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1.
Aesthetic Plast Surg ; 2022 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-35701593

RESUMEN

BACKGROUND: The surgical goals of gender reassignment surgery of the breast in female-to male transsexuals (FMT) is the aesthetic shaping of a male thoracic wall with minimal scarring, while preserving the sensitivity of the nipple-areola complex (NAC). For large and ptotic breasts, we perform a mastectomy over an inframammary access with inferior pedicled NAC under color Doppler visualization of the perforators. This paper presents the technique, including complications and assessment of quality of life, as part of a unicentric analysis. METHODS: This was a retrospective analysis of 23 patients (46 mastectomies) performed between September 2014 and September 2020. The complication rate and the number of corrective surgeries were recorded for quality assessment. A semiquantitative score was used to evaluate aesthetic outcome, nipple sensitivity, quality of life, and sexuality. RESULTS: A total of 46 mastectomies were performed in 23 patients. The patient survey showed high patient satisfaction. Loss of nipple sensitivity was observed after one mastectomy (2.17%). In 91.67% of cases, patients reported that their appearance reflected how they feel on the inside. In 75% of cases, patients reported feeling equal to other men. The overall complication rate was 10.87%. Shape correction due to persistent excess of volume was rare (2.17%, equivalent to one mastectomy). CONCLUSION: Subcutaneous mastectomy with inferior nipple pedicle can be performed with a high degree of safety and satisfaction in FMT. Color Doppler-guided visualization of the perforator vessels is helpful in allowing a thin pedicle preparation, thus reducing the need for secondary surgeries to optimize the shape. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

2.
Arch Gynecol Obstet ; 303(4): 1025-1037, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33389096

RESUMEN

Pectus excavatum (PE) is one of the most common congenital deformities of the thorax and is characterized by a depressed sternum with reduction of the antero-posterior thoracic diameter. Although the majority of patients with PE have no physiologic limitations, it is often associated with psychological problems influencing the patients' quality of life. Surgical treatment options show particular variation with regard to invasiveness and morbidity of the respective procedures. Surgical treatment using a custom-made silicone implant represents a less invasive alternative for patients without further accompanying physical symptoms. This article describes the simultaneous correction of a PE combined with tubular breast deformity using this minimally invasive technique.


Asunto(s)
Mama/anomalías , Tórax en Embudo/cirugía , Procedimientos de Cirugía Plástica , Adolescente , Mama/cirugía , Femenino , Tórax en Embudo/complicaciones , Humanos , Mamoplastia , Procedimientos Quirúrgicos Mínimamente Invasivos , Prótesis e Implantes
3.
Qual Life Res ; 25(6): 1327-37, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26573019

RESUMEN

BACKGROUND: The thentest design aims to detect and control for recalibration response shift. This design assumes (1) more consistency in the content of the cognitive processes underlying patients' quality of life (QoL) between posttest and thentest assessments than between posttest and pretest assessments; and (2) consistency in the time frame and description of functioning referenced at pretest and thentest. Our objective is to utilize cognitive interviewing to qualitatively examine both assumptions. METHODS: We conducted think-aloud interviews with 24 patients with cancer prior to and after radiotherapy to elicit cognitive processes underlying their assessment of seven EORTC QLQ-C30 items at pretest, posttest and thentest. We used an analytic scheme based on the cognitive process models of Tourangeau et al. and Rapkin and Schwartz that yielded five cognitive processes. We subsequently used this input for quantitative analysis of count data. RESULTS: Contrary to expectation, the number of dissimilar cognitive processes between posttest and thentest was generally larger than between pretest and posttest across patients. Further, patients considered a range of time frames when answering the thentest questions. Moreover, patients' description at the thentest of their pretest functioning was often not similar to that which was noted at pretest. Items referring to trouble taking a short walk, overall health and QoL were most often violating the assumptions. CONCLUSIONS: Both assumptions underlying the thentest design appear not to be supported by the patients' cognitive processes. Replacing the conventional pretest-posttest design with the thentest design may simply be replacing one set of biases with another.


