Association between Variables of Eating Habits and Gastric Trophic Changes in a Gastroenterology Institution in Medellín, Colombia

Aim: To establish the relationship between consuming foods considered risk factors for gastric cancer and trophic changes in gastric mucosa. Materials and methods: Cross-sectional study. We included patients older than 18 admitted for upper GI endoscopy with biopsies who adequately answered a survey of personal history and eating habits. Those with a history of gastric cancer or gastric surgical resection for any reason were excluded. The association between feeding variables and trophic changes in the gastric mucosa was estimated. Results: In a population of 1,096 patients, the average age was 51 years (standard deviation [SD]: 15.5), and 59% were women. Trophic changes in the gastric mucosa were identified in 173 patients (15.8%). No statistical association was found between the independent variables of eating habits, obesity, and positive Helicobacter pylori versus the variable "trophic changes," unlike the variable "family history of gastric cancer" (odds ratio [OR]: 1.49 95% confidence interval [CI]: 1.03-2.17, p = 0.036). One case of high-grade dysplasia was detected in the study population (0.91 cases in 1,000 patients). Conclusions: No association was established between eating habits and trophic changes in the gastric mucosa in the studied population. A family history of gastric cancer is a statistically significant risk factor for developing atrophy, metaplasia, or dysplasia changes.

Objetivo: establecer la relación entre el consumo de alimentos considerados como factores de riesgo para cáncer gástrico y la presencia de cambios tróficos de la mucosa gástrica. Materiales y métodos: estudio de corte transversal. Se incluyeron los pacientes mayores de 18 años admitidos para realización de endoscopia digestiva superior con toma de biopsias que respondieron adecuadamente una encuesta de antecedentes personales y hábitos de alimentación. Se excluyeron aquellos con antecedente de cáncer gástrico o resección quirúrgica gástrica por cualquier motivo. Se estimó la asociación entre las variables de alimentación y la presencia de cambios tróficos de la mucosa gástrica. Resultados: en una población de 1096 pacientes, el promedio de la edad fue 51 años (desviación estándar [DE]: 15,5), y correspondió en un 59% a mujeres. Se identificaron cambios tróficos de la mucosa gástrica en 173 pacientes (15,8%). No se obtuvo asociación estadística entre las variables independientes de hábitos de alimentación, obesidad y Helicobacter pylori positivo frente a la variable "cambios tróficos", a diferencia de la variable "antecedente familiar de cáncer gástrico" (odds ratio [OR]: 1,49; intervalo de confianza [IC] 95%: 1,03-2,17; p = 0,036). Se obtuvo 1 caso de displasia de alto grado en la población estudiada (0,91 casos en 1000 pacientes). Conclusiones: no se estableció una asociación entre los hábitos de alimentación y la presencia de cambios tróficos de la mucosa gástrica en la población estudiada. El antecedente familiar de cáncer gástrico se muestra como un factor de riesgo estadísticamente significativo para el desarrollo de cambios de atrofia, metaplasia o displasia.

Transmural Ultrasonography in the Evaluation of Horse Hoof Internal Structures: Comparative Quantitative Findings-Part 2.

The transmural ultrasound allows for the definition of the normal appearance of the hoof tissues and internal structures. Determining such measurements and proportions could contribute to evaluations of the normal spatial distal phalanx-hoof relationship. The objective was to describe the hoof's dermis and epidermis measurements using the transmural technique, in comparison with DR and anatomical sections. Sixty-two healthy hooves without digital radiographic abnormalities, made up of 30 anatomical pieces (phase 1) and 32 alive horse hooves (phase 2), and 16 sagittal sections of the first ones were used. The proximal and distal planes were compared, defining the following measurements: coronary band-extensor process, distal phalanx apex-hoof wall, sole dermis, middle stratum, parietal dermis, lamellar layer, the sublamellar dermis, and ratios between them. Most of the measurements were consistent among methods. Some showed measurement differences and a minority was impossible to determine. The transmural technique allowed for the observation and replication of measurements of the hoof structures, described with other diagnostic aids. It also allowed for the implementation of new measurements that would help to determine the spatial location of the distal phalanx. Additionally, it contributes to the visualization of normal findings, which will be useful to compare variations in the different phases of laminitis.

Transmural Ultrasonography in the Evaluation of Horse Hoof Internal Structures: Comparative Qualitative Findings-Part 1.

