Erratum to "Gastroenteropancreatic Neuroendocrine Neoplasia Characterization in Portugal: Results from the NETs Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism".

[This corrects the article DOI: 10.1155/2019/4518742.].

Gastroenteropancreatic Neuroendocrine Neoplasia Characterization in Portugal: Results from the NETs Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism.

BACKGROUND: The incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been increasing in the last five decades, but there is no large-scale data regarding these tumours in Portugal. We conducted a cross-sectional, multicentric study in main Portuguese centers to evaluate the clinical, pathological, and therapeutic profile of GEP-NENs. METHODS: From November, 2012, to July, 2014, data from 293 patients diagnosed with GEP-NENs from 15 centers in Portugal was collected and registered in an online electronic platform. RESULTS: Median age at diagnosis was 56.5 (range: 15-87) years with a preponderance of females (54.6%). The most frequent primary sites were the pancreas (31.1%), jejunum-ileum (24.2%), stomach (13.7%), and rectum (8.5%). Data regarding hormonal status was not available in most patients (82.3%). Stratified by the tumour grade (WHO 2010 classification), we observed 64.0% of NET G1, 24.7% of NET G2, and 11.3% of NEC. Poorly differentiated tumours occurred mainly in older patients (p = 0.017), were larger (p < 0.001), and presented more vascular (p = 0.004) and lymphatic (p = 0.001) invasion. At the time of diagnosis, 44.4% of GEP-NENs presented metastatic disease. Surgery (79.6%) and somatostatin analogues (30.7%) were the most frequently used therapies of GEP-NENs with reported grading. CONCLUSION: In general, Portuguese patients with GEP-NENs presented similar characteristics to other populations described in the literature. This cross-sectional study represents the first step to establish a national database of GEP-NENs that may aid in understanding the clinical and epidemiological features of these tumours in Portugal.

Pulsed radiofrequency of the brachial plexus in the treatment of chemotherapy-induced peripheral neuropathy of the upper limb.

We describe the treatment of chemotherapy-induced peripheral neuropathy in the upper limb of a patient via ultrasound-guided pulsed radiofrequency of the brachial plexus. A 54-year-old female, who underwent chemotherapy and mastectomy for left-sided breast cancer, presented to the pain clinic describing continuous and severe shock-like pain in the posterolateral aspect of the left upper limb, above the elbow. A diagnosis of chemotherapy-induced peripheral neuropathy was made. Pain management with multi-modal analgesia was not fully effective and pulsed radiofrequency was offered as an alternative. Ultrasonography of the supraclavicular region was used to identify the brachial plexus, followed by pulsed radiofrequency using an insulated-tip needle that produced paraesthesia in the affected area. Onset of pain relief occurred one week post-procedure and lasted approximately 10 weeks. An estimated 80% decrease in pain intensity was reported by the patient. We propose that pulsed radiofrequency can be offered as a pain management alternative in certain presentations of chemotherapy-induced peripheral neuropathy.

Metabolism of triglyceride-rich lipoproteins and transfer of lipids to high-density lipoproteins (HDL) in vegan and omnivore subjects.

BACKGROUND AND AIMS: Vegan diet excludes all foodstuffs of animal origin and leads to cholesterol lowering and possibly reduction of cardiovascular disease risk. The aim was to investigate whether vegan diet improves the metabolic pathway of triglyceride-rich lipoproteins, consisting in lipoprotein lipolysis and removal from circulation of the resulting remnants and to verify whether the diet alters HDL metabolism by changing lipid transfers to this lipoprotein. METHODS AND RESULTS: 21 vegan and 29 omnivores eutrophic and normolipidemic subjects were intravenously injected triglyceride-rich emulsions labeled with (14)C-cholesterol oleate and (3)H-triolein: fractional clearance rates (FCR, in min(-1)) were calculated from samples collected during 60 min for radioactive counting. Lipid transfer to HDL was assayed by incubating plasma samples with a donor nanoemulsion labeled with radioactive lipids; % lipids transferred to HDL were quantified in supernatant after chemical precipitation of non-HDL fractions and nanoemulsion. Serum LDL cholesterol was lower in vegans than in omnivores (2.1 ± 0.8, 2.7 ± 0.7 mmol/L, respectively, p < 0,05), but HDL cholesterol and triglycerides were equal. Cholesteryl ester FCR was greater in vegans than in omnivores (0.016 ± 0.012, 0.003 ± 0.003, p < 0.01), whereas triglyceride FCR was equal (0.024 ± 0.014, 0.030 ± 0.016, N.S.). Cholesteryl ester transfer to HDL was lower in vegans than in omnivores (2.7 ± 0.6, 3.5 ± 1.5%, p < 0,05). Free-cholesterol, triglyceride and phospholipid transfer were equal, as well as HDL size. CONCLUSION: Remnant removal from circulation, estimated by cholesteryl oleate FCR was faster in vegans, but the lipolysis process, estimated by triglyceride FCR was equal. Increased removal of atherogenic remnants and diminution of cholesteryl ester transfer may favor atherosclerosis prevention by vegan diet.

