RESUMO: Vernonia rubricaulis é uma planta responsável por causar surtos de intoxicação em bovinos que vivem em áreas sujeitas a alagamento no bioma Pantanal do Brasil. Por causar necrose hepática aguda e quadro anatomopatológico semelhante a outras plantas hepatotóxicas, como Xanthium spp., era suposto que seu princípio ativo fosse semelhante ao desta planta. No entanto, os potenciais componentes tóxicos permanecem desconhecidos. Este estudo buscou determinar o perfil químico dos extratos aquoso e etanólico das folhas de V. rubricaulis, na fase de brotação, sabidamente tóxica, e na fase adulta. Para investigar a presença das substâncias tóxicas nos extratos, estudos experimentais utilizando camundongos e ovinos foram realizados. Ensaios experimentais utilizando ratos e ovinos investigaram a presença de substâncias tóxicas nos extratos. Três grupos de camundongos receberam diferentes doses do extrato de V. rubricaulis. Outros quatro grupos foram formados com ovinos que receberam: (1) extrato aquoso de folhas imaturas, (2) extrato aquoso de folhas maduras, (3) extrato etanólico de folhas maduras, e (4) extrato etanólico de folhas imaturas. A intoxicação foi reproduzida em ovinos apenas com o extrato aquoso dos brotos de V. rubricaulis, revelando que o etanol não é um bom solvente extrator dos compostos tóxicos e corroborando com achados prévios que sugerem que estes componentes não estão presentes em quantidades tóxicas na planta adulta. Camundongos Swiss não foram classificados como modelos experimentais adequados para a reprodução da intoxicação, uma vez que nenhum dos extratos foi tóxico, nem mesmo aquele que foi tóxico para ovinos. O perfil químico dos extratos revelou a presença de compostos das classes dos açúcares, flavonoides, esfingolipídeos e ácidos clorogênicos. Assim, os perfis químicos determinados por HPLC-DAD-MS dos extratos aquoso e etanólico das folhas em fase de brotação e das folhas adultas, não revelaram compostos com potencial tóxico conhecido, indicando que outras estratégias de determinação do perfil químico ou outras técnicas de caracterização estrutural devem ser empregadas para tal finalidade. Entretanto, o estudo demonstrou que o método de extração aquosa de V. rubricaulis foi eficiente na extração dos componentes tóxicos das folhas em fase de brotação. RESUMO Brasil hepatotóxicas spp spp. entanto desconhecidos V tóxica adulta realizados 1 (1 imaturas 2 (2 maduras 3 (3 4 (4 açúcares flavonoides clorogênicos Assim HPLCDADMS HPLC DAD MS adultas conhecido finalidade Entretanto (

ABSTRACT: Vernonia rubricaulis is a plant responsible for poisoning cattle living in areas subject to flooding in the Pantanal biome of Brazil. Because V. rubricaulis causes acute hepatic necrosis and clinical signs and lesions similar to other hepatotoxic plants, its action pathways are probably similar. However, the potentially toxic components of V. rubricaulis remain unknown. Our study aims to determine the chemical profiles of aqueous and ethanolic extracts of the leaves of V. rubricaulis in the budding stage, which is known to be toxic, and in the mature stage. Experimental trials using mice and sheep investigated the presence of toxic substances in the extracts. Three groups of mice received different doses of V. rubricaulis extract. Another four groups were carried out with sheep that received: (1) aqueous extract of immature leaves, (2) aqueous extract of mature leaves, (3) ethanolic extract of mature leaves, and (4) ethanolic extract of immature leaves. Intoxication was reproduced in sheep only with the aqueous extract of V. rubricaulis buds; ethanol was not a suitable solvent for extracting toxic compounds. This finding suggests that toxic components are not present in considerable amounts in the mature plant. Swiss mice proved not to be suitable experimental models for reproducing intoxication because none of the extracts was toxic to the animals, including the one that was toxic in sheep. The chemical profile of the extracts revealed the presence of sugars, flavonoids, sphingolipids, and chlorogenic acids. Chemical profiles determined by HPLC-DAD-MS of the aqueous and ethanolic extracts of the buds and mature leaves of V. rubricaulis did not reveal compounds with known toxic potential. We demonstrated that the aqueous extraction method of V. rubricaulis was efficient at extracting toxic components from the plant’s leaves in the budding stage. ABSTRACT Brazil V plants However unknown stage 1 (1 2 (2 3 (3 4 (4 animals sugars flavonoids sphingolipids acids HPLCDADMS HPLC DAD MS potential s (

