National Network of Depression Centers' Recommendations on Harmonizing Clinical Documentation of Electroconvulsive Therapy.

ABSTRACT: Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications.

The first modified Delphi consensus statement on sleeve gastrectomy.

INTRODUCTION: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG. METHODS: We established a committee of 54 globally recognized opinion makers in this field. The committee agreed to vote on several statements concerning SG. An agreement or disagreement amongst ≥ 70.0% experts was construed as a consensus. RESULTS: The committee achieved a consensus of agreement (n = 71) or disagreement (n = 7) for 78 out of 97 proposed statements after two rounds of voting. The committee agreed with 96.3% consensus that the characterization of SG as a purely restrictive procedure was inaccurate and there was 88.7% consensus that SG was not a suitable standalone, primary, surgical weight loss option for patients with Barrett's esophagus (BE) without dysplasia. There was an overwhelming consensus of 92.5% that the sleeve should be fashioned over an orogastric tube of 36-40 Fr and a 90.7% consensus that surgeons should stay at least 1 cm away from the angle of His. Remarkably, the committee agreed with 81.1% consensus that SG patients should undergo a screening endoscopy every 5 years after surgery to screen for BE. CONCLUSION: A multinational team of experts achieved consensus on several aspects of SG. The findings of this exercise should help improve the outcomes of SG, the commonest bariatric procedure worldwide, and guide future research on this topic.

Social media, advertising, and internet use among general and bariatric surgeons.

INTRODUCTION: The use of the internet and technology has increased, and its implication with medicine is inevitable. Along with these technologies, social media platforms have changed the interaction between peers, forcing an evolution on medical activities and patient relationship. There is no clear information on how surgeons interact with these platforms within their daily practice. METHODS: A transverse study with a survey obtained from general and bariatric surgeons from Mexico was performed, aimed to gather information about social media platforms use (Facebook, Instagram, Twitter, and LinkedIn). Personal, professional, academic, and marketing activities were analyzed and compared between general and bariatric surgeons. Secondly, the same analysis was performed in younger participants. Other variables were also analyzed, such as type of marketing and monthly budget. RESULTS: We obtained 523 surveys (84.1% general and 15.8% bariatric surgeons), where male gender comprised 86.4%. Almost a third considered social media as an important tool. In 53% of the cases, Facebook was preferred for professional activities; Twitter was the second most used. Bariatric surgeons were younger, used all platforms more frequently, and preferred Facebook for every activity. They also invested more in publicity, and showed wider marketing methods than general surgeons. CONCLUSION: There is an important awareness of internet and social media use among general and bariatric surgeons. Facebook leads the activities for both specialties (personal, professional, academic, and marketing), but bariatric surgeons are significantly more involved; additionally, there are more marketing strategies and investment among them.

Effect of oral calcium administration on the cure and reproductive performance of Holstein cows diagnosed with puerperal metritis.

Our objective was to evaluate the effect of oral calcium administration on clinical cure, survival, subsequent presentation of peripartal health disorders, and reproductive performance of Holstein cows diagnosed with puerperal metritis (PM) under certified organic management. A second objective was to evaluate the metabolic status at calving and at the time of PM diagnosis (d 0) in affected and matched healthy cows. Cows diagnosed with PM (n = 200) were assigned randomly to receive 1 of 2 treatments: (1) control received 3.75 mL of Optimum UterFlush [Van Beek Natural Science, Orange City, IA, containing yucca extract, cinnamaldehyde, thymol, and a proprietary blend of carvacrol (4-isopropyl-2-methylphenol, at 0.47 g/mL)] diluted in 117 mL of distilled water by intrauterine infusion, administered every other day for a total of 3 treatments (n = 100); (2) calcium-supplemented (CA) received the same intrauterine treatment plus 6 oral capsules providing calcium ('O' Cal-D Cap, Bio-Vet Inc., Barneveld, WI; 7.5-9.0 g of Ca/capsule) once per day, for 3 consecutive days after diagnosis of PM. All cows received hypertonic saline solution (500 mL of 7.2% solution i.v. once), dextrose (500 mL of 50% solution i.v. once), and oral aspirin (5 boluses/d for 3 d). Outcome variables included fever, presence of fetid vaginal discharge, and uterine score at d 6 and 14 after diagnosis, survival at 30 and 100 d in milk, reproductive performance, and incidence of other health disorders after PM. A group of 200 control healthy cows (CH) was matched with PM cows at d 0, and calcium and fatty acid serum concentrations were determined at calving and at the day of diagnosis of PM (d 0). Calcium status was also assessed in PM cows at d 1, 2, 3, and 6 after diagnosis. Treatment effects were tested by logistic regression, repeated measures analysis, and ANOVA. Average calcium serum concentrations at d 0 were lower in PM cows (1.57 mmol/L) compared with CH cows (2.10 mmol/L). In PM cows, calcium concentrations at d 1, 2, 3, and 6 after diagnosis were significantly higher in the CA group. Fatty acid serum concentrations at calving and at d 0 were higher in PM cows compared with CH cows (0.48 vs. 0.37 mmol/L and 0.49 vs. 0.35 mmol/L, for calving and d 0). No effect was observed for calcium administration on health and survival outcomes. However, the proportion of cows inseminated by 150 d in milk was greater for CA compared with control cows (66 vs. 55%). In conclusion, supplementing oral calcium at the time of diagnosing PM had no effect on health. High fatty acid concentrations at calving were significant risk factors for occurrence of PM. Furthermore, cows affected with PM had lower calcium and higher fatty acid concentrations than CH cows at d 0.