Ultrasonography is commonly used to evaluate equine lameness-related structures, but traditional hoof approaches cannot adequately visualize internal structures such as the lamellar layer. To address this limitation, we used 62 healthy hooves without digital radiographic abnormalities, made up of thirty anatomical pieces (phase 1) and thirty-two hooves from living horses (phase 2). In both phases, half of the digits were submerged in water (group 1) and the other half in water and ice (group 2) for 24 h. Ultrasonographic views and temperature and humidity measurements were taken every two hours, and sagittal sections were obtained in phase 1. Good quality images were obtained in both phases. The transmural technique allowed the evaluation of several structures of the DEJ (tubular and lamellar strata of the hoof wall, sublamellar dermis, and solar and coronary papillae) and of the distal phalanx (extensor process, parietal surface, and apex). Our findings suggest that the transmural technique following hoof submersion can be useful for internal evaluation of hoof conditions, such as laminitis. However, further validation of the technique in natural or experimental cases is required.

Trends in Grinding of Agroindustrial Products-A Literature Review.

BACKGROUND: This article aims to present the results of a literature review on food milling, to identify the most recent uses, types of mills, and new grinding trends. METHODS: For this, a search was made with the keywords "grinding", "milling" and "food" in the Scopus, which yielded 192 articles, 52 of which directly related to food, were analyzed. RESULTS: Contributions were found related to various types of grinding such as cryogenic grinding, nano-scaled grinding, ultrafine and superfine grinding. The authors highlighted the uses of these types of milling in agro-industrial products such as nutmeg (Myristica fragrans), wheat bran (Triticum spp.), ginger (Zingiber officinale), and green tea powder (Camellia sinensis), among others. CONCLUSION: It is observed that engineering texts dealing with theoretical and analytical food milling operations do not emphasize the new trends found. As a complementary part of this study, eight patents related to cryogenic grinding in food were analyzed, identifying uses of this type of grinding in coffee, lipids, lycopene, proteins, grains, and seeds. Besides, a search was carried out to find out commercial suppliers of cryogenic grinding equipment, in which six companies from China with their equipment were identified.

Comparison of 99mTc-Tilmanocept and Hybrid Indocyanine Green-99mTc-Albumin Nanocolloid Drainage in a Patient With Melanoma in the Scalp.

We present the planar lymphoscintigraphies and SPECT/CT images of a 60-year-old man diagnosed as having melanoma (Breslow 1.8 mm) in left parietal scalp, close to head midline. Sentinel lymph node biopsy using Tc-tilmanocept was performed, but the surgery was canceled. Two weeks later, sentinel lymph node biopsy was repeated, but using the hybrid radiotracer indocyanine green-Tc-albumin nanocolloid. The lymphatic drainage in left laterocervical region was similar with these 2 radiotracers, but on the right side, more sentinel lymph nodes were detected with nanocolloid compared with tilmanocept.

BlockSIEM: Protecting Smart City Services through a Blockchain-based and Distributed SIEM.

The Internet of Things (IoT) paradigm has revolutionized several industries (e.g., manufacturing, health, transport, education, among others) by allowing objects to connect to the Internet and, thus, enabling a variety of novel applications. In this sense, IoT devices have become an essential component of smart cities, allowing many novel and useful services, but, at the same time, bringing numerous cybersecurity threats. The paper at hand proposes BlockSIEM, a blockchain-based and distributed Security Information and Event Management (SIEM) solution framework for the protection of the aforementioned smart city services. The proposed SIEM relies on blockchain technology to securely store and access security events. Such security events are generated by IoT sentinels that are in charge of shielding groups of IoT devices. The IoT sentinels may be deployed in smart city scenarios, such as smart hospitals, smart transport systems, smart airports, among others, ensuring a satisfactory level of protection. The blockchain guarantees the non-repudiation and traceability of the registry of security events due to its features. To demonstrate the feasibility of the proposed approach, our proposal is implemented using Ethereum and validated through different use cases and experiments.

Chronic Inferior Vena Cava Filter Thrombosis: Endovascular Treatment and One-Year Follow-Up with Intravascular Ultrasonography.

Inferior vena cava (IVC) filter thrombosis can be fatal when it is not detected and treated. Its management can be challenging, because little evidence supports specific treatments. We present the case of a 72-year-old man with a history of deep vein thrombosis in whom IVC filter thrombosis developed 7 years after filter placement. Recanalization with oral anticoagulation had failed. Using intravascular ultrasonography, we performed pharmacomechanical thrombolysis, deploying 2 stents simultaneously through the IVC filter and then 2 more into the iliac veins, with excellent results. One year later, the patient's veins and IVC filter were patent, his symptoms were greatly improved, and only nonobstructive neointimal hyperplasia was seen. This case highlights the usefulness of balloon venoplasty and double-barrel stent placement in restoring blood flow through an occluded IVC, and the value of intravascular ultrasonography during and after such procedures.

