The use of the double uterine segment tourniquet in obstetric hysterectomy for bleeding control in patients with placenta accreta spectrum.

OBJECTIVES: To evaluate surgical outcomes of using a double uterine segment tourniquet in obstetric hysterectomy for bleeding control in patients with placenta accreta spectrum. METHODS: Retrospective case-control study conducted at the Central Hospital of San Luis Potosi, Mexico. Patients with the diagnosis of placenta accreta spectrum who underwent obstetric hysterectomy were included. Two groups were formed: in the first, a double uterine segment tourniquet was used; and in the second, the hysterectomy was performed without a tourniquet. Primary surgical outcomes were compared. RESULTS: Forty patients in each group were included. The use of a double uterine segment tourniquet had lower total blood loss compared with the non-tourniquet group (1054.00 ± 467.02 vs. 1528.75 ± 347.12 mL, P = 0.0171) and a lower drop in hemoglobin (1.74 ± 1.10 vs. 2.60 ± 1.25 mg/dL, P = 0.0486). Ten patients (23.80%) in the double tourniquet group required blood transfusion, compared with 26 (65.00%) in the non-tourniquet group (P = 0.0003). Surgical time did not show a statistical difference between groups. CONCLUSION: The use of a uterine segment tourniquet in obstetric hysterectomy may improve surgical outcomes in patients with placenta accreta spectrum with no difference in surgical time and urinary tract lesions.

COVID-19 Infection Induce miR-371a-3p Upregulation Resulting in Influence on Male Fertility.

In December 2019, the first case of COVID-19 was reported and since then several groups have already published that the virus can be present in the testis. To study the influence of SARS-CoV-2 which cause a dysregulation of the androgen receptor (AR) level, thereby leading to fertility problems and inducing germ cell testicular changes in patients after the infection. Formalin-Fixed-Paraffin-Embedded (FFPE) testicular samples from patients who died with or as a result of COVID-19 (n = 32) with controls (n = 6), inflammatory changes (n = 9), seminoma with/without metastasis (n = 11) compared with healthy biopsy samples (n = 3) were analyzed and compared via qRT-PCR for the expression of miR-371a-3p. An immunohistochemical analysis (IHC) and ELISA were performed in order to highlight the miR-371a-3p targeting the AR. Serum samples of patients with mild or severe COVID-19 symptoms (n = 34) were analyzed for miR-371a-3p expression. In 70% of the analyzed postmortem testicular tissue samples, a significant upregulation of the miR-371a-3p was detected, and 75% of the samples showed a reduced spermatogenesis. In serum samples, the upregulation of the miR-371a-3p was also detectable. The upregulation of the miR-371a-3p is responsible for the downregulation of the AR in SARS-CoV-2-positive patients, resulting in decreased spermatogenesis. Since the dysregulation of the AR is associated with infertility, further studies have to confirm if the identified dysregulation is regressive after a declining infection.

Non-invasive urine markers for the differentiation between RCCs and oncocytoma.

BACKGROUND: Recently, our group showed that Vim3 is overexpressed in tissue samples of renal oncocytomas and Mxi-2 in clear cell renal carcinoma (ccRCC). The mechanism leading to the truncation of both proteins is known and involves with two miRs, both detectable in urine. Since the analysis of miRs is time-consuming, our aim was to identify the truncated proteins in urine instead. Furthermore, urine samples from small renal masses (SRMs) (n = 45, <4 cm) were analyzed to get a pre-surgical differentiation of the cancer subtypes. METHODS: Urines were accessed from the urological biobank (n = 350). Proteins were isolated from urine samples, and Western blots were performed. Each sample was analyzed with ELISA for the expression of Vim3 and Mxi-2. A lateral flow assay was established. For the detection of SRMs, the miRs were isolated and qRT-PCR was performed. RESULTS: A significant increase of Vim3 in urines from patients with oncocytoma (n = 20) was detectable with ELISA compared to all other subtypes of RCCs (chromophobe (n = 50), papillary (n = 40), ccRCC (n = 200), and controls (n = 40) (***p < 0.0001)). Mxi-2 was predominantly overexpressed in ccRCCs (***p < 0.0001). Lateral flow assay of Vim3 and Mxi-2 shows two bands in the case of oncocytoma and ccRCC indicating the specificity of this test. For SRMs, an overexpression of miR-15a/Mxi2 was detectable in urine samples from ccRCC and chromoRCC patients. In contrast to that, miR-498/Vim3 were predominantly overexpressed in oncocytoma patients. CONCLUSION: Both proteins (Vim3 and Mxi-2) were detectable in patients' urines and can be used for the non-invasive differentiation of kidney cancers.

