Image-guided Ablative Procedures.

Various image-guided ablative procedures include chemical and thermal ablation techniques and irreversible electroporation. These have been used for curative intent for small tumours and palliative intent for debulking, immunogenicity and pain control. Understanding these techniques is critical to avoiding complications and achieving superior clinical outcomes. Additionally, combination with immunotherapy and chemotherapies is rapidly evolving. There are numerous opportunities in interventional radiology to advance ablation techniques and seamlessly integrate into current treatment regimens for both benign and malignant tumours.

Clinical and thyroid profile in patients with COVID-19 hospitalized in an intensive care unit.

OBJECTIVE: This study aimed to summarize the epidemiological and clinical features of thyroid function in COVID-19 patients in the intensive care unit (ICU) of Civil Fray Antonio Alcalde Hospital in Mexico. PATIENTS AND METHODS: This is a cross-sectional study that included 63 ICU patients with COVID-19 from August 2021 to December 2021. Thyroid function was evaluated through the TSH, T4, T3, and FT3 measures. Comorbidities such as diabetes mellitus type 2 (T2DM), arterial hypertension (HT), body mass index (BMI), and biochemical biomarkers, including procalcitonin (PCT) and C reactive protein (CRP), were also analyzed. RESULTS: A total of 63 patients with COVID-19 were hospitalized in the ICU; 42 (67%) were male, and 21 (33%) were female, with a mean age of 47 (range of 26-76 years). A total of 49 (78%) patients were non-vaccinated, 5 (8%) had an incomplete vaccination schedule, and 4 (6%) had completed the vaccination schedule. Regarding BMI, 10 (16%) were overweight, and 26 (40%) reported obesity. When assessing thyroid function, 8 (13%) patients were euthyroid, and 55 (87%) showed alterations on the thyroid hormonal axis, mainly a low concentration of TSH (0.56±0.79; p=0.0001) and FT3 (2.34±0.52; p=0.0006). In addition, increased PCT concentrations were associated with a higher risk to decease (1.22 vs. 8.21; p=0.0001) in this group of patients. CONCLUSIONS: Based on our findings, it appears that COVID-19 patients with low TSH and FT3 levels, who have not been vaccinated against SARS-CoV-2, are overweight or obese, and exhibit high levels of PCT are more likely to experience a poor prognosis and even mortality.

Progression and variation of competitive 100 and 200m performance at the 2021 European Swimming Championships.

Competitive progressions are necessary to ensure that peak performance occurs when medals are decided. This study aimed to: i) study the coefficient of variation (CV) and performance changes (%Δ) among swimmers who participated in different rounds (i.e., heats, semi-finals and finals); ii) study the CV changes as a function of FINA-points. A total of 1447 performances were analysed in the 100 and 200 m-races during the Budapest 2021 European-Championships. Linear mixed-effects models were applied for total and split-times to obtain intra-athlete CV and %Δ. The FINA-points were studied with two-way ANOVA and Pearson's correlation assessed the relations with CV. The CV in 100 m-races was: 0.48 ± 0.21% for males and 0.50 ± 0.20% for females (Δ = -0.66%); in 200 m-races: 0.63 ± 0.36% and 0.60 ± 0.34% (Δ = -0.82%). There were differences in FINA-points between strokes and distances (p < 0.02) associated with higher CV for the 200 m-races (r = 0.37; p = 0.003), indicating changes in performance over the rounds. Swimmers' finalists performed easier during the heats by going slower in the first 50 m-lap; however, some of them would have little chance of qualifying during major championships because some events were below FINA-points world-standards.

Identifying barriers to the use of ultrasound in the perioperative period: a survey of southwestern Ontario anesthesiologists.

