Experiencia en el manejo de cancer colorrectal en el hospital universitario mayor - Mederi

Introducción: El cáncer colorrectal es el tercer cáncer más diagnosticado en los hombres y el segundo en las mujeres a nivel mundial. Hasta 1.000 casos nuevos se diagnostican en Colombia cada año, por lo que es importante conocer la experiencia con esta patología en un centro de experiencia recientemente creado en el “Méderi, Hospital Universitario Mayor”. Materiales y métodos: Se realizó un estudio de corte transversal de la población con diagnóstico de cáncer colorrectal atendida entre agosto 2012 y diciembre 2014 que corresponde al tiempo de funcionamiento del servicio de Coloproctología. Resultados: Se atendieron un total de 152 pacientes con cáncer colorrectal en la institución. Se operó el 91% de los pacientes. El estadío más frecuente fue el IV. Solo el 4.9% presentó dehiscencia de anastomosis, datos concordantes con la literatura cuando el manejo es a cargo de expertos. El subtipo histológico más frecuente fue adenocarcinoma moderadamente diferenciado y la mortalidad perioperatoria de 2.63%. Discusión: El cáncer colorrectal es una entidad con alta morbimortalidad lo cual puede cambiar si se realizan pruebas de tamizaje, para realizar un manejo temprano y oportuno. Además juega un papel importante la experiencia del cirujano y la discusión de los pacientes en juntas multidisciplinarias. Palabras clave: cáncer de colon, cáncer de recto, epidemiología, estadificación

A comparison of the hazard perception ability of matched groups of healthy drivers aged 35 to 55, 65 to 74, and 75 to 84 years

We examined differences in response latencies obtained during a validated video-based hazard perception driving test between three healthy, community-dwelling groups: 22 mid-aged (35-55 years), 34 young-old (65-74 years), and 23 old-old (75-84 years) current drivers, matched for gender, education level, and vocabulary. We found no significant difference in performance between mid-aged and young-old groups, but the old-old group was significantly slower than the other two groups. The differences between the old-old group and the other groups combined were independently mediated by useful field of view (UFOV), contrast sensitivity, and simple reaction time measures. Given that hazard perception latency has been linked with increased crash risk, these results are consistent with the idea that increased crash risk in older adults could be a function of poorer hazard perception, though this decline does not appear to manifest until age 75+ in healthy drivers.

Anatomy of a submarine pyroclastic flow and associated turbidity current : July 2003 dome collapse, Soufrière Hills volcano, Montserrat, West Indies

The 12 to 13 July 2003 andesite lava dome collapse at the Soufrière Hills volcano, Montserrat, provides the first opportunity to document comprehensively both the sub-aerial and submarine sequence of events for an eruption. Numerous pyroclastic flows entered the ocean during the collapse, depositing approximately 90% of the total material into the submarine environment. During peak collapse conditions, as the main flow penetrated the air–ocean interface, phreatic explosions were observed and a surge cloud decoupled from the main flow body to travel 2 to 3 km over the ocean surface before settling. The bulk of the flow was submerged and rapidly mixed with sea water forming a water-saturated mass flow. Efficient sorting and physical differentiation occurred within the flow before initial deposition at 500 m water depth. The coarsest components (∼60% of the total volume) were deposited proximally from a dense granular flow, while the finer components (∼40%) were efficiently elutriated into the overlying part of the flow, which evolved into a far-reaching turbidity current.

Reliability and validity of physical fitness field tests for adults aged 55 to 70 years

The aim of this study was to examine the reliability and validity of field tests for assessing physical function in mid-aged and young-old people (55-70 y). Tests were selected that required minimal space and equipment and could be implemented in multiple field settings such as a general practitioner's office. Nineteen participants completed 2 field and I laboratory testing sessions. Intra-class correlations showed good reliability for the tests of upper body strength (lift and reach, R=.66), lower body strength (sit to stand, R=.80) and functional capacity (Canadian Step Test, R=.92), but not for leg power (single timed chair rise, R=.28). There was also good reliability for the balance test during 3 stances: parallel (94.7% agreement), semi-tandem (73.7%), and tandem (52.6%). Comparison of field test results with objective laboratory measures found good validity for the sit to stand (cf 1RM leg press, Pearson r=.68, p <.05), and for the step test (cf PWC140, r = -.60, p <.001), but not for the lift and reach (cf 1RM bench press, r=.43, p >.05), balance (r=-.13, -.18, .23) and rate of force development tests (r=-.28). It was concluded that the lower body strength and cardiovascular function tests were appropriate for use in field settings with mid-aged and young-old adults.