Comparative Study of Ultrasonication-Induced and Naturally Self-Assembled Silk Fibroin-Wool Keratin Hydrogel Biomaterials.

This study reports the formation of biocompatible hydrogels using protein polymers from natural silk cocoon fibroins and sheep wool keratins. Silk fibroin protein contains ß-sheet secondary structures, allowing for the formation of physical cross-linkers in the hydrogels. Comparative studies were performed on two groups of samples. In the first group, ultrasonication was used to induce a quick gelation of a protein aqueous solution, enhancing the ability of Bombyx mori silk fibroin chains to quickly entrap the wool keratin protein molecules homogenously. In the second group, silk/keratin mixtures were left at room temperature for days, resulting in naturally-assembled gelled solutions. It was found that silk/wool blended solutions can form hydrogels at different mixing ratios, with perfectly interconnected gel structure when the wool content was less than 30 weight percent (wt %) for the first group (ultrasonication), and 10 wt % for the second group (natural gel). Differential scanning calorimetry (DSC) and temperature modulated DSC (TMDSC) were used to confirm that the fibroin/keratin hydrogel system was well-blended without phase separation. Fourier transform infrared spectroscopy (FTIR) was used to investigate the secondary structures of blended protein gels. It was found that intermolecular ß-sheet contents significantly increase as the system contains more silk for both groups of samples, resulting in stable crystalline cross-linkers in the blended hydrogel structures. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) were used to analyze the samples' characteristic morphology on both micro- and nanoscales, which showed that ultrasonic waves can significantly enhance the cross-linker formation and avoid phase separation between silk and keratin molecules in the blended systems. With the ability to form cross-linkages non-chemically, these silk/wool hydrogels may be economically useful for various biomedical applications, thanks to the good biocompatibility of protein molecules and the various characteristics of hydrogel systems.

Base rates of failure on various performance validity tests as a function of age in adults referred for neuropsychological assessment.

This study aimed to investigate the relationship between age and base rates of failure (BRFail) on various performance validity tests (PVTs) administered in medical-legal settings. Archival data were analyzed from 3,297 adults (Mage = 42.3 years; Meducation = 11.2) referred for psychological or neuropsychological assessments in a medical-legal or forensic civil disability context who passed the Word Memory Test. BRFail on 10 PVTs (three freestanding and seven embedded) were reported at multiple cutoffs across five age groups ranging from 16 years to 69 years. BRFail increased with age on most embedded PVTs, with a couple of notable exceptions. Reliable Digit Span was unrelated to age at ≤6 but produced elevated BRFail among older examinees at ≤7. Within freestanding PVTs, a positive relationship emerged between age and BRFail on most instruments/cutoffs. Older age is associated with an increased risk of false positive errors on many embedded PVTs that rely on raw scores. Although freestanding PVTs tend to be more resistant to the effects of age, several commonly used cutoffs may still produce increased false positive rates in older examinees. Taken together, results suggest that PVT scores should be interpreted in the context of patient characteristics, in an evidence-based manner, rather than by rigidly applying omnibus cutoffs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rational Design of a Portable Chemometric-Assisted Voltammetric Sensor Based on Ion-Imprinted Polymeric Film for Co(II) Determination in Water.