Abstract In the midst of the debate regarding the new Chilean Constitution, this paper goes through the consequences of an eventual incorporation of a norm of constitutional rank in our law that, to a greater or lesser extent, establishes the duty of reparation in the event of a violation of human rights, similar to other Latin American Constitutions; in particular we will analyze the topic of damage repair. The reason behind looking through the different modes that damage repairing for human rights violation takes, is to demonstrate that the law of liability and the standards of human rights law can complement each other, especially in the case that the state or its agents are the culprits of those violations.

Resumen En medio del debate de una nueva Carta Fundamental, este trabajo reflexiona acerca de la eventual incorporación de una norma de rango constitucional que, con mayor o menor amplitud, establezca el deber de reparación ante una violación de derechos fundamentales, como ya ocurre en el entorno constitucional latinoamericano, a fin de evaluar si ello es necesario en materia de resarcimiento del daño. El propósito de mirar de cerca las modalidades que adopta la reparación del daño que se padece por la vulneración de un derecho fundamental, es demostrar que los estándares del derecho de los derechos humanos y el derecho de la responsabilidad civil, se pueden complementar en forma armónica, especialmente en caso de que sea el Estado o sus agentes los causantes de dicha vulneración.

ABSTRACT Introduction: The absence of home hospitalization (HH) of children and youth with special health care needs (CYSHCN) generates prolonged hospitalizations in closed care (CC). Objective: To compare the estimated cost of HH of high complexity CYSHCN versus the actual cost of the same patient in CC and its impact on hospital production. Methods: Descriptive and comparative study between costs of both hospitalization modalities of high complexity CYSHCN. From January to December 2016, non-oncological CYSHCN hospitalizations were registered by the Pediatric Service (PS) according to the Ministry of Health-Chile (MINSAL) norm. It was classified for clinical groups and similar consumption of resources according to groups related to diagnosis (DRG). The stay was adjusted, and financial analysis of both modalities (CC) and (HH) was performed to evaluate the impact on hospital production. Results: Of 3690 discharges, 126 (3.4%) were related to 27 CYSHCN, the average age was 4.6 years (± 5 SD) with technological dependencies to live. The mean CYSHCN stay was 16 days, compared with 5.9 for patients without special health needs. CYSHCN stays reached 2017 days (8.6%). Disregarding the CYSHCN discharges would have contributed 320 additional discharges, and his HH would have saved US $ 15 / day per patient, which for the total number of stays consumed would have been an annual saving of US $ 29170. Conclusion: HH has an estimated cost lower than the CA of high complexity CYSHCN, improves hospital productivity, and frees critical beds with financially viable investment.

RESUMEN Introducción: La ausencia de hospitalización domiciliaria (HD) de niños y adolescentes con necesidades especiales en salud de alta complejidad (NANEAS) genera hospitalizaciones prolongadas en la atención cerrada (AC). Objetivo: Comparar el gasto estimado de HD de NANEAS de alta complejidad versus costo real del mismo paciente en AC y su impacto en la producción hospitalaria. Métodos: Estudio descriptivo y comparativo entre costos de ambas modalidades de hospitalización de NANEAS de alta complejidad. De enero a diciembre 2016 se registraron hospitalizaciones NANEAS no oncológicos del Servicio de Pediatría (SP) según norma del Ministerio de Salud-Chile (MINSAL). Se clasificó para grupos clínicos y consumos similares de recursos según grupos relacionados al diagnóstico (GRD). Para evaluar el impacto en la producción hospitalaria la estancia fue ajustada y se realizó un análisis financiero de ambas modalidades (AC) y (HD). Resultados: De 3690 egresos, 126 (3,4%) se relacionaron a 27 NANEAS, la edad promedio fue 4,6 años (± 5 DS) con dependencias tecnológicas para vivir. La estancia media NANEAS fue 16 días, comparada con 5,9 de los pacientes sin necesidades especiales en salud. Las estancias NANEAS llegaron a 2017 días (8,6%). Prescindir de los egresos NANEAS hubiera aportado 320 egresos adicionales y su HD habría ahorrado US $15/día por paciente, que para el total de estancias consumidas habría sido un ahorro anual de US $ 29 170. Conclusiones: La HD tiene un costo estimado menor a la AC de NANEAS de alta complejidad, mejora la productividad hospitalaria y libera camas críticas con inversión financieramente viable.

