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Whether cirrhotic patients with Streptococcus bovis bacteremia have an increased risk of colorectal neoplasm is uncertain. A multicentric retrospective cohort study was conducted investigating associations between S. bovis biotype and species, cirrhosis, and colorectal neoplasm. Out of 779 patients with S. bovis bacteremia, 69 (8.7%) had cirrhosis. No differences were found in the prevalence of colorectal neoplasm between cirrhotic and non-cirrhotic patients undergoing colonoscopy. Among cirrhotic patients, prevalence of colorectal neoplasms was higher in S. bovis biotype I (S. gallolyticus) bacteremia (80%) than in S. bovis biotype II (33.3%; p < 0.007). In conclusion, risk of colorectal neoplasm is high among cirrhotic patients with S. gallolyticus bacteremia.
Assuntos
Bacteriemia , Neoplasias do Colo , Neoplasias Colorretais , Infecções Estreptocócicas , Streptococcus bovis , Humanos , Estudos Retrospectivos , Neoplasias do Colo/complicações , Neoplasias do Colo/epidemiologia , Neoplasias Colorretais/microbiologia , Cirrose Hepática/complicações , Bacteriemia/complicações , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologiaAssuntos
Proctite , Adulto , Dor nas Costas , Doença Crônica , Humanos , Masculino , Proctite/complicações , Proctite/diagnósticoRESUMO
OBJECTIVES: R5-tropic viruses are associated with HIV-1 transmission and predominate during the early stages of infection. X4-tropic populations have been detected in ~50% of patients with late-stage disease infected with subtype B viruses. In this study, we compared the frequency of X4 tropism in individuals infected with HIV-1 CRF14_BG viruses, which have a V3 loop of subtype B, with a control group of individuals infected with subtype B viruses. METHODS: Sixty-three individuals infected with HIV-1 CRF14_BG (n = 31) or subtype B (n = 32) were studied. Similar proportions of newly diagnosed and chronically infected individuals were included in the subtype B and CRF14_BG groups. V3 sequences were obtained and coreceptor tropism was predicted using the Geno2pheno[coreceptor] algorithm. V3 net charge and 11/25 rules were also used for coreceptor prediction. RESULTS: Overall, X4 tropism was more frequent among individuals infected with CRF14_BG viruses (87.1%) than subtype B viruses (34.3%), a difference that was statistically highly significant (P = 0.00001). Importantly, the frequencies among newly diagnosed individuals were 90% and 13.3%, respectively (P = 0.0007). Characteristic amino acids in the V3 loop (T13, M14, V19 and W20) were identified at higher frequencies in CRF14_BG viruses (54%) than subtype B viruses (0%; P < 0.000001). CONCLUSIONS: CRF14_BG is the genetic form with the highest proportion of X4-tropic viruses reported to date in newly diagnosed and chronic infections. This suggests high pathogenicity for CRF14_BG viruses, potentially leading to rapid disease progression. CCR5 antagonists will be ineffective in most CRF14_BG-infected patients, even at early stages of infection.
Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/virologia , HIV-1/fisiologia , Receptores CXCR4/metabolismo , Receptores de HIV/metabolismo , Tropismo Viral , Genótipo , HIV-1/classificação , HIV-1/genética , HIV-1/isolamento & purificação , Humanos , MasculinoRESUMO
Background and objectives: Dimensional response is an unmet need in second lines of advanced soft tissue sarcomas (STS). Indeed, the three approved drugs, pazopanib, trabectedin, and eribulin, achieved an overall response rate (ORR) of less than 10%. This fact potentially hinders the options for fast symptomatic relief or surgical rescue. The combination of trabectedin plus low-dose radiation therapy (T-XRT) demonstrated a response rate of 60% in phase I/II trial, while real-life data achieved 32.5% ORR, probably due to a more relaxed timing between treatments. These results were obtained in progressing and advanced STS. In this study, the merged databases (trial plus real life) have been analyzed, with a special focus on leiomyosarcoma patients. Design and methods: As responses were seen in a wide range of sarcoma histologies (11), this study planned to analyze whether leiomyosarcoma, the largest subtype with 26 cases (30.6%) in this series, exhibited a better clinical outcome with this therapeutic strategy. In addition, four advanced and progressing leiomyosarcoma patients, all with extraordinarily long progression-free survival of over 18 months, were collected. Results: A total of 847 cycles of trabectedin were administered to 85 patients, with the median number of cycles per patient being 7 (1-45+). A trend toward a longer progression-free survival (PFS) was observed in leiomyosarcoma patients with median PFS (mPFS) of 9.9 months [95% confidence interval (CI): 1.1-18.7] versus 5.6 months (95% CI: 3.2-7.9) for the remaining histologies, p = 0.25. When leiomyosarcoma and liposarcoma were grouped, this difference reached statistical significance, probably due to the special sensitivity of myxoid liposarcoma. The mPFS for L-sarcomas was 12.7 months (95% CI: 7-18.5) versus 4.3 months (95% CI: 3.3-5.3) for the remaining histologies, p = 0.001. Cases with long-lasting disease control are detected among leiomyosarcoma patients. Conclusion: Even when extraordinarily long-lasting responses do exist among leiomyosarcoma patients treated with T-XR, we were unable to demonstrate a significant difference favoring leiomyosarcoma patients in clinical outcomes.