Herein, chemometric-assisted synthesis of electrochemical sensors based on electropolymerised ion-imprinted polymeric (e-IIP) films was explored. Co(II)-IIPs sensors were prepared by performing electropolymerisation procedures of polymerisation mixtures comprising varying concentrations of an electroactive o-aminophenol (o-AP) monomer and Co(II) ions, respectively, according to the Taguchi L9 experimental design, exploiting the simultaneous evaluation of other controlled parameters during electrosynthesis. Each e-IIP developed from Taguchi runs was compared with the respective non-imprinted polymer (NIP) films and fitted according to Langmuir-Freudlich isotherms. Distinctive patterns of low and high-affinity films were screened based on the qualities and properties of the developed IIPs in terms of binding kinetics (KD), imprinting factor, and the heterogeneity index of produced cavities. These results can provide a generic protocol for chemometric-assisted synthesis of e-IIPs based on poly-o-AP, providing highly stable, reproducible, and high-affinity imprinted polymeric films for monitoring purposes.

HRAS-Mutant Cardiomyocyte Model of Multifocal Atrial Tachycardia.

BACKGROUND: Germline HRAS gain-of-function pathogenic variants cause Costello syndrome (CS). During early childhood, 50% of patients develop multifocal atrial tachycardia, a treatment-resistant tachyarrhythmia of unknown pathogenesis. This study investigated how overactive HRAS activity triggers arrhythmogenesis in atrial-like cardiomyocytes (ACMs) derived from human-induced pluripotent stem cells bearing CS-associated HRAS variants. METHODS: HRAS Gly12 mutations were introduced into a human-induced pluripotent stem cells-ACM reporter line. Human-induced pluripotent stem cells were generated from patients with CS exhibiting tachyarrhythmia. Calcium transients and action potentials were assessed in induced pluripotent stem cell-derived ACMs. Automated patch clamping assessed funny currents. HCN inhibitors targeted pacemaker-like activity in mutant ACMs. Transcriptomic data were analyzed via differential gene expression and gene ontology. Immunoblotting evaluated protein expression associated with calcium handling and pacemaker-nodal expression. RESULTS: ACMs harboring HRAS variants displayed higher beating rates compared with healthy controls. The hyperpolarization activated cyclic nucleotide gated potassium channel inhibitor ivabradine and the Nav1.5 blocker flecainide significantly decreased beating rates in mutant ACMs, whereas voltage-gated calcium channel 1.2 blocker verapamil attenuated their irregularity. Electrophysiological assessment revealed an increased number of pacemaker-like cells with elevated funny current densities among mutant ACMs. Mutant ACMs demonstrated elevated gene expression (ie, ISL1, TBX3, TBX18) related to intracellular calcium homeostasis, heart rate, RAS signaling, and induction of pacemaker-nodal-like transcriptional programming. Immunoblotting confirmed increased protein levels for genes of interest and suppressed MAPK (mitogen-activated protein kinase) activity in mutant ACMs. CONCLUSIONS: CS-associated gain-of-function HRASG12 mutations in induced pluripotent stem cells-derived ACMs trigger transcriptional changes associated with enhanced automaticity and arrhythmic activity consistent with multifocal atrial tachycardia. This is the first human-induced pluripotent stem cell model establishing the mechanistic basis for multifocal atrial tachycardia in CS.

First National Consensus on the Safe Practice of Medical Tourism for Bariatric Surgery in Mexico.

BACKGROUND: Medical tourism is increasing every year, especially in fields such as bariatric surgery. Global concerns rely on the fact of its safety, mainly because of a lack of standardization, unknown number of cases, and the type of specialists performing such procedures. Mexico continues to be among the top countries receiving patients from abroad, but there is no national consensus, guidelines, or recommendations about the practice in such fields. METHODS: A group of 32 bariatric surgeons with an accumulated experience of 25,196 procedures in the medical tourism modality were gathered to perform a national consensus in bariatric surgery tourism. The Delphi methodology was used for this project, with a total of 52 items applied. A consensus was reached when the experts' position was ≥ 70% for each statement. The items included pre- and postoperative phases, patient selection, follow-up, and ethical and legal considerations. RESULTS: Of the 52 statements, 40 (76.9%) reached a consensus of ≥ 70%; 36 in favor, 5 against, and 11 with indeterminate responses. CONCLUSIONS: Although more than two-thirds of the statements related to high standard practice reached a consensus, weak points in the medical tourism modality were identified. This first consensus serves to establish the basis of safe practices, eventually reach national guidelines, and define the top standards of care when performing bariatric surgery tourism.

Ocular surface frostbite secondary to ethyl chloride spray.

