Revisión sistemática : uso de imágenes por difusión en RMN, para predecir sobrevida en pacientes adultos con diagnostico de glioblastoma multiforme

El Glioblastoma multiforme (GBM), es el tumor cerebral más frecuente, con pronóstico grave y baja sensibilidad al tratamiento inicial. El propósito de este estudio fue evaluar si la Difusión en RM (IDRM), es un biomarcador temprano de respuesta tumoral, útil para tomar decisiones tempranas de tratamiento y para obtener información pronostica. Metodología La búsqueda se realizo en las bases de datos EMBASE, CENTRAL, MEDLINE; las bibliografías también fueron revisadas. Los artículos seleccionados fueron estudios observacionales (casos y controles, cohortes, corte transversal), no se encontró ningún ensayo clínico; todos los participante tenían diagnostico histopatológico de GBM, sometidos a resección quirúrgica y/o radio-quimioterapia y seguimiento de respuesta al tratamiento con IDRM por al menos 6 meses. Los datos extraídos de forma independiente fueron tipo de estudio, participantes, intervenciones, seguimiento, desenlaces (sobrevida, progresión/estabilización de la enfermedad, muerte) Resultados Quince estudios cumplieron los criterios de inclusión. Entre las técnicas empleadas de IDRM para evaluar respuesta radiológica al tratamiento, fueron histogramas del coeficiente aparente de difusion ADC (compararon valores inferiores a la media y el percentil 10 de ADC, con los valores superiores); encontrando en términos generales que un ADC bajo es un fuerte predictor de sobrevida y/o progresión del tumor. (Esto fue significativo en 5 estudios); mapas funcionales de difusion (FDM) (midieron el porcentaje de cambio de ADC basal vs pos tratamiento) que mostro ser un fuerte predictor de sobrevida en pacientes con progresión tumoral. DISCUSION Desafortunadamente la calidad de los estudios fue intermedia-baja lo que hace que la aplicabilidad de los estudios sea limitada.

Asociación entre relaciones románticas y la calidad de sueño percibida por jóvenes universitarios

Introducción: Uno de los aspectos con mayor variación durante la adolescencia es el sueño, el cual se ve afectado por factores biológicos así como por los estados afectivos y emocionales. En esta etapa, los individuos establecen sus primeras relaciones sentimentales románticas, vínculos esenciales para la maduración de las relaciones sociales y psicosexuales. Este trabajo busca determinar la asociación existente entre las relaciones sentimentales románticas y sus características, con la calidad sueño percibida por los jóvenes. Metodología: Estudio realizado en una población de 1794 estudiantes de ciencias de la salud entre los 18 y 25 años de edad en Bogotá, Colombia, entre 2012 y 2013. Se obtuvo una muestra probabilística con asignación proporcional de 443 sujetos, estratificada por programa académico y sexo. Utilizando dos cuestionarios de auto reporte se exploraron las características de las relaciones sentimentales y la calidad de sueño percibida. Resultados: El 64% (IC 95%: 59,4-68,9%) de la población estudiada se encontró en una relación sentimental romántica. Estos sujetos tuvieron latencias de sueño prolongadas con menor frecuencia que quienes no tenían en una relación (p <0,05). La calidad de sueño percibida se asoció al nivel de satisfacción que tuvieron los sujetos en su relación, así como la atracción por su pareja. Rasgos obsesivos, ansiosos, temerosos y evitativos en la relación disminuyeron la calidad de sueño percibida. Conclusión: Las relaciones sentimentales románticas y sus características se asocian con la calidad de sueño percibida por los individuos. Se requieren estudios que determinen causalidad en esta asociación y definan potenciales estrategias de intervención al respecto.

Factores asociados a fenómeno de no reflujo coronario en pacientes adultos llevados a angioplastia

Introducción: La disminución de flujo en los vasos coronarios sin presencia de oclusión, es conocido como fenómeno de no reflujo, se observa después de la reperfusión, su presentación oscila entre el 5% y el 50% dependiendo de la población y de los criterios diagnósticos, dicho suceso es de mal pronóstico, aumenta el riesgo de morir en los primeros 30 días posterior a la angioplastia (RR 2,1 p 0,038), y se relaciona con falla cardiaca y arritmias, por eso al identificar los factores a los cuales se asocia, se podrán implementar terapias preventivas. Metodología: Estudio de casos y controles pareado por médico que valoró el evento, para garantizar que no existieron variaciones inter observador, con una razón 1:4 (18:72), realizado para identificar factores asociados a la presencia de no reflujo en pacientes llevados a angioplastia, entre noviembre de 2010 y mayo de 2014, en la Clínica San Rafael de Bogotá, D.C. Resultados: La frecuencia del no reflujo fue del 2.89%. El Infarto Agudo de Miocardio con elevación del ST (IAMCEST) fue la única variable que mostró una asociación estadísticamente significativa con este suceso, valor de p 0,002, OR 8,7, IC 95% (2,0 – 36,7). Discusión: El fenómeno de no reflujo en esta población se comportó de manera similar a lo descrito en la literatura, siendo el IAMCEST un factor fuertemente asociado.

