Factores de riesgo para el desarrollo de complicaciones: infecciones en varicosafenectomia

La enfermedad venosa periférica de miembros inferiores se considera una de las afecciones más prevalentes, con morbilidad considerable, deterioro de la calidad de vida, e importante demanda de recursos de salud, que en la mayoría de casos requiere manejo quirúrgico como parte del tratamiento. Este estudio busca analizar si la técnica quirúrgica es un factor de riesgo, que incrementa la aparición de infección de sitio quirúrgico en 257 pacientes a quienes se les realizó varicosafenectomia. Metodología: Se realizó un estudio de cohorte retrospectiva; se recolectaron los datos a partir de los registros clínicos y quirúrgicos de pacientes que cumplieron con los criterios de inclusión, registrando factores de riesgo, descripción quirúrgica, complicaciones, y evolución post operatoria hasta 8 semanas. El análisis estadístico se realizó mediante el cálculo de riesgo relativo y regresión logística binomial. Resultados: Se demostró asociación entre la presencia de infección de sitio quirúrgico y tipo de cirugía con un RR = 3,05 (P= 0,01), clasificación CEAP con 29% menos riesgo en varicosafenectomia total (P= 0,008). Conclusiones: Existen variables clínicas y quirúrgicas que influyen en la probabilidad de desarrollar infección del sitio quirúrgico.

Functional studies of the deubiquitinating enzymes USP19, USP4 and UCH-L1

El marcaje de proteínas con ubiquitina, conocido como ubiquitinación, cumple diferentes funciones que incluyen la regulación de varios procesos celulares, tales como: la degradación de proteínas por medio del proteosoma, la reparación del ADN, la señalización mediada por receptores de membrana, y la endocitosis, entre otras (1). Las moléculas de ubiquitina pueden ser removidas de sus sustratos gracias a la acción de un gran grupo de proteasas, llamadas enzimas deubiquitinizantes (DUBs) (2). Las DUBs son esenciales para la manutención de la homeostasis de la ubiquitina y para la regulación del estado de ubiquitinación de diferentes sustratos. El gran número y la diversidad de DUBs descritas refleja tanto su especificidad como su utilización para regular un amplio espectro de sustratos y vías celulares. Aunque muchas DUBs han sido estudiadas a profundidad, actualmente se desconocen los sustratos y las funciones biológicas de la mayoría de ellas. En este trabajo se investigaron las funciones de las DUBs: USP19, USP4 y UCH-L1. Utilizando varias técnicas de biología molecular y celular se encontró que: i) USP19 es regulada por las ubiquitin ligasas SIAH1 y SIAH2 ii) USP19 es importante para regular HIF-1α, un factor de transcripción clave en la respuesta celular a hipoxia, iii) USP4 interactúa con el proteosoma, iv) La quimera mCherry-UCH-L1 reproduce parcialmente los fenotipos que nuestro grupo ha descrito previamente al usar otros constructos de la misma enzima, y v) UCH-L1 promueve la internalización de la bacteria Yersinia pseudotuberculosis.

Resultados de la cirugía laparoscópica comparada con la cirugía abierta en el cáncer colorrectal. Revisión sistemática

Determinar el efecto de la cirugía laparoscópica versus cirugía abierta sobre la supervivencia en el manejo de pacientes del cáncer colorectal.

Apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing on root canal disinfection in dog teeth

Objective. The aim of this study was to compare in vivo the efficacy of 2 root canal disinfection techniques (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dog teeth with apical periodontitis. Study design. Two groups of root canals with pulp necrosis and apical periodontitis were evaluated according to the disinfection technique: group 1: apical negative pressure irrigation (EndoVac system); and group 2: apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. The first sample (S1) was collected after lesions were radiographically visible, and the second sample (S2) was collected after apical negative pressure irrigation (group 1) or conventional irrigation/triantibiotic dressing (group 2). All samples were seeded in a culture medium for anaerobic bacteria. Colony-forming unit counts were analyzed statistically by the Mann-Whitney test (alpha = .05). Results. Microorganisms were present in 100% of canals of both groups in S1. In S2, microorganisms were absent in 88.6% of group 1`s canals and 78.28% of group 2`s canals. There was no significant difference between the groups in either S1 (P = .0963) or S2 (P = .0566). There was significant (P < .05) bacterial reduction from S1 to S2 in both groups. Conclusion. In immature teeth with apical periodontitis, use of the EndoVac system can be considered to be a promising disinfection protocol, because it provided similar bacterial reduction to that of apical positive pressure irrigation (conventional irrigation) plus intracanal dressing with the triantibiotic paste, and the use of intracanal antibiotics might not be necessary. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e42-e46)