EBV induced loss of sperm quality.

OBJECTIVE: To analyze the presence of Epstein-Barr-virus (EBV) in sperm samples from patients diagnosed with some impairment of the fertility parameters evaluated using seminogram and to observe if there is any difference with the normozoospermic samples. We hypothesize that an EBV infection is responsible for the upregulation of the miRNA 199-3p, which binds to the 3'UTR of endothelin-1 (ET-1). ET-1 is a key factor to produce Vimentin (Vim3), and therefore, it influences the expression of Vim3. Since Vim3 is predominantly detectable in sperms without any structural defects, the newly identified regulation mechanism can be responsible for the loss of sperm quality. MATERIAL AND METHODS: This study was performed from January 2017 to December 2020 and included 27 patients who provided ejaculated samples obtained by masturbation. Ejaculates were evaluated according to the Word Health Organization's criteria. Posteriorly, the samples were sorted according to the seminogram diagnosis and further analyzed using different enzyme-linked absorbed immune assays to determine the level or concentration of Epstein-Barr nuclear antigen (EBNA), ET-1, and Vim3. RESULTS: All sperm samples with the impairment of fertility parameters contained the EBNA and presented a downregulation of ET-1 and Vim3. In addition, sperms located in the swim ups are also partially positive for the EBV virus in different clinical aspects. CONCLUSION: Based on the regulation mechanism here presented, it seems that the EBV induces changes at the miRNA level, which are responsible for the decreasing of sperm quality.

Percepción del paciente sobre la calidad del cuidado que brinda la enfermera del Servicio de Cirugía del Factores determinantes de la percepción de riesgo de desastres en el Hospital San Bartolomé, Lima, 2015 / Determinants factors of the perception of disaster risk in the Hospital San Bartolome, Lima, 2015

Introducción: Aunque el concepto de riesgo de desastre es un término concreto y cuantificable, es un parámetro relativo ya que depende de la percepción que cada persona tenga sobre él. Objetivos: Identificar los factores determinantes de la percepción del riesgo de desastres en el personal de salud del Hospital "San Bartolomé" de Lima, en 2015. Diseño: Estudio observacional, descriptivo, trasversal, cuantitativo y correlacional. Institución: Hospital Nacional Docente Madre Niño "San Bartolomé" de Lima, Perú. Participantes: Trabajadores asistenciales y administrativos; profesionales, técnicos y auxiliares; nombrados o contratados. Intervenciones: Se aplicó una encuesta estructurada a 355 personas seleccionadas aleatoriamente según grupos ocupacionales. Los datos fueron evaluados mediante la prueba de Chi-cuadrado de Pearson (X2) con valor de p < 0,01. Principales medidas de resultados: Niveles de percepción del riesgo de desastres, frecuencia de las variables en estudio y establecimiento de los factores determinantes. Resultados: El 8.4 por ciento de los encuestados tiene una percepción baja del riesgo de desastres, el 51.0 por ciento tiene una percepción media y el 40.6 por ciento tiene una percepción alta. Se encontró una asociación estadísticamente significativa entre la percepción del riesgo de desastres y factores determinantes como antigüedad de residencia en Lima (p=0.00003884), capacitación previa sobre desastres (p=0.008034), interés en el tema de desastres (p<0.0000001), antigüedad laboral (p=0.005796), fidelidad laboral (p=0.005293) y sexo (p=0.003681). No se encontró asociación con experiencia previa de desastres, edad y ocupación.