Phenotyping cotton ovule fibre initiation with spatial statistics

Yield in cultivated cotton (Gossypium spp.) is affected by the number and distribution of fibres initiated on the seed surface but, apart from simple statistical summaries, little has been done to assess this phenotype quantitatively. Here we use two types of spatial statistics to describe and quantify differences in patterning of cotton ovule fibre initials (FI). The following five different species of Gossypium were analysed: G. hirsutum L., G. barbadense L., G. arboreum, G. raimondii Ulbrich. and G. trilobum (DC.) Skovsted. Scanning electron micrographs of FIs were taken on the day of anthesis. Cell centres for fibre and epidermal cells were digitised and analysed by spatial statistics methods appropriate for marked point processes and tessellations. Results were consistent with previously published reports of fibre number and spacing. However, it was shown that the spatial distributions of FIs in all of species examined exhibit regularity, and are not completely random as previously implied. The regular arrangement indicates FIs do not appear independently of each other and we surmise there may be some form of mutual inhibition specifying fibre-initial development. It is concluded that genetic control of FIs differs from that of stomata, another well studied plant idioblast. Since spatial statistics show clear species differences in the distribution of FIs within this genus, they provide a useful method for phenotyping cotton. © CSIRO 2007.

Patterned growth of nanoscale in clusters on the Si(111)-7×7 and Si(111)-Ge(5×5) reconstructions

Results of a study designed to investigate the possibility of using the Si(111)- Ge(5×5) surface reconstruction as a template for In cluster growth are described. As with Si(111)-7×7, the In adatoms preferentially adsorb in the faulted half-unit cell, but on Si(111)- Ge(5×5) a richer variety of cluster geometries are found. In addition to the clusters that occupy the faulted half-unit cell, clusters that span two and four half-unit cells are found. The latter have a triangular shape spanning one unfaulted and three, nearest neighbor, faulted half-unit cells, Triangular clusters in the opposite orientation were not found. Many of the faulted halfunit cells have a streaked appearance consistent with adatom mobility.

Elastic modulus of Ti-6Al-4V-xB alloys with B up to 0.55 wt.%

An anomalous variation in the experimental elastic modulus, E, of Ti-6Al-4V-xB (with x up to 0.55 wt.%) is reported. Volume fractions and moduli of the constituent phases were measured using microscopy and nanoindentation,respectively. These were used in simple micromechanical models to examine if the E values could be rationalized. Experimental E values higher than the upper bound estimates suggest complex interplay between microstructural modifications, induced by the addition of B, and properties.

Total hip arthroplasty in young patients : with special references to patients under 55 years of age and to patients with developmental dysplasia of the hip