Malignant ameloblastoma metastasis to the lung: a case report

Ameloblastoma is an odontogenic tumor, usually benign, which rarely metastasizes to distant organs. The case of a 27-year-old white woman is described, who presented a metastatic pulmonary ameloblastoma 7 years after the removal of a mandibular ameloblastoma. She presented no pulmonary symptoms, but a lung nodule was found in a chest x-ray during a routine check-up for job admission. Computed tomography (CT) revealed a 2-cm well-defined solitary round nodule without calcifications, leading to the hypothesis of a metastatic tumor. Clinical and CT investigation confirmed no ameloblastoma recurrence in the jaw and no other primary tumor. The diagnosis of metastatic ameloblastoma was confirmed by microscopic evaluation of the pulmonary nodule.

Prevalence and clinical characteristics of urinary incontinence in elderly individuals of a low income

To estimate the prevalence of urinary incontinence (UI) in elderly individuals of low income assisted by the primary health care system in Sao Paulo, Brazil. In this community-based, observational, cross-sectional study, participants assisted by the health family program in Sao Paulo, Brazil, were sampled and interviewed face to face by questionnaire. Participants (n = 388) were selected from the collaborative program developed by the 10/66 Dementia Research Group, an International Network of investigators. Demographics, health history and a detailed assessment of UI and urinary symptoms were obtained. Prevalence of UI was calculated. Other variables included age, body mass index (BMI), duration of incontinence and characteristics of the symptoms. The association between UI and the variables was estimated using the Kruskal-Wallis test, Chi-squared test and Fisher test (depending on normality of the distribution and expected frequencies). Prevalence of UI was 38.4%. UI was more common in women than in men (50% vs. 18.3%, p < 0.001). Diabetes, obesity and hypertension were associated with UI. Almost 36.2% of the cases were of mixed incontinence, 26.8% of urge incontinence and 24.2% of stress incontinence. Men were more likely to have urge-incontinence, while women were more likely to have mixed incontinence (p = 0.001). UI is prevalent in the elderly of low income living in Sao Paulo and rates are higher than most previous studies. Chronic conditions such as hypertension, diabetes and obesity were associated with UI. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Dall'involucro all'invaso. Lo spazio a pianta centrale nell'opera architettonica di Adalberto Libera