CONTEXT: Ethyl chloride (EC) is a fast-acting vapo-coolant spray that provides rapid, transient, local analgesia for minor invasive procedures. Although the application of EC has decreased, it can be used as a cryoanalgesic agent in minor surgical procedures. OBJECTIVE: Despite the widespread use of EC as a local anesthetic, there are few reported cases of serious adverse side effects. MATERIAL AND METHODS: We report a 67-year old otherwise healthy man who underwent excision of a papilloma on his superior right eyelid by a general practitioner at a primary care center. The lesion was removed by curettage after slight freezing with EC spray. This chemical agent was applied without the adequate eye protection, and eight hours later the patient presented an acute frost injury of ocular surface. RESULTS: Urgent treatment included copious irrigation of the affected eye, especially the conjunctival fornices, corticosteroid (prednisone) and antibiotic (neomycin) ointment. A week later, the eyelid lesion and keratoconjunctivitis had resolved but evidence of early cicatrization involving the inferior conjucntival fornix and symblepharon formation were present. DISCUSSION: To the best of our knowledge, this is the first reported case of an acute burn of the ocular surface following EC spray exposure. CONCLUSION: EC should be avoided for short-term local anesthesia in the periocular region to prevent this serious complication.

Autoimmune hepatitis in pediatrics, a review by the Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. / Hepatitis autoinmune en pediatría, una revisión del Grupo de Trabajo de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (LASPGHAN).

Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver characterized by a complex interaction among genetic factors, immune response to antigens present in hepatocytes, and immune regulation alterations. Its distribution is global and there is a female predominance. AIH is divided into 2 groups, depending on the type of serum autoantibodies detected. The most common presentation is acute hepatitis (40%), with non-specific symptoms, high aminotransferase levels, and hypergammaglobulinemia. Standard treatment consists of the administration of immunosuppressive drugs. It is a complex condition, often difficult to diagnose. If not managed adequately, the 5-year mortality rate may reach 75%.

La hepatitis autoinmunitaria es una enfermedad inflamatoria crónica del hígado caracterizada por una interacción compleja entre factores genéticos, respuesta inmunitaria a antígenos presentes en los hepatocitos y alteraciones de la regulación inmunitaria. Presenta una distribución global, con predominio en individuos de sexo femenino. Se clasifica en dos grupos, según el tipo de autoanticuerpos séricos detectados. La forma de presentación más frecuente es la hepatitis aguda (40 %), con síntomas inespecíficos, elevación de aminotransferasas e hipergammaglobulinemia. El tratamiento estándar consiste en la administración de fármacos inmunosupresores. Es una patología compleja, a veces difícil de diagnosticar. Si no se trata de manera adecuada, la mortalidad puede alcanzar el 75 % a los 5 años de evolución.

Bariatric surgery in Mexico: training, practice and surgical trends.

Bariatric surgery is extremely safe and effective, but several factors need to be addressed to obtain such results. Patient selection, type of training, accreditation, type of practice, and surgical trends and technique are involved in this process. Local and global standardization are ill-advised, especially in countries with high obesity prevalence, and where the bariatric practice is fast growing.An online survey with 22 questions was sent to bariatric surgeons in Mexico. Only participants with the active practice were included, and the aim was to obtain for the first time insight in bariatric surgery training, characteristics of current practice and surgical trends.Complete responses from 114 surgeons were obtained. Most were male, under 50 years-old, ≤ 10 years of experience, and practice in low-volume hospitals. Less than half had a 12-month formal training. Gastric bypass and sleeve gastrectomy were the most common procedures. Practice trends like leak tests, use of drains, preoperative weight loss, routine endoscopy, and pharmacological tromboprofilaxis are common. In surgical technique, the gastric bypass and sleeve gastrectomy confection was more homogenic when compared to the one-anastomosis gastric bypass.Complete responses from 114 surgeons were obtained. Most were male, under 50 years-old, ≤ 10 years of experience, and practice in low-volume hospitals. Less than half had a 12-month formal training. Gastric bypass and sleeve gastrectomy were the most common procedures. Practice trends like leak tests, use of drains, preoperative weight loss, routine endoscopy, and pharmacological tromboprofilaxis are common. In surgical technique, the gastric bypass and sleeve gastrectomy confection was more homogenic when compared to the one-anastomosis gastric bypass. An important number of bariatric surgeons in Mexico are young, male, and with < 10 years of practice. The most common techniques performed are gastric bypass and sleeve gastrectomy. Several practices and technique trends are similar to global consensus. Fellowship programs and Board Certification in bariatric surgery are major advances in our country, thus standardization and high-quality practice can be achieved.

