo Uretral Intermitente/efectos adversos , Cateterismo Uretral Intermitente/métodos , Internet , Estudios Prospectivos , Enfermedades de la Vejiga Urinaria/terapia , Vejiga Urinaria Neurogénica/complicaciones , Vejiga Urinaria Neurogénica/terapia , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/métodos , Infecciones Urinarias/etiología , Infecciones Urinarias/prevención & controlRESUMEN
Vitamin D or calciferol is a fat-soluble vitamin that has a unique feature of synthesizing in the body mainly by exposure to UV from the sunlight and then transformed to 25 (OH) D by the liver and finally to a vital form 1,25-dihydroxyvitamin D by the kidneys. Vitamin D receptor gene polymorphism (FokI-rs2228570) has been proposed as the major cause of anemia. The present study aimed to discover the association between vitamin D deficiency and vitamin D receptor gene polymorphism (FokI-rs2228570) in patients with anemia. A total of 120 men with anemia and no kidney disorders have been compared with 60 healthy controls in the present case-control study. A single nucleotide polymorphism (SNP) FokI-rs2228570 was detected by PCR and PCR-RFLP techniques. Levels of serum vitamin D, erythropoietin, and some biochemical parameters were detected by the ELISA assay technique. The mutant homozygous genotype ff was more frequent in patients with anemia (45%) than in the controls (15%). Also, the frequency of the f allele was associated with a significant decrease in the levels of vitamin D and hemoglobin in patients (0.62%); therefore, the mutant allele is a risk factor for developing anemia compared with genetic patterns FF and Ff. Vitamin D deficiency is common in those with anemia which is often associated with low hemoglobin and high levels of erythropoietin. Additionally, the genetic frequencies also affect the level of vitamin D which is indicated by low levels of mutant patterns (Ff, ff) in which patients suffer from severe anemia.
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Anemia , Eritropoyetina , Receptores de Calcitriol , Deficiencia de Vitamina D , Anemia/epidemiología , Anemia/genética , Eritropoyetina/genética , Irak/epidemiología , Polimorfismo de Nucleótido Simple , Receptores de Calcitriol/genética , Vitamina D , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/genética , Humanos , MasculinoRESUMEN
INTRODUCTION: Vesico-vaginal fistula (VVF) is a global healthcare problem that has a high prevalence in developing countries. The aim of this work is to study the epidemiological, clinical and therapeutic characteristics of VVF post-obstetric and gynecologic procedures in order to identify the predictive factors of surgical treatment failure. METHODS: Data were collected from 132 VVF patients in our institution between 1985 and 2017. VVF was classified according to Zmerli's classification. Patients underwent surgical treatment and were evaluated after a follow-up period of 6 months. Successful treatment was defined as the absence of urine leakage whereas recurrence was defined as the presence of urine leakage immediately after the surgery or after a period of dryness with a confirmed VVF. Risk factors of surgical treatment failure were identified. RESULTS: The average age of patients was 44 years. The patients were multiparous in 62% of cases. VVF was consecutive to hysterectomy in 62.1% of cases, and after childbirth in 34%. VVF was retro-trigonal in 99 cases (75%) and trigonal in 33 cases (25%). The average size of the fistula was 1cm (0.3-2cm). VVF repair was performed by vaginal approach in 68% of cases and abdominal approach in 32% of cases. Treatment failure was noted in 36 patients (27%). Predictive factors of treatment failure were: vaginal fibrosis (P<0.001); trigonal location of the fistula (P<0.001); large diameter of the VVF>1cm (P<0.001); and complex and complicated fistulas (P=0.02). CONCLUSION: Although Tunisia is a developing country, the main cause of VVF was not obstetrical. Treatment failure, noted in almost one third of cases, was, in our series, correlated with the quality of the vaginal tissue, the size and the location of the fistula, and its complexity. LEVEL OF PROOF: 4.