Introduction: Although the concept of disaster risk is a concrete and quantifiable term, it is a relative parameter since it depends on the perception that each person has upon it. Objectives: Identify the determinant factors of risk perception of disasters in the health personnel of the Hospital "San Bartolome" of Lima, in 2015. Design: Observational, descriptive, cross-sectional and correlational quantitative study. Setting: National Teaching Hospital Mother-Child "San Bartolome" of Lima, Peru. Participants: Healthcare and administrative workers; professionals, technicians and auxiliaries; appointed or hired. Interventions: A structured survey to 355 randomly selected people by occupational groups was applied. The data were evaluated using the Pearson Chi-square test (X2) with p value < 0.01. Main outcome measures: Levels of disasters risk perception, frequency of study variables and determinants factors establishment. Results: The 8.4 per cent of respondents have a low disasters risk perception, 51.0 per cent have an average risk perception and 40.6 per cent have a high perception. A statistically significant association was found between disaster risk perception and determining factors such as length of residence in Lima (p=0.00003884) previous training on disaster (p=0.008034), interest in the disaster topic (p<0.0000001), time of work at hospital (p=0.005796), labor fidelity (p=0.005293) and sex (p=0.003681). No association with prior disaster experience, age and occupation was found.

Basta ya de recortes. Es la hora de las reformas / No disponible

No disponible

Percepción de estudiantes de postgrado sobre el desempeño de las funciones esenciales de salud pública / Graduate student perception on the performance of the core functions of public health

En opinión de los encuestados, el desempeño de las funciones esenciales de la Salud Pública FESP por la autoridad nacional de salud, muestra una calificación media superior, coincidente con la evaluación del país. Debido a diferencias con el instrumento empleado y la metodología a seguir para la recolección de la información, no es posible realizar comparaciones con los datos obtenidos a nivel nacional; sin embrago, nuestros resultados permiten conocer la percepción de los alumnos de post grado en salud pública sobre algunos indicadores de las FESP, quienes representan un grupo que se espera influya en las políticas de salud del país, y son el recurso humano de los servicios que brindan la atención de salud a la población.

According to respondents, the performance of FESP by national health authorities, shows a higher average score, which coincides with the assessment of the country. Due to differences with the instrument used and methodology to collect information, not possible to make comparisons with national data, however, our results provide insights into the perception of graduate students in public health on some indicators of EPHF, who represent a group that is expected to influence the policies of our countrys health and human resources are services that provide health care to the population.

Medicina legal / Legal mediine

Contiene: La medicina legal; deontologia medica; etica medica; responsabilidad profesional, ejercicio de la medicina; traumatologia medicolegal; homicidio -suicidio; lesiones; formas de lelsiones; medicina legal del trabajo; riesgos y accidentes de trabajo; peritaje medico en materia laboral; tanatologia medicolegal; la muerte; autopsia medico legal; criminalistica; identificacion policial, dactiloscopia;identificacion medico legal; sexologia forence; desviaciones del institnto sexual; delitos de caracter sexual; medicina legal del matrimonio embarazo y nacimiento; aborto, infanticidio; asfixiologia; psicopatologia forence; los disturbios transitorios de la conciencia; capacidad vital

Estudio del comportamiento de los lípidos plasmáticos en la insuficiencia renal crónica / Study of pasmatic lipid behaviour in chronic renal failure

Se estudian 21 pacientes que presentan insuficiencia renal crónica, que siguen programa de hemodiálisis y diálisis peritoneal. Al estudiar los siguientes parámetros lipídicos se obtiene tendencias a la elevación de los triglicéridos en los pacientes hemodializados, considerable elevación del nivel sérico de colesterol en todos los casos e incremento considerable elevación del nivel sérico de colesterol en todos los casos e incremento significativo de los ácidos grasos no esterificados o libres en los enfermos bajo plan hemodialítico, no así en aquellos en diálisis peritoneal que presentan neta reducción de los mismos. Se comparan los resultados obtenidos con los existentes en la literatura y se exponen los posibles mecanismos patogénicos de las alteraciones encontradas(AU)