Asunto(s)
Cognición , Calidad de Vida/psicología , Perfil de Impacto de Enfermedad , Encuestas y Cuestionarios , Anciano , Anciano de 80 o más Años , Sesgo , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Neoplasias/psicología , Neoplasias/radioterapia , Investigación Cualitativa , Estudios Retrospectivos , Factores de Tiempo
4.
J Urol ; 194(5): 1202-8, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26143111

RESUMEN

PURPOSE: Despite intravesical therapy with immunotherapy or chemotherapy intermediate and high risk nonmuscle invasive bladder cancer is associated with a high risk of recurrence and progression to muscle invasive bladder carcinoma. While intravesical hyperthermia combined with mitomycin C has proved effective to treat nonmuscle invasive bladder cancer, there is less experience with invasive regional 70 MHz hyperthermia and mitomycin C. Therefore, we examined the safety and feasibility of this treatment combination for intermediate and high risk nonmuscle invasive bladder cancer. MATERIALS AND METHODS: Between 2009 and 2011, 20 patients with intermediate and high risk nonmuscle invasive bladder cancer were treated with intravesical mitomycin C (40 mg) combined with regional hyperthermia. Treatment consisted of 6 weekly sessions followed by a maintenance period of 1 year with 1 hyperthermia-mitomycin C session every 3 months. Regional hyperthermia was administered using a 70 MHz phased array system with 4 antennas. Toxicity was scored using CTC (Common Toxicity Criteria) 3.0. RESULTS: The records of 18 of 20 patients could be analyzed. Median followup was 46 months. Of the 18 patients 15 (83%) completed the induction period of 6 treatments. Four patients (22%) discontinued treatment because of physical complaints without exceeding grade 2 toxicity. Toxicity scored according to CTC 3.0 was limited to grade 1 in 43% of cases and grade 2 in 14%. Mean T90 and T50 bladder temperatures were 40.6C and 41.6C, respectively. The 24-month recurrence-free survival rate was 78%. CONCLUSIONS: Treatment with regional hyperthermia combined with mitomycin C in patients with intermediate and high risk nonmuscle invasive bladder cancer is feasible with low toxicity and excellent bladder temperatures.


Asunto(s)
Hipertermia Inducida/métodos , Mitomicina/administración & dosificación , Neoplasias de la Vejiga Urinaria/terapia , Administración Intravesical , Adulto , Anciano , Anciano de 80 o más Años , Antibióticos Antineoplásicos/administración & dosificación , Terapia Combinada , Progresión de la Enfermedad , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Proyectos Piloto , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/patología
5.
J Fish Biol ; 85(5): 1617-33, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25263288

RESUMEN

A review of the primary literature on the cartilaginous fishes (sharks, skates, rays and chimaeras), together with new information suggests that 106 species occur in Chilean waters, comprising 58 sharks, 30 skates, 13 rays and five chimaeras. The presence of 93 species was confirmed, although 30 species were encountered rarely, through validated catch records and sightings made in artisanal and commercial fisheries and on specific research cruises. Overall, only 63 species appear to have a range distribution that normally includes Chilean waters. Actual reliable records of occurrence are lacking for 13 species. Chile has a cartilaginous fish fauna that is relatively impoverished compared with the global species inventory, but conservative compared with countries in South America with warm-temperate waters. The region of highest species richness occurs in the mid-Chilean latitudes of c. 30-40° S. This region represents a transition zone with a mix of species related to both the warm-temperate Peruvian province to the north and cold-temperate Magellan province to the south. This study provides clarification of species occurrence and the functional biodiversity of Chile's cartilaginous fish fauna.