Impacto en la calidad de la Inducción anestésica con premedicación en pacientes pediatricos

La inducción anestésica en niños es uno de los mayores retos para los anestesiólogos ya que es la fase más estresante del período perioperatorio para el paciente pediátrico. Existen diferentes intervenciones para minimizar la ansiedad perioperatoria y aumentar la cooperación del paciente pediátrico con la inducción anestésica. Entre las intervenciones exitosas la premedicación farmacológica con midazolam ha mostrado grandes beneficios en pacientes pediátricos. Metodología: Se realizó un estudio de casos y controles en pacientes pediátricos llevados a cirugía en la Fundación Cardioinfantil entre 2011-2014. Por medio de muestreo aleatorio por conveniencia se tomaron como casos pacientes con premedicación y controles pacientes sin premedicación. El éxito en la inducción se midió por medio de la escala ICC, usada a nivel mundial. Resultados: El promedio de edad fue 4.9 σ 3.01 años para los casos y 5.02σ3.2 años para controles, presentaron la misma distribución por género, 40.6% femenino, 59.3% masculino. El éxito de la inducción anestésica con midazolam mostró resultados significativos (OR 7.3 IC95% 4.3 – 12.5 p0,000), en hombres (OR 9.44 IC95%4.5 – 19.8 p0,000), en menores de 5 años (OR 10.33 IC95% 5.07 – 21.04 p0,000), en pacientes con antecedentes quirúrgicos (OR 12.2 IC95% 5.28 – 27.8 p0.000) o anestesias previas (OR 7.9 IC95% 4.4 – 14.4 p0,000). Discusión: El midazolam como agente farmacológico usado para premedicación en pacientes pediátricos presenta resultados exitosos contundentes, por lo cual debe usarse en todos los casos.

Estado situacional de los modelos basados en agentes y su impacto en la investigación organizacional

En un mundo hiperconectado, dinámico y cargado de incertidumbre como el actual, los métodos y modelos analíticos convencionales están mostrando sus limitaciones. Las organizaciones requieren, por tanto, herramientas útiles que empleen tecnología de información y modelos de simulación computacional como mecanismos para la toma de decisiones y la resolución de problemas. Una de las más recientes, potentes y prometedoras es el modelamiento y la simulación basados en agentes (MSBA). Muchas organizaciones, incluidas empresas consultoras, emplean esta técnica para comprender fenómenos, hacer evaluación de estrategias y resolver problemas de diversa índole. Pese a ello, no existe (hasta donde conocemos) un estado situacional acerca del MSBA y su aplicación a la investigación organizacional. Cabe anotar, además, que por su novedad no es un tema suficientemente difundido y trabajado en Latinoamérica. En consecuencia, este proyecto pretende elaborar un estado situacional sobre el MSBA y su impacto sobre la investigación organizacional.

State-of-the-art for entity-centric repository and authoring environment for multimedia

Many projects, e.g. VIKEF [13] and KIM [7], present grounded approaches for the use of entities as a means of indexing and retrieval of multimedia resources from heterogeneous sources. In this paper, we discuss the state-of-the-art of entity-centric approaches for multimedia indexing and retrieval. A summary of projects employing entity-centric repositories are portrayed. This paper also looks at the current state-of-the-art authoring environment, Macromedia Authorware, and the possibility of potential extension of this environment for entity-based multimedia authoring.