There is an ongoing controversy as to which methods in total hip arthroplasty (THA) could provide young patients with best long-term results. THA is an especially demanding operation in patients with severely dysplastic hips. The optimal surgical treatment for these patients also remains controversial. The aim of this study was to evaluate the long-term survival of THA in young patients (<55 years at the time of the primary operation) on a nation-wide level, and to analyze the long-term clinical and radio-graphical outcome of uncemented THA in patients with severely dysplastic joints. Survival of 4661 primary THAs performed for primary osteoarthritis (OA), 2557 primary THAs per-formed for rheumatoid arthritis (RA), and modern uncemented THA designs performed for primary OA in young patients, were analysed from the Finnish Arthroplasty Register. A total of 68 THAs were per-formed in 56 consecutive patients with high congenital hip dislocation between 1989-1994, and 68 THAs were performed in 59 consecutive patients with severely dysplastic hips and a previous Schanz osteotomy of the femur between 1988-1995 at the Orton Orthopaedic Hospital, Helsinki, Finland. These patients underwent a detailed physical and radiographical evaluation at a mean of 12.3 years and 13.0 years postoperatively, respectively. The risk of stem revision due to aseptic loosening in young patients with primary OA was higher for cemented stems than for proximally porous-coated or HA-coated uncemented stems implanted over the 1991-2001 period. There was no difference in the risk of revision between all-poly cemented-cups and press-fit porous-coated uncemented cups implanted during the same period, when the end point was defined as any revision (including exchange of liner). All uncemented stem designs studied in young patients with primary OA had >90% survival rates at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93-97) survival rate even at 15 years. When the end point was defined as any revision, 10 year survival rates of all uncemented cup designs except the Harris-Galante II decreased to <80%. In young patients with RA, the risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porous-coated uncemented stems. In contrast, the risk of cup revision was higher for all uncemented cup concepts than for all-poly cemented cups with any type of cup revision as the end point. The Harris hip score increased significantly (p<0.001) both in patients with high con-genital hip dislocation and in patients with severely dysplastic hips and a previous Schanz osteotomy, treated with uncemented THA. There was a negative Trendelenburg sign in 92% and in 88% of hips, respectively. There were 12 (18%) and 15 (22%) perioperative complications. The rate of survival for the CDH femoral components, with revision due to aseptic loosening as the end point, was 98% (95% CI 97-100) at 10 years in patients with high hip dislocation and 92% (95% CI, 86-99) at 14 years in patients with a previous Schanz osteotomy. The rate of survival for press-fit, porous-coated acetabular components, with revision due to aseptic loosening as the end point, was 95% (95% CI 89-100) at 10 years in patients with high hip dislocation, and 98% (95% CI 89-100) in patients with a previous Schanz osteotomy. When revision of the cup for any reason was defined as the end point, 10 year sur-vival rates declined to 88% (95% CI 81-95) and to 69% (95% CI, 56-82), respectively. For young patients with primary OA, uncemented proximally circumferentially porous- and HA-coated stems are the implants of choice. However, survival rates of modern uncemented cups are no better than that of all-poly cemented cups. Uncemented proximally circumferentially porous-coated stems and cemented all-poly cups are currently the implants of choice for young patients with RA. Uncemented THA, with placement of the cup at the level of the true acetabulum, distal advancement of the greater trochanter and femoral shortening osteotomy provided patients with high congenital hip dislocation good long-term outcomes. Most of the patients with severely dysplastic hips and a previous Schanz osteotomy can be successfully treated with the same method. However, the subtrochanteric segmental shortening with angular correction gives better leg length correction for the patients with a previous low-seated unilateral Schanz osteotomy.

Role of rigidity and temperature in the kinetics of photodarkening in Ge(x)As((45-x))Se(55) thin films

We present insightful results on the kinetics of photodarkening (PD) in Ge(x)As(45-x)Se(55) glasses at the ambient and liquid helium temperatures when the network rigidity is increased by varying x from 0 to 16. We observe a many fold change in PD and its kinetics with decreasing network flexibility and temperature. Moreover, temporal evolution of PD shows a dramatic change with increasing x. (C)2011 Optical Society of America

Influencia de rotación de cultivos y métodos de control sobre la dinámica de las malezas y el crecimiento, desarrollo y rendimiento del sorgo (Sorghum bicolor (L) Moench) var. D-55)

