Ausentismo y organización del espacio. Aportes preliminares en casos patagónicos

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Santiago Bondel

2015-04-01

Full Text Available La presentación se corresponde con avances de un proyecto de investigación1 cuya finalidad principal está vinculada con el entendimiento de nuevas formas de organización de los espacios rurales patagónicos. Se ponen en discusión las posibilidades explicativas que sugieren, en su complejidad, distintas modalidades de tenencia de la tierra, tomando al ausentismo como característica analítica conducente. Metodológicamente concurren planteos de observación sistemática, con relevamientos bibliográficos y a campo, y la generación de referentes tipológicos. Los resultados preliminares muestran un espectro de situaciones diferenciadas en sus lógicas territoriales; así, el perfil económico rural (ganadería, minería, turismo, forestaciones, ahorro y/o especulación inmobiliaria se ve atravesado tanto por lógicas productivas como contemplativas. A todo esto, la organización de los espacios sobrelleva influencias cada vez más activas de varios procesos socio-culturales reivindicativos y/o conservacionistas. Se destaca asimismo el marco de discusión creciente de lo que se da en llamar ‘territorialidad virtual’, cuya asociación con el ausentismo, la sustitución dominial y los cambios en los usos del espacio resultan casi evidentes.La propuesta aspira a reflejar lineamientos básicos en la configuración espacial rural a favor de encontrar argumentos explicativos que permitan contribuir tanto con los enfoques multidisciplinarios que atañen al desenvolvimiento territorial en general, como con el Planeamiento regional.

ESCENARIOS PARA LA UBICACIÓN ÓPTIMA DE GENERACIÓN DISTRIBUIDA CON BASE EN UN ALGORITMO ANALÍTICO

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Diego Leonardo González Herrera

2013-09-01

Full Text Available En este artículo se presentan los escenarios de simulación planteados en base a un algoritmo analítico para la ubicación de la generación distribuida. En primera instancia se hace un recorrido por el estado del arte referente a los factores involucrados en la planeación de la demanda  y estudios de cortocircuito. Así mismo, se exhibe la propuesta metodológica para evaluar el impacto y algunos resultados preliminares obtenidos.

Retalhos de avanço no tratamento da fissura anal crônica: experiência inicial Advancement flap in the treatment of chronic anal fissure: inicial experience

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Maria Auxiliadora Prolungatti Cesar

2009-12-01

Full Text Available A fissura anal é uma laceração do canal anal relacionada ao trauma, hipertonia esfincteriana e isquemia. A maioria cicatriza espontaneamente ou com tratamento conservador, e poucas requerem tratamento cirúrgico. O objetivo deste trabalho é verificar os resultados clínicos e alterações manométricas de pacientes submetidos ao tratamento cirúrgico da fissura anal com avançamento de retalhos em v-y. Métodos: Estudo prospectivo, realizado nos anos de 2007, 2008 e 2009, que abrangeu nove pacientes portadores de fissura anal crônica submetidos ao avançamento de retalho anal. Foram avaliadas as pressões do canal anal ao repouso, contração e esforço evacuatório; no pré e pós-operatório. Resultados: Na amostra, todos os pacientes apresentaram hipertonia esfincteriana prévia. seis (66,6% obtiveram resolução total dos sintomas e das lesões. Um (11,11% sofreu deiscência parcial do retalho, sem sintomas clínicos; e outros dois (22,22%, infecção com perda dos mesmos e persistência da fissura. A análise manométrica das pressões de repouso, contração e evacuação nos grupos não mostrou alteração estatisticamente significativa (p>0,05, o que comprova que a cirurgia não incluiu manipulação dos esfíncteres. Conclusão: Os retalhos anais mostraram-se efetivos no tratamento da fissura anal, com cicatrização da lesão, sem que ocorram alterações nas pressões anais desses pacientes.The anal fissure is a laceration of the anal canal related to trauma, hypertonic sphincter and ischemia. The majority heals spontaneously or with conservative treatment and only a few requires surgical treatment. The objective of this study is to verify the clinical results and manometric alterations of patients submitted to the surgical treatment of the anal fissure with advance of v-y skin flaps. Methods: Prospective study, accomplished in 2007,2008 and 2009, in witch nine patients with chronic anal fissure were submitted to v-y advance. The

COROTIPOS PRELIMINARES DE PERÚ BASADOS EN LA DISTRIBUCIÓN DE LA FAMILIA ASTERACEAE

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Berni Britto

2014-01-01

Full Text Available El presente estudio se basa en el concepto de categorías corológicas o corotipos para formular una nueva hipótesis de clasificación biogeográfica del Perú basado en la distribución de la familia Astera - ceae. La información recabada dio como resultado que existen 1669 especies de Asteraceae registradas en Perú (hasta el año 2008, distribuidas en 255 géneros. El territorio peruano se dividió en 218 Distritos de Reporte que representan a los 24 departamentos divididos en franjas de 500 m de altitud. La base de datos biogeográficos de Asteraceae se obtuvo cruzando los registros de distribución actualizados con los Distritos de Reporte, expresándose en una matriz de presencia-ausencia. El análisis de datos dio como resultado un total de 14 corotipos preliminares para el Perú: Abiseo, Amotape, Andino, Apurímac-Huan - cavelica, Chachapoyas-Huánuco, Huancabamba, Huascarán, Ica, Lima-Piura, Loreto-Ucayali, Manu, Pasco, Sandia y Tacna.

Velhice e espiritualidade na perspectiva da psicologia analítica

OpenAIRE

Mello, Maria Aparecida

2012-01-01

Esta Tese de Doutorado é resultado da pesquisa "Velhice e Espiritualidade na Perspectiva da Psicologia Analítica" realizada no Núcleo de Psicossomática e Psicologia Hospitalar da PUC-SP. Foi utilizado os métodos quantitativo e qualitativo na análise dos resultados. O objetivo geral do estudo foi compreender a percepção do idoso acerca do processo de envelhecimento e da vivência da espiritualidade nessa fase da vida. Esta pesquisa foi realizada com uma amostra de 100 idosos, a m...

Escritura colaborativa en línea. Un estudio preliminar orientado al análisis del proceso de co-autoría

OpenAIRE

Bustos Sánchez, Alfonso

2009-01-01

Se presenta el análisis exploratorio del seguimiento de una actividad de escritura colaborativa en línea. Desde una perspectiva que integra las ideas de la escritura como una herramienta para aprender y el aprendizaje colaborativo, diseñamos una metodología para el seguimiento del proceso de escritura colaborativa. Se analizaron los resultados de 6 grupos que realizaron un ensayo como producto final en una asignatura de la carrera de Psicología. Los datos preliminares que se prese...

Resultados preliminares del Sistema de Telemonitorización para Unidades de Cuidados Intensivos

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María del Carmen Tellería Prieto

2013-10-01

Full Text Available Introducción: se exponen en el trabajo los primeros resultados obtenidos en el desarrollo del sistema de telemonitorización de pacientes críticos, ejecutado como parte de un proyecto ramal de la Dirección Nacional de Urgencias Médicas del Ministerio de Salud Pública de Cuba. El sistema se desarrolla a partir de los requerimientos de diseño definidos por el grupo de emergencistas e intensivistas de todo el país que participaron de la investigación. Objetivo: establecer una estructura única al registro de los procedimientos que se desarrollan en la atención al paciente, mejorando con ellos la recepción y el procesamiento de los datos que se registran, para la posterior emisión de resultado. Material y método: el sistema es una aplicación web con arquitectura cliente-servidor, desarrollada con el framework JBoss Seam en lenguaje Java. Se ha desarrollado de forma modular, con una interfaz para la navegación de los médicos y enfermeros muy sencilla e interactiva. Resultados: el sistema se ocupa de la gestión y el registro de las actividades clínicas y administrativas que se llevan a cabo en un servicio de hospitalización, mediante el sistema de información clínica, así como de la comunicación con los equipos médicos que monitorizan al paciente en su cabecera. Conclusiones: se facilita la captura, gestión, tratamiento y almacenamiento de la información generada para cada paciente hospitalizado, integrando toda la información que se maneja en el servicio. Se han desarrollado los módulos correspondientes al registro del recibimiento médico, la indicación médica de tratamiento y su cumplimiento por parte de enfermería, la prescripción de medicamentos al paciente, las gestiones de medicamentos en la farmacia y de las dietas con el departamento dietético, entre otros.

Reanastomose Tubária Laparoscópica: Resultados Preliminares

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Ribeiro Sérgio Conti

2002-01-01

Full Text Available Objetivos: avaliar as taxas de gravidez após realização de reversão laparoscópica de obstrução tubária por laqueadura prévia. Métodos: entre dezembro de 1998 e dezembro de 2001, realizamos estudo prospectivo no qual foram incluídas 26 pacientes previamente submetidas a esterilização tubária. As pacientes tinham idades entre 28 e 37 anos e a reanastomose foi efetuada por via laparoscópica. O período de seguimento variou entre 150 e 425 dias e as taxas de permeabilidade tubária (estudada por meio da histerossalpingografia e as taxas de gestação foram avaliadas. Resultados: a reversão laparoscópica pôde ser realizada em 23 pacientes, sendo bilateral em 21. Duas pacientes apresentavam uma tuba extremamente danificada e três haviam sido submetidas a fimbriectomia bilateral. O tempo cirúrgico variou de 95 a 155 minutos e a alta hospitalar ocorreu na manhã seguinte em todos os casos. Constatou-se permeabilidade tubária em 15 pacientes (15/23 e a taxa de gestação foi 56,5% (13/23, sem gestações ectópicas. O intervalo entre a interrupção do uso do condom e a gravidez foi de até quatro meses em nove pacientes e de até 10 meses em quatro pacientes. Conclusão: em casos selecionados, a reversão tubária videolaparoscópica pode ser oferecida à pacientes laqueadas que desejam novas gestações. A seleção adequada das pacientes, assim como técnica cirúrgica meticulosa, são os fatores-chave para atingir taxas de gestação satisfatórias.

Actividad farmacológica preliminar del fruto de Bromelia pinguin L. (piña de ratón

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Juan Abreu Payrol

2001-04-01

Full Text Available Se presentan los resultados del estudio farmacológico preliminar de un extracto hidroalcohólico concentrado de los frutos de Bromelia pinguin L. (piña de ratón mediante bioensayos sencillos y confiables. Se determinó la toxicidad frente a Artemia salina Leach, que resultó muy baja. Se probó la actividad antihelmíntica contra Lombricus terrestri, con resultados relevantes. El extracto no mostró actividad contra diversas cepas de hongos y bacterias.The results of the preliminary pharmacological study of a concentrated hydroalcoholic extract from the fruits of Bromelia pinguin L. ("piña de ratón" by simple and reliable bioassays are presented. The toxicity against Artemia salina Leach, which was very low, was determined. The anthelmintic activity against Lombricus terrestri was proved with remarkable results. No activity of the extract against the strains of fungi and bacteria was observed.

Empleabilidad percibida en alumnos de los últimos años de la carrera de Licenciatura en Psicología, Psicopedagogía y Gestión de Recursos Humanos : Estudio preliminar

OpenAIRE

Alonso, Horacio Jorge; Izquierdo Rus, Tomás; Domínguez, Daniel Alberto

2013-01-01

El principal interés del presente trabajo es conocer con mayor precisión las expectativas de variables de empleabilidad en alumnos que a corto plazo se encontrarán buscando su inserción en el mercado laboral. Por su carácter preliminar solamente se incluye el análisis del resultado del cuestionario de una muestra parcial.

The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

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A. M. Vieira

2010-05-01

15 de junio de 2008, en todos los pacientes referenciados para hacerse la ecografía endoanal, debido a dolor anal con exploración física normal o sin alteraciones que justifiquen el dolor anal. Resultados: analizamos 90 pacientes con edad media de 50,5 años, 58% mujeres. Veintitrés pacientes presentaban criterios de dolor anal funcional. La ecografía endoanal reveló alteraciones en el 49% de los casos. Las alteraciones más frecuentes fueron las alteraciones esfinterianas, en 14 pacientes, seguido de sepsis anal, en 12 pacientes, de fisura anal, en 10 pacientes, de las lesiones perirrectales, en 6 pacientes y de úlcera del canal anal, en 2 pacientes. De los pacientes con alteraciones esfinterianas, 5 pacientes tenían criterios de dolor crónico. En este grupo de pacientes, no se encuentran diferencias en los hallazgos manométricos y defecográficos entre las diferentes alteraciones ecográficas. Conclusiones: la ecografía endoanal detectó lesiones estructurales no sospechadas en el examen físico en la mitad de los enfermos con dolor anal. Se han encontrado alteraciones ecográficas en el 22% de los pacientes con dolor anal funcional. Sin embargo, no se encontró correlación entre los hallazgos ecográficos y los estudios fisiológicos, así que no fue posible encontrar factores etiológicos o patogénicos del dolor anal funcional.

Anal acoustic reflectometry

DEFF Research Database (Denmark)

Mitchell, Peter J; Klarskov, Niels; Telford, Karen J

2011-01-01

Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

Value of conventional cytology in the presence of macroscopic lesions of the anal canal

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Lêda Pereira de Barcellos

2014-01-01

Full Text Available Objectives: To verify the value of conventional cytology for the diagnosis of macroscopic le- sions of the anal canal and to describe the limitations of the samples. Method: We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination. Results: Of the total, 91.6% of samples were classified as adequate. Cellular elements repre- sentative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion: The study demonstrates the feasibility of using conventional anal cytology in outpatients. Resumo: Objetivo: verificar o valor da citologia convencional no diagnóstico de lesões macroscópicas do canal anal e descrever as limitações das amostras obtidas. Método: avaliamos 395 exames citológicos convencionais obtidos por escovado do canal anal de pacientes predominantemente do sexo masculino, soropositivos para HIV, e com- paramos com a presença de lesões macroscópicas do canal anal constatadas ao exame proctológico. Resultado: o percentual de amostras adequadas foi de 91,6%, e os elementos celulares re- presentativos da zona de transformação anal foram observados em 63,5% das amostras. Encontramos sensibilidade de 80% e 31% na presença ou ausência desta celularidade, res- pectivamente. Conclusão: O estudo demonstra a possibilidade de utilização da citologia anal convencional no rastreio de lesões macroscópicas do canal anal em pacientes ambulatoriais. Keywords: HPV Prevention of anal neoplasia Conventional cytology, Palavras-chave: HPV Prevenção de neoplasia anal Citologia convencional

Adubação da batatinha resultados preliminares referentes ao emprêgo parcelado do N e K Preliminary results on parcelling out nitrogen and potash to potatoes

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O. J. Boock

1956-01-01

Full Text Available Procurando estudar a influência da aplicação parcelada de nitrogênio e potássio, sôbre o desenvolvimento e produção de tubérculos de batatinha, foi organizado um plano preliminar com a duração de três anos, executado em Campinas, em solo pertencente ao grande tipo Glacial. Nêsse plano foram subdivididas as doses de nitrogênio e potássio, provenientes respectivamente do salitre do Chile e cloreto, de maneira a têrmos a aplicação de uma só vez (no ato do plantio, em duas, três e quatro vezes. Os resultados obtidos vieram demonstrar que houve um pequeno aumento de produção quando se subdividiu o nitrogênio três ou quatro vêzes, aumento êsse mais substancial no ano em que foi mais acentuada a queda pluviométrica durante o período de cultivo da batatinha. Quanto ao potássio, já não verificamos esse fato, pois, tanto aplicando-o em uma só vez como em três ou quatro, os resultados foram praticamente semelhantes. Em relação ao tipo dos tubérculos, também não foram notadas diferenças acentuadas entre os diversos lotes adubados.The effects of nitrogen and potash when applied once or in several parcels to potatoes was compared in a series of experiments carried out in a soil of the glacial type. Nitrogen was applied as Chilean nitrate and potash, as potassium chloride. One, 2, 3, and 4 applications of the two fertilizers were compared in 3 separate experiments each. Results of the tests indicated that there was a small gain in yield when nitrogen was applied 3 or .4 times during the growing period. The increase in yield was substantially greater in one experiment that received heavy rains. Parcelling out the potash did not induce any increase in yield when compared with a single application. No definite difference in the size or type of tubers was noticed between the lots that received the various fertilizer treatments.

Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

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Alice Capobiango

2009-12-01

Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

Resolución experimental y analítica de un problema de dinámica rotacional: interpretación de los resultados

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Beatriz Rosario Follari

2016-09-01

Full Text Available http://dx.doi.org/10.5007/2175-7941.2016v33n2p606   La resolución de problemas y las prácticas de laboratorio son parte esencial de las actividades que deben realizar los estudiantes de Física en sus primeros cursos de Física. Se relata una experiencia de aula en la que se propuso a los estudiantes de Física II del primer año de las carreras Profesorado y Licenciatura en Física, el estudio de un carrete que rueda sin deslizar. La misma constó de dos partes: en la primera se les solicitó que planificaran y llevaran a cabo una experiencia para determinar el momento de inercia del carrete; en la segunda se les pidió el desarrollo analítico para encontrar la aceleración y fuerza de rozamiento al hacerlo rodar. La actividad se llevó a cabo en grupo y los resultados fueron expuestos y discutidos. La propuesta resultó positiva ya que llevó a los estudiantes a expresar sus ideas, a la discusión grupal y promovió la autonomía para planificar experiencias sencillas y llevarlas a cabo. Se puso énfasis en la interpretación de las ecuaciones resultantes.

Varicocele e infertilidad. Resultados del tratamiento quirúrgico

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Julio A. Fariñas Martínez

2015-12-01

Full Text Available Se realizó un estudio observacional analítico, con el objetivo de precisar los resultados del tratamiento quirúrgico en los pacientes con infertilidad causada por varicocele, en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, de la provincia de Las Tunas; en el período de enero de 2011 hasta abril de 2012. Se revisaron las historias clínicas de 756 pacientes con varicocele e infertilidad, operados por la técnica de Lewis entre enero de 2008 y diciembre de 2011. Se observó la mayor incidencia en el grupo de edades de 26 a 35 años. La calidad del semen mejoró en el 73.3% después de la operación. El grupo de edades que tuvo mejores resultados en cuanto a calidad del semen y embarazos fue el de 26 a 35 años. Lograron el embarazo el 75% de los pacientes.