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Fístula Vesicovaginal , Adulto , Femenino , Humanos , Histerectomía , Embarazo , Factores de Riesgo , Insuficiencia del Tratamiento , Túnez/epidemiología , Fístula Vesicovaginal/epidemiología , Fístula Vesicovaginal/etiología , Fístula Vesicovaginal/cirugíaRESUMEN
Aromatic heterocyclic compounds are commonly used in pharmaceutical and agrochemical products. The usage has been also extended in the production of corrosion inhibitors and electronic, opto-electronic, and NLO devices. The four regioisomers of the aromatic heterocyclic molecule, tetrakis(4-pyridyl)cyclobutane (tpcb), were optimized, and their chemical, electronic, and biological properties were examined. The rctt and rtct isomers were isolated and further characterized by the infrared and Raman spectroscopic techniques, and their vibrational modes with attention on important functional groups were discussed. The theoretical vibrational data obtained by DFT/B3LYP/6-311++G(d,p) were in very good agreement with the experimental ones. The occupancy, bond polarization, hybridization of the N-C bond, bonding characteristics between the pyridyl carbon and cyclobutane moiety, and distribution of electron density for the four tpcb isomers have been explored through NBO analysis. The inversion barrier of the cyclobutane moiety was obtained based on the optimized structures of the planar and puckered configurations of the isomers. The rccc isomer exhibited the least electrophilic character compared to the other tpcb isomers. The chemical significance of tpcb has been further explained by the wave function analyses. Molecular docking results revealed that the tpcb ligand would possess a potential anti-viral and anti-bacterial activity via a membrane-permeable mechanism.
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Ciclobutanos/química , Simulación del Acoplamiento Molecular , Piridinas/química , Teoría Cuántica , Análisis Espectral , Antiinfecciosos/química , Antiinfecciosos/farmacología , Permeabilidad de la Membrana Celular/efectos de los fármacos , Ciclobutanos/farmacología , Isomerismo , Conformación MolecularRESUMEN
The mechanical response of an advanced high strength and corrosion resistant 10 % Cr nanocomposite steel (ASTM A1035CS Grade 120) is measured under uniaxial tension and compression at the strain rates of 10-4 s-1, 10-2 s-1, 100 s-1, 700 s-1, and 3000 s-1. The experiments are performed at 22 °C as well as 80 °C to investigate the material behavior at the expected temperature rise due to adiabatic deformation at 15 % strain. Additionally, different compression-shear hat-shaped specimens are tested at quasi-static and dynamic strain rates to investigate the localization behavior of this material. The material exhibits small strain rate sensitivity (SRS) during quasi-static loading, but a pronounced SRS between quasi-static and dynamic strain rates. Tension-compression asymmetry is also observed at both temperatures. Experiments at 80 °C reveal a decrease in flow stress in both tension and compression indicating the material is sensitive to thermal softening due to adiabatic heating. Load-Unload-Reload (LUR) and strain rate jump experiments are performed to investigate the reasoning behind the approximate rate insensitivity of ASTM A1035CS steel during quasi-static strain rates. A new constitutive model is also developed using a novel rate dependent material model with a modified Hockett-Sherby (MHS) hardening model and incorporating Lode angle dependence to capture the tension-compression asymmetry. The model is also used to predict the LUR and strain rate jump experiments. Finally, reasoning behind the unique rate dependent thermo-mechanical behavior of ASTM A1035CS steel is discussed in regards to adiabatic heating, strain-partitioning, and phase transformation.
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AIM OF THE STUDY: The main difficulties during retroperitoneal laparoscopic adrenalectomies are due to its location. Our objective was to define the relationship of the adrenals with the diaphragm and the psoas muscle. METHODS: Our work is an anatomical dissection of 80 fresh cadavers' adrenals. To study the right adrenal, we performed a right nephrectomy and adrenal remained attached to the Inferior vena cava by its main vein. On the left, the edges of the adrenal have been identified by needles and the adrenal was reclined to study its projection on the posterior muscular wall. RESULTS: The right adrenal is located higher, 13mm [4-20mm] above the medial arcuate ligament (MAL) in 16 cases (40%). Its lower border was at the same level as the MAL in 18 cases (45%) and 11mm [10-17mm] below the MAL in 6 cases (15%). The posterior support of the right adrenal was the right crus of the diaphragm (Right-CD) in 34 cases (85%) and straddling the Right-CD and the psoas in 6 cases (15%). The study of the relationships of the left adrenal with the MAL showed that the lower edge of the gland was at its same level in 16 cases (40%) and below in 24 cases (60%) by 14mm [8-24mm]. The posterior support of the left adrenal was the left crus of the diaphragm (Left-CD) in 16 cases (40%) and straddling the Left-CD and the psoas in 24 cases (60%). CONCLUSIONS: Our results showed that the right adrenal is higher. The MAL is an important posterior element to the adrenal gland that could serve as an anatomical landmark to identify the adrenal during laparoscopic adrenalectomy.
