Supervivencia a dos años en pacientes con cáncer gástrico localmente avanzado en una institución de Popayán entre 2018 y 2020 / Two-year survival in patients with locally advanced gastric cancer at an institution in Popayán between 2018 and 2020

Introducción. El tratamiento oncológico perioperatorio en pacientes con cáncer gástrico localmente avanzado está indicado; aun así, no siempre es posible. El objetivo de este estudio fue evaluar la supervivencia de los pacientes según la administración de quimioterapia perioperatoria. Métodos. Estudio observacional, tipo cohorte ambispectivo, incluyendo pacientes con cáncer gástrico localmente avanzado quienes recibieron o no quimioterapia perioperatoria. Resultados. Se incluyeron 33 pacientes, 90,9 % pertenecían al régimen subsidiado de salud y el 78,8 % en estadio T4. El grupo que recibió quimioterapia perioperatoria, que solo tuvo 5 pacientes (15,1 %), presentó mayor supervivencia global a 2 años (100 %), seguido del grupo de quimioterapia postoperatoria (58,8 %) y del grupo sin quimioterapia, que alcanzó una supervivencia global a 2 años de 54,5 %. Discusión. La supervivencia global fue mayor en el grupo de quimioterapia perioperatoria, consonante a lo descrito a nivel internacional, aunque los pacientes se encontraban en un estadío localmente más avanzado, la mayoría con T4 y N+ según AJCC VIII edición. Conclusiones. El estadío clínico es un factor pronóstico importante y, en nuestro medio, la mayoría de los pacientes consultan en estadíos localmente más avanzados. A eso se suman las dificultades en el acceso a la atención en salud. Aun así, la quimioterapia perioperatoria mostró una supervivencia mayor en pacientes con cáncer gástrico localmente avanzado

Introduction. Perioperative cancer treatment in patients with locally advanced gastric cancer is indicated; even so, it is not always possible. The objective was to evaluate survival according to time and receipt of perioperative chemotherapy. Methods. Observational study, ambispective cohort type, including patients with locally advanced gastric cancer who received or did not receive perioperative chemotherapy. Results. Thirty-three patients were included, 90.9% belonged to the subsidized regimen and 78.8% with TNM T4. The perioperative chemotherapy group, which only had five patients (15.1%), had a higher overall survival at 2 years (100%), followed by the postoperative chemotherapy group and by the group without chemotherapy, with an overall survival at 2 years of 58.8% and 54.5%, respectively. Discussion. Overall survival was higher in the perioperative chemotherapy group, consistent with what has been described internationally, although the patients were in a more advanced stage, most being with T4 and N+ according to the AJCC VIII edition. Conclusions. The clinical stage is an important prognostic factor and in our environment, most patients consult in more advanced stages, coupled with difficulties in accessing health care. Even so, perioperative chemotherapy showed a longer survival in patients with locally advanced gastric cancer, the data should not be extrapolated since the number of patients in each group is significantly different

Tricuspid Regurgitation Related to Cardiac Implantable Electronic Devices: An Integrative Review.

The use of cardiac implantable electronic devices, including permanent pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy, has dramatically increased in recent years. The interaction between the device lead and tricuspid valve leaflets is a potential cause of tricuspid regurgitation that in turn has an impact on morbidity and mortality. Echocardiography is necessary to grade tricuspid regurgitation severity. The use of three-dimensional imaging helps determine whether the device lead is interfering with normal leaflet coaptation. Early identification of lead-related tricuspid regurgitation is critical to select the optimal treatment, which may include lead extraction or even tricuspid valve repair or replacement in severe cases. The aims of this review are to provide a thorough assessment of the evidence about lead-associated tricuspid regurgitation and the benefits of using three-dimensional echocardiography with some technical considerations and to propose a treatment algorithm.

Diagnostic challenge presented by right atrial mass: A report of two cases.

Right atrial masses raised pose 3 major possibilities including tumors, thrombi, or vegetations. We present 2 cases: first, a 34-year-old male with no medical history, who presented with dyspnea, pleuritic pain, and fever; and the second, 65-year-old male with similar symptoms and a history of a left renal carcinoma. Both patients had right atrial masses found on a transthoracic echocardiogram. Cardiac magnetic resonance imaging and an 18 FDG-PET were necessary finding thrombi in the first patient; and tumoral thrombi in the second one. A multimodality imaging approach to right atrial masses is essential for proper diagnosis and therapeutic decision-making.

Tumor tricolémico proliferante maligno en cuero cabelludo con extensión al cuello Reporte de caso / Malignant proliferative trichilemmal tumour of neck and scalp Case report

El tumor tricolémico maligno de cabeza y cuero cabelludo es un tumor que se origina de la vaina radicular externa del folículo piloso, fue descrito por primera vez por Wilson-Jones en 1966 como "proliferación de quiste epidermoide'', su frecuencia de presentación es rara y se encuentran pocos casos reportados en la literatura. Es un tipo de tumor que tiene un comportamiento biológicamente benigno aunque puede presentar transformación maligna y puede confundirse con carcinoma escamocelular, por lo que es importante la experiencia de clínico y el patólogo es este tipo de casos. A continuación se presenta un caso clínico en cuero cabelludo y cuello del instituto nacional de cancerología y la forma de abordaje quirúrgico

Malignant Trichilemmal tumor of neck and scalp are tumors that originate from the outer root sheath of the hair follicle, was first described by Wilson-Jones in 1966 as "proliferation of epidermoid cyst", its frequency is extremely rare and there are very few cases reported, is considered biologically benign but may present malignant transformation can be confused with squamous cell carcinoma, is important the experience of clinical and pathologist is this type of case. A clinical case is presented in scalp and the National Cancer Institute and the form of surgical approach neck.