Verificación analítica para las determinaciones de cromo hexavalente en aguas por espectrofotometría

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Carlos Alberto Severiche Sierra

2013-06-01

Full Text Available En la actualidad la prestación de servicios analíticos de laboratorios, toma de forma ascendente más auge y utilidad. El efecto de un análisis de aguas es forjar resultados correctos y confiables, siendo la verificación de ensayos uno de los aspectos más importantes y factor clave para conseguir este propósito. La determinación de cromo hexavalente en aguas por colorimetría con la difenilcarbazida es la metodología analítica más usada y útil que se conoce en el ámbito científico técnico, principalmente, por su alta selectividad y también debatida por su reacción a las interferencias. En el presente estudio se hizo la valoración analítica del método espectrofotométrico para la determinación de cromo hexavalente en aguas; el objetivo de este trabajo fue confirmar correctamente la aplicación del método para el análisis de aguas. Se trabajaron muestras de diferentes tipos de agua: potable, residual y superficial, siguiéndose estrictamente los protocolos de verificación. Se encontraron resultados satisfactorios en precisión y exactitud con el fin de emitir resultados confiables y reales de la muestra analizada.

Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

Science.gov (United States)

ElNaggar, Adam C; Santoso, Joseph T; Xie, Huiwen Bill

2012-02-01

To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213). Copyright © 2011 Elsevier Inc. All rights reserved.

Regulação emocional: a construção de um instrumento e resultados iniciais Regulación emocional: construcción de un instrumento y resultados preliminares Emotional regulation: the construction of an instrument and preliminary results

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Miriam Cruvinel

2010-09-01

Full Text Available Este estudo descreve os passos da construção de um instrumento qualitativo para investigar estratégias de regulação emocional de estudantes brasileiros e relata os resultados iniciais obtidos com a aplicação do instrumento. Participaram 54 alunos de 3ª e 4ª séries de uma escola pública de Campinas. O instrumento é composto por uma entrevista com 24 questões relativas a quatro emoções: tristeza, raiva, medo e alegria, e oito pranchas com figuras de crianças expressando cada emoção investigada. As respostas dos estudantes foram submetidas à análise de conteúdo. Um sistema de categorização foi desenvolvido para cada questão. A consistência do processo de codificação foi avaliada por dois juízes independentes, alcançando valores aceitáveis. Os resultados indicam que o engajamento em atividades prazerosas foi a estratégia mais mencionada para lidar com a tristeza, a raiva e o medo e para manter a alegria. Sugere-se que novos estudos sejam conduzidos com base no instrumento desenvolvido, tendo em vista contribuir para o seu refinamento.Este estudio describe los pasos de la construcción de un instrumento cualitativo para investigar estrategias de regulación emocional de estudiantes brasileños y describe los resultados preliminares. Participaron 54 alumnos de 3ª e 4ª serie, de una escuela pública de Campinas. El instrumento es compuesto por una entrevista con 24 cuestiones relativas a cuatro emociones: tristeza, rabia, miedo y alegría y ocho tablas con figuras de niños expresando cada emoción investigada. Las respuestas de los estudiantes fueron sometidas al análisis de contenido. Un sistema de categorización fue desarrollado para cada cuestión. La consistencia del proceso de codificación fue evaluada por dos jueces independientes. La concordancia entre ellos fue buena. Los resultados indican que la implicación en actividades placenteras fue la más mencionada para lidiar con la tristeza, rabia y miedo y para

Calidad del agua de la niebla captada artificialmente en la microcuenca del río Pixquiac, Veracruz, México: resultados preliminares

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Rodolfo Jofre-Meléndez

2015-01-01

Full Text Available Con el fin de determinar si el agua recolectada artificialmente de la niebla en la zona central montañosa del Estado de Veracruz es apta para el consumo humano, se realizó un muestreo preliminar de enero a marzo del año 2010, periodo de mayor frecuencia de nieblas, para analizar sus aspectos físicos, químicos y biológicos y evaluar su calidad. Se encontró que el agua contiene metales pesados como el mercurio, organismos coliformes y cantidades altas de nitrógeno amoniacal, pero esto se puede solucionar aplicando un tratamiento de saneamiento para uso humano con un costo de 0.00341 USD L -1 que no incluye mano de obra ni infraestructura. Se discuten las causas que pueden originar su contaminación y se concluye que el agua recolectada de la niebla no es adecuada para el consumo humano, pero sí para la agricultura.

Créditos ECTS en la asignatura de Electrónica Analógica

OpenAIRE

Galiana-Merino, Juan José; Pascual, Carolina; Albaladejo Blázquez, Adolfo; Gimeno, Encarnación; Ortiz Zamora, Francisco Gabriel; Marini, Stephan

2007-01-01

En este trabajo se ha analizado la asignatura de electrónica analógica, asignatura troncal de Ingeniería Técnica de Telecomunicación, especialidad en Sonido e Imagen. El resultado final de este trabajo de investigación docente ha derivado en la elaboración de una guía docente adaptada al nuevo sistema de créditos ECTS, donde el proceso educativo ya no se evalúa bajo criterios de duración temporal sino por objetivos concretos, competencias y resultados.

Anal fissure - series (image)

Science.gov (United States)

Anal fissures are tears in the skin overlying the anal sphincter, usually due to increased tone of the anal sphincter muscles, and a failure of these muscle to relax. Anal fissures cause pain during defecation and bleeding from the anus.

HIV-associated anal cancer

OpenAIRE

Newsom-Davis, T; Bower, M

2010-01-01

HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

IMPORTANCE OF THE ANAL MANOMETRY IN THE JUDICIALMEDICAL EXPERTISE OF THE ANAL PENETRATION

Directory of Open Access Journals (Sweden)

Jelica Miljkovic

2001-11-01

Full Text Available The forceful anal penetration can leave as a consequence a lasting damage ofthe anal sphincter function. The anal manometry is one of the methods that, in anindirect way, by measuring the pressure in the anal channel, may determine theexistence of the anus-closing muscles' function damage. The importance of the analmanometry application as an objective indicator of a possible damage of the analsphincter function is presented in the cases of the judicial-medical expertise of theanal penetration. Three cases of criminal acts of sexual abuse and rape in which thejudicial-medical expertise by the anal manometry method was applied are analyzed.The anal manometry method is reliable in determining the functional stote of theexternal and the internal anal sphincter and it should be accepted as obligatory indiagnostics and verification of the anal penetration.

Miradas desde la Historia de la Música a la formación profesional de músicos en Colombia: resultados preliminares

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María Victoria Casas Figueroa

2014-07-01

Full Text Available La formación profesional de músicos en Colombia, se caracteriza por una variada oferta de programas, los cuales siguiendo lo exigido por la legislación nacional en torno a las carreras de artes, incluyen en su currículo asignaturas de Historia de la Música, que se diferencian en: número de niveles, número de créditos, orientaciones de contenido y de enfoque. Frente a la implementación de estas asignaturas es necesario establecer la pertinencia de éstas en la construcción de calidad, en la formación de pensamiento crítico, en el conocimiento de la cultura musical, elementos para la interpretación de un estilo, investigación formativa, entre otros. Para ello se adelantó un proyecto de investigación cuyo  propósito fue caracterizar las tendencias de formación en Historia de la música en programas de pregrado o Licenciatura en Música en Colombia, y establecer algunos estándares de calidad relacionados. El estudio se llevó a cabo en un periodo de 18 meses. Se tomaron, como referencia, 12 de los programas académicos de pregrado y Licenciatura en Música, reconocidos por el Ministerio de Educación Nacional seleccionados tanto en instituciones de educación pública como privada. La metodología fue de tipo descriptivo y analítico, combinando los enfoques cuantitativo y cualitativo y se desarrolló en las siguientes fases: 1 revisión teórica; 2 trabajo de campo; 3 procesamiento de información y Análisis de resultados  con el uso del software Atlas-ti. A partir de la determinación de categorías de análisis se estableció un mapeo nacional, de la formación en Historia de la Música, contrastando el marco conceptual y teórico.

Avaliação manométrica anal de crianças com encoprese Anal manometric evaluation of children with encopresis

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Maria Auxiliadora Prolungatti Cesar

2010-12-01

Full Text Available INTRODUÇÃO: A constipação crônica é doença comum na infância, ocorrendo em 5 a 10% dos pacientes pediátricos, considerada a segunda maior causa de procura nos consultórios de pediatria, sendo a encoprese decorrente de constipação grave associada à impactação fecal no reto. Dentre os exames diagnósticos, a manometria anal é utilizada para a avaliação de pacientes com distúrbios funcionais, como a constipação intestinal e a incontinência fecal, em alguns serviços para a avaliação de pacientes com encoprese, pois pode trazer informações sobre o mecanismo evacuatório e possíveis lesões esfincterianas anais. OBJETIVO: Verificar alterações manométricas em pacientes com encoprese. MÉTODOS: Foi realizado estudo de 40 manometrias anais de crianças constipadas com encoprese (G1 e 12 crianças constipados sem encoprese (G2. Foram obtidos os seguintes dados: pressões de repouso, contração e evacuação do canal anal e ampola retal, ponto de maior pressão, reflexo inibitório anal e sensibilidade retal. As manometrias foram realizadas com o aparelho Alacer de perfusão com 8 canais. RESULTADOS: Não foram encontradas diferenças nas pressões de repouso, contração e evacuação do canal anal entre os grupos. Chamou-nos a atenção a ausência de necessidade de maior volume retal para desencadear o reflexo inibitório anal. Não houve diferença da incidência de anismus entre os dois grupos, demonstrando que não se trata de fator importante na manutenção da encoprese, mas sim da constipação. CONCLUSÃO: Não houve necessidade de maior volume para desencadear o reflexo inibitório anal. O anismus não foi diferente entre os dois grupos, não sendo importante na manutenção da encoprese.INTRODUCTION: Chronic constipation is a common childhood disorder that affects 5 to 10% of pediatric patients, being the second most common cause for seeking medical help, with the encopresis arising out of severe constipation

Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture

DEFF Research Database (Denmark)

Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens

2017-01-01

PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross......-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women...... affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. CONCLUSIONS: Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal...

HPV infection, anal intra-epithelial neoplasia (AIN and anal cancer: current issues

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Stanley Margaret A

2012-09-01

Full Text Available Abstract Background Human papillomavirus (HPV is well known as the major etiological agent for ano-genital cancer. In contrast to cervical cancer, anal cancer is uncommon, but is increasing steadily in the community over the last few decades. However, it has undergone an exponential rise in the men who have sex with men (MSM and HIV + groups. HIV + MSM in particular, have anal cancer incidences about three times that of the highest worldwide reported cervical cancer incidences. Discussion There has therefore traditionally been a lack of data from studies focused on heterosexual men and non-HIV + women. There is also less evidence reporting on the putative precursor lesion to anal cancer (AIN – anal intraepithelial neoplasia, when compared to cervical cancer and CIN (cervical intraepithelial neoplasia. This review summarises the available biological and epidemiological evidence for HPV in the anal site and the pathogenesis of AIN and anal cancer amongst traditionally non-high risk groups. Summary There is strong evidence to conclude that high-grade AIN is a precursor to anal cancer, and some data on the progression of AIN to invasive cancer.

Anal Cancer—Patient Version

Science.gov (United States)

Anal cancer cases have been increasing over several decades. Infection with human papillomavirus (HPV) is the major risk factor for anal cancer. Start here to find information on anal cancer treatment, causes and prevention, research, and statistics.

Capital humano y resultados organizativos: análisis en un conjunto de empresas del Eje Cafetero Colombiano

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Cristhian Guillermo Naranjo Herrera

2017-02-01

Full Text Available El objetivo de este documento es establecer el efecto del capital intelectual en los resultados de un conjunto de empresas del Eje Cafetero colombiano, por ello se busca realizar un análisis comparativo entre las empresas objeto de estudio sobre los efectos del capital humano en sus resultados. La metodologí­a empleada se trata de un estudio empí­rico-analí­tico, en el cual se hace un análisis exploratorio descriptivo que compara las empresas que obtuvieron mejores resultados y las que tienen los más altos í­ndices de capital humano. Se concluye que las comparaciones entre las mejores empresas estudiadas muestran que la mayorí­a alcanzan resultados sobresalientes, también son las que cuentan con más altos í­ndices de capital humano, de lo cual se infiere una relación positiva entre ambas variables: a mayor capital humano, mejores resultados financieros, operacionales y comerciales.

Onicomicosis: resultados preliminares del tratamiento clinicoquirúrgico en un grupo de pacientes

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Rubén Pérez Armas

1995-08-01

Full Text Available Se hace un estudio de 40 pacientes con onicomicosis tratadas con la técnica quirúrgica seguida de aplicación local de zeolita esterilizada al 100 %, en el Servicio de Dermatología del Hospital Provincial Clinicoquirúrgico "Celia Sánchez Manduley" en el período comprendido entre mayo de 1992 y mayo de 1993. Sólo participaron pacientes con los criterios de inclusión propuestos en el protocolo de investigación. El 30 % correspondió a candidiasis ungueal y el 70 % a tiña ungueal. Se observaron resultados excelentes de curación en el 96,8 %. El tiempo mínimo de curación fue de 3 meses y el máximo de observación de 6 meses. Se subrayan las ventajas de esta técnsica en comparación con otros tratamientos utilizados según reportes de la literatura médica revisada, porque acorta el tiempo de curación y tratamiento, disminuye el costo por paciente curado, se evitaron los efectos secundarios que los medicamentos de nuevo tipo pueden producir, disminuyendo además sus importaciones con el consiguiente ahorro de divisas para el país. Demuestra el efecto polivalente de la zeolita tópica al 100 % sobre los dermatofitos y candidas.

Observações citolúgicas em Citrus: VI. Resultados preliminares do efeito da colchicina sôbre sementes em germinação

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Osvaldo Bacchi

1944-11-01

Full Text Available Salientamos, em linhas gerais, as possibilidades econômicas da triplcidia em Citrus. Citamos a constatação de um tetraplóide (2n = 36 e de um pentaplóide (2n = 45, que constituem os únicos poliplóides naturais por nós observados. Apresentamos, a seguir, as observações preliminares sôbre uma experiência de tratamento de sementes com a colchicina, para a obtenção de plantas poliplóides. Nos tratamentos efetuados não notamos qualquer influência da mesma sobre a percentagem de germinação. As contagens do número de cromosômios em pontas de raízes e as medições das áreas dos estornas nas fôlhas nos revelaram os seguintes resultados : 1 Das plantas examinadas, três (C.3, C.9 e C.15 têm raízes di-tetraplóides, e apresentam, a julgar pela área dos seus estornas, epiderme tetraplóide. 2 Uma outra planta, a C.12, além de hiperdiplóide, com 2n=19 (e 20?, apresentou uma raiz de natureza quimérica, pois em uma de suas células contamos, aproximadamente, 38 cromosômios somáticos ; a despeito dessa alteração cromosômica, não verificamos, nesta planta, qualquer modificação no tamanho dos seus estomas.Attention is drawn to the economic importance of triploidy in Citrus. During his investigations, the author only found one tetraploid (2n = 36 and one pentaploid (2n = 45 as natural polyploids in Citrus. Preliminary results are then presented of an experiment to produce polyploids through the treatment of seeds with colchicine. Germination was not influenced by these treatments. Chromosome counts in root tips and the mensurement of stomata area gave the following results : 1 Three of the examined plants (C.3, C.9 and C.15 had diploid and tetraploid roots and a tetraploid epidermis, to judge from its stomata area. 2 Another plant, C.12, besides being an hyperdiploid (2n=19 and 20?, had one root which was a chimera, as in one of its cells approximated 38 chromosomes were counted; in spite of this chromosomal alteration, the

Resultados Preliminares sobre Estudios de Evapotranspiración del Cacao.

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Navarrete S. Cristóbal

1960-06-01

Full Text Available El objeto de este trabajo fue determinar los requerimientos de agua por el cacaotero. De los múltiples métodos que existen para este fin, solo el que hace uso de la evapotranspirometría da la solución deseada. El método se basa en que el agua del suelo establece un equilibrio entre el agua que entra, como resultado de la precipitación y el agua que sale a través de la evaporación y transpiración. Para este estudio se están usando cuatro evapotranspirómetros de 2 x 2 metros en la parte superior y 1.20 metros de profundidad: un quinto tanque sirve de fosa colectora, donde se tienen las canecas que recogen las aguas de drenajes. A los evapotranspirómetros se trasplantaron cacaoteros de tres y medio años de edad del Clon 6. Posteriormente fueron rellenados consuelo del mismo lugar y procedente de la excavación. La estación de evapotranspirometría se localizó en medio de una plantación comerciaal de cacao del clon 6 de la misma edad, en la que se ha demarcado una zona buffer de 50 x 50 mts., ésta se riega en la misma forma que los tanques evapotranspirómetros. A éstos se les aplica una cantidad medida de agua cuando no llueve en las 24 horas anteriores. La evapotranspiración potencial se mide restando del agua aplicarla la la cantidad recogida en las canecas, esto se hace para cada tanque todos los días a las 8 a.m. Además de la evapotranspiración potencial, diariamente se toman datos metereológicos en aparatos localizados junto a los tanques experimentales. La información para tres meses; indica que el agua de lluvia sólo suministró el 42.19% y el 63.33% de los requerimientos de agua para el cacaotero en los meses de febrero y marzo respectivamente. En el mes de abril la precipitación fue superior a los requerimientos de agua, va que el consumo fue de 58.46 mm. Y la precipitación de 129.5 mm. Debido a la información tan escasa (tres meses solamente aquí presentada, es imposible, por el momento

Anal Cancer—Health Professional Version

Science.gov (United States)

Anal cancer is a rare malignancy and accounts for a small percentage of cancers of the lower alimentary tract. The most common type of anal cancer is squamous cell carcinoma in the anal canal. Find evidence-based information on anal cancer treatment, causes and prevention, research, and statistics.

De la afectación a nuevas posibilidades: niñas y niños en el conflicto armado colombiano

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María Isabel Valencia-Suescún, Colombia

2015-07-01

Full Text Available (Analítico: El artículo presenta resultados preliminares de la investigación, obtenidos de la validación de instrumentos realizada con niños y niñas de Benposta-nación de muchach@s en Bogotá (talleres creativos y entrevistas semiestructuradas. Relaciona resultados obtenidos en la aproximación al estado del arte sobre niñez y conflicto armado derechos como salud y alimentación, educación, juego y esparcimiento. Evidencia vulneraciones de derechos de protección (por homicidios, reclutamiento forzado, desplazamiento y de participación. Analiza la afectación en procesos de construcción de subjetividad. Aborda potencias y capacidades de acción que se develan en estos contextos y en procesos de socialización política en los cuales niños y niñas se involucran.