En la Estación Experimental de Las Mercedes municipio de Managua, se inició en la época de postrera en 1991, un experimento de rotación de cultivos bajo diferentes niveles de control de malezas. El presente trabajo evaluó el efecto de los cultivos antecesores sorgo, maíz y pepino con tres niveles de control de malezas : químico, período crítico y limpias periódicas a la dinámica de la cenosis de malezas, crecimiento y rendimiento del cultivo sucesor sorgo. Cuando antecedió el pepino la abundancia de maleza fue mayor con 504 Ind/m2 reduciéndose considerablemente a la cosecha obteniendo una biomasa promedio de 133.9 gr/m2. Sucedió lo contrario con maíz como cultivo antecesor ya que al principio la abundancia fue de 201 Ind/m2 y se obtuvo la mayor biomasa con 259.8 gr/m2 y para sorgo-sorgo tuvo valores de 232 Ind/m2 y a la cosecha en menor valor en biomasa de sorgo 130.0 gr/m2. En el rendimiento se enmarcó una tendencia a favor de maíz como cultivo antecesor con 1878 Kg/ha de sorgo, mientras sorgo-sorgo obtuvo un rendimiento de 1839 Kg/ha comparándose con pepino como antecesor con 1832 Kg/ha de sorgo. Comparando los controles aquí hubo diferencias significativas y en mayor valor le correspondió al control químico con 2048.0 Kg/ha, control período crítico con 1786 Kg/ha y el menor valor le correspondió a limpia periódica con sólo 1715 Kg/ha. En el control período crítico presentó mayor abundancia la maleza al inicio con 444 Ind/m2, teniendo una reducción hasta 62 Ind/m2 en la cosecha. El control químico tuvo un comportamiento similar que el control período crítico con 295 Ind/m2, reduciendo al final del ciclo con 135 Ind/m2. El control limpias periódicas tuvo al inicio la menor abundancia con 200 Ind/m2, reduciendo a la cosecha a 3 Ind/m2.

Efecto de tres cultivos antecesores sobre la cenosis de malezas y el crecimiento, desarrollo y rendimiento del cultivo de sorgo (Sorghum bicolor (L) Moench.) cv. D-55, en la Hacienda Las Mercedes

El presente Vallejo experimental se realizó a partir del 18 de Agosto de 1989, día en que se realizó la siembra de postrera en la hacienda "Las Mercedes”, evaluándose la rotación de cultivos y diferentes métodos de control de malezas en el cultivo de sorgo. Dicho experimento culminó el 2 de Diciembre del mismo año. Se utilizó el diseño de Bloques Completos al Azar en parcelas divididas, siendo el factor A: el cultivo antecesor; sorgo, maiz y pepinillo; y el factor los métodos de control de malezas; Atrazina (en pre-emergencia a dosis de 1.5 kg/ha), Limpia mecánica en periodo crítico (5ta y 6ta hoja) y limpia periódica cada 15 días con azadon. Los resultados demuestran que tanto en los cultivos antecesores al sorgo como en los diferentes métodos de control se presentó el Cypenis rotundus como presdominante, seguido por las Poáceas, en donde sobresale la Rottboellia cochichinensis , observándose más individuos cuando antecedía el sorgo y en la aplicación de Atrazina. Esto permitió una mayor acumulación de biomasa de malezas al momento de la cosecha en ambos casos (monocultivo sorgo y método de control con atrazina). En las variables de crecimiento, desarrolla y rendimiento del sorgo los cultivos antecesores presentaron diferencias significativas en: El diámetro del tallo, longitud de panoja y peso de mil semillas. Referente al efecto de los diferentes métodos de control de malezas sobre dichos caracteres en el cultivo de sorgo hubo diferencias significativas en la longitud de panoja, peso seco de paje y en el rendimiento. Siendo la rotación maíz - sorgo la que presentó los mejores resultados en las diferentes variables evaluadas. El método de control de malezas que mejor comportamiento tuvo fue la limpia en periodo crítico principalmente en las variables como el rendimiento que obtuvo 2,822.19 kg/he y peso de mil semillas de 14.53 gramos. Es importante señalar el alto rendimiento que se obtuvo con la rotación antes mencionada, lo cual es de 3,190.49 kg/ha, sin embargo no presentaron diferencias significativas.

Sapientia, 1960, Vol. XV, nº 55 (número completo)

Contenido: Contemplación y acción / Octavio N. Derisi – El humanismo de Heidegger / José Ignacio Alcorta – Cultura o humanismo cristiano / Octavio N. Derisi – Notas y comentarios -- Bibliografía