Can the microcystic, elongated and fragmented pattern of invasion influence the evaluation of the depth of myometrial invasion in low-grade endometrioid endometrial cancer using imaging techniques?

Objectives: The microcystic, elongated and fragmented pattern of invasion can be associated with an underestimation of the depth of myometrial invasion by imaging techniques. We aimed to evaluate the influence of microcystic, elongated and fragmented pattern of invasion in the diagnostic performance of transvaginal ultrasound scan and magnetic resonance imaging for the prediction of the depth of myometrial invasion in low-grade endometrioid endometrial carcinomas. Methods: Prospective and consecutive study including all low-grade (G1-G2) endometrioid endometrial carcinomas diagnosed between October 2013 and July 2018 in a tertiary hospital. Preoperative staging was performed with transvaginal ultrasound scan and/or magnetic resonance imaging followed by surgical staging. Final histology was considered as the reference standard. Sensitivity, specificity and diagnostic accuracy for the prediction of depth of myometrial invasion was calculated for both imaging techniques. The STARD 2015 guidelines were used. Results: A total of 136 patients were consecutively included. Transvaginal ultrasound scan was performed in 132 patients and magnetic resonance imaging in 119 patients. The diagnostic accuracy of transvaginal ultrasound scan for the prediction of depth of myometrial invasion in the microcystic, elongated and fragmented negative group (82% (95% confidence interval = 73-88)) was higher compared to the microcystic, elongated and fragmented positive group (61% (95% confidence interval = 36-83)). The diagnostic accuracy of magnetic resonance imaging was also higher in the microcystic, elongated and fragmented negative group (80% (95% confidence interval = 71-87)) compared to the microcystic, elongated and fragmented positive (47% (95% confidence interval = 21-73)). Conclusions: In low-grade endometrioid endometrial carcinomas with a positive microcystic, elongated and fragmented pattern of invasion, the evaluation of the depth of myometrial invasion using transvaginal ultrasound scan and magnetic resonance imaging may be underestimated.

Analytical connotations of point-of-care testing.

The main objective of this Tutorial Review is to approach the modern principles and practices of Analytical Chemistry to Point-of-Care Testing (POCT) systems in order to contribute to improve both the development of new devices and the reliable application of the existing ones. In this article, after contextualization of the topic, POCT systems (POCTs) are fully defined using several approaches. The requirements of a POCT system to be a robust and reliable tool available to patients and medical workers are described as well as their desirable complementary characteristics. In addition, the technical components of POCTs materialized in the implementation of the steps of the analytical processes (sample introduction, sample processing, visual or instrumental detection, and data processing) are outlined. Besides, analytical properties assigned to POCTs and to their quantitative and qualitative results are highlighted. Special emphasis is given to Quality Assurance and Quality Control procedures, which are essential aspects to achieving reliable results. Finally, decision making based on the results obtained with POCTs is discussed as are their benefits and drawbacks.

Selective sample pretreatment by molecularly imprinted polymer for the determination of LSD in biological fluids.

For the first time, a molecularly imprinted polymer (MIP) was synthesized by a noncovalent imprinting approach for the selective extraction of an illicit drug, LSD, from hair and urine samples. For the synthesis of MIP, an analog of LSD, was taken as a dummy template, methacrylic acid as a functional monomer, and ACN as a porogen solvent. The MIP was used for offline extraction before HPLC-MS analysis. By studying the interactions taking place between the LSD and the MIP, a selective procedure was established in organic media and applied to hair samples. By this way, 0.1 ng/mg of LSD was successfully detected in hair with 82% of extraction recovery. A low retention was also obtained on the control polymer (only 9%). This procedure was then modified to obtain a selective extraction in aqueous media for the determination of LSD in urine samples. The comparison with a conventional C18 clearly demonstrated the selectivity brought by the MIP to the determination of LSD in urine. LSD was easily detected in urine at only 0.5 ng/mL with 83% of extraction recovery on the MIP and 11% on the NIP. An LOQ of 0.2 pg/mL was estimated in urine samples.