Asunto(s)
Biodiversidad , Elasmobranquios/clasificación , Animales , Chile , Océano Pacífico
6.
Acta Oncol ; 52(3): 658-65, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23282111

RESUMEN

BACKGROUND: Due to improved visibility on MRI, contouring of the prostate is improved compared to CT. The aim of this study was to quantify the benefits of using MRI for treatment planning as compared to CT-based planning for temporary implant prostate brachytherapy. MATERIAL AND METHODS: CT and MRI image data of 13 patients were used to delineate the prostate and organs at risk (OARs) and to reconstruct the implanted catheters (typically 12). An experienced treatment planner created plans on the CT-based structure sets (CT-plan) and on the MRI-based structure sets (MRI-plan). Then, active dwell-positions and weights of the CT-plans were transferred to the MRI-based structure sets (CT-plan(MRI-contours)) and resulting dosimetric parameters and tumour control probabilities (TCPs) were studied. RESULTS: For the CT-plan(MRI-contours) a statistically significant lower target coverage was detected: mean V100 was 95.1% as opposed to 98.3% for the original plans (p < 0.01). Planning on CT caused cold-spots that influence the TCP. MRI-based planning improved the TCPs by 6-10%, depending on the parameters of the radiobiological model used for TCP calculation. Basing the treatment plan on either CT- or MRI-delineations does not influence plan quality. CONCLUSION: Evaluation of CT-based treatment planning by transferring the plan to MRI reveals underdosage of the prostate, especially at the base side. Planning on MRI can prevent cold-spots in the tumour and improves the TCP.


Asunto(s)
Braquiterapia/métodos , Carcinoma/radioterapia , Imagen por Resonancia Magnética , Próstata/diagnóstico por imagen , Neoplasias de la Próstata/radioterapia , Planificación de la Radioterapia Asistida por Computador/métodos , Carcinoma/diagnóstico por imagen , Carcinoma/patología , Humanos , Masculino , Tamaño de los Órganos/fisiología , Órganos en Riesgo , Probabilidad , Próstata/patología , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Dosificación Radioterapéutica , Tomografía Computarizada por Rayos X , Carga Tumoral/fisiología , Ultrasonografía
7.
Biomed Pharmacother ; 158: 114070, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36526536

RESUMEN

Stauprimide, a semi-synthetic derivative of staurosporine, is known mainly for its potent differentiation-enhancing properties in embryonic stem cells. Here, we studied the effects of stauprimide in cell growth and migration of triple-negative breast cancer cells in vitro, evaluating its potential antitumoral activity in an orthotopic mouse model of breast cancer in vivo. Our results from survival curves, EdU incorporation, cell cycle analysis and annexin-V detection in MDA-MB-231 cells indicated that stauprimide inhibited cell proliferation, arresting cell cycle in G2/M without induction of apoptosis. A decrease in the migratory capability of MDA-MB-231 was also assessed in response to stauprimide. In this work we pointed to a mechanism of action of stauprimide involving the modulation of ERK1/2, Akt and p38 MAPK signalling pathways, and the downregulation of MYC in MDA-MB-231 cells. In addition, orthotopic MDA-MB-231 xenograft and 4T1 syngeneic models suggested an effect of stauprimide in vivo, increasing the necrotic core of tumors and reducing metastasis in lung and liver of mice. Together, our results point to the promising role of stauprimide as a putative therapeutic agent in triple-negative breast cancer.


Asunto(s)
Neoplasias de la Mama , Neoplasias de la Mama Triple Negativas , Humanos , Animales , Ratones , Femenino , Neoplasias de la Mama Triple Negativas/patología , Línea Celular Tumoral , Ciclo Celular , Proliferación Celular , Neoplasias de la Mama/tratamiento farmacológico , División Celular , Apoptosis
8.
Cancer ; 118(1): 180-7, 2012 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-21713762