Observation of the antimatter helium-4 nucleus

High-energy nuclear collisions create an energy density similar to that of the Universe microseconds after the Big Bang(1); in both cases, matter and antimatter are formed with comparable abundance. However, the relatively short-lived expansion in nuclear collisions allows antimatter to decouple quickly from matter, and avoid annihilation. Thus, a high-energy accelerator of heavy nuclei provides an efficient means of producing and studying antimatter. The antimatter helium-4 nucleus ((4)(He) over bar), also known as the anti-alpha ((alpha) over bar), consists of two antiprotons and two antineutrons (baryon number B = -4). It has not been observed previously, although the alpha-particle was identified a century ago by Rutherford and is present in cosmic radiation at the ten per cent level(2). Antimatter nuclei with B -1 have been observed only as rare products of interactions at particle accelerators, where the rate of antinucleus production in high-energy collisions decreases by a factor of about 1,000 with each additional antinucleon(3-5). Here we report the observation of (4)<(He) over bar, the heaviest observed antinucleus to date. In total, 18 (4)(He) over bar counts were detected at the STAR experiment at the Relativistic Heavy Ion Collider (RHIC; ref. 6) in 10(9) recorded gold-on-gold (Au+Au) collisions at centre-of-mass energies of 200 GeV and 62 GeV per nucleon-nucleon pair. The yield is consistent with expectations from thermodynamic(7) and coalescent nucleosynthesis(8) models, providing an indication of the production rate of even heavier antimatter nuclei and a benchmark for possible future observations of (4)(He) over bar in cosmic radiation.

Reaction mechanisms in the (6)Li+(59)Co system

The reactions induced by the weakly bound (6)Li projectile interacting with the intermediate mass target (59)Co were investigated. Light charged particles singles and alpha-d coincidence measurements were performed at the near barrier energies E(lab) = 17.4, 21.5, 25.5 and 29.6 MeV. The main contributions of the different competing mechanisms are discussed. A statistical model analysis. Continuum-Discretized Coupled-Channels (CDCC) calculations and two-body kinematics were used as tools to provide information to disentangle the main components of these mechanisms. A significant contribution of the direct breakup was observed through the difference between the experimental sequential breakup cross section and the CDCC prediction for the non-capture breakup cross section. (C) 2009 Elsevier B.V. All rights reserved.

Synthesis, spectroscopic characterization and X-ray structures of five-coordinate diorganotin(IV) complexes containing 5-hydroxypyrazoline derivatives as ligands

Four new diorganotin(IV) complexes have been prepared from R(2)SnCl(2) (R = Me, Ph) with the ligands 5-hydroxy-3-metyl-5-phenyl-1-(S-benzildithiocarbazate)-pyrazoline (H(2)L(1)) and 5-hydroxy-3-methyl-5-phenyl-1-(2-thiophenecarboxylic)-pyrazoline (H(2)L(2)). The complexes were characterized by elemental analysis, IR. (1)H (13)C, (119)Sn NMR and Mossbauer spectroscopes The complexes [Me(2)SnL(1)], [Ph(2)SnL(1)] and [Me(2)SnL(2)] were also studied by single crystal X-ray diffraction and the results showed that the Sn(IV) central atom of the complexes adopts a distorted trigonal bipyramidal (TBP) geometry with the N atom of the ONX-tridentate (X = O and S) ligand and two organic groups occupying equatorial sites. The C-Sn-C angles for [Me(2)Sn(L(1))] and [Ph(2)Sn(L(1))] were calculated using a correlation between (119)Sn Mossbauer and X-ray crystallographic data based on the point-charge model Theoretical calculations were performed with the B3LYP density functional employing 3-21G(*) and DZVP all electron basis sets showing good agreement with experimental findings General and Sn(IV) specific IR harmonic frequency scale factors for both basis sets were obtained from comparison with selected experimental frequencies (C) 2010 Elsevier B V All rights reserved

Role of the ATP-binding cassette drug transporters in the intestinal absorption of tanshinone IIB, one of the major active diterpenoids from the root of Salvia miltiorrhiza