Ionic liquid-based dynamic liquid-phase microextraction: application to the determination of anti-inflammatory drugs in urine samples.

Dynamic liquid-phase microextraction (dLPME) using an ionic liquid as acceptor phase is proposed for the determination of six non-steroidal anti-inflammatory drugs (NSAIDs) in human urine samples for the first time. The extraction is carried out in a simple and automatic flow configuration. The chemical affinity between the extractant (1-butyl-3-methylimidazolium hexafluorophosphate) and the analytes permits a selective isolation of the drugs from the sample matrix allowing also their preconcentration. The whole analytical method has been optimized taking into account all the chemical, physical and hydrodynamic variables. The proposed method is a valuable alternative for the analysis of these drugs in urine within the concentration range 0.1-10 microg mL(-1), allowing their determination at therapeutic and toxic levels. Limits of detection were in the range from 38 ng mL(-1) (indomethacin) to 70 ng mL(-1) (naproxen). The repeatability of the proposed method expressed as RSD (n=5) varied between 2.1% (flurbiprofen) and 3.8% (tolmetin).

Combined use of carbon nanotubes and ionic liquid to improve the determination of antidepressants in urine samples by liquid chromatography.

Antidepressants are widely used for the treatment of psychiatric disorders and therefore their monitoring in biological fluids is quite important taking into account that they can produce dangerous biochemical imbalances in toxic doses. A method for the determination of antidepressants in urine samples is presented using solid-phase extraction (SPE) and high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection. Home-made cartridges containing 30 mg multiwall carbon nanotubes are employed for isolation of the analytes from the sample, allowing also the preconcentration of the analytes prior to the HPLC analysis. Chromatographic separation was achieved in a reversed-phase C(8) column using the ionic liquid 1-butyl-3-methylimidazolium trifluoromethanesulfonate as silanol activity suppressor, which enhances peak symmetry and chromatographic resolution. Limits of detection were 12.3 ng mL(-1) for trazodone and 90.1 ng mL(-1) for fluoxetine. The repeatability of the proposed method expressed as RSD (n = 11) varied between 3.4% (fluoxetine) and 5.0% (desipramine and mianserine). Thus, the method is suitable for the therapeutic monitoring of antidepressants in urine samples.

Fast urinary screening for imipramine and desipramine using on-line solid-phase extraction and selective derivatization.

A continuous-flow configuration based on sequential solid-phase extraction and derivatization is proposed for the screening of urine samples for imipramine and related metabolites. For the first time, a 50/50 (v/v) methanol/nitric acid mixture is used as both eluent and derivatizing reagent. Sample aliquots are injected into the flow manifold and driven by a water stream to an RP-C(18) column where the drugs are quantitatively retained. Following clean-up step with 40/60 (v/v) methanol/water, the eluent/derivatizing reagent is injected and passed through the sorbent column, eluted drugs reacting with nitric acid to form a blue dye that is monitored at 600 nm. The global signal thus obtained for the antidepressants can be used to estimate their total concentration in the samples without the need to individually quantify the analytes. This total index can be used for timely decision-making in case of overdosage. The proposed method is sensitive and selective; thus, typical interferents such as endogenous and diet compounds have no substantial effect on the analytical signal. This allows imipramine and its metabolites to be determined at therapeutic levels in urine samples.

[Analysis of the European Directive 98/83/EC: paradigm of the justification and establishment of parametric values. The specific case of pesticides]. / Análisis de la Directiva Europea 98/83/CE: paradigma de la justificación y establecimiento de los valores paramétricos. El caso concreto de los plaguicidas.

The health protection while ensuring the access to safe drinking water to the entire population is one of the main objectives all over the world. In this regard, the European Union, through Directive 98/83/EC, sets the parameters and maximum allowable parametric values to ensure the quality of water intended for human consumption. The aim of this paper is to give an overview of the values established in the European Directive in comparison with other countries and organizations, such as the World Health Organization, based on toxicological justification, doing special mention to the case of pesticides, in which there is great difference between the parametric values set. It also presents a comparison with the values fixed by the Directive 91/414/EEC concerning maximum residue limits of pesticides in food, highlighting the importance of joining criteria.