RESUMEN

BACKGROUND: The objective of this study was to evaluate the role of reirradiation and hyperthermia in the treatment of radiation-associated sarcoma (RAS) in the thoracic region, which is an increasing, yet extremely rare condition with a poor prognosis. METHODS: Between 1979 and 2009, 16 patients with RAS in the thoracic region were treated in the Academic Medical Center and the Institute Verbeeten with reirradiation and hyperthermia. In 13 patients, this treatment was given for unresectable disease and 3 times after resection as adjuvant treatment. The median latency period between the original malignancy diagnosis and the RAS diagnosis was 86 months (range 19-212 months). Histology was angiosarcoma in 11 patients (69%). The literature on reirradiation with or without hyperthermia for RAS was reviewed. RESULTS: The median survival was 15.5 months (range, 3-204 months). Four patients were not evaluable for response. The response rate for the remaining 12 patients was 75% (7 complete responses and 2 partial responses). Six patients remained free of local failure until death (5 months and 7 months) or last follow-up (8 months, 11 months, 39 months, and 68 months). CONCLUSIONS: The current study indicates that combined reirradiation and hyperthermia for RAS in the thoracic region is feasible. The high response rate and the possibility of durable local control suggest that this treatment is promising.


Asunto(s)
Hipertermia Inducida/métodos , Neoplasias Inducidas por Radiación/terapia , Radioterapia/efectos adversos , Sarcoma/etiología , Sarcoma/terapia , Tórax/efectos de la radiación , Anciano , Anciano de 80 o más Años , Terapia Combinada , Radiación Electromagnética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/mortalidad , Dosificación Radioterapéutica , Resultado del Tratamiento
9.
Acta Oncol ; 51(4): 512-20, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22414096

RESUMEN

BACKGROUND: Our study aims to investigate whether information given by radiation oncologists to their patients is tailored to the patient's desired level of information and, if so, what the effect of tailoring is on patient-reported outcomes, i.e. satisfaction, health, anxiety and self-efficacy. MATERIAL AND METHODS: Consecutive radiotherapy patients (n = 150) completed a baseline questionnaire one week before their initial consultation, immediately following this consultation, and again one week prior to their first follow-up visit. The initial consultation was videotaped and 10 radiation oncologists' information giving behavior (content and duration) analyzed. RESULTS: The overall amount of information provided by the radiation oncologists matched with patients' information needs in 50.8% (k = 0.07) of the consultations. No significant associations between tailored information giving and patient-reported outcomes were found, except for tailoring of information on procedures, and patients' anxiety and global health. These associations were no longer significant when correcting for patients' background characteristics. CONCLUSION: This study shows that radiation oncologists poorly tailor their information to the needs of their patients. However, lack of tailoring is not associated with worse patient-reported outcomes. Until more evidence is available, radiation oncologists may explicitly ask patients about their information preferences and tailor the information provided accordingly.


Asunto(s)
Actitud del Personal de Salud , Difusión de la Información , Neoplasias/psicología , Relaciones Médico-Paciente , Oncología por Radiación , Derivación y Consulta , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad , Comunicación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Neoplasias/radioterapia , Satisfacción del Paciente , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto Joven
10.
Support Care Cancer ; 20(9): 2167-76, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22081119

RESUMEN

PURPOSE: We aimed to investigate if cancer patients' information needs decrease during radiotherapy and if so, which patient, consultation and radiation oncologist characteristics are associated with a decrease in information needs over time. METHODS: In this longitudinal study, patients (n = 104) completed a baseline questionnaire a week before the initial radiotherapy consultation, immediately following this initial consultation, and 1 week prior to the first follow-up visit, which took place on average 3-5 weeks after the initial visit. Besides information needs, measured by the Information Preference for Radiotherapy Patients scale, the questionnaire assessed patient, consultation and radiation oncologist characteristics. RESULTS: Information needs decreased over time, but remained at a high level. Being religious, being male, having low health literacy and higher perceived involvement during the consultation were all statistically significantly associated to a decrease in information needs on specific domains (e.g. procedures or side effects). CONCLUSIONS: Cancer patients' information needs decline between the initial consultation and the first follow-up visit, but remain high. It is therefore advised to investigate the patients' information needs at every radiotherapy visit and not rely on giving information just once. Furthermore, radiation oncologists should check if the information given at first consultation is understood and remembered. By those means, tailored information giving becomes possible.