Preliminar plan of a machine for the synchrotron radiation production

International Nuclear Information System (INIS)

Moscati, G.; Takahashi, J.; Miyao, Y.

1985-01-01

A preliminar plan, with all the technical specifications, for the construction of a machine for the synchrotron radiation production to be done by the National Synchrotron Radiation Laboratory in Brazil is presented. (L.C.) [pt

Vida Chile 1998-2006: resultados y desafíos de la política de promoción de la salud en Chile The Vida Chile program: results and challenges with health promotion policy in Chile, 1998-2006

OpenAIRE

Judith Salinas; Anselmo Cancino; Sergio Pezoa; Fernando Salamanca; Marina Soto

2007-01-01

La prioridad política otorgada por el Gobierno de Chile a la promoción de la salud se expresa en el desarrollo alcanzado por el Consejo Vida Chile y su Plan Nacional de Promoción de la Salud (PNPS). En este artículo se presenta el modelo evaluativo del PNPS chileno y sus principales resultados preliminares en el ámbito técnico y económico en el período 1998-2006. Para medir los resultados de las metas de proceso se utilizaron indicadores de cobertura (número de personas, de espacios promotore...

Analítica del aprendizaje en un entorno virtual mediante un sistema de computación cognitiva: estudio preliminar

OpenAIRE

Larry Lugo Urribarrí

2016-01-01

En esta investigación se aplicaron métodos de la Analítica del Aprendizaje en el estudio de los datos masivos provenientes de la plataforma virtual de Fruticultura, mediante el sistema de computación cognitiva IBM Watson, basado en inteligencia artificial y aprendizaje automático. Se analizaron los registros de las evaluaciones en línea, así como las interacciones sociales en los foros para determinar su influencia sobre el desempeño estudiantil, durante los períodos lectivos desde el2006 has...

Anal incontinence in women with recurrent obstetric anal sphincter rupture

DEFF Research Database (Denmark)

Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

2015-01-01

UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

[Acute anal pain].

Science.gov (United States)

Pittet, Olivier; Demartines, Nicolas; Hahnloser, Dieter

2013-07-01

Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically.

Estudos preliminares com bromoacetamida, um novo moluscicida

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Naftale Katz

1985-09-01

Full Text Available A bromoacetamida tem sido testada como moluscicida na República Popular da China, para tratamento de criadouros de Oncomelania, hospedeiro do Schistosoma japonicum, com bons resultados. O produto é solúvel em água, o que simplifica seu uso. Foram feitos ensaios biológicos preliminares deste produto em caramujos adultos (Biomphalaria glabrata, B. tenagophila e B. straminea, recém-eclodidos e desovas. Paralelamente foram feitos ensaios com o pentaclorofenol para avaliar a suscetibilidade dos caramujos. O produto foi testado também sobre peixes, Lebistes reticulatus. Os moluscos testados mediam 8-10 mm de diâmetro; os recém-eclodidos tinham 1-3 dias de idade e as desovas 0-1 dia de idade. A temperatura da água durante os experimentos variou de 24,3 a 27,0°C. O produto foi ativo para caramujos adultos, recém-eclodidos e desovas, em concentrações em tomo de 1 a 4 ppm. Para os peixes o produto foi menos tóxico do que para os caramujos (CLço 7,5 ppm. Estes resultados indicam que a bromoacetamida apresenta propriedades moluscicidas promissoras para o controle da Biomphalaria spp.Bromocetamide has been tested as molluscicide, with good results, in the People's Republic of China, on Oncomelania, host of Schistosoma japonicum. We have conducted preliminary assays with bromoacetamide on adult snails (B. glabrata, B. tenagophila and B. straminea, newly hatched smails and egg-masses. This product has been also tested on fishes (Lebistes reticulatus. Comparative assays have been made with pentaclorophenol to evaluate the suceptibility of the snails. Snails tested had a diameter of 8-10 mm; the newly hatched were 1-3 days old and the eggs-masses. 0-1 day old. The temperature of the water varied from 24.3 to 27.5° C. Bromoacetamide was active on adult and newly hatched snails and egg-masses, in concentrations from 1-4ppm. The product was less toxic for jish (LC90 = 7,5 ppm. These results indicate that bromoacetamide has promising molluscicide

Endosonographic and manometric assessment of the anal sphincters after ileal pouch-anal anastomosis

International Nuclear Information System (INIS)

Sudol-Szopinska, I.; Jakubowski, W.; Ciesielski, A.; Bielecki, K.; Baczuk, L.; Tarnowski, W.

2003-01-01

Background. The aim of this study was to compare endosonography and manometry of the anal sphincters in patients after ileal pouch-anal anastomosis (IPAA). Patients and methods. Ten patients aged between 23 and 50 years with IPAA performed for ulcerative colitis were examined with anal endosonography (AES) and manometry. Results. AES visualised abnormal image of the internal anal sphincter (IAS) in 9 patients (90%). Defects of the external anal sphincter (EAS) and puborectalis muscle (PR) were shown in 4 patients (40%). In 5 patients (50%) correlation between endosonographic and manometric assessment for the all analysed muscles: IAS, EAS and PR was found. In 4 cases (40%) both methods correlated with the evaluation of the EAS only and in 1 patient (10%) no correlation was found. Correlation between both methods for the IAS was found in half of the patients (50%) while in the evaluation of the EAS and PR dynamic activity, it was found in 9 cases (90%). Conclusions. Anal endosonography and manometry allow us to assess the morphology as well as the function of the anal sphincters in patients with IPAA. The methods mentioned above show high correlation in the assessment of the EAS function (9 cases; 90%) whereas in the case of IAS, manometry frequently (5 patients; 50%) does not confirm endosonografically detected defects. (author)

Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging.

Science.gov (United States)

Erden, Ayşe; Peker, Elif; Gençtürk, Zeynep Bıyıklı

2017-02-01

OBJECTıVE: To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system. Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann-Whitney U test, and Spearman correlation. The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal. CONCLUSıON: 3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

Recién nacidos pequeños para la edad gestacional: sensibilidad del diagnóstico y su resultado

OpenAIRE

Díaz, Lucía; Cóppola, Francisco; Vargas, Diego; Quiñones, Patricia

2014-01-01

OBJETIVODeterminar la sensibilidad en el diagnóstico clínico-ecográfico de pequeños para la edad gestacional (PEG) y valorar el impacto del diagnóstico prenatal en la tasa de cesáreas y los resultados neonatales (Apgar y gasometría).MATERIAL Y MÉTODOEstudio descriptivo-analítico retrospectivo.RESULTADOSDe 4548 nacidos vivos, se detectó un total de 379 PEG; 99 casos (26%) tenían diagnóstico previo de RCIU. Los resultados neonatales de depresión, acidosis y Apgar bajo no fueron diferentes en el...

Reti di città, mobilità e ambiente: il Preliminare di PTCP di Avellino

Directory of Open Access Journals (Sweden)

Carmela Gargiulo

2010-02-01

Full Text Available  L’articolo propone la lettura dei contenuti del Preliminare del PTCP di Avellino, un piano per molti aspetti innovativo, soprattutto per aver coniugato pianificazione di area vasta di tipo tradizionale e logica “strategica”. In particolare, l’articolo descrive idee guida, contenuti e strategie del piano orientate, prevalentemente, a stimolare lo sviluppo sostenibile di un’area in ritardo di sviluppo come la provincia irpina, attraverso la salvaguardia e valorizzazione delle risorse naturali e storico-culturali, la costruzione di reti di medie e piccole città e reti di mobilità alle diverse scale, da quella urbana a quella internazionale, e interventi sul sistema della mobilità. Nel 2004, ormai più di cinque anni fa, è stato adottato, a maggioranza assoluta (solo due gli astenuti, il Preliminare di Piano Territoriale di Coordinamento della Provincia di Avellino, dopo un lavoro di oltre due anni che ha visto impegnati gli uffici provinciali con due dipartimenti universitari. Il lavoro, che va ben oltre il significato e la valenza di un preliminare e che coniuga due pratiche di piano diverse (quella tradizionale e quella strategica ruota attorno a tre idee di fondo, tra loro strettamente interrelate, che costituiscono i criteri guida che finora ha inteso seguire la provincia di Avellino nell’attività di governo delle trasformazioni. Tali idee, quindi, costituiscono le fondamenta su cui è stato costruito il Preliminare e sono la griglia di specificazione delle strategie e degli obiettivi di piano. Esse sono alla base delle scelte elaborate per lo sviluppo compatibile del territorio, e sono riferibili alle azioni operative di trasformazione del territorio che gli Enti locali, cui è demandato tale compito, nel prossimo futuro dovranno affrontare. Le tre idee forza del Preliminare, descritte nel seguito, sono riferibili ai sistemi di risorse principali della provincia di Avellino, oggetto di una indagine analitico

[Surgical treatment of anal fistula].

Science.gov (United States)

Zeng, Xiandong; Zhang, Yong

2014-12-01

Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

Caracterización de la población del corregimiento de Salgar (Atlántico, Colombia) como fase preliminar para la implementación de un Modelo de Atención Primaria en Salud, 2014

OpenAIRE

Hernando Baquero-Latorre; Ana Liliana Ríos-García

2015-01-01

Objetivo:Caracterizar la población del corregimiento de Salgar (Atlántico) como fase pre-liminar para la implementación de un Modelo de Atención Primaria en Salud. Materiales y método: Investigación descriptiva transversal de ámbito comunitario. Fuente primaria, se recolectó con tarjeta familiar en el lugar de residencia. Se realizaron intervenciones en salud con docentes y estudiantes de medicina y enfermería, con base en riesgos identificados.Resultados:Se caracterizó a 418 familias, 7...

Caracterización de la población del corregimiento de Salgar (Atlántico, Colombia) como fase preliminar para la implementación de un Modelo de Atención Primaria en Salud, 2014

OpenAIRE

Baquero-Latorre, Hernando; Ríos-García, Ana Liliana

2015-01-01

Objetivo: Caracterizar la población del corregimiento de Salgar (Atlántico) como fase preliminar para la implementación de un Modelo de Atención Primaria en Salud. Materiales y método: Investigación descriptiva transversal de ámbito comunitario. Fuente primaria, se recolectó con tarjeta familiar en el lugar de residencia. Se realizaron intervenciones en salud con docentes y estudiantes de medicina y enfermería, con base en riesgos identificados. Resultados: Se caracterizó a 418 familias, 78.9...

Las fábricas de la charla en Chile: apuntes preliminares sobre la materialidad y la subjetividad del trabajo en los call centers

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Areli Escobar Salazar

2013-06-01

Full Text Available Este artículo expone los resultados preliminares de la investigación doctoral en Antropología, orientada a conocer la materialidad y la subjetividad del trabajo de los call centers en Chile. Un salario definido por metas inalcanzables, el maltrato, el cansancio de nuevo tipo, la doble extracción del valor productivo y reproductivo de las mujeres trabajadoras y su entorno familiar, la explotación de las capacidades subjetivas, entre otros aspectos, dan cuenta de las nuevas formas que asume la precarización del trabajo. Las fábricas de la charla en Chile son un claro ejemplo de las formas que asume la organización del trabajo en el escenario laboral contemporáneo.

Evaluación preliminar. Tratamiento del mercurio de fluorescentes y bombillas del alumbrado público

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Juan Carlos Salas-Jiménez

2015-12-01

Full Text Available La actividad que se estudia es un proceso para inertizar el mercurio de las luminarias (desechos de bombillos y fluorescentes. Este consiste en triturar y mezclar los desechos con azufre aplicando calentamiento para formar un polímero de sulfuro de mercurio, que resulta un producto sólido, inerte, estable y de baja lixiviación que se puede depositar en un relleno sanitario. El calentamiento causa la generación de vapores de azufre molestos y de olor desagradable, por lo que se realizó un cambio del método de tratamiento sin calentar, mediante el uso de una mezcla del desecho de luminaria con azufre y mortero (cemento y arena. Las pruebas de laboratorio preliminares presentan resultados positivos para efectuar pruebas a nivel de planta piloto con este nuevo método a temperatura ambiente. Este proyecto se desarrolló en una de las actividades productivas del Centro de Investigación en Protección Ambiental (CIPA del Tecnológico de Costa Rica.

Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

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C. Ciriza de los Ríos

2010-12-01

Full Text Available Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL, squeeze maximum pressure (SMP, squeeze pressure duration (SPD, first sensation, urge and maximum tolerated volume (MTV. Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA, presión de máxima contracción voluntaria (PMCV, duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT. Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001, la presión de reposo (p < 0,001, la LCA (p < 0,001 y la PMCV (p < 0,01 en el grupo de IA con

Analítica del aprendizaje en un entorno virtual mediante un sistema de computación cognitiva: estudio preliminar

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Larry Lugo Urribarrí

2016-01-01

Full Text Available En esta investigación se aplicaron métodos de la Analítica del Aprendizaje en el estudio de los datos masivos provenientes de la plataforma virtual de Fruticultura, mediante el sistema de computación cognitiva IBM Watson, basado en inteligencia artificial y aprendizaje automático. Se analizaron los registros de las evaluaciones en línea, así como las interacciones sociales en los foros para determinar su influencia sobre el desempeño estudiantil, durante los períodos lectivos desde el2006 hasta 2014 de la asignatura Fruticultura. Los factores estudiados permitieron mejorar el sistema de evaluación y estimarla nota definitiva con una fortaleza predictiva del 72%.

Anal Sphincter Augmentation Using Biological Material.

Science.gov (United States)

Alam, Nasra N; Narang, Sunil K; Köckerling, Ferdinand; Daniels, Ian R; Smart, Neil J

2015-01-01

The aim of this review is to provide an overview of the use of biological materials in the augmentation of the anal sphincter either as part of an overlapping sphincter repair (OSR) or anal bulking procedure. A systematic search of PubMed was conducted using the search terms "anal bulking agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies using biological material as part of an overlapping sphincter repair (OSR) or as an anal bulking agent were identified. 122 patients underwent anal bulking with a biological material. Anorectal physiology was conducted in 27 patients and demonstrated deterioration in maximum resting pressure, and no significant change in maximum squeeze increment. Quality of life scores (QoLs) demonstrated improvements at 6 weeks and 6 months, but this had deteriorated at 12 months of follow up. Biological material was used in 23 patients to carry out an anal encirclement procedure. Improvements in QoLs were observed in patients undergoing OSR as well as anal encirclement using biological material. Incontinence episodes decreased to an average of one per week from 8 to 10 preoperatively. Sphincter encirclement with biological material has demonstrated improvements in continence and QoLs in the short term compared to traditional repair alone. Long-term studies are necessary to determine if this effect is sustained. As an anal bulking agent the benefits are short-term.

Guía del Operador del Molino Preliminar -- 2009

Science.gov (United States)

Jan Wiedenbeck; Philip H. Mitchell; Bobby Ammerman; Daniel Saloni

2009-01-01

Los fabricantes de productos de madera requieren de una recuperación eficiente de los productos de la madera para que el negocio se mantenga lucrativo. La habilidad de una compañía para obtener el mayor rendimiento en las operaciones de corte de madera (e.g. Molino preliminar) puede variar de acuerdo a la material prima, productos, equipo de...

Parasitoses intestinais em região semi-árida do Nordeste do Brasil: resultados preliminares distintos das prevalências esperadas

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Alves Jair Rodrigues

2003-01-01

Full Text Available No presente trabalho procurou-se conhecer o perfil das enteroparasitoses na cidade de São Raimundo Nonato, sudeste do Piauí, e confirmar ou não os resultados obtidos em estudos anteriores em relação à infecção por Ascaris lumbricoidese Trichuris trichiura. No período de setembro de 2000 a fevereiro de 2001, por meio de amostragem domiciliar por conveniência, foram examinadas 265 amostras fecais da população pelo método de sedimentação espontânea, das quais 57% foram positivas para enteroparasitos. Entamoeba coli (35,8%, Endolimax nana (13,6%, Hymenolepis nana (9,4% e os ancilostomídeos (9,4% foram os parasitos mais freqüentes. Foram observados dois casos de A. lumbricoides, possivelmente adquiridos fora do município. Nenhuma amostra foi positiva para T. trichiura. Esses resultados mostram um padrão diferente do restante do país. Traça-se um paralelo entre os resultados deste estudo com os achados paleoparasitológicos na população pré-histórica, habitante da região há pelo menos sete mil anos.

Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

DEFF Research Database (Denmark)

Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

2012-01-01

The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all...... anal cancers in the Danish Cancer Register in the period 1978-2008 and all cases of AIN2/3 in the Danish Registry of Pathology. Overall and age-, period- and histology-specific incidence rates were estimated. During the 30-year period, 2187 anal cancers were identified, two thirds of which were...... in women. Between 1978-1982 and 2003-2008, the age-standardized incidence rate of anal cancer increased from 0.68 to 1.48 per 100 000 person-years in women and from 0.45 to 0.80 per 100 000 person-years in men. Although there is no systematic screening for AIN in Denmark, we nevertheless identified 608...

Repercusión del implante coclear en el aprendizaje de la lectura de los alumnos sordos: resultados preliminares

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Ana Belén DOMÍNGUEZ GUTIÉRREZ

2009-05-01

Full Text Available RESUMEN: El propósito de este trabajo es mostrar unos primeros resultados que permitan comprobar la repercusión que están teniendo los implantes cocleares (ayudas técnicas que transforman las señales acústicas en señales eléctricas que estimulan el nervio auditivo en el aprendizaje de la lectura de los alumnos sordos. Para ello, se analizan los mecanismos de lectura desarrollados por dos grupos de alumnos sordos, con y sin implante coclear, a lo largo de la escolaridad obligatoria; tomando como referencia un grupo de alumnos oyentes de la misma edad. Los resultados muestran que existen diferencias en los mecanismos de lectura en función del uso de los implantes cocleares. Los alumnos sordos con implante coclear usan mecanismos semánticos y sintácticos en la lectura de oraciones y emplean códigos ortográficos y fonológicos; mientras que los alumnos sordos sin implante coclear usan preferentemente mecanismos semánticos y códigos ortográficos en lectura. En consecuencia, se analizan las implicaciones de estos resultados para la práctica educativa.ABSTRACT: The first aim of the present paper is to show a preliminary findings about the repercussion of cochlear implant in reading acquisition in deaf children. For this, reading strategies were analyzed in two groups of deaf children, with and without cochlear implants, during compulsory schooling. Their performance was compared with that hearing children of the same chronological age. The findings suggest that there are differences in reading strategies in funtion of the use of cochlear implants. The children who had received a cochlear implantation can use semantic and sintactic strategies in reading sentences, and they can use orthografical and phonological codes; whereas deaf children without cochlear implant use more semantic strategies in reading sentences and orthografical codes. Implications of these results for educational practice are being discussed.