BACKGROUND: Ultrasound (US) can be used for many perioperative procedures, but evidence is lacking as to its frequency of use and barrier of application. The objectives of this survey were to determine i) how often US guidance was used perioperatively for vascular access placement, nerve blocks, and heart and lung assessment, and ii) to identify the barriers and the limitations of using US amongst anesthesiologists in southwestern Ontario. METHODS: We conducted a web-based survey in over 40 academic or community hospitals at southwestern Ontario. RESULTS: Of 266 surveys sent, 66 complete surveys were obtained (response rate of 25%). Most respondents (> 80%) reported that US was commonly used for central venous catheter (CVC) insertion, followed by regional blocks; the uses were less frequent for neuraxial blockade and cardiopulmonary assessment. Most respondents wanted to use US more frequently as part of their practice and felt that they already had adequate US training. However, most respondents (59%) reported limited access to US machines in their working institutes as being the major barrier to incorporating US in their daily practice. CONCLUSION: The most common uses of US in anesthesia practice in southwestern Ontario were for CVC insertion and regional blocks. Most anesthesiologists in southwestern Ontario are interested to incorporate US in their daily practice but most were limited by the lack of US resources. Apparently, only providing knowledge and skills teaching may not be sufficient to further improve the US utilization in our region; a matched administrative effort appears to be the next challenge.

Macrodislocación de electrodos de marcapasos cardiaco previo a cirugía por tumor renal / Macrodislocation of cardiac pacemaker electrodes prior to surgery for renal tumour

No disponible

The Growth arrest specific 1 (Gas1) gene is transcriptionally regulated by NeuroD1 via two distal E-boxes.

Growth arrest specific 1 (GAS1) is a signaling mediator for the development of the central nervous system that works as a co-receptor for sonic hedgehog (SHH) to induce the amplification of neural progenitors during the patterning of the mammalian neural tube and establishing granular cells in the cerebellum. Recently, we confirmed that Gas1 is also expressed by neural progenitors of the developing cortex and the dentate gyrus of the hippocampus. The presence of GAS1 in progenitor stages indicates that one of its principal roles is the maintenance of these cells during neurogenic events. However, the signals responsible for the expression of Gas1 in progenitor cells are unknown, an aspect that is relevant to understand its functions during neurogenesis. Here, we focused on elucidating the mechanisms of the transcriptional regulation of Gas1 and using comparative genomics methods found two highly conserved E-boxes in the Gas1 promoter which mediate its up-regulation by NeuroD1. Additionally, we found that GAS1 and NeuroD1 co-localize in the neocortex, the dentate gyrus of the hippocampus and the external granular layer of the cerebellum, suggesting a previously unsuspected regulatory relationship. Our data indicate that Gas1 is a direct target of NeuroD1 during the induction of the neurogenic program.

Image-guided percutaneous management of duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP): assessment of efficacy and safety.

AIM: To evaluate the efficacy and safety of image-guided percutaneous drain placement for duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS: A retrospective review of 7,249 ERCP examinations over a 10-year period was performed to identify cases of duodenal perforation. Indications for ERCP were documented, along with the clinical, laboratory, and imaging findings following perforation. Technical and clinical success of percutaneous drain placement was reviewed. RESULTS: Duodenal perforation occurred in 35 of 7,249 patients during the study period. Management included primary surgical debridement (n=2), conservative management consisting of bowel rest, nasogastric/nasojejunal tube placement (n=20), and percutaneous catheter drainage (n=13). Twenty-seven percutaneous drainage catheters were placed in 13 patients, with a mean duration of catheter drainage of 30.9 days (range 4-108 days). Ten patients were successfully treated with percutaneous management alone, and three required subsequent surgical intervention. CONCLUSION: Percutaneous management of duodenal perforation related to ERCP is associated with high technical and clinical success, and may obviate the need for surgical intervention.

Comparison of PrestoBlue® and plating method to evaluate antimicrobial activity of ascorbic acid, boric acid and curcumin in an in vitro gastrointestinal model.