Abstract: Introduction: Acute kidney injury (AKI) is common in COVID-19 patients. Nonetheless, its actual incidence is based in case series and retrospective studies, reporting a wide range of presentations. It has been suggested that AKI is an independent risk factor for mechanical ventilation and death in patients with that viral infection. Material and methods: Observational, descriptive, cross-sectional and retrospective study. The files of interned patients at Hospital Ángeles Mocel between March and July 2020, with a COVID-19 diagnosis, were reviewed. Patients over 18 years old, with a confirmed COVID-19 diagnosis and a complete file were included (n = 83). A descriptive analysis to calculate percentages, means and standard deviation was employed. Results: 36.14% of patients developed AKI, 43.3% were classified as KDIGO 1, 20% as KDIGO 2, 36.6% as KDIGO 3, and 23.3% required kidney replacement therapy. Of the patients under invasive mechanical ventilation, 77.7% developed AKI. Out of the total of patients with AKI, 56.6% died. Conclusions: The incidence of AKI in COVID-19 patients in our population, was similar to that reported in the international literature. AKI was more frequent in patients hospitalized in intensive care units and under invasive mechanical ventilation, in which a higher mortality was observed.

Resumen: Introducción: La lesión renal aguda (LRA) es común en enfermos con COVID-19. Sin embargo, su incidencia actual se basa en series de casos y estudios retrospectivos, que reportan un rango muy amplio de presentación. Se ha sugerido que la LRA es un factor de riesgo independiente para el requerimiento de ventilación mecánica y muerte intrahospitalaria en pacientes con dicha enfermedad viral. Material y métodos: Estudio observacional, descriptivo, transversal y retrospectivo. Se revisaron los expedientes de enfermos internados en el Hospital Ángeles Mocel con diagnóstico de COVID-19, entre marzo y julio del 2020. Se incluyeron personas mayores de edad, con diagnóstico confirmado de esa infección y expediente clínico completo (n = 83). Se utilizó estadística descriptiva a fin de calcular porcentajes, medias y desviación estándar. Resultados: El 36.14% desarrolló LRA, 43.3% fueron nivel uno de KDIGO (Kidney Disease: Improving Global Outcomes), 20% en KDIGO 2, 36.6% KDIGO 3 y 23.3% requirieron terapia de reemplazo de riñón. De quienes tenían ventilación mecánica invasiva (VMI), 77.7% generaron LRA. El 56.6% de aquellos con LRA fallecieron. Conclusiones: La incidencia de LRA en afectados con COVID-19 en esta población fue similar a lo reportado en la literatura internacional. Fue más frecuente en pacientes en unidad de cuidados intensivos y con VMI, en quienes se observó más alta mortalidad.

Resumen: La atrofia muscular espinal (AME) es una enfermedad del asta anterior de la médula espinal, genéticamente determinada y causada por síntesis insuficiente de la proteína de supervivencia de la motoneurona. La debilidad muscular lleva a una disminución progresiva de la capacidad vital y de flujos medibles durante la tos. La intensidad y precocidad de la expresión motora se vincula con los grados de afectación de los grupos musculares respiratorios, determinando la meseta en la capacidad vital y progresión a la insuficiencia ventilatoria, como también el compromiso de los músculos inervados bulbares. Las formas clínicas más severas de AME, en especial aquellas con presentaciones más tempranas y respiración paradojal, tienen capacidades vitales y flujos pico tosidos menores. La evaluación secuencial de estos parámetros es esencial para el pronóstico funcional y vital de estos pacientes. La subclasificación de AME tipo 1 y 2 se relaciona con momentos deseables para la realización de cuidados respiratorios no invasivos en la infancia temprana y en la edad escolar, que mejoran la sobrevida y calidad de vida. Este documento sintetiza dichas recomendaciones con especial referencia a intervenciones guiadas por etapas que incluyan apilamiento de aire (air stacking), protocolos de tos asistida y soporte ventilatorio no invasivo con alta intensidad de presiones de soporte, incluso en aquellos pacientes con pérdida de la autonomía respiratoria, minimizando el riesgo de traqueotomía. La no consideración de estas recomendaciones en la valoración regular de los pacientes resta la oferta de tratamientos oportunos.