One-step in-syringe ionic liquid-based dispersive liquid-liquid microextraction.

Dispersive liquid-liquid microextraction (DLLME) has been proved to be a powerful tool for the rapid sample treatment of liquid samples providing at the same time high enrichment factors and extraction recoveries. A new, simple and easy to handle one step in-syringe set-up for DLLME is presented and critically discussed in this paper. The novel approach avoids the centrifugation step, typically off-line and time consuming, opening-up a new horizon on DLLME automation. The suitability of the proposal is evaluated by means of the determination of non-steroidal anti-inflammatory drugs in urine by liquid chromatography/ultraviolet detection. In the presented approach an ionic liquid is used as extractant. The target drugs can be determined in urine within the concentration range 0.02-10 microg mL(-1), allowing their determination at therapeutic and toxic levels. Limits of detection were in the range from 8.3 ng mL(-1) (indomethacin) to 32 ng mL(-1) (ketoprofen). The repeatability of the proposed method expressed as RSD (n=5) varied between 2.5% (for ketoprofen) and 8.6% (for indomethacin).

Liquid-phase microextraction in bioanalytical sample preparation.

Liquid-phase microextraction (LPME) emerged in the mid-to-late 1990s, facing up to the main shortcomings of the classical liquid-liquid extraction. Since its origin, this new technique has been in continuous development driven by its successful and widespread use in the analytical sciences. Its inherent properties, such as low sample volume requirement, high preconcentration factors achieved and excellent sample clean-up, make LPME a very useful technique for bioanalytical sample preparation. This review focuses on the main LPME-related techniques, predominantly single-drop microextraction and supported hollow-fiber LPME, paying particular attention to the bioanalytical applications. A general view of the essential trends, including the description of promising extraction modes and solvents, is also highlighted.

Association of atlanto-occipital dislocation and retroclival haematoma in a child.

INTRODUCTION: The authors present the case of a 5-year-old girl with traumatic hydrocephalus secondary to a retroclival haematoma associated with atlanto-occipital dislocation (AOD) after a motor vehicle accident. Clinical history and neuroimaging of the patient are described. DISCUSSION: Computed tomography (CT) imaging of the head revealed a retroclival haematoma with secondary hydrocephalus. The cranio-cervical junction showed an AOD that was initially overlooked. Traumatic AOD is a rare diagnosis although in the recent years it has become an emergent entity due to the improvement of emergency medical treatment on the field. CONCLUSION: An initial diligent imaging study and interpretation should be made to avoid misdiagnosis and to provide adequate treatment. This is the first case reported of the association of AOD, hydrocephalus and retroclival haematoma. A brief review of the literature is also presented.

Análisis de la Directiva Europea 98/83/CE: paradigma de la justificación y establecimiento de los valores paramétricos. El caso concreto de los plaguicidas / Analysis of the European Directive 98/83/EC: paradigm of the justification and establishment of parametric values. The specific case of pesticides

La protección de la salud a la vez que se garantiza el acceso al agua potable a toda la población es uno de los objetivos principales a nivel mundial. En ese sentido, la Unión Europea, a través de la Directiva 98/83/CE, establece los parámetros y valores paramétricos máximos admisibles para garantizar la calidad del agua destinada al consumo humano. El objetivo de este artículo es dar una visión global de los valores establecidos en la Directiva Europea en comparación con otros países y organizaciones, como la Organización Mundial de la Salud, en base a su justificación toxicológica, haciendo especial mención al caso concreto de los plaguicidas, en los que existe una gran diferencia entre los valores paramétricos fijados. Asimismo, se presenta una comparativa con los valores establecidos por la Directiva 91/414/CEE para límites máximos de residuos de plaguicidas en alimentos, destacando la importancia de aunar criterios(AU)