A Global Survey by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) on Perceptions of Bariatric Medical Tourism (BMT) by Health Professionals: Guidelines from IFSO for BMT.

BACKGROUND: Bariatric medical tourism (BMT) is a rapidly expanding industry, with over 650 million people with obesity worldwide and total number rising by over 300% between 2003 and 2014. The overall health tourism industry is worth over $400 billion/year. METHODS: International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) conducted a global survey to analyze the details of BMT and the perceptions of bariatric health care professionals (HCP) regarding BMT. RESULTS: A total of 383 bariatric HCP's with experience of 272,548 procedures responded from 65 countries. Seventy-three percent of respondents had managed BMT patients, whilst low cost of surgery was felt to be the driving factor in 77% of cases. The USA contributed the most patients travelling for BMT with 11.6%. Twenty-four percent of respondents stated that they had no access to adequate notes regarding the patient's operation, whilst 12% felt BMT is associated with a higher mortality. Only 49% of respondents felt that IFSO guidelines were followed by the operating surgeon. Sleeve gastrectomy was the commonly offered surgery and an overall mean operation cost was $8716. Nearly 64% of respondents felt BMT needed better coordination between practitioners, whilst almost 85% of respondents supported the idea of a forum to facilitate safe BMT worldwide. CONCLUSION: This IFSO survey has outlined the current BMT trends worldwide and highlighted areas of concern in the care of such patients. It has expanded our knowledge and should be used as a starting point to establish international forums to aid collaboration.

Evaluation of the In-Vitro Dissolution Permeation Systems 1 (IDAS1) as a potential tool to monitor for unexpected changes in generic medicaments in poorly regulated markets.

Panama, like most Latin American countries, has insufficient regulatory safeguards to ensure the safety and efficacy of all pharmaceutical products in the market, a situation that results in a two-tier system, where affluent citizens can afford innovator products while poor citizens must consume 'generics' of uncertain quality. Given that one lot of each drug product is analyzed every five years during registration while commercial lots are not, and since most products are not bioequivalent but simply copies or similars, there is a concern that commercial and registration lots of these 'generics' may not be of the same quality. The objective of this study was to assess the ability of various in vitro quality control tests to detect difference among five amlodipine products available in the Panamanian market: four 'generics', made in various countries, and the innovator, made in Germany and used as reference listed drug in Panama (Pan-RLD). The innovator manufactured in the United States (US-RLD) was used to compare the two RLDs. The Content Uniformity test, 30-min Dissolution test and multiple-pH Dissolution Profiles did not show any difference among the products. However, the in vitro dissolution absorption system 1 (IDAS1) showed a statistically significant difference in the amount dissolved between Pan-RLD and three out of the four 'generics', and significantly lower permeated amount for all the 'generics' compared with Pan-RLD; only US-RLD was similar to Pan-RLD. Thus, IDAS1 showed promise as a potential tool that authorities in weakly regulated markets can use to monitor for possible lot-to-lot product changes, which can help improve the quality of pharmaceutical products available to their entire populations. The significance of the similarity between the innovators made in Germany and the United States and their difference from the 'generics' (manufactured in other countries) is not known but deserves investigation.

COVID-19: IFSO LAC Recommendations for the Resumption of Elective Bariatric Surgery.

BACKGROUND: COVID-19 pandemic varies greatly and has different dynamics in every country, city, and hospital in Latin America. Obesity increases the risk of SARS-CoV-2 infection, and it is one of the independent risk factors for the most severe cases of COVID-19. Currently, the most effective treatment against obesity available is bariatric and metabolic surgery (BMS), which further resolves or improves other independent risk factors like diabetes and hypertension. OBJECTIVE: Provide recommendations for the resumption of elective BMS during COVID-19 pandemic. METHOD: This document was created by the IFSO-LAC Executive Board and a task force. Based on data collected from a survey distributed to all IFSO-LAC members that obtained 540 responses, current evidence available, and consensus reached by other scientific societies. RESULTS: The resumption of elective BMS must be a priority maybe similar to oncological surgery, when hospitals reach phase I or II, treating obesity patients in a NON-COVID area, avoiding inadvertent intrahospital contagion from healthcare provider, patients, and relatives. Same BMS indication and types of procedures as before the pandemic. Discard the presence of SARS-CoV-2 within 72 h prior to surgery. Continues laparoscopic approach. The entire team use N95 mask. Minimum hospital stays. Implement remote visits for the follow-up. CONCLUSION: Resumption of elective BMS is crucial because it is not only a weight loss operation but also resolves or improves comorbidities and appears to be an immune restorative procedure of obese patients in the medium term, offering them the same probability of contracting COVID-19 as the regular population.