There is an increasing use of herbal medicines worldwide, and the extracts from the root of Salvia miltiorrhiza are widely used in the treatment of angina and stroke. In this study, we investigated the mechanism for the intestinal absorption of tanshinone IIB (TSB), a major constituent of S. miltiorrhiza. The oral bioavailability of TSB was about 3% in rats with less proportional increase in its maximum plasma concentration (C_max) and area under the plasma concentration-time curve (AUC) with increasing dosage. The time to C_max (T_max) was prolonged at higher oral dosage. In a single pass rat intestinal perfusion model, the permeability coefficients (P_app) based on TSB disappearance from the lumen (P_lumen) were 6.2- to 7.2-fold higher (p < 0.01) than those based on drug appearance in mesenteric venous blood (P_blood). The uptake and efflux of TSB in Caco-2 cells were also significantly altered in the presence of an inhibitor for P-glycoprotein (PgP) or for multi-drug resistance associated protein (MRP1/2). TSB transport from the apical (AP) to basolateral (BL) side in Caco-2 monolayers was 3.3- to 5.7-fold lower than that from BL to AP side, but this polarized transport was attenuated by co-incubation of PgP or MRP1/2 inhibitors. The P_app values of TSB in the BL-AP direction were significantly higher in MDCKII cells over-expressing MDR1 or MRP1, but not in cells over-expressing MRP2-5, as compared with the wild-type cells. The plasma AUC_0-24hr in mdr1a and mrp1 gene-deficient mice was 10.2- to 1.7-fold higher than that in the wild-type mice. Furthermore, TSB significantly inhibited the uptake of digoxin and vinblastine in membrane vesicles containing PgP or MRP1. TSB also moderately stimulated PgP ATPase activity. Taken collectively, our findings indicate that TSB is a substrate for PgP and MRP1 and that drug resistance to TSB therapy and drug interactions may occur through PgP and MRP1 modulation.

Thermal degradation of natural rubber/ZNO nanocomposites

Nanoparticies have been widely used to enhance the properties of natural rubber (NR). In the present paper a novel nanocomposite was developed by blending nano-ZnO slurry with prevulcanized NR latex, and the thermal degradation process of pure NR and NR/ZnO nanocomposites with different nano-ZnO loading was studied with a Perkin Elemer TGA-7 thermogravimetric analyzer. The thermal degradation parameters of NR/ZnO (2 parts ZnO per hundred dlY rubber) at different heating rates (Bs) were studied. The results show that the thermal degradation of pure NR and NR/ZnO nanocomposites in nitrogen is a one-step reaction. The degradation temperatures of NR/ZnO nanocomposite increase with an increasing B. The peak height (R_p) on the differential thermogravimetric curve increases with the increase of B. The degradation rates are not affected significantly by B, and the average values of thermal degradation rate C_p and C_f are 44.42 % and 81.04 %, respectively. The thermal degradation kinetic parameters are calculated with Ozawa-Flynn-Wall method. The activation energy (E) and the frequency factor (A) vary with ecomposition degree, and can be divided into three phases corresponding to the volatilization of low-molecular-weight materials, the thermal degradation ofNR main chains and the decomposition of residual carbon.

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.

Effects of mucor mucedo on corncob decomposition in pyr-contaminated soil remediation

The effect of polycyclic aromatic hydrocarbon and highly effective degradation fungi Mucor mucedo (MU) was studied on corncob decomposition in Pyr-contaminated soil for 120 days to identify the impact of a degradable immobilized carrier on the remediation of soil contaminated by persistent organic pollutants. Results showed that the corncob was mainly composed of hemicelluloses, cellulose, and water dissolved (WD) material, which accounted for 85 percent of its total weight. MU addition significantly affected corncob decomposition. Thus, humic acid production and WD and benzene-ethanol dissolved material degradation increased. The peaking of the WD content was delayed for 30 days or more. The extractable pyrene content positively correlated with the WD content in the corncob during the decomposition. These results theoretically support a refined remediation principle of immobilized microorganisms.

Undoped and calcium doped borate glass system for thermoluminescent dosimeter

Borate glasses present an absorption coefficient very close to that of human tissue. This fact makes some borates ideal materials to develop medical and environmental dosimeters. Glass compositions with calcium tetraborate (CaB4O7) and calcium metaborate (CaB2O4), such as the xCaB(4)O(7) - (100-x)CaB2O4 System (0 <= x <= 100 wt%) were obtained by the traditional melting/quenching method. A phenomenon widely known as the 'boron anomaly' was observed in our thermal analysis measurements, as indicated by the increase of T, and the appearance of a maximum value in the composition with 40 wt% of CaB2O4. The Dy doped and Li co-doped 80CaB(4)O(7)-20CaB(2)O(4) (Wt%) glass samples were studied by the thermoluminescence technique. The addition of Dy improved the signal sensitivity in about three times with respect to the undoped glass sample. The addition of Li as a co-dopant in this glass caused a shift to a lower temperature of about 20 degrees C in the main glow peak. The structural analysis of the 80CaB(4)O(7)-20CaB(2)O(4) (wt%) undoped and doped samples were studied through infrared absorption. We have noted an increase in the coordination number of the boron atoms from 3 to 4, i.e., the conversion of the BO3 triangular structural units into BO4 tetrahedra. (c) 2006 Elsevier B.V. All rights reserved.