Summary: Spinal Muscular Atrophy (SMA) is a disease of the anterior horn of the spinal cord, genetically determined, and caused by deficiency of survival motor neuron (SMN) protein. Muscle weakness leads to a progressive decrease in vital capacity and to diminished cough flows. Respiratory morbidity and mortality are a function of respiratory and bulbar-innervated muscle impairment. It can be measured by the sequential evaluation of vital capacity to determine the life time maximum (plateau) and its subsequent rate of decline, progressing to ventilatory failure. Bulbar-innervated muscle impairment can also be monitored and measured by spirometry. The more severe clinical forms of SMA, especially those with earlier onsets and paradoxical breathing, have lower vital capacities and cough peak flows. The sequential assessment of these parameters is key for the vital and functional prognosis of these patients. SMA sub-classification types 1 and 2 of SMA involve appropriate times for non-invasive respiratory interventions in early childhood and school age and improve afterlife and quality of life. This document summarizes these recommendations, as a function of SMA type, with special reference to interventions that include air stacking, manually and mechanically assisted coughing protocols and noninvasive ventilatory support techniques, even for patients who have no ventilator-free breathing ability to minimize or eliminate the need to resort to tracheotomy. Failure to properly evaluate these patients regularly reduces their survival and chances to avoid invasive airway tubes.

Resumo: A Atrofia Muscular Espinhal (SMA) é uma doença do corno anterior da medula espinhal, geneticamente determinada e causada pela síntese insuficiente da proteína de sobrevivência dos neurônios motores. A fraqueza muscular leva a uma diminuição progressiva da capacidade vital e fluxos mensuráveis durante a tosse. A intensidade e a precocidade da expressão motora estão relacionadas aos graus de envolvimento dos grupos musculares respiratórios, determinando o platô da capacidade vital e a progressão para insuficiência ventilatória, bem como o envolvimento dos músculos inervados do bulbar. As formas clínicas mais graves de SMA, especialmente aquelas com apresentações anteriores e respiração paradoxal, têm capacidades vitais mais baixas e fluxos de tosse mais baixos. A avaliação sequencial desses parâmetros é essencial para o prognóstico funcional e vital desses pacientes. A subclassificação de SMA tipo 1 e 2 está relacionada aos momentos desejáveis para cuidados respiratórios não invasivos na primeira infância e idade escolar, que melhoram a sobrevida e a qualidade de vida. Este documento resume essas recomendações com referência especial às intervenções guiadas por etapas que incluem empilhamento de ar, protocolos de tosse assistida e suporte ventilatório não invasivo com suporte pressórico de alta intensidade, mesmo em pacientes com perda de autonomia respiratória, minimizando o risco de traqueostomia. A não consideração dessas recomendações na avaliação regular dos pacientes reduz a oferta de tratamentos oportunos.

Abstract: In this paper, we discuss the scope of so-called efficient breach, in order to determine whether it is feasible that under Chilean law the creditor to obtain restitution of profits experienced by the debtor in these cases, or whether, on the contrary, creditor may only exercise the rights or remedies that the law gives arising from breach.

Resumen: En este trabajo analizaremos los alcances del denominado incumplimiento eficiente, con el fin de determinar si en estos casos es factible que de conformidad al derecho chileno el acreedor obtenga la restitución de las ganancias experimentadas por el deudor; o si, por el contrario, el acreedor sólo puede ejercer los derechos o remedios que la ley le confiere derivados de tal incumplimiento.