HIV/AIDS, HPV and Anal Cancer

Science.gov (United States)

Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.

2016-01-01

SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034

Modelos esquemáticos para avaliação da qualidade analítica dos dados nacionais de fibra alimentar

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CARUSO Lúcia

1999-01-01

Full Text Available O controle de qualidade de uma análise laboratorial é essencial para garantir a confiabilidade da informação. Os resultados analíticos serão considerados restritos se não houver um programa definido de controle de qualidade analítico. O presente trabalho propõe modelos esquemáticos para a avaliação da qualidade dos dados nacionais de fibra alimentar. A fibra alimentar foi escolhida, como um modelo, com o propósito de se aplicar os critérios do USDA (U.S. Department of Agriculture empregados na avaliação do selênio, cobre e de carotenóides. Esta escolha foi baseada na escassez de informações desse nutriente e pela importância da fibra alimentar na prevenção de doenças crônico-degenerativas. Para a avaliação da qualidade dos dados foram consideradas cinco categorias: número de amostras, plano de amostragem, tomada de amostra, método analítico e controle de qualidade analítica. Estes modelos foram utilizados na avaliação da qualidade das determinações de fibra alimentar de 180 alimentos. O resultado obtido foi de 29% com código A e B (considerável e razoável confiança e 68% com código C (reduzida confiança. Com a determinação da qualidade dos dados, foi possível estabelecer quais os alimentos que constituem prioridades de análise, que são aqueles nos quais ainda não foi determinada a fração fibra alimentar, e aqueles com código de confiança C.

Breast. cancer. Prognosis factors - preliminar study

International Nuclear Information System (INIS)

Rotstein, S.; Fonseca, N.M.

1984-01-01

A preliminar study of prognosis factors in 8 cases of breast cancer is made. Are used as parameters the dimension, the localization and the nuclear differentiation degree (gN) of the primary tumor, the vascular invasion and the axillary histologic status (pN) and the sinus histiocytosis phenomenon. Among the studied factors, have special importance the presence of vascular invasion and the negative sinus histiocytosis (minimal or absent sinus histiocytosis). Both phenomena are considered as an expression of potential systemic disease, independent of the clinical stage. Consequently the use of chemotherapy in the surgery complementation is preconized, to a best control of the disease. (author)

ANAL SPHINCTER INJURIES (OASIS AT DELIVERY

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Katja Jakopič

2018-02-01

Full Text Available Background: Anal incontinence severely impairs quality of life. It affects 4 to 19 % of women and is statistically related to number of vaginal deliveries. It is grossly underreported and most patients that do seek help are referred to gastroenterologists or colorectal surgeons. Incidence of recognized sphincter injuries at time of delivery is 1 to 2 %. However studies with anal ultrasound showed incidence of anal sphincter injuries at 28 to 41 %. Depending on the degree of injury symptoms range from partial to complete inability to control passing of winds, liquid or solid stools. About three thirds of patients are asymp- tomatic in puerperium, however half of them are at risk of developing anal incontinence in later life. Hypoestrogenisem, additional perineal trauma during consequent deliveries and sphincter atrophy can unmask anal sphincter damage years later. Timely recognition and treatment are vital for good long term results and quality of life, if possible immediately after delivery. Good knowledge of perineal anatomy, recognition of risk factors, intense search and appropriate treatment and follow-up are essential to management of anal sphincter injuries. All secondary sphincter repair is less effective. Content: Updated overview of current opinion and guidelines on anal sphincter injuries are pre- sented. Anal sphincter is composed of external anal sphincter (EAS and internal anal sphincter (IAS. Striated EAS is divided into three parts – subcutaneous, superficial, deep, and con- nected to puborectalis muscle posteriorly. Smooth-muscled IAS is a continuation of a cir- cular smooth-muscle layer of rectum. In between there is a thin longitudinal muscle layer. IAS constitutes 70 % of resting tone and is under constant contraction. EAS contributes to 30 % of resting tone and almost all pressure during active contraction. EAS injury leads to insufficient contraction after rectal sampling and filling which causes urgency – patient can

Tamizaje fitoquímico preliminar de plantas que crecen en Holguín

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Armando Payo

1996-08-01

Full Text Available Se realizaron pruebas químicas preliminares de detección de aminoácidos, saponinas, taninos, esteroles y triterpenos, glicósidos cardiotónicos, fenoles símples, cumarinas y flavonoides (antocianidinas a 83 partes vegetales de 39 especies, de ellas 34 endémicas, correspondientes a 24 familias de plantas que crecen en Sierra de Nipe, provincia Holguín, para lo cual se utilizó el método establecido por Rondina y Coussio con modificaciones. Se presentan en forma de tablas las familias, géneros y especies ordenadas alfabéticamente, las partes de las plantas investigadas, los resultados químicos obtenidos y las aplicaciones de cada grupo de fitoconstituyentes.Preliminary chemical tests for detecting aminoacids, saponins, tannins, sterols and triterpenes, cardiotonic glycosides, simple pehnols, cumarins and flavonoids (antocyanidins were carried out in 83 vegetable parts from 39 species, 34 of them endemics, corresponding to 24 families of plants growing in Sierra de Nipe, province of Holguin. The method established by Rondina and Coussio was used with modifications. Families, genera, and species in alphabetical order, as well as the parts of plants investigated, the chemical results obtained, and the applications of each group of phytoconstituents, are shown in the tables.

Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain? ¿Se debe incluir la ecografía rectoanal como prueba diagnóstica del dolor anal crónico?

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M. J. García-Montes

2010-01-01

excluyeron del estudio pacientes con fisura anal y con hemorroides internas de cualquier grado, enfermedad supurativa perianal y cirugía pélvica. Se utilizó un ecógrafo ALOKA ProSound SSD-4000 al que se conectó un transductor radial multifrecuencia ASU-67 (7,5 y 10 MHz. Resultados: un paciente no toleró la exploración. En 8 pacientes (20% de los casos estudiados se detectaron alteraciones en el estudio ecográfico: en 4 pacientes, 10% de los casos (1 hombre y 3 mujeres, hipertrofia del esfínter anal interno (EAI y en 5 pacientes (4 mujeres y 1 hombre rotura del complejo esfinteriano. En una mujer se observó rotura de EAI en canal alto e hipertrofia del mismo en el canal medio. Conclusiones: la ecografía rectoanal es una prueba sencilla, económica y útil para el estudio de la patología rectoanal. Si bien, en la mayoría de los casos estudiados no se han detectado lesiones en el canal anal ni en la pared rectal, en un porcentaje no desdeñable de pacientes hemos observado engrosamiento del EAI, que podría considerarse posible causa del dolor anal. Por tanto, consideramos que la ecografía rectoanal debe ser incluida en el estudio del dolor anal crónico idiopático.

Encopresis and anal masturbation.

Science.gov (United States)

Aruffo, R N; Ibarra, S; Strupp, K R

2000-01-01

Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.

Internal anal sphincter: Clinical perspective.

Science.gov (United States)

Kumar, Lalit; Emmanuel, Anton

2017-08-01

To summarise current knowledge of Internal anal sphincter. The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research. The PubMed database was used to identify relevant studies relating to internal anal sphincter. The available evidence has been summarised and advantages and limitations highlighted for the different diagnostic and therapeutic techniques. Our understanding of the physiology and pharmacology of IAS has increased greatly in the last three decades. Additionally, there has been a rise in diagnostic and therapeutic techniques specifically targeting the IAS. Although these are promising, future research is required before these can be incorporated into the management algorithm. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Ensayos preliminares de germinación en Puya raimondii Harms (Bromeliaceae

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Mery L. Suni

2014-06-01

Full Text Available Puya raimondii Harms es una especie endémica de la zona altoandina de Perú y Bolivia, cuyas poblaciones y área de distribución se están reduciendo. Con el objetivo de contribuir al conocimiento de los mecanismos de propagación de la especie se realizaron estudios del efecto de la iluminación y estratificación en la germinación de sus semillas. Éstas se colectaron en el rodal de P. raimondii de Huashta Cruz (Pueblo Libre, Áncash en diciembre de 1999 y fueron almacenadas bajo condiciones de laboratorio en Lima, Perú, hasta el momento de los ensayos. Las semillas fueron desinfectadas con hipoclorito de sodio 2,6% y la germinación se realizó en placas petri con agua destilada estéril durante el año 2000. Los resultados preliminares muestran que las semillas de P. raimondii tienen altos valores de porcentaje e índice de velocidad de germinación al ser iluminadas. Efecto semejante tuvo estratificarlas por dos meses a 11 °C o incrementar el tiempo de almacenamiento hasta 8 meses pero resultó negativo aplicar los dos tratamientos a la vez. Se plantea que los altos contenidos de humedad de la semilla, temperatura de almacenamiento así como temperatura de germinación afectan negativamente los valores de germinación.

[Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].

Science.gov (United States)

Padilla-España, Laura; Repiso-Jiménez, Juan Bosco; Fernández-Sánchez, Fernando; Pereda, Teresa; Rivas-Ruiz, Francisco; Fernández-Morano, Teresa; de la Torre-Lima, Javier; Palma, Fermín; Redondo, Maximino; de Troya-Martín, Magdalena

2016-01-01

The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Anal squamous intraepithelial lesions in HIV+ MSM

NARCIS (Netherlands)

Siegenbeek van Heukelom, M.L.

2018-01-01

In this thesis we report on several aspects of high-grade anal squamous intraepithelial lesions (HSIL) in HIV+ men who have sex with men (MSM). It is estimated that 10% of HIV+ MSM with anal HSIL will develop anal squamous cell carcinoma (ASCC) over 30 years time. Screening programs similar to

Registro brasileiro de biológicos: processo de implementação e resultados preliminares do BiobadaBrasil Brazilian biologic registry: BiobadaBrasil implementation process and preliminary results

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David C Titton

2011-04-01

Full Text Available OBJETIVOS: O presente estudo teve por objetivo descrever o processo de implementação de um registro nacional em um país em desenvolvimento (Brasil e relatar os principais resultados preliminares do registro BiobadaBrasil. MATERAL E MÉTODOS: Através de um acordo com a PANLAR, o protocolo Biobadaser foi utilizado como modelo para a implementação de um novo registro no nosso país. Durante os dois primeiros anos desse esforço, o protocolo original foi adaptado, traduzido e apresentado a todos os reumatologistas brasileiros. Durante dez meses, dados de 1.037 pacientes (750 tratados com biológicos e 287 controles de 15 centros foram coletados. RESULTADOS: A maioria dos pacientes tinha artrite reumatoide (AR (n = 723. Infliximabe foi o agente anti-TNF mais usado, e a exposição total a biológicos foi 2.101 pacientes-ano. A razão mais comum para suspensão da droga foi ineficiência ou perda de efetividade (50%, e 30% dos pacientes interromperam o tratamento devido a eventos adversos. Três casos de tuberculose foram observados no grupo biológico, representando maior incidência do que aquela da população brasileira geral. Infecções foram observadas em 23% dos pacientes do grupo biológico, sendo o trato respiratório superior o local mais comumente afetado. Apenas um caso de hanseníase tuberculoide foi observado. Nenhuma morte nem malignidade atribuível ao efeito dos medicamentos foi observada até fevereiro de 2010. CONCLUSÕES: A implementação do registro foi bem sucedida. Embora recente, o registro BiobadaBrasil já forneceu importantes dados.OBJECTIVES: The present study aimed at describing the implementation process of a national registry in a developing country (Brazil and at reporting the main preliminary results of the BiobadaBrasil registry. MATERIAL AND METHODS: Through a PANLAR agreement, the Biobadaser protocol was used as a model for implementing the new registry in our country. During the first two years of this

A Mouse Model for Human Anal Cancer

Science.gov (United States)

Stelzer, Marie K.; Pitot, Henry C.; Liem, Amy; Schweizer, Johannes; Mahoney, Charles; Lambert, Paul F.

2010-01-01

Human anal cancers are associated with high-risk human papillomaviruses (HPVs) that cause other anogenital cancers and head and neck cancers. As with other cancers, HPV16 is the most common high-risk HPV in anal cancers. We describe the generation and characterization of a mouse model for human anal cancer. This model makes use of K14E6 and K14E7 transgenic mice in which the HPV16 E6 and E7 genes are directed in their expression to stratified squamous epithelia. HPV16 E6 and E7 possess oncogenic properties including but not limited to their capacity to inactivate the cellular tumor suppressors p53 and pRb, respectively. Both E6 and E7 were found to be functionally expressed in the anal epithelia of K14E6/K14E7 transgenic mice. To assess the susceptibility of these mice to anal cancer, mice were treated topically with dimethylbenz[a]anthracene (DMBA), a chemical carcinogen that is known to induce squamous cell carcinomas in other sites. Nearly 50% of DMBA-treated HPV16 E6/E7 transgenic mice showed overt signs of tumors; whereas, none of the like treated non-transgenic mice showed tumors. Histopathological analyses confirmed that the HPV16 transgenic mice were increased in their susceptibility to anal cancers and precancerous lesions. Biomarker analyses demonstrated that these mouse anal cancers exhibit properties that are similar to those observed in HPV-positive precursors to human anal cancer. This is the first mouse model for investigating the contributions of viral and cellular factors in anal carcinogenesis, and should provide a platform for assessing new therapeutic modalities for treating and/or preventing this type of cancer. PMID:20947489

Hallazgos ecográficos en la proctalgia espontánea y postoperatoria Ultrasound findings in spontaneous and postoperative anal pain

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I. Pascual

2008-12-01

Full Text Available Objetivo: valorar la utilidad de la ecografía endoanal como prueba de imagen para identificar la causa del dolor anal en los pacientes que presentan proctalgia idiopática o dolor postoperatorio y analizar cuáles son sus causas más frecuentes. Métodos: se realiza un estudio descriptivo de los hallazgos encontrados en las ecografías endoanales de pacientes con dolor anal en los últimos seis años. Todas las ecografías se llevaron a cabo con un ecógrafo B&K (Cheetah 2003, B&K Medical, Gentofte, Denmark con sonda endoanal de 7 MHz. Resultados: se estudiaron noventa y cinco casos de proctalgia mediante ecografía endoanal. Sesenta y siete correspondieron a pacientes con una cirugía previa perineal o pélvica tras la cual comenzó el dolor anal: 48 habían sido intervenidos de fisura anal, 12 de hemorroidectomía, 4 de episiotomía, 2 de fístula y 1 de prostatectomía. El hallazgo más frecuente tras la cirugía de fisura anal fue la presencia de una esfinterotomía incompleta. Entre los veintiocho pacientes sin cirugía previa, el 57,14% presentaba hipertrofia del esfínter anal interno como única alteración ecográfica. Conclusiones: los pacientes con proctalgia espontánea y postoperatoria pueden ser estudiados mediante ecografía endoanal ya que el uso de la sonda no impide completar la exploración. Con esta prueba se encontró una causa del dolor en el 81,93% de los casos. La hipertrofia del esfínter anal interno aislada es el hallazgo ecográfico más frecuente asociado a proctalgia espontánea.Objective: to assess the use of endoanal ultrasounds to identify anal pain etiology in patients with either spontaneous or postoperative pain, and to review the most frequent causes. Methods: a descriptive study of ultrasound findings in patients with anal pain during the last six years was performed. All ultrasound scans were performed using a B&K Diagnostic Ultrasound System (Cheetah 2003, B&K Medical, Gentofte, Denmark with a 7-MHz

Relevancia valorativa del resultado global y sus Componentes frente al resultado neto

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Núria Arimany Serrat

2011-08-01

Full Text Available Este trabajo tiene como objeto verificar si el resultado global presenta mayor relevancia valorativa respecto al resultado tradicional, y si es así cuáles son los componentes del resultado global que explican las diferencias. El estudio muestra que el resultado global es una variable relevante tanto para explicar el valor intrínseco de la empresa como para explicar su rentabilidad. Sin embargo, sólo al explicar la rentabilidad el resultado global y su incremento aumentan la relevancia valorativa del resultado neto y su incremento. De los componentes analizados del resultado global, tan sólo los resultados por diferencias de conversión de la moneda extranjera a la moneda de presentación añaden poder explicativo adicional al del resultado neto, aunque sólo en los modelos de rentabilidad. Ni los resultados por valoración de instrumentos financieros a valor razonable con cambios en patrimonio ni los resultados por coberturas de flujos de efectivo aportan un mayor poder explicativo al del resultado neto.

Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

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Gandra S

2015-01-01

Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

Anal Itching

Science.gov (United States)

... has many possible causes, such as skin problems, hemorrhoids, and washing too much or not enough. If ... dermatitis. Other medical conditions. These include chronic diarrhea, hemorrhoids, anal tumors and diseases that affect the whole ...

Evaluación del estado de salud con la Encuesta SF-36: resultados preliminares en México

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Zúniga Miguel A.

1999-01-01

Full Text Available Objetivo. Establecer, con la Encuesta SF-36, un perfil multidimensional del estado de salud de una población del sureste de México y analizar las propiedades psicométricas de una traducción de la Encuesta SF-36 autorizada por el Proyecto Internacional de Evaluación de la Calidad de Vida. Material y métodos. La SF-36 se aplicó a 257 participantes voluntarios de una clínica médica y a un grupo control de una institución pública gubernamental. Se utilizó, sin modificar, la metodología de construcción de las escalas de salud propuestas por los autores de la encuesta. Se analizó psicométricamente la validez y la confiabilidad de la adaptación de la SF-36 para su uso en México. Resultados. Se construyeron ocho escalas o conceptos de salud relacionados con función física, rol físico, dolor corporal, salud general, vitalidad, función social, rol emocional y salud mental. En los participantes de los servicios médicos la escala con más bajo promedio fue la de salud general (63, y la más alta, la de rol físico (89. En la población control la escala con promedio más alto fue función física (94.6, y la más baja, salud general (73. La comparación de promedios de escalas en ambos grupos de participantes mostró diferencias estadísticamente significativas en función física, rol físico, dolor corporal, salud general y vitalidad. Conclusiones. Con base en los resultados de la evaluación psicométrica, la SF-36 muestra que es consistente con todos los supuestos de validez y confiabilidad en forma satisfactoria, aunque la traducción de ciertas preguntas se examinará en profundidad para determinar modificaciones subsecuentes.