The health protection while ensuring the access to safe drinking water to the entire population is one of the main objectives all over the world. In this regard, the European Union, through Directive 98/83/EC, sets the parameters and maximum allowable parametric values to ensure the quality of water intended for human consumption. The aim of this paper is to give an overview of the values established in the European Directive in comparison with other countries and organizations, such as the World Health Organization, based on toxicological justification, doing special mention to the case of pesticides, in which there is great difference between the parametric values set. It also presents a comparison with the values fixed by the Directive 91/414/EEC concerningmaximum residue limits of pesticides in food, highlighting the importance of joining criteria(AU)

Las cefaleas en urgencias: revisión de sus causas / Headaches in the emergency department: a review of their etiology

La cefalea representa un motivo de consulta frecuenteen los servicios de urgencias pediátricas y, a pesar de quehabitualmente genera enorme preocupación y angustia,en la mayoría de las ocasiones es secundaria a procesos banales.Nuestro objetivo es analizar las características y losdiagnósticos de los pacientes que acuden a nuestro Serviciode Urgencias por cefalea.Métodos. Estudio retrospectivo de todos los pacientesque consultaron por cefalea en el año 2003.Resultados. Se revisan 1.080 historias clínicas, el 5.5%precisa de ingreso hospitalario. La media de edad en lospacientes es de 9.6 ± 4.1 años. En el 25.8% de los casosconsta historia previa de cefalea y en el 25.8% antecedentesfamiliares. El 4% son portadores de válvula de derivaciónventrículo-peritoneal. El 67,7% de los pacientes consultantras más de 12 horas de la sintomatología y el 62.3%dentro de las primeras 72 horas de evolución. Se determinala tensión arterial a 234 niños (21.7%), se realizafondo de ojo a 228 (21.1%), punción lumbar a 18 (1.7%) yTAC craneal a 64 (5.9%), que resultan alterados en uno,dos, seis y diez casos respectivamente. Los diagnósticosmás frecuentes son cefalea inespecífica (57%), infeccionesvíricas (19%), migraña (10%) y sinusitis (5.1%). Ocho casos(0.7%) son diagnosticados de una enfermedad potencialmentegrave; el hallazgo de una exploración neurológicaalterada es el único signo de alarma analizado que semuestra como variable independiente que orienta a estediagnóstico.Conclusiones. La mayoría de consultas por cefalea enniños son debidas a procesos banales. Una cuidadosaanamnesis y exploración física, incluyendo el fondo de ojo,permite identificar a aquellos pacientes cuya cefalea essecundaria a un proceso grave

Headache represents a common chief complaint inpediatric emergency departments, and although it is acommon cause of worry and anxiety, most causes arebenign. The aim of this study is to review the characteristicsof children presenting to our emergency departmentsuffering headache, and to determine the relativefrequency of the various diagnoses.Methods. Retrospective review of children presentingto the emergency room with headache during the year2003.Results. The clinical records of 1080 children were reviewed.Hospital admission for work-up and treatmentwas required in 5.5% of the cases. The mean age was 9.6± 4.1 years. Prior history of headache and family history ofheadache were present in 26% of the cases, respectively.4% of the children had a ventriculo-peritoneal shunt.67.7% of the cases consulted after more than 12 hours of onset of the symptoms, and 62.3% within the first 72hours. The blood pressure was determined in 234 children(21.7%), a funduscopic eye examination was performed in228 children (21.2%), a lumbar puncture in 18 (1.7%), anda brain CT in 64 cases (5.9%), and abnormal findings weredocumented in 1, 2, 6, and 10 cases, respectively. The mostcommon diagnoses were non-specific headache (57%), viralinfection (19%), migraine (10%), and sinusitis (5%).Eight cases (0.7%) were diagnosed with a potentially severedisease; an abnormal neurological exam was the onlysign that would indicate the presence of such condition.Conclusions. In most children consulting for headache,the etiology is usually a benign process. A careful reviewof the history and a thorough physical examination thatincludes a funduscopic eye exam will help in the identificationof those patients with headache secondary to a severecondition

O jovem consumidor universitário na cidade de São Paulo / The consumer profile of the university student of the city of São Paulo