Resumo Nesta entrevista inédita realizada pelo Fórum Permanente IEA-USP em 17 de dezembro de 2009, o historiador, crítico de arte, curador e dirigente cultural Walter Zanini fala sobre sua formação internacional em artes visuais, sua experiência como docente da Faculdade de Filosofia, Letras e Ciências Humanas da USP, da Escola de Comunicações e Artes da USP e da Fundação Alvaro Penteado; assim como seu papel na constituição e desenvolvimento das bases conceituais e curatoriais do Museu de Arte Contemporânea da USP, o primeiro museu de arte contemporânea no mundo, durante sua gestão (1963-1978). Relembra também sua atuação como curador de duas Bienais Internacionais de Arte de São Paulo no início dos anos 1980, que transformaram a matriz epistemológica desse evento que é uma centralidade no sistema da arte contemporânea no Brasil.

Abstract In this unpublished interview held by the Fórum Permanente IEA-USP on December 17, 2009, Walter Zanini, historian, art critic, curator and cultural manager, talks about his international training in the Visual Arts; his experience as a lecturer at Faculdade de Filosofia, Letras e Ciências Humanas da USP, Escola de Comunicações e Artes da USP and Fundação Alvaro Penteado; as well as his role in the constitution and development of the conceptual and curatorial bases of the Museu de Arte Contemporânea da USP, the first contemporary art museum in the world, during his tenure as director (1963-1978). He also recalls his role as curator of two International Art Biennials of São Paulo in the early 1980s that transformed the epistemological matrix of this event, which is a centrality in the contemporary art system in Brazil.

Resumen: Los días 24 y 25 de noviembre del 2016, en Montevideo, Uruguay, tuvo lugar un encuentro de capacitación en cuidados respiratorios no invasivos con más de 200 profesionales médicos, kinesiólogos y licenciadas de enfermería. El encuentro fue presidido por el Dr. John Bach, Director Médico del Centro de Ventilación Mecánica No Invasiva en la Escuela de Medicina de Rutgers, New Jersey en Newark, New Jersey, quien es reconocido a nivel mundial por su amplia trayectoria en estudios y trabajos publicados sobre ventilación no invasiva y enfermedades neuromusculares Los cuidados respiratorios no invasivos, combinando la asistencia ventilatoria, inicialmente nocturna y luego durante las 24 horas del día, incluso en pacientes con capacidad vital mínima, y la implementación de estrategias para asistencia de la tos y respiración glosofaríngea, han contribuido a una mejor calidad de vida y sobrevida de los pacientes con enfermedades neuromusculares. Los avances tecnológicos, la capacitación de los pacientes y sus cuidadores facilitan su estadía en el hogar sin depender de instituciones o cuidados de enfermería permanentes promoviendo su autonomía e integración. Resulta esencial que los profesionales de la salud, conozcan todas las opciones terapéuticas posibles para ofrecer a sus pacientes y sus familias, de modo que, conforme avanza la enfermedad, ellos puedan expresar sus voluntades en forma anticipada y sin apremios derivados de eventos “inesperados”. Es necesario impulsar un cambio de paradigma en la forma en que los profesionales de la salud ven a estos individuos. Las recomendaciones claves de ese encuentro están resumidas en este artículo.

Summary: A November 2016 Noninvasive Ventilatory Support workshop and meeting with more than 200 medical professionals, physiotherapists, respiratory therapists and nurses took place in the city of Montevideo, Uruguay. It was conducted by Dr. John Robert Bach, Medical Director of the Center for Non-Invasive Mechanical Ventilation at Rutgers New Jersey School of Medicine in Newark, New Jersey, who is recognized worldwide for his extensive background in studies and publications on noninvasive ventilation and neuromuscular diseases. Non-invasive respiratory care which combines ventilatory support initially at night and then support continuously 24 hours per day, even in patients with minimal vital capacity combined with the implementation of specifics techniques for assisted coughing and glossopharyngeal breathing have contributed to a better quality of life and survival of patients with neuromuscular diseases. Technological advances and proper training for patients and caregivers facilitates the patient’s ability to stay at home and also promotes their autonomy and integration, without them having to depend on hospice or permanent nursing care. It is essential for health care professionals to know all the therapeutic possibilities available for their patients and share with both the patients and the patient’s family, so as the disease progresses it will help everyone clearly understand all options during conscious decision-making. It is necessary to promote a paradigm shift in the way health professionals approach individuals with neuromuscular diseases. The key recommendations from that meeting are summarized in this article.