Endoscopia lumbar póstero lateral con sistema YESS: reporte preliminar Endoscopia lombar póstero-lateral com sistema YESS: resultados preliminares Lumbar disc herniation treated with post lateral lumbar endoscopy by YESS system: preliminary results

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Carlos Montes García

2009-06-01

Full Text Available INTRODUCCIÓN: en los pacientes con diagnóstico de hernia de disco lumbar, los cuales son candidatos a tratamiento quirúrgico, la disectomía posterior abierta ha sido por muchos anos el estándar de oro. Sin embargo, las complicaciones de este procedimiento, en el que se invade el canal medular, han hecho que se busquen otros métodos menos invasivos. Uno de estos procedimientos es la disectomía endoscópica lateral con el método YESS (Young Endoscopic Spine System. OBJETIVO: revisar los resultados por dos años de cien pacientes diagnosticados con hernia de disco lumbar, tratados con endoscopia lateral con sistema YESS. MÉTODOS: se estudiaron cien pacientes con diagnóstico de hernia de disco lumbar comprobada con resonancia magnética y discografía evocativa positiva. Todos los pacientes nunca habían hecho un tratamiento quirúrgico y se les dio seguimiento durante dos años. RESULTADOS: los resultados se clasificaron en buenos, regulares, y malos. Se encontraron buenos resultados en 82 pacientes, regulares en 10, y malos en 8. CONCLUSIONES: los resultados del tratamiento de la hernia de disco lumbar con la endoscopia lateral y sistema YESS son, hasta el momento, similares con el abordaje posterior abierto, aunque el tiempo de recuperación y capacidad son menores así también como el costo, ya que es un procedimiento ambulatorio.INTRODUÇÃO: nos pacientes com diagnóstico de hérnia de disco lombar, candidatos ao tratamento cirúrgico, a discectomia posterior aberta tem sido por muitos anos o padrão-ouro. Embora as complicações deste procedimento, no qual se invade o canal medular, têm levado a procurar outros métodos menos invasivos. Um destes procedimentos é a discectomia endoscópica lateral com o método YESS (Young Endoscopic Spine System. OBJETIVO: revisar os resultados por dois anos de cem pacientes com diagnóstico de hérnia de disco lombar tratados com endoscopia lateral, com sistema YESS. MÉTODOS: foram estudados

Intoxicação mercurial: resultados preliminares em duas áreas garimpeiras - PA

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Rosa Carmina de Sena Couto

1988-09-01

Full Text Available Com o objetivo de verificar o problema da intoxicação mercurial em garimpeiros, foi realizado um estado-piloto em duas áreas de garimpo no Estado do Pará: Cachoeiro e Cumaru. Foram coletadas 35 amostras de cabelos seguindo-se as recomendações da International Atonde Energy Agency. Para a dosagem dos teores de mercúrio nestas amostras foi utilizado o método de absorção atômica pela técnica de vapor frio. O mercúrio total foi detectado em 100% das amostras analisadas. No grupo de garimpeiros do Cachoeiro o teor de mercúrio encontrado variou numa amplitude de 1,97 - 68,98 ppm, X = 11,49 ppm; enquanto que no grupo de garimpeiros do Cumaru a amplitude foi de 1,50 - 13,68 ppm, X = 5,18 ppm. Estes resultados demonstram o alto risco de exposição da população garimpeira. Levantamos a hipótese que outros grupos sociais nesta área estejam sendo atingidos indiretamente, como os Índios caiapó da Reserva Gorotire.With the purpose of checking the problem concerning mercury poisoning in prospectors, it was carried out a pilot study in two prospect areas in the State of Pará: Cachoeiro and Cumaru. We collected 35 samples of hair following the recommendations of the International Atomic Energy Agency. For dosing mercury contents in these samples we used the method of atomic absorption through the technique of cold steam. The overall mercury was detected in 100% of the samples which have been analysed. In the group of prospectors of Cachoeiro the mercury contents found varied with an amplitude of 1.97 - 68.98 ppm, X = 11.49 ppm, while in the group of prospectors of Cumaru the amplitude was of 1.50 - 13.68 ppm, X = 5.18 ppm. These results show the high risk of exposition to which the population of prospectors in subjected. We hipothezed that other social groups in this area, e.g., caiapó natives of the Gorotire Reserve, are being indirectly affected.

Early discharge after external anal sphincter repair

DEFF Research Database (Denmark)

Rosenberg, J; Kehlet, H

1999-01-01

PURPOSE: The aim of this study was to describe an accelerated-stay program for repair of the external anal sphincter. METHODS: Twenty consecutive patients undergoing overlapping repair of the external anal sphincter were included in the study. Effect parameters were length of hospitalization....... CONCLUSION: We have described a safe accelerated-stay program (24 to 48 hours) for overlapping repair of external anal sphincter....

Assessment of fistulectomy combined with sphincteroplasty in the treatment of complicated anal fistula

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Fakhrolsadat Anaraki

2017-07-01

fistulectomia, seguida imediatamente pela esfincteroplastia, é procedimento seguro e apropriado no tratamento da fístula perianal. O objetivo deste estudo foi avaliar os resultados em longo prazo da fistulectomia e da esfincteroplastia no tratamento da fístula perianal complexa. Métodos: Neste estudo prospectivo analisamos os dados de 80 pacientes tratados por fistulectomia e esfíncteroplastia no período de maio de 2013 até maio de 2016. Foram coletadas as seguintes informações pré-operatórias: exame físico, avaliação pré-operatória de incontinência fecal e história completa sobre doenças subjacentes e cirurgias prévias afins. Resultados: De todos os 80 pacientes com fístula complexa, 57,5% (46 pacientes pertenciam ao gênero masculino. Setenta pacientes se apresentaram com fístula trans-esfinctérica alta (87,5%; em 10 desses pacientes (12,5%, foi diagnosticada fístula anterior. Nove pacientes (11,3% sofriam de hipertensão (HT, tendo sido observada recorrência de fístula após cirurgias prévias em 43 pacientes (53,75%. Durante o período de seguimento, o percentual de sucesso global foi de 98,8%, e em apenas um paciente os procedimentos de fistulectomia e esfincteroplastia não obtiveram sucesso (percentual de falha: 1,3%. Os escores pré-operatórios e pós-operatórios revelaram incontinência fecal leve em 8 pacientes (10%. Não observamos nenhuma relação significativa entre idade, gênero, HT, cirurgia prévia e recorrência pós-operatória. Conclusão: Fistulectomia e esfincteroplastia constituem procedimento cirúrgico seguro no tratamento de fístulas anais anteriores em mulheres e de fístulas trans-esfinctéricas altas. Keywords: Fistulectomy, Sphincteroplasty, Anal fistula, Palavras-chave: Fistulectomia, Esfincteroplastia, Fístula anal

Validación Estructural de la Escala Básica de Empatía (Basic Empathy Scale Modificada en Adolescentes: un Estudio Preliminar

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César Merino-Soto

2015-10-01

Full Text Available Se hizo un estudio preliminar para verificar la estructura de una versión de 9 ítems de la Escala Básica de Empatía (EBE, un instrumento que evalúa la empatía afectiva y cognitiva. Los participantes fueron 135 adolescentes entre 11 y 18 años (M=14, DE=1.4 de educación regular, en una región urbana de Lima Metropolitana. Se usó metodología de ecuaciones estructurales para confirmar la estructura, y la transformación Schmid-Leiman para evaluar el modelo bi-dimensional. Los resultados indican que un modelo oblicuo de dos factores es satisfactorio para los datos, la confiabilidad es superior a .70, y no se justifica la interpretación de un solo puntaje tal como anteriormente se hacía. Se discuten las diferencias en la interpretación de los modelos y la valoración de la metodología factorial.

Mode of delivery after obstetric anal sphincter injury.

Science.gov (United States)

Karmarkar, Roopali; Bhide, Alka; Digesu, Alex; Khullar, Vik; Fernando, Ruwan

2015-11-01

To assess the effect of vaginal delivery and caesarean section on faecal symptoms and structure and function of anal sphincter in women who sustained obstetric anal sphincter injuries (OASIS) in their previous pregnancy and were advised about the mode of delivery based on faecal incontinence symptoms, anal manometry and endoanal ultrasound. It is a descriptive study on a cohort of women who had OASIS from 2006 to 2013. They were assessed after OASIS and during subsequent pregnancy with a questionnaire, endoanal ultrasound and anal manometry. Vaginal delivery was recommended to asymptomatic women with normal investigations. Elective caesarean section was recommended to women with faecal symptoms, anal sphincter defects of more than 30° or low resting or incremental anal pressures. All women were reassessed after subsequent delivery. Fifty women who had pregnancies after OASIS, were seen after OASIS, during subsequent pregnancy and after the second delivery. 15 women had faecal symptoms after OASIS. The external, internal and combined anal sphincter defects were seen in 13, 11 and 9 women respectively. Low resting and incremental pressure were seen in 15 and 11 women respectively. Caesarean section was done in 22 women and 28 women delivered vaginally. Worsening of faecal symptoms and reduction in anal pressures were not observed in planned vaginal delivery or elective caesarean section groups. Faecal symptoms were worse with reduced anal pressures in three women from the planned caesarean section group. One of the women had a vaginal delivery and two women had emergency caesarean section at 7cm and 10cm dilatation. There were no new sphincter defects or recurrent OASIS in any of the women in the study group. Decision about the mode of delivery of pregnancy after OASIS based on symptoms, anal manometry and endoanal ultrasound helps in preserving the anal sphincter function and avoiding unnecessary caesarean sections. Further follow-up of these patients is essential

Alcoolismo feminino: um estudo de suas peculiaridades. Resultados preliminares Alcoholism in women: a study of its peculiarities. Preliminary results

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Beatriz Aceti Lenz Cesar

2006-01-01

Full Text Available OBJETIVO: Apresentar os resultados parciais de um estudo qualitativo realizado com mulheres alcoolistas, discutir as peculiaridades do alcoolismo feminino e a importância do seu significado nos serviços especializados. MÉTODOS: Foram realizadas entrevistas semi-estruturadas com nove mulheres que se tratavam no serviço de alcoolismo de uma instituição pública. RESULTADOS: Observou-se comportamento particular de beber, violência doméstica e maior adesão ao tratamento quando eram participantes de um grupo composto somente por mulheres. CONCLUSÃO: O estudo apontou a relevância de tentar compreender o alcoolismo feminino com todas as suas peculiaridades e a possível relação dessa compreensão com os tratamentos oferecidos.OBJECTIVE: To present preliminary results of a qualitative study carried out with women with alcohol use disorders, to assess the peculiarities of alcoholism in women, and to point out its meanings in specialized services. METHODS: Semi-structured interviews were carried out with nine women at an alcohol abuse disorders clinic in a public psychiatric center. RESULTS: Some peculiar behaviors were observed such as domestic violence and a better adherence to treatment during their participation in a supportive group with other women. CONCLUSION: The study pointed out the relevance of trying to understand alcoholism in women with all its peculiarities and the possible impact of this understanding in future interventions.

Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa

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Cassandra Chaptini, MBBS

2015-12-01

Full Text Available We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

Anal intraepithelial neoplasia in HIV+ men

NARCIS (Netherlands)

Richel, O.

2014-01-01

In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions

Science.gov (United States)

... Professional Anal Cancer Treatment Anal Cancer Prevention Research Electrocautery Superior to Topical Treatments for Precancerous Anal Lesions ... randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at ...

Evaluación externa de la calidad analítica en hematología: una necesidad en América Latina

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Fink Nilda E.

1997-01-01

Full Text Available La garantía de calidad analítica de un laboratorio clínico se logra mediante un sistema de control de calidad interno complementado por un programa de evaluación externa. Esa garantía es la base que fundamenta la confiabilidad de los resultados obtenidos por los laboratorios y su uso en el diagnóstico y tratamiento de las enfermedades. En los países de América Latina hay muchos laboratorios que no cuentan con sistemas apropiados de evaluación y control de la calidad. Dada la importancia de los diagnósticos basados en datos hematológicos, durante el XI Congreso Latinoamericano de Bioquímica Clínica (México, 1993 la Organización Panamericana de la Salud patrocinó un curso de control de la calidad en hematología en el que participaron Argentina, Chile, Cuba, México, Paraguay, República Dominicana y Uruguay. Como parte del curso se produjeron materiales de control: solución estándar secundario de cianmetahemoglobina (HICN, solución concentrada estabilizada de hemoglobina (Hb y sangre entera humana preservada con seudoleucocitos. Estos materiales fueron enviados a laboratorios de los siete países participantes para su uso en procedimientos analíticos, con objeto de llevar a cabo posteriormente una evaluación externa del desempeño individual y de la comparabilidad de los resultados en conjunto. Las tareas asignadas fueron: 1 determinación de hemoglobina, hematocrito, y glóbulos rojos y blancos con los métodos en uso en cada laboratorio; 2 registro de los datos obtenidos en formularios especiales para la notificación de datos y 3 envío de dichos formularios al coordinador de cada país. Los resultados fueron analizados en función de los procedimientos analíticos y de los países participantes. Los valores de referencia se establecieron por consenso general de todos los participantes después de someterse al método estadístico de truncamiento. El análisis comparado de los resultados mostró coeficientes de variaci

Influencia de la Web 2.0 en el uso de las herramientas de autoría multimedia: estudio preliminar

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Diego Linares Romera

2014-10-01

Full Text Available El objetivo de este artículo es presentar un estudio preliminar que siente las bases para una futura investigación destinada a conocer el uso que los profesores españoles hacen de las herramientas de autoría multimedia y el modo en que éstas se están adaptando o no a los cambios promovidos en los usuarios por la llamada Web 2.0. En esta primera fase, mediante el método del estudio de caso, se analiza el modo en que un grupo de profesores están creando contenidos educativos sin conocimientos de programación y los motivos por los que se han decantado por una u otra herramienta. A partir de los resultados obtenidos se elaborará un estudio más amplio destinado a conocer en qué medida los servicios de la Web 2.0 están influyendo en el desarrollo de las herramientas de autoría multimedia y en su uso por parte de los profesores. Influence of Web 2.0 in the use of Multimedia Authoring Tools: preliminar study Abstract The aim of this paper is twofold: On the one hand, to present a preliminary study that will lay the groundwork for future research on the way in which Spanish teachers are using multimedia authoring technologies. On the other, to establish whether these technologies have adapted to the changes in user expectations brought about by the rise of the so-called Web 2.0. Using the case study method, this first phase of the study analyses both how a specific group of teachers are creating educational content without having any prior programming skills, as well as their reasons for opting for one tool over another. The obtained results will be incorporated into a larger study focusing on the influence of Web 2.0 applications on the development of multimedia authoring tools, and their use by teachers. Keywords: Authoring tool; multimedia; Web 2.0; social web; educational content; elearning.

Resultados preliminares do tratamento dos pacientes submetidos a radiofreqüência (baixa freqüência, somnoplastia no ronco e apnéia leve do sono

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Dibbern Ralph S.

2002-01-01

Full Text Available Introdução: O ronco afeta 5 a 50% da população tornando-se um problema médico e social importante. O tratamento pode ser com medidas comportamentais, CPAP e cirúrgico. Objetivo: Avaliar os resultados pós-operatórios dos pacientes submetidos à radiofreqüência em palato. Forma de estudo: retrospectivo clínico. Material e método: 28 pacientes submetidos à radio-freqüência em palato, com diagnóstico de Ronco e Apnéia Leve do Sono. Observamos os resultados pós-operatórios através das Escalas de Epworth, Ronco e Sonolência diurna, complicações e percentual de melhora dos sintomas. A análise estatística foi pelo Mann Whytney Test. Resultados: 16 pacientes com melhora subjetiva do Ronco acima de 70% após a cirurgia; 26 pacientes mostraram redução significativa pelas Escalas, com complicações mínimas. Conclusão: Radio-freqüência é um método seguro e eficaz no tratamento do Ronco e Apnéia Leve do Sono. Resultados melhores serão obtidos com avaliação criteriosa pré e pós-operatórias.

Neuronal hyperplasia in the anal canal

DEFF Research Database (Denmark)

Fenger, C; Schrøder, H D

1990-01-01

In a consecutive series of minor surgical specimens from the anal canal, neuronal hyperplasia was found in nine of 56 haemorrhoidectomy specimens and in four of 23 fibrous polyps. In an additional series of 14 resections of the anal canal, neuronal hyperplasia was present in six cases, of which f...

Relevancia valorativa del resultado global y sus componentes frente al resultado neto

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Núria Arimany Serrat

2011-12-01

Full Text Available Este trabajo tiene como objeto verificar si el resultado global presenta mayor relevancia valorativa respecto al resultado tradicional, y si es así cuáles son los componentes del resultado global que explican las diferencias. El estudio muestra que el resultado global es una variable relevante tanto para explicar el valor intrínseco de la empresa como para explicar su rentabilidad. Sin embargo, sólo al explicar la rentabilidad el resultado global y su incremento aumentan la relevancia valorativa del resultado neto y su incremento. De los componentes analizados del resultado global, tan sólo los resultados por diferencias de conversión de la moneda extranjera a la moneda de presentación añaden poder explicativo adicional al del resultado neto, aunque sólo en los modelos de rentabilidad. Ni los resultados por valoración de instrumentos financieros a valor razonable con cambios en patrimonio ni los resultados por coberturas de flujos de efectivo aportan un mayor poder explicativo al del resultado neto.This study analyses if comprehensive income is more value relevant than the net income and, if that is the case, what are the elements of the comprehensive income explaining the difference. Our study shows that comprehensive income is a relevant variable both to explain the value of the company and also to explain its return. However, comprehensive income and its variation show to be more relevant than the net income and its variation only when explaining return. As for the components of the comprehensive income, foreign currency adjustments increase usefulness in the return models but cash flow hedges and adjustments due to fair value valuation do not add value relevance to the net income.

Anal Cancer Treatment (PDQ®)—Patient Version

Science.gov (United States)

Anal cancer is uncommon, but often curable with treatment. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information about anal cancer including risk factors, symptoms, diagnosis, prognosis, and treatment in this expert-reviewed summary.

Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

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Araiz Cajueiro Carneiro Pereira

Full Text Available Abnormalities found with anuscopy under colposcopic vision, anal cytology and anal biopsy were evaluated in 21 men with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS at the Federal University of Pernambuco Hospital in Brazil. Mean age was 38.4 ± 6.0 years, and mean time of HIV infection was 8.3 ± 5.1 years; 95.2% of the patients had been on highly active antiretroviral therapy (HAART for an average of 6.6 ± 4.5 years. Mean CD4+ cell count was 482.2 ± 173.75 cells/mm³, and 80.9% presented a HIV viral load of < 5,000 copies/mL. Reported sexual preference was 52.4% homosexuals, 28.6% bisexuals, and 19.0%heterosexuals; 81% reported having had receptive anal intercourse and 61.9% reported more than 10 sexual partners of the same sex. Results of anuscopy under colposcopic vision revealed 17 (81.0% low-grade lesions and/or condylomata or micropapillae and four (19.0% high-grade lesions with or without condylomata. Among the 21 anal cytology examinations, seven (33.3% revealed low-grade squamous intraepithelial lesions (LSIL; three (14.3% presented atypical squamous cells of undetermined significance (ASCUS and 11 (52.4% were normal. Seventeen patients were submitted to anal biopsy with the following findings: three patients (17.6% with normal epithelium, one (5.9% with infection by HPV, three (17.6% with condylomatas, two (11.8% with AIN 1, four (23.6% with AIN 2, three (17.6% with AIN 3, and one (5.9% with PAIN 2. Anuscopy under colposcopic vision was found to be useful for detecting anal lesions and for guiding anal biopsies. Anal cytology was less useful, as it underestimated the frequency of lesions.

Aprendizaje de los conceptos de masa, peso y gravedad. Investigación de la efectividad de un modelo analógico

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Lucrecia E. Moro

2007-01-01

Full Text Available La línea de investigación sobre los procesos de enseñanza y aprendizaje científico basada en modelos analógicos ha adquirido relevancia, pero notamos que son pocas las aplicaciones en el aula, sobre todo en el nivel medio de enseñanza. Los modelos didácticos analógicos son una herramienta importante para la instrucción pero a condición de que el profesor y los alumnos adquieran una visión en común sobre el análogo y se describan sus limitaciones comparado con el modelo teorético. Se espera del alumno una toma de conciencia sobre sus procesos y eventos cognitivos para que pueda evaluar los progresos y resultados, comprendiendo su propia versión acerca de la naturaleza de su conocimiento y sobre el proceso de aprendizaje, es decir sobre sus esencias epistemológicas. En este trabajo se evalúa la eficiencia de un modelo didáctico analógico para la enseñanza de los conceptos de masa, peso y gravedad mediante un estudio correlacional, cuasiexperimental con posprueba y grupo control.

Clinical and manometric evaluation of women with chronic anal fissure before and after internal subcutaneous lateral sphincterotomy

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Silvana Marques e Silva

2012-06-01

Full Text Available OBJECTIVE: To evaluate clinical and manometric parameters of chronic anal fissure females undergoing lateral internal sphincterotomy (LIS. METHODS: A total of eight women with chronic anal fissure who underwent LIS were included in this study. The preoperative assessment was performed one week before surgery and included general and anorectal examination, anorectal manometry, and Jorge Wexner questionnaire. The post operative follow up was made every 15 days until complete healing. Jorge Wexner questionnaires and anorectal manometry were repeated at 1 month and 3 months after the surgery. Time to healing, manometric changes and complications were assessed. RESULTS: All patients had preoperative increased anal resting pressure. The resting pressures and anal canal length were significantly decreased 3 months after surgery. Patients' complaints of itching and bleeding were also reduced. Fissures healed in 7 patients and median healing time was 45 days. No complications were observed due to the procedure. One patient had transient incontinence to flatus. CONCLUSION: Lateral internal sphincterotomy provided clinical improvement and reduced resting pressure of the internal anal sphincter in women with chronic anal fissure.OBJETIVO: Avaliar a evolução clínica e manométrica de mulheres com fissura anal crônica submetidas à esfincterotomia lateral interna subcutânea. MÉTODOS: Estudo prospectivo com oito pacientes. A avaliação inicial foi realizada por meio de questionários, exame físico e manometria anorretal na semana anterior ao procedimento cirúrgico. Durante o período pós-operatório, as pacientes foram avaliadas clinicamente a cada 15 dias, até a cicatrização completa. Os questionários e a manometria anorretal foram repetidos 1 mês e 3 meses após a operação. Foi avaliado o tempo para cicatrização da fissura, as alterações manométricas e as complicações decorrentes do procedimento. RESULTADOS: Todas as pacientes

Microdiscectomia lombar tubular com o uso de seringas descartáveis de diâmetros progressivos: resultados cirúrgicos Microdiscectomía lumbar tubular con el uso de seringas desechables de diámetros progresivos: resultados quirúrgicos Tubular lumbar microdiscectomy using disposable syringes of progressive diameters: surgical results

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Diogo Valli Anderle

2010-06-01

Full Text Available OBJETIVO: descrever técnica minimamente invasiva para abordagem das hérnias discais com material de baixo custo. MÉTODOS: estudo prospectivo da avaliação dos resultados cirúrgicos de dez pacientes submetidos à microdiscectomia lombar tubular com uso de seringas descartáveis de diâmetros progressivos. RESULTADOS: utilizando os critérios de MacNab modificados, 60% dos pacientes apresentaram resultados considerados excelentes, 30% bons e 10% razoáveis. O tempo médio de cirurgia foi de 70 minutos e o de permanência hospitalar, de 14 horas. CONCLUSÃO: o uso de seringas descartáveis para microdiscectomia tubular foi seguro, de baixo custo e com resultados preliminares semelhantes aos da literatura para o tratamento minimamente invasivo da hérnia discal lombar.OBJETIVO: describir una técnica mínimamente invasiva para el abordaje de las hernias discales con material de bajo costo y de fácil acceso. MÉTODOS: estudio prospectivo de la evaluación de los resultados quirúrgicos de diez pacientes sometidos a una microdiscectomía lumbar utilizando jeringas desechables de diámetros progresivos. RESULTADOS: utilizando los criterios de MacNab cambiados, un 60% de los pacientes tuvieron resultados considerados como excelentes, el 30% buenos y el 10% razonables. El tiempo medio de cirugía fue 70 minutos y de permanencia en el hospital fue de 14 horas. CONCLUSIÓN: los resultados del estudio indican que la técnica es viable, de bajo costo y con resultados similares a los reportados en la literatura para el tratamiento mínimamente invasivo de la hernia discal lumbar.OBJECTIVE: to describe a minimally invasive technique to treat lumbar disc herniation with low-cost material. METHODS: this is a prospective evaluation of ten patients submitted to a tubular lumbar microdiscectomy with disposable syringes for herniated disc. The modified MacNab criteria were used to evaluate the surgical results. RESULTS: according to the modified Mac

Ettevõtte konkurentsieelis inimeste analüüsi abil / Mait Raava

Index Scriptorium Estoniae

Raava, Mait

2015-01-01

Ettevõtte töötajate analüüsimisest, analüütika tulemuste rakendamisest juhtivates ettevõttes. Viiest sambast, millel põhineb inimeste analüüsi edukas rakendamine, analüütika rakendamise etapid

Diagnóstico do anismus através dos exames de fisiologia anal Diagnosis of the anismus through the anorectal physiology tests

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Maria Auxiliadora Prolungatti Cesar

2009-06-01

Full Text Available Dentre as causas de defecação obstruída, a disfunção do pubo-retal ou anismus é a mais frequente e o seu diagnóstico é feito com maior frequência através de eletromiografia , considerado como o melhor exame para o diagnóstico desta afecção. O objetivo deste trabalho é verificar a influência do anismus ou contração paradoxal do pubo-retal nos exames de fisiologia anal. Para este trabalho foram estudados 40 pacientes com diagnóstico de defecação obstruída e separados em dois grupos: com e sem anismus. Todos os pacientes foram submetidos aos exames de manometria, sensibilidade retal, eletromiografia, latência do nervo pudendo e proctografia com a finalidade de observar a influência da presença de anismus nos resultados de exames de fisiologia anal. Não observamos diferenças entre os dois grupos em relação aos exames realizados, exceto na eletromiografia que é considerada padrão ouro e no ângulo ano retal na proctografia em que nos pacientes com anismus foi significantemente menor. CONCLUSÃO: a presença de anismus interferiu nos resultados dos exames de fisiologia anal apenas na eletromiografia, considerado padrão ouro para esse diagnóstico.Amongst the causes of outlet obstruction, the anismus is most frequent and its diagnosis is made more frequently through electromyografy, considered as optimum examination for this diagnosis. The objective of this work is to verify the influence of anismus in the examinations of anal physiology. For this work 40 patients with diagnosis of outlet obstruction were separate in two groups had been studied: with and without anismus. All of the patients were submitted to manometric exams, rectal sensibility, electromyography, pudendal latency and defecography with the purpose of serving which ones exams would be important in the presence or not of the anismus. We didn´t observe differences between the two groups in relation to the carried through examinations, except in the

La cultura del feminicidio en Ciudad Juárez, 1993-1999

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Julia Estela Fragoso Monárrez

2000-01-01

Full Text Available El proposito de esta investigación es analizar los asesinatos cometidos contra niñas y mujeres de Ciudad Juárez en los años de 1993 a 1999, a través de la categoría analítica del feminicidio. Diferenciar las distintas clases de feminicidios y delinear los perfiles sociodemográficos de vulnerabilidad de las niñas y las mujeres asesinadas. Finalmente clasificar la relación de parentesco entre la víctima y el victimario. Los datos se recolectaron de fuentes secundarias y oficiales para 162 víctimas. Los resultados arrojan un perfil preliminar sociodemográfico de las víctimas y confirman la existencia de varios tipos de feminicidios en algunos casos en relación a la ocupación de las víctimas. En cuanto a la noción de un asesino serial o una epidemia de machismo que repite patrones de exterminio, ambas categorías se encuentran presentes. Los resultados también confirman una relación de parentesco o desconocimiento entre las víctimas y el victimario

Validación del método analítico para tabletas de dicloroisocianurato de sodio para desinfección de agua potable

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Luis Octavio Martínez Álvarez

Full Text Available Introducción: en Cuba se han desarrollado las primeras tabletas efervescentes de 3,5 mg dicloroisocianurato de sodio, como ingrediente activo no terapéutico, el cual libera una determinada cantidad de cloro al disolverse en un litro de agua, capaz de inducir a una adecuada desinfección del agua potable y lista para ingerir después de transcurrido 30 min. Objetivo: desarrollar y validar un método analítico yodométrico, aplicable al control de la calidad de las tabletas efervescentes de 3,5 mg de dicloroisocianurato de sodio. Métodos: para la cuantificación del contenido de cloro activo libre en las tabletas efervescentes, se empleó como técnica un método potenciométrico, utilizando electrodos de platino y solución valorada de tiosulfato de sodio 0,1 N. El método desarrollado fue validado según los parámetros exigidos para la categoría I, que incluye las técnicas destinadas a cuantificar principios activos en las formas terminadas. Adicionalmente se realizaron otras pruebas para evaluar la influencia del analista y el día en los resultados analíticos. Resultados: los parámetros evaluados en la validación del método se encontraron dentro de los límites establecidos. El método resultó ser específico, lineal, exacto y preciso en el rango de concentraciones estudiadas. Conclusiones: los resultados permiten que el método pueda emplearse de manera confiable y segura.

Diseño de un instrumento para evaluar las creencias disfuncionales del trastorno obsesivo-compulsivo: resultados preliminares del Inventario de Creencias Obsesivas (ICO

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Amparo Belloch

2003-01-01

Full Text Available Los modelos actuales sobre el trastorno obsesivo-compulsivo prestan una especial atención a las creencias y valoraciones para explicar la etiología y el mantenimiento del mismo. Para poner a prueba estos modelos es necesario desarrollar instrumentos de evaluación que sean fiables. En el presente estudio instrumental de corte transversal se presenta un cuestionario específicamente diseñado para evaluar estas creencias en muestras españolas, así como los datos preliminares sobre su fiabilidad y validez. El cuestionario de 58 ítems fue completado junto con el Cuestionario Maudsley de Obsesión-Compulsión (MOCI por 253 sujetos normales (79 hombres y 174 mujeres; edad media=27,8 ±11,12 años. El análisis factorial reveló la existencia de siete dimensiones en las que se agrupaban las creencias: Fusión pensamiento-acción tipo probabilidad, Perfeccionismo e intolerancia a la incertidumbre, Sobrestimación del peligro, Fusión pensamiento-acción tipo moral, Responsabilidad excesiva e importancia de controlar los pensamientos, Sobrestimación de la importancia de los propios pensamientos y Rigidez de ideas. Estos factores fueron idénticos en ambos sexos, que además no difirieron en las puntuaciones medias alcanzadas en cada uno de ellos. Los indicadores de consistencia interna y repetibilidad fueron excelentes. El inventario correlacionó significativamente con el MOCI y la dimensión de sobrestimación del peligro fue la que mejor predijo la puntuación en este último cuestionario.

Nocturnal faecal soiling and anal masturbation.

Science.gov (United States)

Clark, A F; Tayler, P J; Bhate, S R

1990-01-01

Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

Estudio sobre el consumo de sustancias psicoactivas en niños entre 10 y 12 años: Estado del arte y resultados preliminares Study on the use of psychoactive substances in children between 10 and 12 years old: State of the art and preliminary results

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Marcelo Juan Grigoravicius

2009-12-01

Full Text Available Se presentan los resultados preliminares de la primera etapa de una investigación multidimensional sobre el consumo de sustancias psicoactivas. Se indagaron niños entre 10 y 12 años provenientes de familias con escasos recursos económicos y que concurren a una escuela pública del sur del conurbano bonaerense. Asimismo, se indagaron sus actitudes, valores y creencias hacia dichas sustancias. Metodología: Muestra: niños y niñas de 10 a 12 años que asisten a dicha escuela pública. n= 162; Varones n=61; Mujeres n= 101. Instrumentos: CORIN (conducta de riesgo en niños, Fuente: CONICET. Protocolo de datos sociodemográficos. Resultados y Conclusiones: El 46,3% de los niños manifiesta haber consumido alcohol y el 7,4% tabaco. Se concluye que las sustancias legales, principalmente el alcohol, se consumen y toleran en mayor proporción que las ilegales. Asimismo, se observa una discordancia entre las creencias y valores de los niños respecto del alcohol y sus conductas hacia esta sustancia.This paper presents the preliminary results from the first stage of a multidimensional research about the psychoactive substances use. Children between 10 and 12 years old were investigated. All of them belong to low socioeconomic status families and attend to public schools in the south of Buenos Aires province. Also, their attitudes, values and beliefs towards psychoactive substances were investigated. Methods: Sample: boys and girls between 10 and 12 years old attending to a public school. N=162; boys n= 61; girls n=101. Intruments: CORIN (risk behavior in children, source: CONICET; and Sociodemographic data protocol. Results and conclusions: The 46,3% of the children reports to have consumed alcohol and the 7,4% reports to have consumed tobacco. It is concluded that legal substances, specially alcohol, are consumed and tolerated better than illegal ones. Also, there is a dissonance between beliefs and values in children regarding to alcohol and their

Complex anal fistulas: plug or flap?

Science.gov (United States)

Muhlmann, Mark D; Hayes, Julian L; Merrie, Arend E H; Parry, Bryan R; Bissett, Ian P

2011-10-01

Rectal mucosal advancement flaps (RMAF) and fistula plugs (FP) are techniques used to manage complex anal fistulas. The purpose of this study was to review and compare the results of these methods of repair. A retrospective review of all complex anal fistulas treated by either a RMAF or a FP at Auckland City Hospital from 2004 to 2008. Comparisons were made in terms of successful healing rates, time to failure and the use of magnetic resonance imaging. Overall, 70 operations were performed on 55 patients (55.7% male). The mean age was 44.9 years. Twenty-one patients (30%) had had at least one previous unsuccessful repair. Indications for repair included 57 high cryptoglandular anal (81%), 4 Crohn's anal (6%), 7 rectovaginal (10%), 1 rectourethral (1%) and 1 pouch-vaginal fistula (1%). All patients were followed up with a mean of 4.5 months. Forty-eight RMAFs (69% of total) were performed with 16 successful repairs (33%). Twenty-two FPs (31% of total) were performed with 7 successful repairs (32%, P = 0.9). In failed repairs, there was no difference in terms of mean time to failure (RMAF 4.8 months versus FP 4.1 months, P = 0.62). Magnetic resonance imaging was performed in 21 patients (37%) before the repair. The success rate in these patients was 20%. The results of treatment of complex anal fistulas are disappointing. The choice of operation of either a RMAF or a FP did not alter the poor healing rates of about one third of patients in each group.

Environmental scan of anal cancer screening practices: worldwide survey results

International Nuclear Information System (INIS)

Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

2014-01-01

Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

Vascularized anal autotransplantation model in rats: preliminary report.

Science.gov (United States)

Araki, J; Mihara, M; Narushima, M; Iida, T; Sato, T; Koshima, I

2011-11-01

Ostomy has served as an effective surgery for various anorectal disfunctions. However, it must also be noted that those patients suffered greatly from stresses caused by their stoma. Many alternative therapies have been developed, but none have solved this critical issue. Meanwhile, due to the improvements in operative methods and immunosuppressive therapy, allotranplantation has gained great popularity in recent years. Therefore, we began development of an anal transplantation model. The operation was performed in six adult Wistar rats that were divided into two groups. Group 1 underwent vascular anastomoses, while group 2 did not Group 1 grafts survived, fully recovering anal function. However, many of the group 2 grafts did not survive; those that did survive showed major defects in their anus, never recovering anal function. We succeeded in establishing the rat anal transplantation model utilizing super-microsurgery. While research in anal transplantation was behind compared to that in other fields, we hope that this model will bring significant possibilities for the future. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparación analítica de los métodos ultravioleta selectivo y test spectroquant 1.14773.0001 en la determinación del ión nitrato en aguas tratadas

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Carlos Alberto Severiche Sierra

2014-01-01

Full Text Available La meta de un análisis químico de aguas es generar resultados correctos y confiables, siendo la comparación de métodos uno de los aspectos más importantes para conseguir este propósito; además, constituye un factor clave para la prestación de servicios analíticos. La determinación de ion nitrato en aguas es una de las metodologías analíticas más discutidas que se conoce en el ámbito científico técnico del análisis de aguas, dado los procedimientos complejos con los que se cuentan, la gran posibilidad de encontrar sustancias interferentes y los rangos de concentración limitados que presentan las diferentes técnicas. En la presente investigación, se hizo el cotejo de dos métodos analíticos, el UV selectivo y el test spectroquant 1.14773.0001, para la determinación del ión nitrato en aguas tratadas. El objetivo fue confirmar correctamente la aplicación de los métodos para el análisis de aguas; las muestras analizadas se tomaron de la red de agua potable de la ciudad de Cartagena de Indias, donde para ambos métodos se encontraron resultados satisfactorios en precisión y exactitud.

Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

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Sidney Roberto Nadal

2009-06-01

Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

Prevalence of anal cytological abnormalities in women with positive cervical cytology.

Science.gov (United States)

Calore, Edenilson E; Giaccio, Claudia Maria Serafim; Nadal, Sidney R

2011-05-01

The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc. Copyright © 2010 Wiley-Liss, Inc.

Early effect of external beam radiation therapy on the anal sphincter: A study using anal manometry and transrectal ultrasound

International Nuclear Information System (INIS)

Birnbaum, E.H.; Dreznik, Z.; Myerson, R.J.; Lacey, D.L.; Fry, R.D.; Kodner, I.J.; Fleshman, J.W.

1992-01-01

The early of pelvic irradiation on the anal sphincter has not been previously investigated. This study prospectively evaluated the acute effect of preoperative radiation on anal function. Twenty patients with rectal carcinoma received 4,500 cGy of preoperative external beam radiation. The field of radiation included the sphincter in 10 patients and was delivered above the anorectal ring in 10 patients. Anal manometry and transrectal ultrasound were performed before and four weeks after radiotherapy. No significant difference in mean maximal squeeze or resting pressure was found after radiation therapy. An increase in mean minimal sensory threshold was significant. Histologic examination revealed minimal radiation changes at the distal margin in 8 of 10 patients who underwent low anterior resection and in 1 of 3 patients who underwent abdominoperineal resection. The authors conclude that preoperative radiation therapy has minimal immediate effect on the anal sphincter and is not a major contributing factor to postoperative incontinence in patients after sphincter-saving operations for rectal cancer

Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil Lesões precursoras do câncer anal em pacientes HIV-positivos e HIV-negativos atendidos numa instituição de saúde terciária no Brasil

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Ivan Tramujas da Costa e Silva

2011-02-01

; Grupo 6 _ homens-que-fazem-sexo-com-homens HIV-negativos (26; e Grupo 7 _ mulheres HIV-negativas, com hábitos sexuais anorreceptivos (32. Os resultados histopatológicos das biópsias anais dirigidas pela colposcopia anal foram analisados por meio de estatística frequentista e bayesiana para a determinação da prevalência-ponto de ASIL/câncer e verificar eventual preponderância estatística de um grupo sobre o outro. Resultados: A prevalência-ponto de ASIL para todos os pacientes estudados foi de 93/344 (27%, sendo significativa a diferença entre HIV-positivos e negativos (38,3% versus 13,5%; p < 0,0001. A prevalência de ASIL para cada um dos grupos estudados foi: Grupo 1 = 49,5%, Grupo 2 = 28,6%, Grupo 3 = 3,8%, Grupo 4 = 21,1%, Grupo 5 = 11,1%, Grupo 6 = 30,8% e Grupo 7 = 18,8%. A análise de resíduos demonstrou prevalência significante de ASIL para o Grupo 1 e de ASIL de alto-grau para o Grupo 2. A razão-de-chances do Grupo 1 para ASIL foi significantemente maior em comparação com os Grupos 2, 3, 4, 5 e 7 (p < 0,03. A razão-de-chances para ASIL dos Grupos 2, 4 e 6 foi significantemente maior em comparação com o Grupo 3 (p < 0.03. Conclusões: Nos pacientes estudados, ASIL (baixo e/ou alto-grau foi significantemente mais prevalente em pacientes HIV-positivos. Entretanto, pacientes HIV-negativos anorreceptivos também apresentaram grande probabilidade de possuir as lesões, especialmente os do gênero masculino.

Diagnostic imaging features of normal anal sacs in dogs and cats.

Science.gov (United States)

Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo; Lee, Kichang

2016-09-30

This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions.

HAART slows progression to anal cancer in HIV-infected MSM.

Science.gov (United States)

Duncan, Katrina C; Chan, Keith J; Chiu, Connie G; Montaner, Julio S G; Coldman, Andy J; Cescon, Angela; Au-Yeung, Christopher G; Wiseman, Sam M; Hogg, Robert S; Press, Natasha M

2015-01-28

Antiretrovirals do not prevent anal intraepithelial neoplasia. However, the influence of antiretrovirals in the natural history of invasive anal cancer is less clear. The objective is to investigate the impact of antiretrovirals in the time to the development of anal cancer in HIV-positive MSM. A retrospective analysis of cases of anal cancer in a cohort of HIV-positive MSM receiving antiretrovirals between 1988 and 2008. Time from first CD4 cell count or HIV RNA viral load test to anal cancer diagnosis was analysed using Cox regression and Kaplan-Meier curves. Anal cancer cases treated in the era prior to HAART (cancer cases (n = 37) were compared with a cohort of 1654 HIV-positive MSM on antiretrovirals. Antiretrovirals were started in the pre-HAART era by 70% of cancer cases, and median CD4 cell count nadir was 70 cells/μl (10-130). Time to development of anal cancer was shorter for cases treated during the pre-HAART era [adjusted hazard ratio (AHR) 3.04, 95% confidence interval (95% CI) 1.48-6.24, P = 0.002], with a CD4 cell count nadir less than 100 cells/μl (AHR 2.21, 95% CI 1.06-4.62, P = 0.035) and longer duration of CD4 cell count less than 100 cells/μl (AHR 1.33, 95% CI 1.11-1.58, P = 0.002). Results show that severe immunosuppression and starting therapy pre-HAART are associated with an increased risk of anal cancer. HIV-positive MSM initiating antiretrovirals during the HAART era (1996-2008) had a longer time to the development of anal cancer than those treated pre-HAART. Our results suggest that early use of HAART may delay progression to anal cancer.

Efecto en el aprendizaje y la memoria espacial de un péptido sintético en ratas: estudio preliminar

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R. Oyuela

2004-01-01

Full Text Available Esta investigación tuvo como objetivo la indagación de los efectos de un nuevo péptido, diseñado con base en las conantoquinas, como posible agente sensible al receptor NMDA en el aprendizaje y la memoria espacial en ratas. Por medio del laberinto de agua de Morris, y el protocolo adaptado de Magnusson, mediante un diseño de medidas repetidas con un grupo control y tres experimentales –Péptido, NMDA y MK-801– se evaluó en 24 ratas macho Wistar entre 8 y 9 meses de edad, asignadas aleatoriamente a cada grupo. Los datos sugieren que el péptido diseñado mejora los procesos de memoria espacial y aprendizaje vs. el grupo control y el grupo MK-801 con un nivel de significancia p < .05. En comparación con el grupo NMDA esta mejoría se observó en el 50% de los sujetos. Se discuten las implicaciones de estos hallazgos, y posibles extensiones de esta investigación con el objetivo de validar los resultados de este estudio preliminar.

Anal metastasis originating from colorectal cancer: Report of two cases

Energy Technology Data Exchange (ETDEWEB)

Kim, Jae Min; Lim, Joon Seok; Choi, Jin Young; Park, Mi Suk; Kim, Myeong Jin [Dept. of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Taek; Kim, Ho Guen [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

Anal metastasis from colorectal cancer rarely occurs, but it severely impairs the patient's quality of life, often requiring wide resection including the anal sphincter with permanent colostomy. This lesion can be misdiagnosed as a perianal fistula or an abscess, and it can be overlooked at the time of surgery because it is not included in the routine surgical extent of low anterior resection. We report two rare cases of anal metastasis from colorectal cancer. In both cases, perianal nodules with an internal solid portion were detected on preoperative rectal magnetic resonance imaging and additional local excisions of the anal lesions were performed during the process of treatment. Anal metastasis was pathologically confirmed by histology and immunohistochemical staining.

Lista preliminar de las heliconias de Colombia y cinco especies nuevas

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Kress W. Jhon

1993-12-01

Full Text Available A preliminary check list of the 93 species of Heliconia currently recognized from Colombia is provided. Five new species of subgen. Griggsia (H. arrecta, H. donstonea, H. gigantea, H.terciopete y H. titanum from that country are also described, ilustrated, and discussed.Se proporciona una lista preliminar de las 93 especies de Heliconia reconocidas para Colombia. Además se describen, ilustran y comentan cinco especies nuevas pertenecientes al subgénero Griggsia (H. arrecta, H. donstonea, H. gigantea, H. terciopela y H. titanum.

Avaliação do impacto do Programa Nacional do Leite em Alagoas, através de métodos isotópicos: aspectos metodológicos e resultados preliminares Isotope methods for evaluating the impact of the National Nutritional Program in Alagoas: methodological aspects and preliminary results

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Denise Petrucci Gigante

2002-04-01

Full Text Available OBJETIVOS: Descrever aspectos metodológicos e resultados preliminares de um estudo de intervenção planejado para medir o impacto de um programa de suplementação alimentar sobre a promoção do crescimento infantil de crianças desnutridas. MÉTODOS: Estudo longitudinal, controlado, desenvolvido no estado de Alagoas, com grupos comparados antes e depois da intervenção. Vinte municípios foram selecionados através de um indicador de cobertura do programa de suplementação alimentar. Essa cobertura foi estimada pela diferença entre a proporção de crianças desnutridas e a proporção de crianças atendidas pelo programa. Os dez municípios com indicador de alta cobertura foram selecionados para o grupo intervenção e aqueles de menor cobertura para o grupo controle. Em cada município do grupo intervenção foram selecionadas 15 crianças ingressando no Programa. Em cada município do grupo controle foram incluídas 15 crianças elegíveis, mas que não conseguiram vaga no Programa. RESULTADOS: Foram aplicados 111 e 102 questionários em crianças dos municípios do grupo intervenção e controle, respectivamente. A comparação em relação às características de base mostra que a distribuição das variáveis demográficas e nutricionais foi semelhante entre as crianças dos grupos intervenção e controle. Por outro lado, as crianças do grupo intervenção são provenientes de famílias com menor renda familiar e seus pais apresentaram menor escolaridade quando comparadas às do grupo controle. CONCLUSÕES: Os resultados preliminares mostram que os grupos são comparáveis em relação às variáveis demográficas e nutricionais e que as diferenças observadas quanto ao nível socioeconômico deverão ser consideradas na análise ajustada, na segunda fase do estudo.OBJECTIVE: To describe methodological aspects and preliminary results of an intervention designed to measure the impact on child growth of nutritional programs

Absorción de la Bencidrilamina y derivados : I. Selección de la metodología analítica

OpenAIRE

Volonté, María Guillermina; Taylor, Susana A.; Lufrano, Pablo

1986-01-01

Se correlacionan los resultados obtenidos en la valoración de bencidrilamina y derivados, a través de la utilización de tres métodos analíticos que emplean la extracción líquido-líquido y la cromatografía en capa fina como etapa preparativa, a los efectos de evitar la interferencia por parte de sustancias liberadas desde las membranas gástricas. Se observa buena concordancia de los valores medidos por espectrodensitometría y por espectrofotometría ultravioleta cuando se utiliza la cromatograf...

Resultados preliminares do implante de lente intra-ocular fácica artisan para correção de miopia Preliminary results of artisan phakic intraocular lens implantation to correct myopia

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Leonardo Akaishi

2007-06-01

Full Text Available OBJETIVOS: Avaliar os resultados preliminares quanto à eficácia, estabilidade e segurança da lente intra-ocular de câmara anterior Artisan em olhos fácicos para correção de miopia. MÉTODOS: Foi analisado retrospectivamente o resultado de 34 olhos fácicos que receberam o implante de lente intra-ocular Artisan para correção de miopia. Os parâmetros avaliados foram: contagem endotelial pré e pós-operatória, acuidade visual sem correção pré e pós-operatória, melhor acuidade visual com correção pré e pós-operatória, equivalente esférico pré e pós-operatório, ganho e perda de linhas de visão e complicações. RESULTADOS: Dezoito pacientes (34 olhos foram incluídos neste estudo. Quatorze eram do sexo feminino (77,8% e 4 do sexo masculino. A idade média dos pacientes era de 30 anos (DP ± 7,3, variando de 21 a 46 anos. O período médio de seguimento foi de 8,5 meses (DP ± 3,6. A média de perda endotelial foi de 4,75% em 6 meses. A acuidade visual sem correção pré-operatória era de 0,02 (20/800 variando de 0,01 a 0,13. O equivalente esférico médio pré-operatório na refração dinâmica era de -13,25 D, variando de -5,75 D a -19,75 D. No último seguimento a acuidade visual sem correção era de 0,64 (20/32 variando de 0,33 a 1,00. O equivalente esférico médio na refração dinâmica era de -1,18 D (DP ± 0,92 variando de + 0,25 a -3,0. Entre as complicações observadas em nosso estudo 1 (3,4% paciente apresentou deslocamento da lente por trauma necessitando de uma segunda intervenção para reposicionamento. CONCLUSÃO: O uso de lente fácica de câmara anterior Artisan para correção de miopia no presente estudo se mostrou seguro, eficaz e com boa previsibilidade. No entanto, estudo prospectivo com maior número de casos e maior seguimento é necessário para determinar a segurança do procedimento a longo prazo.PURPOSE: To observe the preliminary results based on the efficacy, stability and safety of

Sotsiaalvõrgustike analüüs / Innar Liiv

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Liiv, Innar, 1982-

2005-01-01

Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

Anal Cancer Treatment (PDQ®)—Health Professional Version

Science.gov (United States)

Anal cancer is often curable with treatment. Major prognostic factors are site, size, and nodal status. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information for anal cancer risk factors, classification, staging, prognosis, and treatment in this summary for clinicians.

KRAS and BRAF mutations in anal carcinoma

DEFF Research Database (Denmark)

Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid

2015-01-01

the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...

Recent Advances in the Pharmacotherapy of Chronic Anal Fissure: An Update

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Bikash Medhi

2008-07-01

Full Text Available Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. Glyceryl trinitrate (GTN ointment (0.2% has an efficacy of up to 68% in healing chronic anal fissure, but it is associated with headache as the major and most common side effect. Though botulinum toxin injected into the anal sphincter healed over 80% of chronic anal fis-sures, it is more invasive and expensive than GTN therapy. Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.

Adaptação da escala Brian para uso em crianças e adolescentes: um estudo preliminar

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Ana Claudia Mércio Loredo Souza

2013-01-01

Full Text Available Introdução: Alterações nos ritmos circadianos tem sido frequentemente observadas entre pacientes com Transtorno do Humor Bipolar (THB. No entanto, existem poucos instrumentos para medi-las e a maioria deles mede exclusivamente distúrbios do sono. A escala BRIAN, validada para adultos com THB, avalia a regularidade dos ritmos biológicos em quatro diferentes aspectos: sono, atividades, social e padrão de alimentação. O objetivo deste estudo piloto foi adaptar a escala BRIAN para uma população de crianças e adolescentes (BRIAN-K e avaliar se o novo instrumento é capaz de detectar diferenças entre pacientes e controles saudáveis. Métodos: Foram avaliados 20 pacientes com THB entre 8-16 anos e 32 controles pareados por sexo e idade. Os sujeitos foram avaliados através de entrevista clínica, K-SADS-PL e testagem cognitiva. A BRIAN-K foi aplicada em ambos os grupos. Resultados: O grupo de pacientes com THB apresentou escores mais altos de alterações em seus ritmos circadianos pelo escore total da BRIAN-K, quando comparados com o grupo controle (p=0,022. Particularmente, maior irregularidade foi observada no domínio “atividades” no grupo de pacientes (p=0,001. Nossos resultados também mostraram uma correlação positiva entre a idade de diagnóstico e o domínio “sono” da BRIAN-K (r = 0,485; p = 0,03. Conclusões: Estes dados preliminares sugerem que a versão BRIAN-K, recentemente adaptada para crianças e adolescentes, é capaz de discriminar pacientes com THB e controles. Futuros estudos com maior tamanho amostral são necessários para determinar a confiabilidade, validade interna e externa do presente instrumento.

Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion

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Maria do Socorro Nobre

2016-05-01

Full Text Available The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64. Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5% had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR = 2.46; p = 0.03. In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR = 2.81; p = 0.02. This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer.

Using of thermoradiotherapy on treatment of cancerous growths of anal canal

International Nuclear Information System (INIS)

Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

1997-01-01

In this chapter of book authors investigated using of thermoradiotherapy on treatment of cancerous growths of anal canal, methods of using of thermoradiotherapy at morbid with anal cancer, methods of irradiation, the characteristic of clinical observations, using of thermoradiotherapy at treatment of epidermoid cancer of anal zone, using of thermoradiotherapy at treatment of non epithelial cancer of anal zone and using thermoradiotherapy at others types of cancerous growths

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

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Oblak Irena

2016-03-01

Full Text Available Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.

Seoseid loov kunstiteose analüüs / Anneli Porri

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Porri, Anneli, 1980-

2013-01-01

Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

Patients with newly diagnosed cervical cancer should be screened for anal human papilloma virus and anal dysplasia: Results of a pilot study using a STELLA computer simulation and economic model

OpenAIRE

Eli D. Ehrenpreis; Dylan G. Smith

2018-01-01

Background: Women with cervical cancer often have anal human papillomavirus (HPV) infection and anal dysplasia. However, effectiveness of anal HPV screening is unknown. Methods: A dynamic model was constructed using STELLA. Populations are represented as ''stocks'' that change according to model rates. Initial anal cytology in new cervical cancer patients, dysplasia progression and regression, cost of treating high-grade squamous intraepithelial lesions (HSIL), and lifetime costs for anal can...

Infl uencia de los Gastos de campaña en los resultados de las elecciones federales de 1997

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J. Ramón Gil García

2004-01-01

Full Text Available Recientemente se ha incrementado la preocupación por el control de los gastos de campaña efectuados por los distintos partidos políticos. Se argumenta que los excesivos gastos provocan inequidad entre las diferentes fuerzas políticas, ya que infl uyen fuertemente en la decisión de los ciudadanos a votar por la opción partidista que más recursos gaste durante las campañas. Asimismo se ha cuestionado el uso de recursos públicos para el fi nanciamiento de estas campañas políticas. Este estudio analiza la incidencia de los gastos de campaña en los resultados electorales. La relación de los gastos de campaña con la votación emitida es estadísticamente signifi cativa tanto para los partidos en su conjunto —lo que explica de alguna forma el abstencionismo— como para cada una de las fuerzas políticas por separado, mostrando de forma preliminar la efi ciencia en el uso de estos gastos. Sin embargo, en ambos casos los coefi cientes estimados muestran una débil relación causal.