O presente trabalho teve como proposta levantar as representações sociais de jovens universitários sobre o consumo individual na cidade de São Paulo. Para tanto, foi firmado uma parceria entre a Fundação Procon-SP e o Curso de Psicologia do Centro Universitário FMU, objetivando a execução de uma pesquisa sobre o jovem consumidor universitário. A amostra foi constituída por 1.041 estudantes de instituições públicas e privadas, sendo utilizada como abordagem a pesquisa quantitativa. A coleta de dados foi realizada através de entrevistas individuais, baseadas em questionários estruturados com perguntas fechadas e abertas, a partir de pré-teste. Como resultados apresentaram-se algumas considerações importantes sobre o perfil do universitário e seus hábitos de consumo, que, se generalizados as situações semelhantes, poderão auxiliar para a compreensão do pluralismo atual e do sistema de valores gerados por ele(AU)

O jovem consumidor universitário na cidade de São Paulo / The consumer profile of the university student of the city of São Paulo

O presente trabalho teve como proposta levantar as representações sociais de jovens universitários sobre o consumo individual na cidade de São Paulo. Para tanto, foi firmado uma parceria entre a Fundação Procon-SP e o Curso de Psicologia do Centro Universitário FMU, objetivando a execução de uma pesquisa sobre o jovem consumidor universitário. A amostra foi constituída por 1.041 estudantes de instituições públicas e privadas, sendo utilizada como abordagem a pesquisa quantitativa. A coleta de dados foi realizada através de entrevistas individuais, baseadas em questionários estruturados com perguntas fechadas e abertas, a partir de pré-teste. Como resultados apresentaram-se algumas considerações importantes sobre o perfil do universitário e seus hábitos de consumo, que, se generalizados as situações semelhantes, poderão auxiliar para a compreensão do pluralismo atual e do sistema de valores gerados por ele

Comportamiento serico de anticuerpos IgG anti Leishmania brsiliensis de pacientes con Leishmaniasis cutanea en Paraguay, pre y post tratamiento / Annual reports 1995 / Serological nehaviour of anti Leishmania Brasiliensis antibodies IgG from patients with cutaneous Leishmaniasis in Paraguay, pre and post treatment

Para analizar las variaciones de los títulos de anticuerpos IgG anti-Leishmania brasiliensis (Ac IgG anti L.B.) se estudiaron 150 casos de pacientes con diagnóstico clínico y parasitológico de leishmaniasis cutáneo (L.C.) registrados en el Departamento de Investigación del L.C.S.P. del M.S.P. y B.S. entre los años 1985 y 1990. El diagnóstico parasitológico se realizó por examen directo, la biopsia y el cultivo de la lesión en medio agar sangre enriquecido con RPMI 1640 y suero fetal bovino. Los pacientes fueron tratados con inyección intramuscular de glucantime (antimoniato de meglumine) o con pentostan (estiboglunato de sodio) en dosis de 20 mg/Kg/día, durante 3 periódos de 20 días con intervalo de 1 semana. Para determinar el título de Ac IgG anti L.b. antes y después de 3 meses de tratamiento se utilizó la Inmunofluorescencia Indirecta (IFI) y promastigotes de Leishmania brasiliensis como antígeno. De los 150 casos analizados antes del tratamiento, 90 casos (60 por ciento) fueron positivos para leishmaniasis, por el método de IFI

Análisis de la Intradermoreacción de montenegro e inmunoflourescencia indirecta en pacientes con leishmaniasis cutánea y mucocutánea de zonas endémicas del Paraguay / Analysis of the intradermo reaction of montenegro and indirect inmunoflourescence in patients with cutaneous and mucocutaneous leishmaniasis in endemic zones of Paraguay

Estudio prospectivo, de corte transversal donde fueron incluídos 102 pacientes con diagnóstico clínico y serológico de Leishmania Cutánea (LC) y Mucocutánea (LMC), que concurrieron al Laboratorio Central de Salud Pública, durante los años 1996 y 97, para la determinación del título de anticuerpos IgG anti-leismania se utilizó la Inmunoflourescencia Indirecta (IFI) y la Intradermoreacción de Montenegro (IDRM)