Characterization of R-ras3/m-ras null mice reveals a potential role in trophic factor signaling.

R-Ras3/M-Ras is a member of the RAS superfamily of small-molecular-weight GTP-binding proteins. Previous studies have demonstrated high levels of expression in several regions of the central nervous system, and a constitutively active form of M-Ras promotes cytoskeletal reorganization, cellular transformation, survival, and differentiation. However, the physiological functions of M-Ras during embryogenesis and postnatal development have not been elucidated. By using a specific M-Ras antibody, we demonstrated a high level of M-Ras expression in astrocytes, in addition to neurons. Endogenous M-Ras was activated by several trophic factors in astrocytes, including epidermal growth factor (EGF), basic fibroblast growth factor, and hepatocyte growth factor. Interestingly, M-Ras activation by EGF was more sustained compared to prototypic Ras. A mouse strain deficient in M-Ras was generated to investigate its role in development. M-Ras null mice appeared phenotypically normal, and there was a lack of detectable morphological and neurological defects. In addition, primary astrocytes derived from Mras(-/-) mice did not appear to display substantial alterations in the activation of both the mitogen-activated protein kinase and phosphatidylinositol 3-kinase pathways in response to trophic factors.

In vitro toxicity assessment of zinc and nickel ferrite nanoparticles in human erythrocytes and peripheral blood mononuclear cell.

Ferrite nanoparticles (NPs) have gained attention in biomedicine due to their many potential applications, such as targeted drug delivery, their use as contrast agents for magnetic resonance imaging and oncological treatments. The information about the risk effects of ferrite NPs in human blood cells is, however, scarce. To assess their potential toxicity, in vitro studies were carried out with magnetite and zinc, nickel and nickel­zinc ferrites NPs at different concentrations (50, 100 and 200 µg·ml-1). The toxicity of the ferrite NPs was evaluated in humans by determining red blood hemolysis, by measuring the content of total proteins, and by assaying catalase and glutathione-S-transferase activities. Our results show that nickel­zinc ferrite lead to hemolysis, and that magnetite, zinc and nickel­zinc ferrites increase glutathione-S-transferase activity. No significant changes in human peripheral blood mononuclear cells viability were observed after the treatment with the four different ferrite NPs in vitro.

Tratamiento quirúrgico del divertículo de Zenker; un caso clínico; Hospital Militar Central de La Paz (COSSMIL) gestión 2022 / Surgical treatment of Zenker's diverticulum, a Clinical Case Central Military Hospital of La Paz (COSSMIL) gestión 2022

Se presenta un caso clínico de una paciente de 66 años de edad masculino que acude a nuestro hospital (COOSMIL), después de hacer una anamnesis donde el paciente manifiestas molestias como tos, regurgitación y mal alientos (halitosis) y se le hace exámenes complementarios y se llega a un diagnóstico de divertículo faringo-esofágico o Zenker. Esta patología no es muy frecuente, pero se presenta en ancianos por una alteración anatomo-funcional que es un debilitamiento del músculo esofágico Hay tres divertículos esofágicos de los cuales el divertículo de Zenker es el más común aunque es relativamente raro que se presente, en la mayoría de las personas en edad seniles. Después de analizar el tamaño y forma del divertículo de este paciente se toma la decisión de una intervención quirúrgica el más acertado por el tamaño que mide es la diverticulectomia este tratamiento quirúrgico actualmente se continúa realizando en esta patología y con buen pronóstico de vida del paciente. Actualmente, el paciente se encuentra en buen estado salud y su recuperación es favorable desde la operación hasta el momento.

A case of a male patient of 66 years old was referred to our hospital (COSSMIL), after making an anamnesis in which the patient manifested cough, regurgitation and bad breath (halitosis). After further examination a the diagnosis is pharyngo-esophageal diverticulum or Zenker. This condition is rare, but sometimes it happens in elders due to an anatomical and functional alteration caused by is an esophagus muscle weakening. There are three esophageal diverticula in which the Zenker diverticulum is the most common but relatively rarely to occur in elder people. Before analyzing the size and shape of the diverticulum in this patient, the decision is proceed with surgery, the most recommended solution for measuring the size of the diverticulectomy. is The surgical treatment is still being applied in this pathology, with a high probability of success. Currently, the patient is in good health and the recovery from surgery is favorable so far.