Cannabis sintético: aspectos toxicológicos, usos clínicos y droga de diseño / Synthetic cannabis: toxicological effects, clinical use and designer drugs

La planta cannabis sativa tiene un largo historial de uso en el transcurso de la humanidad y, desde hace varias décadas, se ha retomado el interés por ella debido a su potencial terapéutico relacionado con diversidad de patologías. Sin embargo, el acercamiento a los aspectos toxicológicos, clínicos y terapéuticos de la planta, y sus derivados sintéticos se ha visto limitado, debido a las connotaciones culturales y legales que existen en la actualidad alrededor de su uso. Pues, dichos derivados sintéticos están siendo utilizados con fines recreativos, exponiendo a gran cantidad de personas a riesgos en su salud. En ese sentido, este artículo expondrá algunas generalidades sobre la planta, el sistema endocannabinoide y sus ligandos, su uso como droga de síntesis y su uso terapéutico, principalmente en las enfermedades neurodegenerativas del Parkinson y el Alzheimer.

The cannabis sativa plant has a long history of use in the course of humanity and, since a few decades ago, has gained attention because of its therapeutic potential associated with diverse pathologies. However, the study of its toxicological, clinical and therapeutical properties, and its synthetic derivatives, has been limited due to cultural and legal connotations about its use. This is because such synthetic derivatives are being used for recreational purposes, exposing many people to health risks. Thus, this article will present some generalities about the plant, the endocannabinoid system and its ligands, its use as synthetic drug and its therapeutical use, especially in neurodegenerative diseases like Parkinson and Alzheimer.

Accessory mitral valve without left ventricular outflow tract obstruction in an adult.

Accessory mitral valve is a rare congenital abnormality and an unusual cause of subvalvular obstruction of the left ventricular outflow tract. Accessory mitral valves are usually detected in children due to symptomatic obstruction; isolated nonobstructive accessory mitral valve is rarely seen in adults. We describe the echocardiographic diagnosis of accessory mitral valve as an isolated congenital anomaly not associated with a substantial degree of obstruction of the left ventricular outflow tract in an asymptomatic adult patient. This case highlights the importance of transthoracic and transesophageal echocardiography in the diagnosis and follow-up of this uncommon congenital anomaly.

Use of fractional flow reserve and intravascular ultrasonography to evaluate ambiguous left main coronary artery stenosis.

Because angiography provides only a 2-dimensional image, it is an imperfect tool for accurately evaluating left main coronary artery stenosis. Additional methods, such as fractional flow reserve evaluation and intravascular ultrasonography, are more frequently being used to gauge the physiologic significance of angiographically ambiguous left main coronary artery stenosis. Previous studies have shown that a fractional flow reserve cutoff value of less than 0.75 indicates a need for surgical revascularization. It has been suggested that a fractional flow reserve value of 0.75 to 0.80 constitutes a "gray zone." Indeed, the management of patients who have angiographically ambiguous left main coronary artery disease and a fractional flow reserve value of 0.75 to 0.80 is not well established.Herein, we describe the cases of 3 patients whose fractional flow reserve values suggested functionally insignificant stenosis, but in whom intravascular ultrasonography showed substantial narrowing-the latter prompting surgical revascularization instead of medical management. All 3 patients underwent revascularization with good outcomes. Further studies are needed to investigate the role of intravascular ultrasonography in determining the severity of left main coronary artery stenosis and the preferred management thereof. Also warranting further investigation is the possible revision of the fractional flow reserve cutoff values that currently indicate significant stenosis of the left main coronary artery.

Intrapericardial primary thymic carcinoma in a 73-year-old man.

Thymic carcinoma is a rare, highly aggressive type of tumor that typically occurs in the anterior mediastinum. We describe the case of a 73-year-old man who presented with weakness, cough, dyspnea, anorexia, and weight loss. An echocardiogram showed an intrapericardial mass that occupied the space around the lateral walls of the left ventricle and distally compressed the right ventricle. Magnetic resonance imaging and a biopsy confirmed the presence of intrapericardial primary thymic carcinoma. The patient underwent surgical excision of the tumor and died of right ventricular rupture during the procedure. This case highlights the importance of considering thymic carcinoma whenever an otherwise unexplained intrapericardial mass is encountered.

Unprotected left main coronary artery intervention for acute myocardial infarction and cardiogenic shock.

Medical therapy alone often insufficiently alters the clinical course of patients who have experienced acute myocardial infarction and concomitant cardiogenic shock, and in whom the left main coronary artery is the culprit vessel. Emergency coronary artery bypass grafting is an effective yet time-consuming approach that entails the risk of extensive, irreversible myocardial damage. Percutaneous coronary intervention in the unprotected left main coronary artery can enable initial revascularization and rapid stabilization even in high-risk patients, but outcomes from the procedure since the recent advent of drug-eluting stents are still being determined. Herein, we report the successful deployment of a sirolimus-eluting stent in a 65-year-old man who had experienced acute myocardial infarction and cardiogenic shock consequent to an occluded left main coronary artery. The patient recovered rapidly and completely. We review the medical literature and compare percutaneous coronary intervention with other methods of treatment.