An archetype selected over the centuries Adalberto Libera wrote little, showing more inclination to use the project as the only means of verification. This study uses a survey of the project for purely compositional space in relation to the reason that most other returns with continuity and consistency throughout his work. "The fruit of a type selected over centuries", in the words of Libera, is one of the most widely used and repeated spatial archetypes present in the history of architecture, given its nature as defined by a few consolidated elements and precisely defined with characters of geometric precision and absoluteness, the central space is provided, over the course of evolution of architecture, and its construction aspects as well as symbolic, for various uses, from historical period in which it was to coincide with sacred space for excellence, to others in which it lends itself to many different expressive possibilities of a more "secular". The central space was created on assumptions of a constructive character, and the same exact reason has determined the structural changes over the centuries, calling from time to time with advances in technology, the maximum extent possible and the different applications, which almost always have coincided with the reason for the monumental space. But it’s in the Roman world that the reason for the central space is defined from the start of a series of achievements that fix the character in perpetuity. The Pantheon was seen maximum results and, simultaneously, the archetype indispensable, to the point that it becomes difficult to sustain a discussion of the central space that excludes. But the reason the space station has complied, in ancient Rome, just as exemplary, monuments, public spaces or buildings with very different implications. The same Renaissance, on which Wittkower's proving itself once and for all, the nature and interpretation of sacred space station, and thus the symbolic significance of that invaded underlying interpretations related to Humanism, fixing the space-themed drawing it with the study and direct observation by the four-sixteenth-century masters, the ruins that in those years of renewed interest in the classical world, the first big pieces of excavation of ancient Rome brought to light with great surprise of all. Not a case, the choice to investigate the architectural work of Libera through the grounds of the central space. Investigating its projects and achievements, it turns out as the reason invoked particularly evident from the earliest to latest work, crossing-free period of the war which for many authors in different ways, the distinction between one stage and another, or the final miss. The theme and the occasion for Libera always distinct, it is precisely the key through which to investigate her work, to come to discover that the first-in this case the central plan-is the constant underlying all his work, and the second reason that the quota with or at the same time, we will return different each time and always the same Libera, formed on the major works remained from ancient times, and on this building method, means consciously, that the characters of architectural works, if valid, pass the time, and survive the use and function contingent. As for the facts by which to formalize it, they themselves are purely contingent, and therefore available to be transferred from one work to another, from one project to another, using also the loan. Using the same two words-at-issue and it becomes clear now how the theme of this study is the method of Libera and opportunity to the study of the central space in his work. But there is one aspect that, with respect to space a central plan evolves with the progress of the work of Libera on the archetype, and it is the reason behind all the way, just because an area built entirely on reason centric. It 'just the "center" of space that, ultimately, tells us the real progression and the knowledge that over the years has matured and changed in Libera. In the first phase, heavily laden with symbolic superstructure, even if used in a "bribe" from Free-always ill-disposed to sacrifice the idea of architecture to a phantom-center space is just the figure that identifies the icon represents space itself: the cross, the flame or the statue are different representations of the same idea of center built around an icon. The second part of the work of clearing the space station, changed the size of the orders but the demands of patronage, grows and expands the image space centric, celebratory nature that takes and becomes, in a different way, this same symbol . You see, one in all, as the project of "Civiltà Italiana" or symbolic arch are examples of this different attitude. And at the same point of view, you will understand how the two projects formulated on the reuse of the Mausoleum of Augustus is the key to its passage from first to second phase: the Ara Pacis in the second project, making itself the center of the composition "breaks" the pattern of symbolic figure in the center, because it is itself an architecture. And, in doing so, the transition takes place where the building itself-the central space-to become the center of that space that itself creates and determines, by extending the potential and the expressiveness of the enclosure (or cover) that defines the basin centered. In this second series of projects, which will be the apex and the point of "crisis" in the Palazzo dei Congressi all'E42 received and is no longer so, the symbol at the very geometry of space, but space itself and 'action' will be determined within this; action leading a movement, in the case of the Arco simbolico and the "Civiltà Italiana" or, more frequently, or celebration, as in the great Sala dei Recevimenti all’E42, which, in the first project proposal, is represented as a large area populated by people in suits, at a reception, in fact. In other words, in this second phase, the architecture is no longer a mere container, but it represents the shape of space, representing that which "contains". In the next step-determining the knowledge from which mature in their transition to post-war-is one step that radically changes the way centric space, although formally and compositionally Libera continues the work on the same elements, compounds and relationships in a different way . In this last phase Freedom, center, puts the man in human beings, in the two previous phases, and in a latent, were already at the center of the composition, even if relegated to the role of spectators in the first period, or of supporting actors in the second, now the heart of space. And it’s, as we shall see, the very form of being together in the form of "assembly", in its different shades (up to that sacred) to determine the shape of space, and how to relate the parts that combine to form it. The reconstruction of the birth, evolution and development of the central space of the ground in Libera, was born on the study of the monuments of ancient Rome, intersected on fifty years of recent history, honed on the constancy of a method and practice of a lifetime, becomes itself, Therefore, a project, employing the same mechanisms adopted by Libera; the decomposition and recomposition, research synthesis and unity of form, are in fact the structure of this research work. The road taken by Libera is a lesson in clarity and rationality, above all, and this work would uncover at least a fragment.

Stitched to the heart--till intervention do us part

The case report describes the situation where a venous infusion catheter was inadvertently stitched to the lateral wall of the right atrium during valve replacement. A dual percutaneous approach was used to first sever the catheter at the suture and then remove both ends safely. The risk of tearing the suture which would have resulted in tamponade had to be avoided.

Comparative assessment of a canine-specific medium to support colony formation from canine hair follicular keratinocytes.