Asunto(s)
Acceso a la Información , Necesidades y Demandas de Servicios de Salud , Radioterapia , Centros Médicos Académicos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Países Bajos , Educación del Paciente como Asunto , Relaciones Médico-Paciente , Encuestas y Cuestionarios
11.
Qual Life Res ; 21(10): 1745-53, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22193882

RESUMEN

OBJECTIVE: If the assumption of measurement invariance is not tested, we cannot be sure whether differences observed are due to true differences in health-related quality-of-life (HRQoL), or are measurement artifacts. We aim to investigate this assumption in a sample of heterogeneous cancer patients, focusing on whether age, sex, previous treatment for cancer, and information regarding treatment preferences result in biased HRQoL scores. METHODS: 155 cancer patients who were about to begin their first session of radiotherapy were included. HRQoL was measured using the EORTC QLQ-C30. Structural equation modeling was applied to assess whether there was a violation of the assumption of invariance. RESULTS: A satisfactory single construct (Functioning HRQoL) measurement model was found and two violations of invariance were identified. Irrespective of patients' Functioning HRQoL, older patients reported worse physical functioning and patients who had received treatment prior to radiotherapy reported worse emotional functioning than we would otherwise expect. CONCLUSIONS: In the present study, accounting for measurement bias lead to a substantial improvement in the overall fit of the model. By ignoring the bias, we would have concluded that the model fit was unsatisfactory. The findings underline the importance of investigating measurement invariance in scales designed for heterogeneous samples.


Asunto(s)
Neoplasias/psicología , Neoplasias/radioterapia , Calidad de Vida , Radioterapia/psicología , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
12.
J Fish Biol ; 80(5): 1213-26, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22497380

RESUMEN

Between 2000 and 2002, three artisanal landing sites were sampled in southern Chile, with data on population structure and reproductive development collected from 5477 yellownose skates Zearaja chilensis. Total length (L(T) ) ranged from 33 to 158 cm for females and 34 to 155 cm for males. No sexual dimorphism was evident in disc size (length or width) or in L(T)-mass relationships. The smallest mature female was 95 cm L(T) and the size at which 50% were mature (L(T50) ) was 109 cm. Males matured between 80 and 90 cm L(T) with a L(T50) of 88 cm. Although the largest Z. chilensis captured by the artisanal fishery was 155 cm L(T) , 89% of landings comprised relatively small, immature fish. This situation may compromise the stock integrity if intrinsic vulnerability and probable long-life span of Z. chilensis are considered. Consequences for the survival of the species and possible signs of a fishery collapse must be reviewed by management authorities by consideration of both artisanal and industrial landings in Chile.


Asunto(s)
Reproducción , Rajidae/fisiología , Animales , Tamaño Corporal , Chile , Conservación de los Recursos Naturales , Femenino , Fertilidad , Explotaciones Pesqueras , Masculino , Océano Pacífico , Caracteres Sexuales , Maduración Sexual
13.
Thorax ; 66(12): 1065-71, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21803931