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Pared Abdominal , Laparoscopía , Glándulas Suprarrenales , Cadáver , Humanos , MúsculosRESUMEN
Perianal abscesses are a common surgical presentation in infants. Historically, general anaesthesia (GA) has been used to facilitate incision and drainage, with or without exploration for a fistula-in-ano (FIA). This review aims to assess outcomes following management of perianal abscesses without GA in infants less than 24 months old. We aim to identify the success of management without GA. Using PRISMA guidelines, studies were identified from MEDLINE, EMBASE and PubMed. Studies including infants less than 24 months with perianal abscesses managed without GA were reviewed. The primary outcome was the number of patients requiring GA following initial management without GA. Secondary outcomes included rates of recurrent perianal abscesses, rates of progression to FIA and time to cure. Nine studies, involving 1049 infants less than 24 months old met inclusion criteria. A total of 1039 (99.0%) were males. Study design consisted of one prospective case series of 18 patients, and eight retrospective cohort studies. There were no randomized control trials. A total of 1037 (98.9%) patients were initially managed without GA. Of these, 59 (5.6%) were documented to subsequently require a general anaesthetic. Treatment modalities included antibiotics, regular baths, needle aspiration, incision and drainage under local anaesthesia, hainosankyuto and fibroblast growth factor. A total of 790 (75.3%) healed primarily without further intervention. A total of 243 (23.2%) were documented to have a recurrence or progression to FIA. All patients who required a subsequent general anaesthetic had progressed to FIA. Despite the lack of well-designed prospective studies, existing evidence supports management of perianal abscesses without initial GA in infants, with more than 75% healing completely. Further research aimed at standardizing care and confirming the safety and efficacy of initial non-operative management are warranted, and may potentially reduce the number of unnecessary initial and subsequent clinical interventions.
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Absceso/terapia , Antibacterianos/uso terapéutico , Enfermedades del Ano/terapia , Manejo de la Enfermedad , Drenaje/métodos , Anestesia General , Humanos , Lactante , Resultado del TratamientoRESUMEN
BACKGROUND: The treatment of overactive bladder syndrome (OABS) by percutaneous pelvic nerve stimulation (PTNS) is usually recommended as a third line treatment. The purpose of this work was to compare PTNS alone on idiopathic OABS in women against a treatment combining PTNS and pelvic floor muscle training (PFMT). METHODS: This was a retrospective comparative study of 58 patients, followed at the urodynamic unit. Thirty patients received PTNS alone and 28 PTNS+pelvic floor rehabilitation. The main instrument used to measure the outcomes was the voiding diary. RESULTS: The average age of our patients was 55.2 years. In the PTNS group, there was a significant improvement in daily micturitions (6 after PTNS vs. 10 before, P<0.001), nocturia (1.08 after PTNS vs. 1.75 before, P=0.003), urgency (7 daily before PTNS vs. 11 before (P<0.001) and maximum voided volume (378mL after PTNS vs. 306mL before, P=0.004). The Ditrovie score and USP scores showed a significant decrease. In the PTNS+PFMT group, a significant improvement was noted for the criteria: daily frequency episodes (5.7 after PTNS+PFMT vs. 7.56 before, P<0.001), nocturia (1.4 after PTNS+PFMT vs. 2.3 before, P=0.001), and daily urgency episodes (7 after PTNS+PFMT vs. 9 before, P<0.01). The OAB and SUI USP scores and the Ditrovie score decreased significantly (USP SUI score: 1.2 after PTNS+PFMT vs. 3.4 before (P<0.001) ; USP OAB score: 5.2 after PTNS+PFMT vs. 10.4 before, P<0.001). The comparison of the two groups (PTNS vs. PTNS+PFMT) did not show any significant difference in the voiding dairy outcomes and in the subjective scores outcomes (USP and Ditrovie). CONCLUSION: No significant difference was observed concerning outcomes following PTNS alone and combined PTNS and PFMT in women presenting OABS. LEVEL OF EVIDENCE: 3.
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Terapia por Ejercicio , Estimulación Eléctrica Transcutánea del Nervio , Vejiga Urinaria Hiperactiva/terapia , Adulto , Anciano , Terapia Combinada , Femenino , Humanos , Persona de Mediana Edad , Diafragma Pélvico , Estudios Retrospectivos , Nervio Tibial , Adulto JovenRESUMEN
A set of experimental and computational techniques have been applied for the understanding of fundamental spectroscopic and reactive properties of 3-(3,4-dichlorophenyl)-1,1-dimethylurea (diuron) compound. Experimental techniques employed in this study encompassed spectroscopic characterization via IR and Raman approaches, while optical properties were studied by measurements of UV/Vis spectra. The thermogravimetric analysis was also studied in order to analyze the stability of diuron. Aside from the determination of reactive properties, DFT calculations on isolated molecules were also used to thoroughly visualize and analyze spectroscopic properties such as IR and UV/Vis. MD simulations were used in order to understand interactions with water, while periodic DFT calculations were used in order to analyze band structure and density of states of the diuron crystal structure. Since the crystal structure of diuron is known, it was used in order to extract the relevant molecular pairs and investigate interactions between them by DFT and symmetry adapted perturbation theory approaches (SAPT).