BACKGROUND Follicular stem cells and their progeny are responsible for the cyclical renewal of hair follicles and maintenance of the hair coat. The understanding of pathways involved in this process is essential to elucidate the pathogenetic mechanisms of primary alopecia. Stem cells and their direct descendants are located in the bulge region of the isthmus of hair follicles. Although these cells have been studied extensively in mice and humans, data for canine isthmic keratinocyte activation and proliferation are not available. HYPOTHESIS/OBJECTIVES The aim was to establish an accurate and reliable in vitro system to study the growth potential of canine isthmic keratinocytes. We assessed the colony-promoting capability of a commercially available canine-specific medium, CELLnTEC (CnT-09), compared with a well-established home-made medium, complete FAD (cFAD). The CnT-09 medium is specific for the growth of canine keratinocytes, while the cFAD medium can support growth and colony formation of keratinocytes from several species. ANIMALS Skin biopsies were obtained from 15 recently euthanized dogs of various breeds with no skin abnormalities. METHODS The isthmic region of compound hair follicles was isolated by microdissection and cell growth monitored using several parameters with colony-forming assays. RESULTS The CnT-09 and cFAD media provided similar growth as measured by the total number and size of colonies, as well as rate of cell differentiation. CONCLUSIONS The commercial canine-specific CnT-09 medium was comparable to the home-made cFAD medium in supporting the growth and proliferation of canine follicular keratinocytes in vitro. The CnT-09 medium should be a viable alternative growth medium for molecular studies of alopecic disorders in dogs.

Monetary and Exchange Rate Policy in Malaysia before the Asian Crisis

This paper provides a case study to characterize the monetary policy regime in Malaysia, from a medium- and long-term perspective. Specifically, we ask how the central bank of Malaysia, Bank Negara Malaysia (BNM), has structured its monetary policy regime, and how it has conducted monetary and exchange rate policy under the regime. By conducting three empirical analyses, we characterize the monetary and exchange rate policy regime in Malaysia by three intermediate solutions on three vectors: the degree of autonomy in monetary policy, the degree of variability of the exchange rate, and the degree of capital mobility.

Monetary Systems in Developing Countries: An Unorthodox View

This paper analyzes some recent theoretical and practical evidence in terms of economic results of different exchange rate systems. It begins with a historical review and a summary of fixed versus flexible exchange rate systems. Then it compares the experiences of recent currency unions, mostly unilateral, and their relative economic performance during the past currency crises in Latin America, East Asia and Eastern Europe. A set of issues is discussed in order to weigh the overall costs and benefits for several economies. These issues include exchange rates, GDP performance, inflation rates and foreign reserves. The case of Argentina is also considered separately, comparing mostly seigniorage costs and interest-rate savings. The benefits and costs of the producers (central banks/governments) and the consumers (citizens) of money are discussed separately. Free banking is also considered in a fast-changing world where there will probably be fewer but better currencies. Not just the euro is a reality now, but maybe the "amero" and the "worldo" or the "mondo" very soon.

The Central Bank and bank credits in the Philippines : a survey on effectiveness of monetary policy and its measures

In the post-Asian crisis period, bank loans to the manufacturing sector have shown a slow recovery in the affected countries, unexceptionally in the Philippines. This paper provides a literacy survey on the effectiveness of the Central Bank’s monetary policy and the responsiveness of the financial market, and discusses on the future works necessary to better understand the monetary policy effectiveness in the Philippines. As the survey shows, most previous works focus on the correlation between the short-term policy rates and during the period of monetary tightening and relatively less interest in quantitative effectiveness. Future tasks would shed lights on (1) the asset side – other than loan outstanding – of banks to analyze their behavior/preference in structuring portfolios, and (2) the quantitative impacts during the monetary easing period.

The asset/liability structure of the Philippine banks and non-bank financial institutions in 2000s : a preliminary study for financial access analyses

Based on the consolidated statements data of the universal/commercial banks (UKbank) and non-bank financial institutions with quasi-banking licenses, this paper presents a keen necessity of obtaining data in detail on both sides (assets and liabilities) of their financial conditions and further analyses. Those would bring more adequate assessments on the Philippine financial system, especially with regard to each financial subsector's financing/lending preferences and behavior. The paper also presents a possibility that the skewed locational and operational distribution exists in the non-UKbank financial subsectors. It suggests there may be a significant deviation from the authorities' (the BSP, SEC and others) intended/anticipated financial system in the banking/non-bank financial institutions' real operations.

Changes in source of profits and business strategies? : some evidence from the Philippines' universal banks in the 2000s

In the 2000s, the Philippines' local banking sector have conducted very conservative lending behavior and at the same time, gradually but continuously improved their profitability in terms of ROE (return on equity). A set of analyses on the flow of funds and segment reports (information) of local universal banks, whose loans outstanding to the industrial sector have dominated more than three fourths of the total outstanding, shows that (1) they have actively manage assets overseas, (2) their profitability has come from investment activities in the securities markets, and (3) some universal banks have shifted their resources into the consumer/retail segment. Although further refinement in the dataset is needed for a more detailed analysis, diverse business strategies would be expected among the local universal banks in the near future.