RESUMEN

BACKGROUND: Childhood cancer survivors (CCSs) have an increased risk of morbidity and mortality. The prevalence and risk factors of pulmonary function impairment were investigated in a large cohort of CCSs treated with potentially pulmotoxic therapy with a minimal follow-up of 5 years after diagnosis. METHODS: The study cohort consisted of all adult 5-year CCSs who were treated with bleomycin, pulmonary radiotherapy and/or pulmonary surgery in the Emma Children's Hospital/Academic Medical Center between 1966 and 1996. Pulmonary function tests were performed to diagnose obstructive and restrictive pulmonary function impairment, and diffusion capacity impairment. RESULTS: The study population consisted of 220 out of 248 eligible CCSs, of whom 193 (87.7%) had performed a pulmonary function test at a median follow-up of 18 years after diagnosis. 85 (44.0%) out of 193 CCSs developed a pulmonary function impairment. Pulmonary function impairments occurred in all treatment groups. Most prevalent were restrictive pulmonary function impairment (17.6%) and a decreased carbon monoxide diffusion capacity (39.9%). Multivariate logistic regression models showed that, compared with bleomycin treatment only, treatment with radiotherapy, radiotherapy combined with bleomycin and radiotherapy combined with surgery were associated with the highest risk of pulmonary function impairment. CONCLUSIONS: The prevalence of pulmonary function impairment in long-term adult CCSs who received potentially pulmotoxic therapy is high. Bleomycin, pulmonary radiotherapy and pulmonary surgery are all associated with pulmonary function impairment. Pulmonary radiotherapy, especially in combination with bleomycin or surgery, is the most important risk factor. This emphasises the need for adequate counselling and follow-up for this patient population.


Asunto(s)
Enfermedades Pulmonares/etiología , Enfermedades Pulmonares/fisiopatología , Neoplasias/terapia , Sobrevivientes , Adolescente , Adulto , Antibióticos Antineoplásicos/efectos adversos , Antineoplásicos Alquilantes , Bleomicina/efectos adversos , Niño , Ciclofosfamida/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Masculino , Neumonectomía/efectos adversos , Prevalencia , Estudios Prospectivos , Sistema de Registros , Pruebas de Función Respiratoria , Factores de Riesgo , Índice de Severidad de la Enfermedad
14.
Sci Total Environ ; 751: 141675, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33181996

RESUMEN

The current livestock farm production model is being questioned due to its excessive use of resources and impacts on the environment, and it has played a major role in climate change due to the excessive level of greenhouse gas (GHG) emissions. A valid tool in the reduction of such emissions is the imposition of a tax on CO2 emissions that can act as an economic and financial instrument. Additionally, livestock production based on grazing animals is proposed as a more sustainable model that involves improved environmental practices and provides society with various ecosystem services, including carbon sequestration. The main purpose of this paper is to estimate the maximum price per tonne of CO2 equivalent (eq) that could be borne by the various models of organic livestock farms in the dehesas and rangelands of southwestern Spain. With this purpose in mind, we have made a scenario-based estimation of the environmental-economic balance in three different scenarios considering farm emissions and CO2 sequestration levels. The results show that the maximum price that farms can bear is within a range of € 0.20 to € 792/tn of CO2 eq depending on the scenario analysed and the production model. In the cases in which carbon sequestration balances GHG emissions, the implementation of carbon pricing implies additional economic income for farm accounts.

15.
Virulence ; 12(1): 35-44, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33372844

RESUMEN

Convergence of virulence and antibiotic-resistance has been reported in Klebsiella pneumoniae, but not in Klebsiella variicola. We, hereby, report the detection and genomic characterization of hypervirulent and hypermucoviscous K. pneumoniae and K.variicola recovered in Chile from health-care associated infections, which displayed resistance to broad-spectrum cephalosporins. One hundred forty-six K. pneumoniae complex isolates were screened by hypermucoviscosity by the "string test." Two hypermucoid isolates, one hypermucoviscous K. pneumoniae (hmKp) and one K. variicola (hmKv), were further investigated by whole-genome sequencing. In vivo virulence was analyzed by the Galleria mellonella killing assay. In silico analysis of hmKp UCO-494 and hmKv UCO-495 revealed the presence of multiple antibiotic-resistance genes, such as blaCTX-M-1, blaDHA-1 and blaLEN-25 among others clinically relevant resistance determinants, including mutations in a two-component regulatory system related to colistin resistance. These genetic features confer a multidrug-resistant (MDR) phenotype in both strains. Moreover, virulome in silico analysis confirmed the presence of the aerobactin gene iutA, in addition to yersiniabactin and/or colicin V encoding genes, which are normally associated to high virulence in humans. Furthermore, both isolates were able to kill G. mellonella and displayed higher virulence in comparison with the control strain. In summary, the convergence of virulence and the MDR-phenotype in K. pneumoniae complex members is reported for the first time in Chile, denoting a clinical problem that deserves special attention and continuous surveillance in South America.


Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/patogenicidad , Klebsiella/genética , Klebsiella/patogenicidad , Animales , Antibacterianos/farmacología , Biopelículas/crecimiento & desarrollo , Chile , Genoma Bacteriano/genética , Humanos , Klebsiella/enzimología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/enzimología , Larva/microbiología , Pruebas de Sensibilidad Microbiana , Mariposas Nocturnas/microbiología , Factores de Virulencia/genética , Secuenciación Completa del Genoma
16.
Arterioscler Thromb Vasc Biol ; 29(2): 158-61, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19038849

RESUMEN

The suggestion was made in the 1870s that mechanical irritation of the arterial wall is a cause of atherosclerosis, because the changes were chiefly found at points "exposed to the full stress and impact of the blood." The mechanical damage theory persisted until well into the 20th century when, with interest increasing in multidisciplinary research, two fluid mechanical proposals were advanced for the patchy distribution of the lesions. One advocated high- and the other low-wall shear. Arterial wall shear stress levels appeared, however, insufficiently high to damage the endothelium. In contrast, examination of cadaver human arteries, combined with flow studies in models and casts of arteries, implied that the lesions occurred preferentially in regions expected to experience low-wall shear; a mechanism, involving arterial wall lipid metabolism and shear-dependent blood-wall mass transport, was suggested to account for that distribution. These proposals helped stimulate extensive investigation of arterial fluid mechanics/mass transport and vascular biology/pathology, revealing mechanisms that may explain the now widely confirmed preferred occurrence of atherosclerosis in low wall shear regions in adult human beings.


Asunto(s)
Arterias/fisiopatología , Aterosclerosis/fisiopatología , Hemodinámica , Estrés Mecánico , Animales , Arterias/metabolismo , Arterias/patología , Aterosclerosis/etiología , Aterosclerosis/metabolismo , Aterosclerosis/patología , Humanos , Metabolismo de los Lípidos , Modelos Cardiovasculares , Flujo Pulsátil , Flujo Sanguíneo Regional
17.
Health Qual Life Outcomes ; 8: 69, 2010 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-20637086

RESUMEN

BACKGROUND: Numerous studies have indirectly demonstrated changes in the content of respondents' QoL appraisal process over time by revealing response-shift effects. This is the first known study to qualitatively examine the assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time. Specific objectives are to examine whether the content of each distinct cognitive process underlying QoL appraisal is (dis)similar over time and whether patterns of (dis)similarity can be discerned across and within patients and/or items. METHODS: We conducted cognitive think-aloud interviews with 50 cancer patients prior to and following radiotherapy to elicit cognitive processes underlying the assessment of 7 EORTC QLQ-C30 items. Qualitative analysis of patients' responses at baseline and follow-up was independently carried out by 2 researchers by means of an analysis scheme based on the cognitive process models of Tourangeau et al. and Rapkin & Schwartz. RESULTS: The interviews yielded 342 comparisons of baseline and follow-up responses, which were analyzed according to the five cognitive processes underlying QoL appraisal. The content of comprehension/frame of reference changed in 188 comparisons; retrieval/sampling strategy in 246; standards of comparison in 152; judgment/combinatory algorithm in 113; and reporting and response selection in 141 comparisons. Overall, in 322 comparisons of responses (94%) the content of at least one cognitive component changed over time. We could not discern patterns of (dis)similarity since the content of each of the cognitive processes differed across and within patients and/or items. Additionally, differences found in the content of a cognitive process for one item was not found to influence dissimilarity in the content of that same cognitive process for the subsequent item. CONCLUSIONS: The assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time was not found to be in line with the cognitive processes described by the respondents. Additionally, we could not discern patterns of (dis)similarity across and within patients and/or items. In building on cognitive process models and the response shift literature, this study contributes to a better understanding of patient-reported QoL appraisal over time.