Effects of lead spatial resolution on the spectrum of cardiac signals: a simulation study.

Spectral analysis is widely applied to bioelectric cardiac signals for quantifying the spatiotemporal organization of cardiac tissue. Nevertheless, to date it is not well understood how lead characteristics affect the spectrum of recorded cardiac signals and, as a consequence, the interpretation of cardiac spectrum is still controversial. In this paper we use simulation methods to investigate the effects of lead spatial resolution on the spectrum of cardiac signals. We simulate three cardiac rhythms of different degrees of spatiotemporal organization in a square sample of cardiac tissue. Then, by using a lead field approach, we synthesize the signals recorded by four idealized leads of different spatial resolution. Finally, we estimate the spectrum of simulated cardiac signals. Our simulations indicate that lead spatial resolution affects cardiac spectrum, although the effects depend on the organization of the underlying rhythm. Specifically, our simulations show that for highly organized rhythms, the smaller the lead resolution region, the broader the distribution of power in frequency. Since lead resolution can affect significantly cardiac spectrum, we conclude that caution should be used when quantifying cardiac spatiotemporal organization based on the spectrum of cardiac signals.

[New methods in training of paediatric emergencies: medical simulation applied to paediatrics]. / Nuevas metodologías en el entrenamiento de emergencias pediátricas: simulación médica aplicada a pediatría.

Patient safety constitutes one of the main objectives in health care. Among other recommendations, such as the creation of training centres and the development of patient safety programmes, of great importance is the creation of training programmes for work teams using medical simulation. Medical simulation is defined as "a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation or to understand systems or human actions". In this way, abilities can be acquired in serious and uncommon situations with no risk of harm to the patient. This study revises the origins of medical simulation and the different types of simulation are classified. The main simulators currently used in Pediatrics are presented, and the design of a simulation course applied to the training of pediatric emergencies is described, detailing all its different phases. In the first non face-to-face stage, a new concept in medical training known as e-learning is applied. In the second phase, clinical cases are carried out using robotic simulation; this is followed by a debriefing session, which is a key element for acquiring abilities and skills. Lastly, the follow-up phase allows the student to connect with the teachers to consolidate the concepts acquired during the in-person phase. In this model, the aim is to improve scientific-technical abilities in addition to a series of related abilities such as controlling crisis situations, correct leadership of work teams, distribution of tasks, communication among the team members, etc., all of these within the present concept of excellence in care and medical professionalism.

Nuevas metodologías en el entrenamiento de emergencias pediátricas: simulación médica aplicada a pediatría / New methods in training of paediatric emergencies: medical simulation applied to paediatrics

La seguridad del paciente constituye uno de los principales objetivos de los sistemas sanitarios y, entre otras recomendaciones para su mejora, destaca el establecimiento de programas de entrenamiento de equipos de trabajo con simulación médica. Ésta se define como una situación o lugar creado para permitir que un grupo de personas experimenten una representación de un acontecimiento real con el propósito de practicar, aprender, evaluar o entender sistemas o acciones humanas. De este modo, se podrán adquirir habilidades en situaciones graves y poco frecuentes, sin perjuicio para el paciente. En este trabajo se recuerdan los orígenes de la simulación médica y se clasifican los distintos tipos de simulación actuales. Se exponen los principales simuladores utilizados actualmente en pediatría, y se describe el diseño de un curso de simulación aplicado al entrenamiento de emergencias pediátricas, detallando las distintas fases del mismo. En la primera fase, no presencial, se aplica un nuevo concepto de formación denominado e-learning, nueva metodología de uso de tecnologías de información para la formación de profesionales. En la segunda fase, esencialmente práctica, se desarrollan los casos clínicos con simulación robótica y posteriormente el análisis-debate o debriefing, elemento clave para la adquisición de habilidades. Por último, en la fase de seguimiento, el alumno dispone de conexión con los docentes para consolidar los conceptos adquiridos durante la fase presencial. En este modelo se pretende mejorar las habilidades científicos-técnicas y además una serie de habilidades relacionales como son el control de la situación de crisis, el liderazgo adecuado de un grupo de trabajo, el reparto de tareas, la comunicación entre los miembros del equipo, etc., todas ellas encuadradas en el actual concepto de excelencia de cuidados y del profesionalismo medico (AU)