RESUMO
Introducción: Debido a dificultades detectadas en el desempeño sobre el diagnóstico de las arritmias cardiacas de los estudiantes de pregrado y postgrado de la carrera de medicina y por lo necesario que es el dominio de estos conocimientos para el perfil del graduado de algunas de las especialidades de ciencias médicas se hace necesario y pertinente desarrollar herramientas educativas que contribuyan a resolver ese problema. Teniendo como antecedente el curso a distancia sobre arritmias cardíacas basado en una hipermedia del mismo nombre, que actualmente no es utilizable por obsolescencia tecnológica y que el uso de software educativo constituye una alternativa que contribuye a elevar la calidad de la docencia se realizó este proyecto. Objetivo: Elaborar una versión actualizada de la hipermedia Arritmias Cardíacas desde el punto de vista tecnológico. Métodos: Se realizó un proyecto de innovación tecnológica. Para la construcción de la hipermedia se siguió la guía cubana de migración a software libre; se utilizaron HTML5, hojas de estilo en cascada y JavaScript versión 1.5 Resultados: Se desarrolló una nueva versión de la hipermedia Arritmias Cardíacas sobre tecnología WEB, multiplataforma y de código abierto que podrá ser utilizada en el proceso de enseñanza-aprendizaje de las disciplinas médicas que tratan la entidad. Conclusiones: La Hipermedia Arritmias Cardíacas es un material de apoyo a la docencia, tecnológicamente actualizado, para que los estudiantes de pregrado y postgrado desarrollen habilidades en el diagnóstico de las arritmias cardiacas pues sus contenidos abordan características, conducta a seguir, electrocardiogramas y sonidos de las arritmias cardiacas.
Introduction: Due to the difficulties detected in the performance of undergraduate and postgraduate medical students in the diagnosis of cardiac arrhythmias and the need to master this knowledge for the graduate profile of some of the medical science specialties, it is necessary and pertinent to develop educational tools that contribute to solve this problem. This project was carried out, taking as a background the distance course on cardiac arrhythmias based on a hypermedia of the same name, which is currently unusable due to technological obsolescence and that the use of educational software constitutes an alternative that contributes to raise the quality of teaching. Objective: To develop an updated version of the hypermedia Cardiac Arrhythmias from a technological point of view. Methods: A technological innovation project was carried out. For the construction of the hypermedia, the Cuban guide for migration to free software was followed; HTML5, cascading style sheets and JavaScript version 1.5 were used. Results: A new version of the Cardiac Arrhythmias hypermedia was developed on WEB technology, multiplatform and open source that can be used in the teaching-learning process of the medical disciplines that deal with this entity. Conclusions: The Cardiac Arrhythmias Hypermedia is a technologically updated teaching support material for undergraduate and postgraduate students to develop skills in the diagnosis of cardiac arrhythmias as its contents address characteristics, conduct to follow, electrocardiograms and sounds of cardiac arrhythmias.
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Objetivo: Caracterizar el rendimiento académico de los estudiantes en el primer año del Plan de Estudios D de la carrera de Medicina en las Facultades 10 de Octubre y Salvador Allende de la Universidad de Ciencias Médicas de La Habana. Métodos: Se realizó un estudio correlacional de corte transversal a partir de las evaluaciones obtenidas por los estudiantes que cursaron las asignaturas del plan en ambas facultades durante el curso 2016-2017. Resultados: detectaron cuatro componentes principales en el conjunto de variables evaluativas del primer año de la carrera: Ciencias Básicas Biomédicas, Disciplinas Complementarias, Educación Física e Idioma Inglés. Los resultados obtenidos corroboran que las Ciencias Básicas Biomédicas constituyen para los estudiantes de Ciencias Médicas la principal dificultad docente en el logro de los objetivos planteados por el nuevo plan de estudios(AU)
Objective: To characterize the academic performance of first year medical curriculum D students at 10 de Octubre and Salvador Allende Medical Schools (Havana Medical University). Methods: A cross-sectional correlational study was carried out from the evaluations obtained by the students of the plan D in both faculties during the academic year 2016-2017. Results: Four main components were detected in the set of evaluative variables of the first year of the degree: Basic Biomedical Sciences, Complementary Disciplines, Physical Education and English Language. Conclusions: The obtained results corroborate that the Basic Biomedical Sciences constitute for the students of Medical Sciences the main teaching difficulty in the achievement of the objectives proposed by the new curriculum(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Desempenho Acadêmico , Estudos Transversais , Educação Médica , Correlação de DadosRESUMO