AIMS: To compare the conventional plating method vs a fluorometric method using PrestoBlue® as a dye by determining the antimicrobial activity of two organic acids and curcumin (CUR) against Salmonella Enteritidis in an avian in vitro digestion model that simulates the crop, proventriculus and intestine. METHODS AND RESULTS: A concentration of 108  CFU per ml of S. Enteritidis was exposed to groups with different rates of ascorbic acid (AA), boric acid (BA) and CUR. Significant differences were observed when the means of the treatments were compared with the controls in the compartments that simulate the crop and intestine (P < 0·05). Ascorbic acid alone and high rates of AA in the mixtures were the most efficient treatments in the crop compartment. However, in the intestinal compartment BA alone and at different rates in the mixture BA-CUR (1 : 1) were the best treatments to decrease the concentration of S. Enteritidis. CONCLUSIONS: The results of this study suggest that there could be an antagonistic bactericidal effect between AA and CUR and AA and BA as well as a synergistic bactericidal effect between BA and CUR. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings may contribute to the development of a formulation with microencapsulated compounds to liberate them in different compartments to combat S. Enteritidis infections in broiler chickens.

¿En qué hemos cambiado a lo largo de una década? Estudio comparativo de la asistencia sanitaria prestada en Líbano (Operación UNIFIL) en 2006 y 2016 / What have we changed over a decade? Comparative study of healthcare provided in Lebanon (UNIFIL Operation) in 2006 and 2016

Introducción: En 2016, España cumple una década de presencia en Líbano dentro de la operación de Naciones Unidas (UNIFIL) United Nations Interim Force in Lebanon. El objetivo del presente estudio es analizar la evolución de la asistencia sanitaria prestada en dos contingentes españoles desplegados en esa zona de operaciones con una diferencia de 10 años. Material y métodos: Estudio transversal descriptivo retrospectivo realizado durante dos periodos (del 8 septiembre al 8 de noviembre de 2006 y del 3 de septiembre al 18 de noviembre de 2016). La población a estudio fueron los pacientes atendidos en el primer escalón sanitario durante los citados periodos. Resultados: Los datos del primer y segundo intervalo respectivamente fueron: efectivos desplegados 523/562; asistencias médicas realizadas 1168/1435; enfermedades digestivas 269/423; enfermedades otorrinolaringológicas 222/147; cirugía menor 187/75; enfermedad dermatológica 175/128; traumatología 152/413; enfermedad odontológica 58/128; enfermedad oftalmológica 53/16; otras 70/105; evacuaciones a ROLE 2 4/76 y evacuaciones a ROLE 4 0/0. Conclusión: Hay similitud entre las atenciones sanitarias realizadas en ambos periodos de tiempo, excepto en las enfermedades traumatológicas donde aparece un incremento de casi un 300% en el segundo intervalo de tiempo respecto al primero

Introduction: In 2016, Spain celebrates a decade of presence in Lebanon within the United Nations Interim Force in Lebanon (UNIFIL). The aim of the present study is to analyse the evolution of the health care provided in two Spanish contingents deployed in that area of operations, comparing two periods within ten years of elapsed time. Material and method: A cross-sectional retrospective study was carried out during two periods (from the 8th of September to the 8th of November of 2006 and from the 3rd of September to the18th of November of 2016). The study population was the patients treated in the first Medical Treatment Facility during those periods. Results: The data of the first and second time interval respectively were: deployed troops 523/562; medical assistance performed 1168/1435; Digestive disease 269/423; Otorhinolaryngological diseases 222/147; Minor surgery 187/75; Dermatological disease 175/128; Traumatology 152/413; Dental disease 58/128; Opthalmologic disease 53/16; Other 70/105; Evacuations to ROLE 2 4/76 and evacuations to ROLE 4 0/0. Conclusion: There is a similarity between the healthcare provided in both periods of time, except in the traumatic diseases, because there was an increase of almost 300% during the second interval of time (AU)

Kca3.1 Activation Via P2y2 Purinergic Receptors Promotes Human Ovarian Cancer Cell (Skov-3) Migration.