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1,1-Dimethyl-3-phenylurea (known as fenuron) which is a phenyl urea-based widely used herbicide exhibits interesting structural and conformational properties and a notable biological activity. A detailed analysis on the vibrational, molecular and electronic characteristics of fenuron has been carried out. Potential energy scans (PESs) performed at the B3LYP/6-311++G(d,p) level of theory predicted two possible minima corresponding to the optimized anti and synforms resulting from the internal rotation about the N-C bond. The presence of an auxochrome together with the interaction with DMSO solvent exhibited a blue shift corresponding to the C=O orbitals. Delocalization of HOMO and LUMO orbital facilitated the charge transfer effect in the molecule. The calculated HOMO-LUMO energies, chemical potential, energy gap and global hardness suggested a low softness value for the compound while its biological activity was described by the value of electrophilicity. Chlorine substitution in the phenyl ring influenced the orbital delocalization for ortho and para substitutions but that of meta remained unaffected. NLO properties were noticed to increase due to chlorine substitution in the parent molecule. The docking results suggested that the compound exhibits an inhibitory activity against mitochondrial ubiquinol-cytochrome-c reductase and can be developed as a potential anticancer agent.
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In the current study, Raman spectroscopy is employed for the identification of the biochemical changes taking place during the development of Hepatitis C. The Raman spectral data acquired from the human blood plasma samples of infected and healthy individuals is analysed by Principal Components Analysis and the Raman spectral markers of the Hepatitis C Virus (HCV) infection are identified. Spectral changes include those associated with nucleic acidsat720 cm-1, 1077â¯cm-1 1678 (CO stretching mode of dGTP of RNA), 1778â¯cm-1 (RNA), with proteins at 1641â¯cm-1(amide-I), 1721â¯cm-1(CC stretching of proteins) and lipids at 1738â¯cm-1(CO of ester group in lipids). These differences in Raman spectral features of blood plasma samples of the patients and healthy volunteers can be associated with the development of the biochemical changes during HCV infection.
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Análisis Químico de la Sangre/métodos , Hepatitis C/diagnóstico , Espectrometría Raman/métodos , Sangre/virología , ADN Viral/sangre , Nucleótidos de Desoxiguanina , Hepatitis C/sangre , Hepatitis C/virología , Humanos , Análisis de Componente Principal , ARN Viral/sangre , Carga ViralRESUMEN
INTRODUCTION: Paragangliomas, defined as extra-adrenal chromaffin-cells tumors, are rarely located in the retro-peritoneum. Clinical presentation is similar to pheochromocytoma, and mainly depends on the producing character of the tumor. Positive diagnosis requires plasmatic and urinary hormonal assays. Radiological and isotopic explorations are essential before surgery. The only curative therapeutic strategy is surgical, associated to peri-operative prevention and monitoring of the frequently reported hemodynamic and cardiovascular disorders. Outcome depends of the metastatic character of the tumor, the presence of tumor remnant after surgical resection. Genetic study is recommended; the risk of recurrence and association to other neoplasm is more described in genetic forms. MATERIAL AND METHODS: Authors report 5cases of retro-peritoneal paraganglioma, operated in the department of urology of Hospital, between 2013 and 2017. Observations are about 2men and 3women. Clinical presentation is not always specific and paraganglioma may be discovered fortuitously. Two patients have been operated by coelioscopic approach, midline incision was performed in two other cases, and dorsal lumbotomy associated to a Rutherford-Morrison incision in a patient. RESULTS: Two patients presented resistant hypertension and palpitation associated to suspect retro-peritoneal masses in imagery and elevated urinary methoxylated derivates before surgery. One patient was asymptomatic and the tumor was discovered in imagery. Per-operative hypertensive crisis and sinus tachycardia occurred in a case. The average follow-up period is 22.8months. Hypertension and palpitation disappeared after surgery. There was no recurrence for all the operated patients. CONCLUSION: Retro-peritoneal paraganglioma is a rare condition. Symptoms are not specific and clinical presentation may be similar to pheochromocytoma. Abdominal CT-scan and MRI, in association with MIBG scintigraphy are strongly evocative. Histological examination ensures diagnosis. Per-operative cardio-vascular disorders are to consider and must prevented and managed by anesthesiologists. Complete surgical resection is the only curative treatment and avoids recurrences.