Asunto(s)
Cognición , Modelos Psicológicos , Calidad de Vida/psicología , Radioterapia , Caminata , Estudios de Seguimiento , Humanos , Entrevistas como Asunto , Investigación Cualitativa , Proyectos de Investigación , Factores de Tiempo
18.
Int J Hyperthermia ; 26(2): 136-44, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20146568

RESUMEN

PURPOSE: To analyse the therapeutic effect and toxicity of re-irradiation (re-RT) combined with hyperthermia (HT) following resection or clinically complete remission (CR) of persistent locoregional recurrent breast cancer in previously irradiated area. METHODS AND MATERIALS: Between 1988 and 2001, 78 patients with high risk recurrent breast cancer underwent elective re-RT and HT. All patients received extensive previous treatments, including surgery and high-dose irradiation (> or =50Gy). Most had received one or more lines of systemic therapy; 44% had been treated for > or = one previous locoregional recurrences. At start of re-RT + HT there was no macroscopically detectable tumour following surgery (96%) or chemotherapy (CT). Re-RT typically consisted of eight fractions of 4Gy, given twice weekly. Hyperthermia was added once a week. RESULTS: After a median follow up of 64.2 months, three-year survival was 66%. Three- and five-year local control rates were 78% and 65%. Acute grade 3 toxicity occurred in 32% of patients. The risk of late > or = grade 3 toxicity was 40% after three years. Time interval to the current recurrence was found to be most predictive for local control in univariate and multivariate analysis. The extensiveness of current surgery was the most relevant treatment related factor associated with toxicity. CONCLUSIONS: For patients experiencing local recurrence in a previously radiated area, re-irradiation plus hyperthermia following minimisation of tumour burden leads to a high rate of local control, albeit with significant toxicity. The latter might be reduced by a more fractionated re-RT schedule.


Asunto(s)
Neoplasias de la Mama , Hipertermia Inducida , Recurrencia Local de Neoplasia , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Quimioterapia Adyuvante , Terapia Combinada/efectos adversos , Terapia Combinada/métodos , Femenino , Humanos , Hipertermia Inducida/efectos adversos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Radioterapia Adyuvante , Estudios Retrospectivos , Tasa de Supervivencia
19.
Int J Food Sci ; 2020: 9816204, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32258097

RESUMEN

This study is aimed at analysing the effect of vacuum frying on the kinetic parameters of mass transfer, the CIE L ∗ a ∗ b ∗ colour parameters of the Carimañola. For the kinetic analysis, the moisture and oil content were measured by means of an experimental design consisting of two factors: frying time with seven levels (60, 120, 180, 240, 300, 420, and 540 s) and frying temperature with three levels (120, 130, and 140°C). The diffusivity coefficient, the moisture transfer rate, and the oil adsorption rate, with their respective activation energies, were calculated. For the colour analysis, the reflectance technique was used to determine the colour coordinates of the CIE L ∗ a ∗ b ∗ space, and the general colour change was calculated (ΔE). Concerning the kinetics, the increase in temperature and frying time reduced the moisture content, while the oil content decreased with the increase in temperature and increases with frying time. The diffusivity ranged from 1, 238 × 10-6 m2/s at 120°C to 2, 84 × 10-6 m2/s at 140°C. The mass transfer coefficients for moisture ranged from 2 × 10-4 m/s at 120°C to 4 × 10-4 m/s at 140°C. The values of the oil uptake rate were from 0.0022 s-1 at 120°C to 0.0018 s-1 at 140°C. Finally, the luminosity parameter shows a decrease with the increase in temperature, although the first 240 s shows a rise and then begins to decrease. Vacuum frying allowed Carimañolas to be obtained with a lower oil and moisture content, with an appropriate colouring, eye-catching and visually attractive to consumers.

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