Disorders in cell signaling mediated by ATP or histamine, activating specific membrane receptors, have been frequently associated with tumorigenesis. Among the elements of response to purinergic (and histaminergic) signaling, ion channel activation controls essential cellular processes in cancer, such as cell proliferation, motility, and death. Here, we studied the effects that ATP had on electrical properties of human ovarian adenocarcinoma cells named SKOV-3. ATP caused increase in intracellular Ca2+ concentration ([Ca2+]i) and, concurrently, it evoked a complex electrical response with a conspicuous outward component. This current was generated through P2Y2 receptor activation and opening of K+ channels, KCa3.1, as indicated by electrophysiological and pharmacological analysis, as well as by immunodetection and specific silencing of P2Y2 or KCa3.1 gene by esiRNA transfection. Low µM ATP concentration increased SKOV-3 cell migration, which was strongly inhibited by KCa3.1 channel blockers and by esiRNA-generated P2Y2 or KCa3.1 downregulation. Finally, in human ovarian tumors, the P2Y2 and KCa3.1 proteins are expressed and co-localized in neoplastic cells. Thus, stimulation of P2Y2 receptors expressed in SKOV-3 cells promotes motility through KCa3.1 activation. Since P2Y2 and KCa3.1 are co-expressed in primary tumors, our findings suggest that they may play a role in cancer progression.

Activity increase in EpoR and Epo expression by intranasal recombinant human erythropoietin (rhEpo) administration in ischemic hippocampi of adult rats.

Erythropoietin in the nervous system is a potential neuroprotective factor for cerebral ischemic damage due to specific-binding to the erythropoietin receptor, which is associated with survival mechanisms. However, the role of its receptor is unclear. Thus, this work assessed whether a low dose (500UI/Kg) of intranasal recombinant human erythropoietin administered 3h after ischemia induced changes in the activation of its receptor at the Tyr456-phosphorylated site in ischemic hippocampi in rats. The results showed that recombinant human erythropoietin after injury maintained cell survival and was associated with an increase in receptor phosphorylation at the Tyr456 site as an initial signaling step, which correlated with a neuroprotective effect.

Prótesis total de rodilla por gonartrosis grado IV / Total knee replacement due to grade IV gonarthrosis

Objetivo: Describir la evolución clínica de pacientes operados de prótesis total de rodilla por gonartrosis grado IV secundaria a enfermedad angular en varo. Material y métodos: Estudio descriptivo, incluimos pacientes operados de artroplastía total de rodilla por gonartrosis secundaria a enfermedad angular en varo. Utilizamos las siguientes variables: género, edad, lado afectado, tipo de abordaje, tipo de prótesis, tipo de marcha postquirúrgica, infección, estado vascular, dolor postquirúrgico, rechazo de material protésico, deformidad angular en varoflexión pre- y postquirúrgicas. Resultados: Revisamos 13 expedientes, 69.2% hombres y 30.8% mujeres, la edad media 72.38, mínima 56-máxima 82, DE 7.11 años. Seis (46.2%) rodillas izquierdas y 7 (53.8%) derechas. A todos los pacientes se les realizó abordaje para-rotuliano medial y balance óseo, al 23.1% se le realizó balance capsuloligamentario; a 7.6% se les colocó prótesis total de rodilla posteroestabilizada y al 93.3% no posteroestabilizada; 1 (7.6%) paciente presentó infección, ninguno presentó compromiso vascular, 76.9% presentaron marcha asistida con bastón, 15.4% marcha independiente y 7.6% no presentó marcha. El grado promedio de deformidad angular prequirúrgico fue 15.77 y el postquirúrgico promedio menor o igual a 5º, la diferencia de promedios grados pre- y postquirúrgicos fue 36.719 y en flexión 0.439, p = 0.00 y p = 0.669 respectivamente (t pareada). Conclusión: Podemos concluir que la evolución clínica de los pacientes con gonartrosis secundaria a enfermedad angular en varo postoperados de ATR es buena, las complicaciones son similares a la literatura.

