Cirugia Y Cirujanos最新文献

Background: Deeper understanding on the risk factors and seeking potential predicted biomarkers for prognosis of total hip arthroplasty (THA) patients are of great significance. Limited researches focused the correlation between high mobility group box protein-1 (HMGB1) and the prognosis of THA patients.

Objective: The objective of this study was to investigate the role of HMGB1 and inflammatory factors in patients underwent total hip arthroplasty (THA).

Methods: The present prospective study enrolled 208 THA patients who went to our hospital during January 2020 to January 2022. Serum levels of HMGB1, C-reactive protein (CRP), interleukin-1b (IL-1β), and IL-6 were detected at the admission, 1 day, 3 days, 7 days, 30 days, and 90 days after surgery. The levels of Harris score, Fugl-Meyer, 36-item short-form health survey (SF-36), and Pittsburgh sleep quality index (PSQI) were detected on 90 days after surgery in two groups. Receiver operating characteristic curve (ROC) was performed for analyzing the diagnostic value of HMGB1 and logistic regression model was used for identifying the risk factor for poor prognosis of THA patients.

Results: Serum levels of HMGB1 and inflammatory factors increased after surgery compared with the baselines. A positive correlation was found between HMGB1 and CRP on 1 day after surgery, and positive correlations were found among HMGB1, IL-1β, and IL-6 on 3 day after surgery. Besides, low HMGB1 reduced the incidence of post-operative complications and improved prognosis of THA patients.

Conclusion: Serum HMGB1 was correlated with inflammatory factors and the prognosis of THA patients.

Objective: The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients.

Methods: This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis.

Results: Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77).

Conclusion: Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.

Background: COVID- 19 disease causes serious anxiety in healthcare workers.

Objective: This study was carried out to determine the relationship between the anxiety level of epidemic diseases and occupational satisfaction.

Method: The "Disease Anxiety Scale," which consists of four subgroups and a total of 18 questions, and the "Vocational Satisfaction Scale," which consists of two subgroups and 20 questions, were utilized to investigate the relationship between epidemic disease anxiety and occupational satisfaction. The statistical analysis was performed using the SPSS 26.0 program.

Results: A total of 395 nurses were included in the study. The mean age of the participants was 33, and 63% were women. About 35.4% of the participants had deaths due to the COVID-19 pandemic in their family or close environment. It was determined that 83% of the nurses have a pandemic disease anxiety. Occupational satisfaction and epidemic anxiety level (p = 0.005, r = 0.560), pandemic (p = 0.01, r = 0.525), economic (p = 0.001, r = -0.473), quarantine (p = 0.003, r = -0.503), and social life (p = 0.003, r = -0.507) were found to be negatively correlated. There was no significant difference between job satisfaction (t = 0.286, p = 0.08) and epidemic anxiety (t = 1.312, p = 0.06) in terms of gender.

Conclusion: Most health-care professionals experience serious anxiety, especially during the pandemic period.

Objective: Provide a description of clinical characteristics, associated factors and outcome of tracheostomies performed in COVID-19 patients.

Method: Observational prospective study of 14 patients who underwent tracheostomy. 10 of them were diagnosed with COVID 19, confirmed with RT-PCR test of nasopharyngeal exudate and compatible tomographic findings.

Results: Of the 10 patients, five were discharged and five died. The average age of patients who died was 66.6 years; of those who were discharged, it was 60.4 years. Ventilatory parameters cut was taken as FiO₂ ≤ 40% and PEEP ≤ 8; of the patients discharged, four met both criteria. On the other hand, of the patients who died, neither met both. Of the latter, an average of APACHE II of 16.4 and SOFA 7.4 were documented, while in discharged patients an average of 12.6 and 4.6 were observed, respectively.

Conclusions: Tracheostomy performed in patients with specific criteria, such as low ventilatory parameters, age, or low score in severity scales, may have a better prognosis.

Background: To date, the main clinical interest in DPP4 is focused on its inhibition in diabetic patients to prolong the half-life of incretins. Epigenetic alterations resulting from DPP4 inhibition have been poorly explored.

Objective: The objective of this study was to determine, whether sitagliptin, a DPP4 inhibitor, has effects on the expression of KAT7 and SIRT1 (genes encoding a histone acetyltransferase and a histone deacetylase, respectively) in MCF7 breast cancer cells, which play an essential role in modulating the epigenetic landscape of chromatin.

Material and methods: MCF7 cells were incubated for 20 h with sitagliptin at concentrations of 0.5, 1.0 and 2.0 μM. Total RNA was isolated and the relative mRNA expression of KAT7 and SIRT1 was determined by RT-qPCR.

Results: There was downregulation in the relative expression of both genes; for KAT7, downregulation reached up to 0.49 (p = 0.027) and for SIRT1, it reached up to 0.55 (p = 0.037).

Conclusions: These results suggest that sitagliptin has effects on the histone epigenetic landscape. This topic deserves further study due to the current sample use of DPP4 inhibitors in diabetic patients.

Objective: To determine the incidence of salivary gland tumors in a population of a tertiary hospital in the State of Mexico, and to describe demographic variables.

Method: An observational, cross-sectional and retrospective study of salivary gland tumors reported in a tertiary hospital in the State of Mexico in the period 2008-2019 is presented.

Results: A prevalence of 0.049% was found. There was no difference between sex in the studied population. Benign salivary gland tumors were the most frequent (86.7%). The age range most affected was 51-60 years. The most frequently found tumor was the pleomorphic adenoma, followed by Warthin's tumor. There was 13.33% of sialolipomas, and one myoepithelioma. There were no cases of sublingual gland tumors or minor salivary glands.

Conclusion: Tumors of the major salivary glands are infrequent tumors; population cases from a central Mexican state and their demographic characteristics are presented to contribute to the information found in local and international literature.

Introduction: The skeletal muscle area (SMA) and prognostic nutritional index (PNI) are both considered as predictive parameters for mortality and morbidity for various type of cancer. In this study, we aimed to identify the effects of pre-operative SMA and PNI values on post-operative mortality and morbidity in patients with periampullary region tumors (PRT).

Methods: Patients between 2010 and 2020 were retrospectively analyzed and divided into two groups according to SMA and PNI cutoff values. Univariate and multivariate analysis was performed to find potential risk factors.

Results: The mean age was 65.94 ± 11.242 and 54 (60.6%) of the patients were male. Hypertension was found a reducing factor for morbidity in both univariate and multivariate analysis (p = 0.039; p = 0.045). Chronic obstructive pulmonary disease and low PNI were found as factors affecting mortality in univariate analysis (p = 0.046; p = 0.014). However, only low PNI was found as an enhancing factor for mortality in multivariate analysis.

Conclusion: Although SMA is not a risk factor for post-operative morbidity and mortality, PNI can be considered as a risk factor for mortality in patients with PRT.