Patient safety constitutes one of the main objectives in health care. Among other recommendations, such as the creation of training centres and the development of patient safety programmes, of great importance is the creation of training programmes for work teams using medical simulation. Medical simulation is defined as "a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation or to understand systems or human actions". In this way, abilities can be acquired in serious and uncommon situations with no risk of harm to the patient. This study revises the origins of medical simulation and the different types of simulation are classified. The main simulators currently used in Pediatrics are presented, and the design of a simulation course applied to the training of pediatric emergencies is described, detailing all its different phases. In the first non face-to-face stage, a new concept in medical training known as e-learning is applied. In the second phase, clinical cases are carried out using robotic simulation; this is followed by a debriefing session, which is a key element for acquiring abilities and skills. Lastly, the follow-up phase allows the student to connect with the teachers to consolidate the concepts acquired during the in-person phase. In this model, the aim is to improve scientific-technical abilities in addition to a series of related abilities such as controlling crisis situations, correct leadership of work teams, distribution of tasks, communication among the team members, etc., all of these within the present concept of excellence in care and medical professionalism (AU)

Efecto de tratamientos térmicos sobre las características químicas de carne de jaiba mora (Homalaspis plana) / Effect of thermal treatments on the chemical characteristics of mora crab meat (Homalaspis plana)

Marine species muscles present non-proteins nitrogenated compounds, used as quality index. They are total volatile basis (NBVT), trimethylamine oxide (TMAO) and trimethylamine (TMA). pH is considered too as a quality index. The aim of this work was to evaluate these parameters in a fresh and canned marine product from the V region, corresponding to mora crab (Homalaspis plana). Fresh pincer meat from mora crab was extracted and kept in ice until theits analysis and thermal process of the canned product. A 3(2) statistical design was applied, considering two variables with 3 levels: 15, 30 y 45 minutes time levels: 80 degrees, 100 degrees y 121 degrees C temperature levels. Nine conditions of time-temperature were obtained. The thermal treatment caused an increase in pH and BVT. The TMA was increased since reduction of TMAO.

[Effect of thermal treatment on the available lysine content of mora crab (Homalaspis plana) meat]. / Efecto de tratamientos térmicos sobre el contenido de lisina disponible en carne de jaiba mora (Homalaspis plana).

The effect of different high temperatures treatments on the available lysine content of mora crab meat, was studied. Fresh pincer meat from mora crab (from the V region) was extracted and kept in ice until the thermal process of the canned product. A 3(2) statistical design was applied, considering the following variables temperature (80 degrees C, 100 degrees C and 121 degrees C) and time (15, 30 and 45 minutes). Nine conditions temperature-time were obtained. Nutritional properties from available lysine were studied. A decrease from 8.33 (in raw meat) to 6.01 g/g protein in the most drastic thermal conditions, was observed. It ca be concluded that the content of available lysine in mora crab meat is more affected by time than by the temperature of the thermal treatments. Therefore the nutritive quality can be maintained applying high temperature and short time treatments.

A comparative study of fish species identification by gel isoelectrofocusing two-dimensional gel electrophoresis, and capillary zone electrophoresis.

A comparative study of fish species identification was accomplished using three different electrophoretic techniques. Sarcoplasmic proteins were extracted from three related fish species and subjected to gel isoelectrofocusing (IEF), two-dimensional polyacrylamide gel electrophoresis (2D-PAGE), and capillary zone electrophoresis (CZE). The fish species--Genypterus chilensis, Genypterus blacodes, and Genypterus maculatus--were from the Ophidiidae family. The three electrophoretic techniques provided suitable fish species identification. Nevertheless, CZE demonstrated several advantages over the other two conventional techniques. Some of the benefits include the use of small amounts of reagents; short separation times, permitting fast comparative analysis; data reproducibility; and ease with which the technique is performed.