Objective: To describe the clinical evolution of patients with total knee replacement surgery due to grade IV gonarthrosis secondary to varus angular deformity. Material and methods: A descriptive trial where we included patients who underwent total knee arthroplasty due to gonarthrosis secondary to varus angular deformity. We used the following variables, sex, age, affected side, type of approach, type of prosthesis, type of gait post-surgically, infection, vascular status, post-surgical pain, rejection of prosthetic material, varus-flection angular deformity pre and post-surgically. Results: We reviewed 13 files, 69.2% men and 30.8% women, the mean age was 72.38, minimum 56, maximum 82, DE 7.11 years. Six (46.2%) left knees and 7 (53.8%) right knees. All patients had a medial parapatellar approach and bone balancing, 23.1% had ligament balancing; 7.6% had a total knee replacement stabilized posteriorly and 93.3% not stabilized posteriorly; 1 (7.6%) patient had infection, none had vascular involvement, 76.9% had to walk with a cane, 15.4% walked on their own and 7.6% had no gait. The average grade of the angular deformity pre-surgery was 15.77 and the average post-surgery was less than or equal to 5º, the difference of average grades pre and post-surgery was 36.719 and in flection 0.439, p= 0.00 and p= 0.669 respectively (paired t). Conclusion: We can conclude that the clinical evolution of patients with gonarthrosis secondary to varus angular deformity who underwent TKA is good, complications are similar to those in the literature.

[Total knee replacement due to grade IV gonarthrosis]. / Prótesis total de rodilla por gonartrosis grado IV.

OBJECTIVE: To describe the clinical evolution of patients with total knee replacement surgery due to grade IV gonarthrosis secondary to varus angular deformity. MATERIAL AND METHODS: A descriptive trial where we included patients who underwent total knee arthroplasty due to gonarthrosis secondary to varus angular deformity. We used the following variables, sex, age, affected side, type of approach, type of prosthesis, type of gait post-surgically, infection, vascular status, post-surgical pain, rejection of prosthetic material, varusflection angular deformity pre and post-surgically. RESULTS: We reviewed 13 files, 69.2% men and 30.8% women, the mean age was 72.38, minimum 56, maximum 82, DE 7.11 years. Six (46.2%) left knees and 7 (53.8%) right knees. All patients had a medial parapatellar approach and bone balancing, 23.1% had ligament balancing; 7.6% had a total knee replacement stabilized posteriorly and 93.3% not stabilized posteriorly; 1 (7.6%) patient had infection, none had vascular involvement, 76.9% had to walk with a cane, 15.4% walked on their own and 7.6% had no gait. The average grade of the angular deformity pre-surgery was 15.77 and the average post-surgery was less than or equal to 5 degrees, the difference of average grades pre and post-surgery was 36.719 and in flection 0.439, p = 0.00 and p = 0.669 respectively (paired t). CONCLUSION: We can conclude that the clinical evolution of patients with gonarthrosis secondary to varus angular deformity who underwent TKA is good, complications are similar to those in the literature.

The D-repeat polymorphism in the ASPN gene and primary knee osteoarthritis in a Mexican mestizo population: a case-control study.

BACKGROUND: A genetic association between osteoarthritis (OA) and a polymorphism in the aspartic acid (D) repeat of the asporin (ASPN) gene has been reported in Japanese, Han Chinese, Greek and UK Caucasian populations of patients having knee and hip OA. Such an association has not been previously described among the Mexican mestizo population. The aim of this study was to analyze the association of the ASPN gene D-repeat polymorphism in a Mexican mestizo population with primary knee OA as well as in healthy controls. MATERIALS AND METHODS: A case-control study was conducted on a Mexican mestizo population of northern Mexico. The repeat polymorphism was genotyped in 440 subjects (218 cases and 222 healthy controls). Primary knee OA was diagnosed according to American College of Rheumatology and Kellgren-Lawrence criteria, and allelic association was examined adjusting for other risk variables. RESULTS: After adjusting for some covariates, menopause and the D16 allele showed a trend toward being risk factors for knee OA in a Mexican mestizo population. Also, the D12 allele could be considered as a protective factor. CONCLUSIONS: These findings suggest that polymorphisms within the ASPN gene could influence knee OA susceptibility, but these associations must be confirmed by independent studies in larger samples and different ethnic groups to support the role of the D-repeat polymorphism in the ASPN gene as risk or protection factors for knee OA in a Mexican population.