ABSTRACT Nowadays, iron oxide based magnetic nanoparticles are used in several science and technology applications due to their magnetic properties. Likewise, these materials are used in biomedical applications such as contrast agents for magnetic resonance imaging, magnetic hyperthermia, targeted drug delivery, etc. In this work, the synthesis and characterization of Mg, Zn-containing ferrites with the chemical formula of Mg1-xZnxFe2O4 (0-0,9) were performed. Synthesis was carried out by thermal decomposition method (DT) using metal acetylacetonates (Mg, Zn and Fe) as reactants and oleic acid/phenyl-ether as reaction medium. The obtaining materials were characterized by X-ray diffraction (XRD), vibrating sample magnetometry (VSM), Fourier transform infrared spectroscopy (FT-IR) and transmission electron microscopy (TEM). The X-ray diffraction patterns of the materials obtained exhibited the formation a single crystalline phase with an inverse spinel structure that corresponds to a magnesium ferrite (JCPDS 88-1935). Magnetic properties of obtained ferrites, such as saturation magnetization (Ms), remanent magnetization (Mr) and coercive field (Hc) were also evaluated by VSM. Ms increased as Zn2+ content was increased, reaching values within 20,22 to 40,03 emu/g, this increase was attributed to the variation of the cations distribution in the spinel structure. FT-IR and TEM results demonstrated that the synthesized nanoparticles have an oleic acid coating, an average size below 10 nm and morphology close to the spherical. According to these results it is possible to incorporate Zn2+ into a crystalline structure of MgFe2O4, by this particular DT method, obtaining ferrites potentially viable for biomedical applications.

RESUMEN Actualmente las nanopartículas magnéticas a base de óxido de hierro son utilizadas en diversas aplicaciones en las áreas de ciencia y tecnología, principalmente por sus propiedades magnéticas. Asimismo, estos materiales son utilizados en aplicaciones biomédicas tales como en la obtención de imágenes por resonancia magnética, hipertermia magnética, liberación de fármacos, etc. En este trabajo se reporta la síntesis y caracterización de ferritas de Mg y Zn con composición química Mg1-xZnxFe2O4 (x=0-0,9) mediante el método de descomposición térmica (DT). Se utilizaron acetilacetonatos metálicos (Mg, Zn y Fe) como reactivos y ácido oleico/feniléter como medio de reacción. Los materiales obtenidos se caracterizaron utilizando las técnicas de difracción de rayos X (DRX), magnetometría de muestra vibrante (MMV), espectroscopia de infrarrojo por transformada de Fourier (FT-IR) y microscopía electrónica de transmisión (MET). Los patrones de difracción de rayos X de los materiales obtenidos muestran la formación de una única fase cristalina con estructura de espinela inversa correspondiente a una ferrita de magnesio (JCPDS 88-1935). Las propiedades magnéticas, tales como magnetización de saturación (Ms), magnetización remanente (Mr) y campo coercitivo (Hc) de las ferritas Mg-Zn fueron evaluadas mediante MMV. Se encontró que la Ms aumenta a medida que se incrementa el contenido de Zn2+ alcanzando valores de 20,22 a 40,30 emu/g, dicho cambio se atribuye a la variación de la distribución de los cationes presentes en la estructura de espinela. Mediante FT-IR y MET se determinó que las partículas sintetizadas poseen un recubrimiento superficial de ácido oleico, una morfología cercana a la esférica y un tamaño de partícula inferior a los 10 nm. De estos resultados se confirma la viabilidad de la incorporación de iones Zn dentro de la estructura cristalina de MgFe2O4 utilizando el método de DT, obteniéndose ferritas potencialmente utilizables en aéreas biomédicas.