Esofagograma: imágenes que valen más que mil palabras / Esophagograms: Images Worth a Thousand Words

Resumen El estudio de las enfermedades esofágicas requiere de múltiples exámenes diagnósticos, ya que ninguno, por sí solo, provee total información sobre la funcionalidad y la anatomía del tracto digestivo superior. Para los cirujanos generales y gastrointestinales, el esofagograma constituye una herramienta esencial que, además de sugerir un diagnóstico, ofrece una idea de la anatomía del órgano y nos permite esbozar un mapa de fácil evaluación (sin la necesidad de un radiólogo), para establecer o definir un plan quirúrgico. El objetivo del presente artículo es mostrar al lector la utilidad del esofagograma en centros de referencia en el estudio y el tratamiento de las enfermedades esofágicas, así como su representación en algunas enfermedades frecuentes.

Abstract The study of esophageal diseases requires multiple diagnostic tests since no one test alone can provide full information on upper digestive tract anatomy and functionality. For general surgeons and gastrointestinal surgeons, the esophagogram is an essential tool that can suggest a diagnosis while simultaneously providing an idea of ​​the anatomy of the organ and outlining an easily evaluated map without the need of a radiologist. This information can be used to establish a surgical plan. The aim of this article is to show readers the usefulness of esophagograms at referral centers for study and treatment of esophageal diseases while providing representations of several frequent diseases.

Using simple models to describe the kinetics of growth, glucose consumption, and monoclonal antibody formation in naive and infliximab producer CHO cells.

Despite their practical and commercial relevance, there are few reports on the kinetics of growth and production of Chinese hamster ovary (CHO) cells-the most frequently used host for the industrial production of therapeutic proteins. We characterize the kinetics of cell growth, substrate consumption, and product formation in naive and monoclonal antibody (mAb) producing recombinant CHO cells. Culture experiments were performed in 125 mL shake flasks on commercial culture medium (CD Opti CHO™ Invitrogen, Carlsbad, CA, USA) diluted to different glucose concentrations (1.2-4.8 g/L). The time evolution of cell, glucose, lactic acid concentration and monoclonal antibody concentrations was monitored on a daily basis for mAb-producing cultures and their naive counterparts. The time series were differentiated to calculate the corresponding kinetic rates (rx = d[X]/dt; rs = d[S]/dt; rp = d[mAb]/dt). Results showed that these cell lines could be modeled by Monod-like kinetics if a threshold substrate concentration value of [S]t = 0.58 g/L (for recombinant cells) and [S]t = 0.96 g/L (for naïve cells), below which growth is not observed, was considered. A set of values for µmax, and Ks was determined for naive and recombinant cell cultures cultured at 33 and 37 °C. The yield coefficient (Yx/s) was observed to be a function of substrate concentration, with values in the range of 0.27-1.08 × 10(7) cell/mL and 0.72-2.79 × 10(6) cells/mL for naive and recombinant cultures, respectively. The kinetics of mAb production can be described by a Luedeking-Piret model (d[mAb]/dt = αd[X]/dt + ß[X]) with values of α = 7.65 × 10(-7) µg/cell and ß = 7.68 × 10(-8) µg/cell/h for cultures conducted in batch-agitated flasks and batch and instrumented bioreactors operated in batch and fed-batch mode.

Continuous flow micro-bioreactors for the production of biopharmaceuticals: the effect of geometry, surface texture, and flow rate.

We used continuous flow micro-devices as bioreactors for the production of a glycosylated pharmaceutical product (a monoclonal antibody). We cultured CHO cells on the surface of PMMA/PDMS micro-channels that had been textured by micromachining and coated with fibronectin. Three different micro-channel geometries (a wavy channel, a zigzag channel, and a series of donut-shape reservoirs) were tested in a continuous flow regime in the range of 3 to 6 µL min(-1). Both the geometry of the micro-device and the flow rate had a significant effect on cell adhesion, cell proliferation, and monoclonal antibody production. The most efficient configuration was a series of donut-shaped reservoirs, which yielded mAb concentrations of 7.2 mg L(-1) at residence times lower than one minute and steady-state productivities above 9 mg mL(-1) min(-1). These rates are at about 3 orders of magnitude higher than those observed in suspended-cell stirred tank fed-batch bioreactors.

A biopharmaceutical plant on a chip: continuous micro-devices for the production of monoclonal antibodies.

We report a proof-of-principle for the use of micro-devices as continuous bioreactors for the production of monoclonal antibodies. We culture CHO cells on the surface of PMMA "zigzag" channels textured with semi-spherical cavities coated with fibronectin, observing steady-state productivities 100 times higher than those observed in full scale systems.