An updated protocol to assess arm swimming power in front crawl.

Mechanical power output is a reliable predictor of swim speed in front crawl. However, a complete power curve (power vs. load) has not been described for swimming, and intra-cycle power has not been assessed. The purpose of this study was to examine intra-cycle power output at propulsive phases and to determine maximum swimming power, the corresponding load and swimming speed. 18 swimmers (age 22.10±4.31years, height 1.79±0.07 m, arm span 1.85±0.08 m and body mass 76.74±9.00 kg) performed a swim power test. It consisted of 12.5 m all-out swims with only the arms, with a load attached to the swimmer. A linear encoder and a load cell recorded intra-cycle speed and force in each trial. The test was recorded with 2 underwater cameras. Intra-cycle power was obtained for propulsive stroke phases (pull: 60.32±18.87 W; push: 71.21±21.06 W). Peak power was 114.37±33.16 W. Mean maximum swim power was 66.49 W (0.86 W/kg), which was reached at a swimming velocity of 0.75 m/s with a 47.07% of the individual maximal load. Significant positive correlation (r=0.76, p<0.01) between maximum swim power and maximum swim speed was observed. These results suggest that the proposed test may be a training tool that is relatively simple to implement and would provide swimmers and coaches with quick feedback.

Differential expression of the P2X7 receptor in ovarian surface epithelium during the oestrous cycle in the mouse.

Purinergic signalling has been proposed as an intraovarian regulatory mechanism. Of the receptors responsible for purinergic transmission, the P2X7 receptor is an ATP-gated cationic channel that displays a broad spectrum of cellular functions ranging from apoptosis to cell proliferation and tumourigenesis. In the present study, we investigated the functional expression of P2X7 receptors in ovarian surface epithelium (OSE). P2X7 protein was detected in the OSE layer of the mouse, both in situ and in primary cultures. In cultures, 2'(3')-O-(4-Benzoylbenzoyl)adenosine-5'-triphosphate (BzATP) activation of P2X7 receptors increased [Ca(2+)]i and induced apoptosis. The functionality of the P2X7 receptor was investigated in situ by intrabursal injection of BzATP on each day of the oestrous cycle and evaluation of apoptosis 24h using the terminal deoxyribonucleotidyl transferase-mediated dUTP-fluorescein nick end-labelling (TUNEL) assay. Maximum effects of BzATP were observed during pro-oestrus, with the effects being blocked by A438079, a specific P2X7 receptor antagonist. Immunofluorescence staining for P2X7 protein revealed more robust expression during pro-oestrus and in OSE regions behind the antral follicles, strongly supporting the notion that the differences in apoptosis can be explained by increased receptor expression, which is regulated during the oestrous cycle. Finally, P2X7 receptor expression was detected in the OSE layer of human ovaries, with receptor expression maintained in human ovaries diagnosed with cancer, as well as in the human ovarian carcinoma SKOV3 cell line.

Case report. Peripancreatic intranodal haemangioma mimicking pancreatic neuroendocrine tumour: imaging and pathological findings.

Haemangiomas are common benign tumours that are generally detected within the skin, mucosal surfaces and soft tissues. However, intranodal haemangiomas are extremely rare and are among the benign primary vascular abnormalities of the lymph nodes that include lymphangioma, haemangioendothelioma, angiomyomatous hamartoma and haemangiomas. In this case report, we present the imaging and pathological findings of an intranodal haemangioma in the pancreatic head simulating a pancreatic neuroendocrine tumour. To the best of our knowledge, this is the first report of an intranodal haemangioma in this location.