Objective: Determine the prognostic significance of metastatic lymph node ratio in 5-year survival of patients after curative distal gastrectomy for advanced gastric carcinoma. Materials and methods: This study survival analysis, prospective, observational, longitudinal, analyzed data from 68 patients with resectable advanced gastric adenocarcinoma treated at the Regional Institute of Neoplastic Disease Luis Pinillos Ganoza during the period 2008-2013. Results: The number of metastatic lymph nodes ranged from 0-29 (mean, 3.9±5.8) and the number of resected lymph nodes understood ranges from 13 to 66 (mean 35.34±12.60). There was no significant correlation between the number of metastatic lymph nodes and number of resected lymph nodes (r=0.208, p=0.089). Survival of the total number at 5 years was 55.9%, with a median survival of 44.11±3.38 months According to regional nodal status (N) of the 7th edition of the UICC, patients with N0 (n=27), pN1 (n=12), pN2 (n=17) and pN3 (n=12) showed survival rates at 5 years of 77.2%, 27.2%, 46.3% and 40% respectively (p=0.005). Patients were stratified into NR0 (reason 0%), NR1 (ratio 1-59%) and NR2 (ratio >60%). Their survival rates at 5 years were 77.2%, 40.9% and 33.3% respectively (p=0.013). Conclusions: The metastatic lymph node ratio is a predictor system actuarial survival at 5 years compared consistent with regional nodal status (N) classification system of the International Union Against Cancer

Objetivo: Determinar la significancia pronóstica de la razón ganglionar metastásica en la sobrevida a 5 años de pacientes luego de gastrectomía distal curativa por carcinoma gástrico avanzado. Materiales y métodos: Estudio de análisis de sobrevida que analizó información de 68 pacientes con adenocarcinoma gástrico avanzado resecable atendidos en el Instituto Regional de Enfermedad Neoplásicas Luis Pinillos Ganoza durante el período 2008-2013. Resultados: El número de ganglios linfáticos metastásicos osciló entre 0-29 (media: 3,9±5,8) y el número de ganglios linfáticos resecados comprendió los rangos de 13-66 (media: 35,34±12,60). No hubo correlación significativa entre el número de ganglios linfáticos metastásicos y el número de ganglios linfáticos extirpados (r=0,208, p=0,089). La sobrevida de la serie total a los 5 años fue de 55,9%. De acuerdo al estado ganglionar regional (N) de la 7ma edición de la UICC, los pacientes con N0 (n=27), pN1 (n=12), pN2 (n=17) y pN3 (n=12) mostraron tasas de sobrevida a los 5 años de 77,2%, 27,2%, 46,3% y 40% respectivamente (p=0,005). Los pacientes fueron estratificados en NR0 (razón 0%), NR1 (razón 1-59%) y NR2 (razón >60%). Sus tasas de sobrevida a 5 años fueron de 77,2%, 40,9% y 33,3% respectivamente (p=0,013). Conclusiones: La razón ganglionar metastásica constituye un sistema predictor de sobrevida actuarial a 5 años coherente en comparación con el estado ganglionar regional (N) del sistema de clasificación de la Unión Internacional Contra el Cáncer

Signet ring gallbladder carcinoma is a rare aggressive variant of mucinous adenocarcinoma with poor prognosis. Positron emission tomography/computed tomography (PET/CT) with Fluor18 deoxyglucose (F18-FDG) is a useful tool in the staging of gallbladder cancer. We report a 68 years old man with a surgically resected acute cholecystitis, whose biopsy was positive for signet ring cell gallbladder carcinoma. During surgery, locoregional lymph nodes, liver or peritoneal involvement were not detected. A PET/CT was performed for staging, finding multiple hypermetabolic lytic bone lesions. Percutaneous biopsy of a pelvis bone lesion, confirmed a metastasis of the tumor. In this case, the staging with PET/CT allowed the diagnosis of unsuspected bone metastases and was a useful tool for deciding the best site of biopsy for histologic confirmation.

Objective: To determine the impact of postoperative infectious complications in the long term survival of patients gastrectomized for gastric carcinoma with curative intent. Materials and methods: The present cohort study evaluated a series of 79 patients diagnosed with resectable advanced gastric carcinoma with curative intent. They were grouped in: Group A (N=28): patients with postoperative infectious complications and Group B (N=51): patients who did not develop postoperative infectious complications. The study covered the years 2008-2013. Results: In group A, the survival rates at 1, 3 and 5 years was 74%, 74% and 47.6% respectively. In group B, the survival rates at 1, 3 and 5 years was 80.3%, 56% and 49.8% respectively (p=0.365). The main postoperative infectious complications not related to the surgical technique were pneumonia (20.3%), followed by urinary tract infection (3.8%). The main postoperative infectious complications related to surgical technique was sepsis (n=5), two of which were related to dehiscence esophagojejunal anastomosis, two bye gastroyeyunal fistula, another bye enterocutaneous fistula and one patient who presented abscess and necrosis peripancreatic’s tissue. Conclusions: There was no impact on survival at 5 years in patients with postoperative infectious complications after gastrectomy with curative intent. However, further studies should be carried over.