Se presenta la existencia de soluciones de la Inteligencia Artificial en la enseñanza aprendizaje inteligente mediante tutores, gestión del aprendizaje o video juegos. Se expone la capacidad de adaptación dinámica de los mismos al desarrollo del aprendizaje del estudiante. Se observa ausencia de los mismos u otros en ámbitos de formación reglamentada, lo cual constituye ya una desventaja inobjetable. Se define el objetivo del presente trabajo como: caracterizar el estado de la aplicación de la Inteligencia Artificial en la pedagogía, y considerar la importancia y factibilidad práctica de la técnica de Inteligencia Artificial para la mejora de los procesos de aprendizaje. Se analizan los métodos Sistemas Expertos, Redes Neurales Artificiales, Algoritmos Genéticos, Razonamiento Basado en Casos, así como se declaran las herramientas informáticas: Servidor Web Apache, Lenguajes Java Script, PHP para servidor y de Gestión MySql de Bases de Datos, requeridas para la utilización de estos métodos de Inteligencia Artificial en entorno multiplataforma. Los resultados se sintetizan en relaciones de inconvenientes al emplear cada una de las varias técnicas de Inteligencia Artificial mencionadas, resultando el Razonamiento Basado en Casos más prometedor y el de mayor perspectiva. Consecuentemente, igualmente la Inteligencia Artificial lo es respecto a la enseñanza, así como también lo es el disponer de esta técnica para el desarrollo de este campo. Se concluye que se cumple el objetivo planteado, el análisis de las técnicas más conocidas, la factibilidad de aplicación del Razonamiento Basado en Casos, y la definición de herramientas informáticas para la aplicación multiplataforma de la técnica de Inteligencia Artificial seleccionada, desde este enfoque preliminar(AU)
Existing Artificial Intelligence solutions for teaching- learning processes by means of tutors, learning management or video games are presented here. Their capacity for dynamic adaptation to student's learning development is detected. Absence of the same or others in areas of regulated training is observed, what constitutesan undeniable disadvantage. The objective of this paper is to characterize the state of application of Artificial Intelligence in pedagogy and to consider the importance and practical feasibility of the Artificial Intelligence techniquefor improving the learning processes. We analyze the Expert Systems, Artificial Neural Networks, Genetic Algorithms and Cases Based Reasoning methods, as well as the computer tools: Apache Web Server and the Java Script, PHP for Serversand MySql Database Management Languages, which all of them are required for using these Artificial Intelligence methods and tools in multiplatform environment. Results sum up as disadvantages when employing several mentioned Artificial intelligence techniques, but Cases Based Reasoning technique turns out to be the most perspective and promising one. Consequently the state of Artificial Intelligence turns out equally so for the teaching process, as well as forhaving this technique available for development in this field. It is concluded that the outlined objective, the analysis of the best known techniques, the feasibility of application of the Cases Based Reasoning, and the definition of the Computer Tools are met for multiplatform application of the selected Artificial Intelligence technique from this preliminary approach(AU)
Assuntos
Humanos , Masculino , Feminino , Algoritmos , Linguagens de Programação , Software/normas , Inteligência Artificial , Filme e Vídeo Educativo , Educação MédicaAssuntos
Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/patologia , Interleucina-2/uso terapêutico , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/patologia , Carcinoma de Células Renais/mortalidade , Carcinoma de Células Renais/cirurgia , Quimioterapia Adjuvante , Feminino , Humanos , Neoplasias Renais/mortalidade , Neoplasias Renais/cirurgia , Masculino , Metástase Neoplásica , Estadiamento de Neoplasias , Nefrectomia/métodos , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Valores de Referência , Medição de Risco , Análise de Sobrevida , Resultado do TratamentoRESUMO
Es de todos conocido el problema de las restricciones para el desarrollo de trabajo y otras operaciones imprescindibles, cuando se cambia de escenario informático. Se enfrentan conflictos frente a las diferentes configuraciones de las computadoras que se encuentren disponibles, falta de privacidad, falta de privilegios para operar los equipos, limitación de instalaciones, problemas con desinstalaciones fallidas o incompletas, ausencia del software necesario o acostumbrado y, en consecuencia, una gran pérdida de tiempo. El uso masivo de memorias y discos externos por puerto USB facilitan y extienden la frecuencia de ocurrencia de los fenómenos anteriormente mencionados. El objetivo del presente trabajo consiste en presentar una respuesta adecuada a este problema. Para ello se recurrió a la búsqueda y análisis de información y software; programación de scripts; configuración de arquitectura, selección y evaluación de herramientas. Se logró determinar un conjunto general de más de 700 herramientas portables clasificadas en 20 categorías. Se precisaron reglas y requisitos para el correcto enfoque y funcionamiento de conjuntos portables(AU)
We all frequently face problems of restrictions with developing work and other necessary operations when changing the computing scenario. Conflict with different computers configurations arise as well as lack of privacy, lack of privileges to operate the equipment, limitation of facilities, problems with failed or incomplete uninstalls, absence of required software and as a result, a predictable waste of time. The massive use of external USB drives facilitates and extends the frequency of occurrence of the above phenomena. This paper presents an adequate response to this problem. This was done through the search and analysis of information and software, scripts programming, configuration of architecture, selection and assessment of tools. It was possible to determine a general set of more than 700 portable tools, classify them in 20 categories. Rules and requirements were established for the proper focus and functioning of portables(AU)