Objetivo: Comprobar el impacto de las complicaciones infecciosas postoperatorias en la sobrevida a largo plazo de pacientes gastrectomizados por carcinoma gástrico con intención curativa. Materiales y métodos: El presente estudio de cohortes evaluó una serie de 79 pacientes con diagnóstico de carcinoma gástrico avanzado resecable con intención curativa. Se agruparon a su vez: Grupo A (N=28): Pacientes con complicaciones infecciosas postoperatorias y Grupo B (N=51): Pacientes que no presentaron complicaciones infecciosas postoperatorias. El estudio abarcó los años 2008-2013. Resultados: En el grupo A, las tasas de sobrevida a 1, 3 y 5 años fueron de 74%, 74% y 47,6% respectivamente. En el grupo B, las tasas de sobrevida a 1, 3 y 5 años fueron de 80,3%, 56% y 49,8% respectivamente (p=0,365). Las principales complicaciones infecciosas postoperatorias no relacionadas con la técnica quirúrgica fue la neumonía (20,3%), seguida de infección del tracto urinario (3,8%). Las principales complicaciones infecciosas postoperatorias relacionadas con la técnica quirúrgica fue la sepsis (n=5), dos de estos pacientes presentaron de dehiscencia de anastomosis esofagoyeyunal, dos presentaron fístula gastroyeyunal, uno fístula enterocutánea y por último un paciente presentó absceso y necrosis de tejido peripancreático. Conclusiones: No hubo un impacto en la sobrevida a 5 años en pacientes con complicaciones infecciosas postoperatorias post gastrectomía con intención curativa. Sin embargo, más estudios adicionales deberían efectuarse.

Resumo O gel de plasma rico em plaquetas (PRP) é uma concentração autóloga de plaquetas em um pequeno volume de plasma com potencial de melhorar a integração dos enxertos. Foram utilizados oito equinos adultos, realizando-se enxertos de pele com largura de 2,5 x 2,5 centímetros em cada lado do pescoço, sendo um lado o tratamento, com o uso do gel de PRP e do outro lado o controle. Os animais foram avaliados nos dias 0, 7, 14, 21 e 28 após a cirurgia por meio de avaliação clínica, histológica, morfométrica e cultura bacteriana dos enxertos. As avaliações clínicas, morfométricas e bacteriológicas dos tecidos enxertados não revelaram diferenças significativas entre o grupo controle e o grupo tratamento com PRP. A avaliação histológica revelou um aumento da inflamação aguda no momento 7 e de concentração de colágeno no momento 14 no grupo tratamento, decorrente da liberação de fatores de crescimento pelas plaquetas presentes no gel, que não diferiu nos demais momentos. De acordo com as condições experimentais utilizadas neste estudo, pode-se concluir que não houve diferenças significativas entre o lado tratado com PRP e o lado controle em enxertos cutâneos em equinos.

Abstract The platelet-rich plasma (PRP) gel is an autologous platelet concentration in a small plasma volume with the potential to improve the integration of the grafts. Eight adult equines were used, performing skin grafts, with 2.5x2.5 centimeters, on both sides of the neck, in which one was the treatment side, using the PRP gel, and the other side was the control. The animals were assessed after the surgery on days 0, 7, 14, 21, and 28, by clinical, histological, morphometric, and culture analysis of the grafts. The clinical, morphological, and biological analysis of tissue grafts revealed no significant differences between the control group and the treatment group with PRP. Histologic evaluation revealed an increase in acute inflammation on day 7 and collagen concentration on day 14, resulting from the release of growth factors by the platelets present in the gel, which did not differ in further moments. According to the experimental conditions used in this study, we concluded there were no significant differences between the side treated with PRP and the control side in skin grafts in horses.