Utilidade da citologia anal no rastreamento dos homens heterossexuais portadores do HPV genital Anal cytology for screening heterosexual men harboring genital HPV infection

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Raphael Marianelli

2010-09-01

Full Text Available Os papilomavírus humanos (HPV de alto risco estão fortemente relacionados à etiologia do carcinoma espinocelular (CEC anogenital e suas lesões precursoras. O HPV-16 é o tipo mais freqüente, estando presente em até 87% dos CEC do canal anal HPV-positivo. Apesar de ser relativamente raro, vem sendo cada vez mais diagnosticado, nas últimas décadas, sobretudo em indivíduos do sexo masculino. A incidência é ainda mais elevada nos grupos considerados de risco, particularmente, os homens e as mulheres HIV-positivo e os homens que fazem sexo com homens (HSH. Grande parte das pesquisas direcionadas à infecção anal pelo HPV e sua relação com neoplasia intraepitelial-anal (NIA e com o carcinoma esteve focada nos grupos de risco. Pouco interesse vem sendo destinado à investigação dos homens heterossexuais. Estudos epidemiológicos da prevalência da infecção pelo HPV em homens, mostraram que os heterossexuais masculinos apresentavam infecção anal pelo HPV em até 12%. As Sociedades médicas e os especialistas recomendam o rastreamento dos portadores de imunodepressão e dos HSH com citologia do raspado do canal anal. Entretanto, até o momento, não há recomendação de rastreamento para homens que fazem sexo com mulheres.The oncogenic human papillomaviruses (HPV are straightly associated with anogenital cancer and dysplasia. The HPV-16 is the most common type, isolated in 87% of the HPV-positive anal squamous cell carcinoma (SCC. Despite being a rare tumor, the incidence of SCC has increased in the last decades, especially in males. Incidence is particularly high amongst men who have sex with men (MSM and among HIV infected men and women. For decades anogenital HPV researches have largely focused risk groups. Poor interest was intended to men who have sex with women (MSW. Prevalence studies of HPV infection in MSW have demonstrated that anal infection was identified in as far as 12%. Medical societies and specialists recommend anal

Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

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Marcelo Corti

2012-12-01

Full Text Available Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

Dysregulation of Autophagy Contributes to Anal Carcinogenesis.

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Evie H Carchman

Full Text Available Autophagy is an intracellular catabolic process that removes and recycles unnecessary/dysfunctional cellular components, contributing to cellular health and survival. Autophagy is a highly regulated cellular process that responds to several intracellular signals, many of which are deregulated by human papillomavirus (HPV infection through the expression of HPV-encoded oncoproteins. This adaptive inhibitory response helps prevent viral clearance. A strong correlation remains between HPV infection and the development of squamous cell carcinoma (SCC of the anus, particularly in HIV positive and other immunosuppressed patients. We hypothesize that autophagy is inhibited by HPV-encoded oncoproteins thereby promoting anal carcinogenesis (Fig 1.HPV16 transgenic mice (K14E6/E7 and non-transgenic mice (FVB/N, both of which do not spontaneously develop anal tumors, were treated topically with the chemical carcinogen, 7,12-Dimethylbenz[a]anthracene (DMBA, to induce anal cancer. The anuses at different time points of treatment (5, 10, 15 and 20 weeks were analyzed using immunofluorescence (IF for two key autophagy marker proteins (LC3β and p62 in addition to histological grading. The anuses from the K14E6/E7 mice were also analyzed for visual evidence of autophagic activity by electron microscopy (EM. To see if there was a correlation to humans, archival anal specimens were assessed histologically for grade of dysplasia and then analyzed for LC3β and p62 protein content. To more directly examine the effect of autophagic inhibition on anal carcinogenesis, nontransgenic mice that do not develop anal cancer with DMBA treatment were treated with a known pharmacologic inhibitor of autophagy, chloroquine, and examined for tumor development and analyzed by IF for autophagic proteins.Histologically, we observed the progression of normal anoderm to invasive SCC with DMBA treatment in K14E6/E7 mice but not in nontransgenic, syngeneic FVB/N background control mice

Determinación de algunos parámetros de pureza en aceites de oliva. Resultados de un estudio colaborativo

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Moreda, W.

1995-10-01

Full Text Available The results of a collaborative study with the participation of Governmental and Olive Oil Industry laboratories is presented. This study was carried out to determine the precision of the analytical methods used for quantifying certain components of olive oils. Samples of virgin olive oil, olive oil and residue olive oil were analysed for total sterols, sterolic composition, trans isomers from fatty acids, waxes and stigmastadienes, using the analytical methods included in the Commission Regulation EEC 2568/91 of the European Union and modifications therein, and in Document TC20/11 of the International Olive Oil Council (1993. The results have been statistically procesed according to the standard ISO 5725-1986 (E.

Se presentan los resultados de un estudio colaborativo realizado con la participación de laboratorios de la Administración Pública y de industrias del Sector Oleícola con el objeto de determinar la precisión de los métodos analíticos que se utilizan para la cuantificación de ciertos componentes de los aceites de oliva. Esteroles totales, composición esterólica, isómeros trans de ácidos grasos, ceras y estigmastadienos han sido determinados en muestras de aceites de oliva virgen, de oliva y de orujo de oliva, mediante la aplicación de los métodos analíticos indicados en el reglamento CEE 2568/91 de la Unión Europea y posteriores modificaciones, así como en el Documento TC20/11 del Consejo Oleícola Internacional (1993. Se ha efectuado un análisis estadístico de los resultados de acuerdo con la norma ISO 5725-1986 (E.

Anal Human Papillomavirus Infection among HIV-Infected Men in Korea.

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Chang Hun Lee

Full Text Available Little is known about the epidemiology on human papillomavirus (HPV infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea.A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour.A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM and 68 from men who have sex with women (MSW. Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW (P < 0.001. High-risk HPV (HR-HPV prevalence was higher among MSM (47.4% than MSW (25.0%; P = 0.002. The HR-HPV types identified most frequently were HPV 16 (11%, HPV 18 (9.9%, and HPV 58 (5% in MSM, and HPV 58(11% and HPV 16 (8.9% in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001. Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001. In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection.Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age.

Presentación de la cohorte "CDC de Canarias": objetivos, diseño y resultados preliminares

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Antonio Cabrera de León

2008-01-01

Métodos: Estudio prospectivo con muestreo aleatorio en población general, en el que participaron 6.729 personas entre los años 2000 y 2005 (edad 18-75 años. Se les realizó antropometría y se extrajo sangre para almacenamiento de muestras séricas y genéticas. Mediante cuestionario se recogió: hábitos dietéticos, actividad física, antecedentes personales y familiares de enfermedad, exposición a FR laborales o ambientales, tabaquismo, etc. Resultados: La prevalencia de obesidad es casi del 30%, sin diferencias entre sexos, pero el sobrepeso afecta más a los varones (45 vs. 33%; p<0'001, los cuales presentan también mayor prevalencia de diabetes (12 vs. 10%; p =0'005, hipertensión (43 vs. 33%; p<0'001, ingesta excesiva de alcohol (13 vs. 2%; p<0'001 y falta de protección solar (46 vs. 18%; p<0'001. En las mujeres es más frecuente la exposición a bajos niveles de colesterol HDL (37 vs. 30%; p<0'001 y al sedentarismo (71 vs. 55%; p<0'001. La exposición a los FR estudiados, entre ellos la pobreza, es mayor en edades avanzadas, salvo el tabaquismo (26% que es mayor en edades jóvenes. La estimación de riesgos relativos de exposición a los factores de riesgo cardiovascular y de cáncer es más alta en las clases sociales pobres. Conclusiones: La actual población adulta de Canarias presenta una elevada prevalencia de exposición a factores de riesgo para las enfermedades cardiovasculares, la diabetes y el cáncer, destacando especialmente el sobrepeso, la obesidad y el sedentarismo.

Anal endosonography and manometry: comparison in patients with defecation problems.

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Schäfer, R; Heyer, T; Gantke, B; Schäfer, A; Frieling, T; Häussinger, D; Enck, P

1997-03-01

Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

Changes in the proportions of types I and III collagen in hemorrhoids: the sliding anal lining theory

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Carlos Sardiñas

2016-07-01

foram reunidas em 2014. Todos os pacientes passaram por uma hemorroidectomia aberta; para tanto, foi empregada a técnica descrita por Milligan e Morgan, publicada no periódico Lancet em 1937. As amostras de hemorroida foram coradas com hematoxilina-eosina com vistas ao estudo histológico para confirmação do diagnóstico de tecido hemorroidal. Após a análise histológica, o material foi corado com o protocolo de picrosirius red. O método empregado para o processamento das imagens está descrito no texto. As imagens foram importadas pelo software Image Tool for Windows. O mesmo processo foi empregado no tecido embrionário. Os dados resultantes da análise das imagens fora processados com o programa STATISTICA, um software para análise estatística. Resultados: Por comparação, constatamos que os dois tecidos apresentavam valores muito diferentes, e as hemorroidas continham os mais altos valores de colágeno do tipo III. Conclusão: Nossos resultados parecem implicar que hemorroidas possuem um percentual mais elevado de colágeno do tipo III versus tecido fetal. Os resultados também sugerem uma possível deterioração do tecido, relacionada à idade. Keywords: Hemorrhoids, Anal, Canal, Collagen, Type I, Type III, Fetus, Deterioration, Palavras-chave: Hemorroidas, Anal, Canal, Colágeno, Tipo I, Tipo III, Feto, Deterioração

Vaccine-preventable anal human papillomavirus in Australian gay and bisexual men

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I. Mary Poynten

2017-06-01

Full Text Available Objective: HPV causes ~90% of anal cancer and HPV16 is the type most commonly associated with anal cancer. Gay and bisexual men (GBM are at greatly increased risk. We investigated patterns of vaccine-preventable anal HPV in older GBM. Methods: The Study of the Prevention of Anal Cancer (SPANC is an ongoing, prospective cohort study of HIV-positive and HIV-negative Australian GBM. Participants completed questionnaires and underwent an anal swab for HPV genotyping using Roche Linear Array. We analysed baseline data from SPANC by HPV type, mean number of types, stratified by age and HIV status. Results: Anal HPV results from 606 (98.2% of 617 participants (median age 49 years, 35.7% HIV-positive showed 525 (86.7% had ≥1 HPV type and 178 (29.4% had HPV16. Over one third of participants (214, 35.3% had no nonavalent vaccine-preventable types detected. Two (0.3% participants had all quadrivalent types and none had all nonavalent vaccine types. HIV-positive participants (p<0.001 and younger participants (p=0.059 were more likely to have more vaccine-preventable HPV types detected. Conclusion: Anal HPV was highly prevalent in this largely community-based GBM cohort. Vaccine-preventable HPV16 was detected in approximately one third of participants. These findings suggest that the potential efficacy of HPV vaccination of older GBM should be explored. Keywords: Human papillomavirus, HPV, Anal, Vaccine, Prevalence, Gay and bisexual men, MSM, HIV

[Caesarean section and anal incontinence].

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Kalis, V; Stipán, J; Chaloupka, P; Karbanová, J; Rokyta, Z

2008-04-01

Summary of the impact of Caesarean section on anal incontinence. Review. Department of Gynaecology and Obstetrics, Charles University and University Hospital Plzen. Review of the current international literature. Currently, Caesarean section is not considered to reduce symptoms of anal incontinence. If there is any reduction of symptoms, that remains only for a short term (40% in 3 months after the delivery in the largest trial). In a long term, virtually in no trial has been observed any difference, and others, non-obstetrical factors (particularly aging) prevail. Current knowledge does not allow to assess sufficiently pros and cons of Caesarean compared to vaginal delivery. High risk groups, that would profit from elective Ceasarean, have not been clearly identified yet.

Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

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Maurilio Toscano de Lucena

2010-06-01

Full Text Available Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses. Houve predomínio do gênero feminino (81,5% dos pacientes. A idade variou de 33 a 83 anos (média de 59 anos. O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6% dos casos. Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61% dos pacientes com carcinoma de células escamosas. O índice de resposta inicial completa foi de 89,8%. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (pObjectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients

Carcinoma of the anal canal: radiation or radiation plus chemotherapy

International Nuclear Information System (INIS)

Cummings, B.J.

1983-01-01

An editorial is presented which discusses the treatment of carcinoma of the anal canal. Following the initial report of the successful preoperative use of combined chemotherapy and radiation by Nigro in 1974, several centers have confirmed the effectiveness of such combinations either as preoperative or as definitive treatment of anal carcinomas, and many patients are now being referred for radiation therapy. The article by Cantril in this issue describe the successful treatment of anal carcinomas by radiation alone, and raises the important issue of whether radiation plus chemotherapy is more effective treatment than radiation alone for squamous or cloacogenic carcinomas arising in the anal canal or perianal area. Several studies are cited

Estudio preliminar para el tratamiento de lixiviados en un reactor de biodiscos

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Ordóñez Losada, Paola Jimena; Betancur Pérez, Alonso

2003-01-01

El presente trabajo hace parte de un proyecto de investigación de la Universidad Nacional de Colombia Sede Manizales y EMAS (Empresa Metropolitana de Aseo S.A. E.S.P) para encontrar la mejor alternativa para el tratamiento de los lixiviados del relleno sanitario “La Esmeralda” de la ciudad de Manizales, con el fin de cumplir la legislación ambiental vigente sobre vertimientos líquidos industriales a las aguas superficiales. Se analizó en forma preliminar la aplicación de la tecnología biodisc...

Pressões retais e anais em primigestas ao defecar Rectal and anal straining pressures in primigravidae

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Wilmar Artur Klug

2008-04-01

Full Text Available OBJETIVO: O estudo teve o objetivo de avaliar as mudanças nas pressões do reto e ânus de primigestas ao simular defecação. MÉTODOS: Selecionamos 60 mulheres no Ambulatório de Pré-natal e no de Cirurgia da Santa Casa de São Paulo. Estas formaram quatro grupos de 15: a grupo-controle: nuligestas; b primigestas no 1º trimestre; c primigestas no 2º trimestre; d primigestas no 3º trimestre. Em todas realizamos manometria retal e anal e as seguintes medidas: a pressão retal em repouso; b pressão retal ao esforço de defecação; c pressão anal à defecação. RESULTADOS: Observamos que as pressões retais ao esforço de defecar aumentam em grávidas em menor proporção que nas nuligestas; estas pressões caíram de 53,9 ± 17,9 em nuligestas para 36,3± 19,6, 38,1 ± 16,2 e 30,5 ± 17,0 nos três trimestres. As pressões anais de defecação foram maiores nas nuligestas (46,9± 17,6 que nas gestantes, respectivamente 37,5 ± 15,5, 32,1 ± 6,2 e 32,9 ± 8,7. Houve maior queda das pressões anais na gestação mais avançada, que compensa a dificuldade para elevar a pressão intra-retal de esforço. CONCLUSÃO: A gravidez altera as pressões retais e anais ao simular defecação, diminuindo- as, mas de forma a compensarem-se mutuamente.OBJECTIVE: This study intended to evaluate rectal and anal straining pressures in primigravidae, at simulated defecation. METHODS: The present study is based on 60 women from de Antenatal Care of Santa Casa de Misericórdia - São Paulo. Patients were divided into four groups of 15: a Control group: nuligravidae; b 1st trimester primigravidae; c 2nd trimester primigravidae; d 3rd trimester primigravidae. All patients underwent rectal and anal measurements to obtain: a Resting rectal pressure; b Straining rectal pressure; c Minimal straining anal pressure. RESULTS: Data was analyzed using statistical methods and reached, the same results: it was observed that the straining rectal pressure decreased from 53

Regenerative medicine provides alternative strategies for the treatment of anal incontinence

DEFF Research Database (Denmark)

Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

2017-01-01

of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem...... cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. CONCLUSION: Cellular therapies with myogenic cells...... and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most...

Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

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Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

2012-01-01

The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

Anal intraepitelial neoplasia: a narrative review

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Garazi Elorza

2016-01-01

Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

HPV infection and intraepithelial lesions from the anal region: how to diagnose?

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Newton Sérgio de Carvalho

Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

Magnetic resonance imaging anatomy of the anal canal

International Nuclear Information System (INIS)

Kashyap, P.; Bates, N.

2004-01-01

The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams. Copyright (2004) Blackwell Science Pty Ltd

Resultados preliminares del forraje de Morus alba en la alimentación de vacas lecheras

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M. Milera

2007-01-01

Full Text Available El objetivo del presente trabajo consistió en evaluar el potencial del forraje de M. alba con vacas mestizas para la producción de leche. El trabajo se desarrolló en Cuba, la cual se encuentra localizada entre los 19° y 81’ de longitud oeste. La Estación Experimental de Pastos y Forrajes “Indio Hatuey” está ubicada en el municipio de Perico, provincia de Matanzas, sobre un suelo ferralítico rojo, a los 22° 40’ 7’’ de latitud norte y 81° 2’ de longitud oeste, a una altura de 10.91 msnm. La evaluación se hizo con vacas mestizas del cruce Holstein x Cebú, que tenían 54 días de lactancia. El estudio se dividió en dos periodos: en el primero (que duró 53 días se suministró el forraje de morera ad libitum, sin trocear, y se pastoreó de forma restringida en gramíneas mejoradas de secano, sin fertilización; en el segundo periodo, los animales dispusieron de pastoreo de gramíneas mejoradas con un 10% de un área establecida con Leucaena leucocephala y recibieron forraje de morera restringido hasta el 1% del peso vivo; éste tuvo una duración de 87 días. Se determinó la disponibilidad de pasto, la composición bromatológica y el consumo de forraje de Morus alba, así como la producción de leche de las vacas. El forraje de morera presentó altos va- lores de proteína y bajos contenidos de fibra; los consumos en el primer periodo llegaron hasta 2.7% del peso vivo. La producción de leche promedio fue de 10.6 kg/vaca/día durante los 140 días de evaluación y la máxima producción se registró en los primeros 53 días (1 kg/vaca/día. Los resultados demostraron la alta calidad de la morera cuando se utiliza como forraje para la alimentación de vacas mestizas. En las condiciones evaluadas, es posible obtener producciones de 10 litros por animal diariamente, cuando se utiliza el forraje de morera en adición al pasto de especies mejoradas, sin suplementación de concentrados.

Fiber types in the striated urethral and anal sphincters

DEFF Research Database (Denmark)

Schrøder, H D; Reske-Nielsen, E

1983-01-01

Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...

Regenerative medicine provides alternative strategies for the treatment of anal incontinence.

Science.gov (United States)

Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

2017-03-01

Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. Animal studies have demonstrated that cellular therapy in the form of local injections of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. Cellular therapies with myogenic cells and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most intensively investigated and several clinical trials were ongoing at the time of this report. The cost-effectiveness of such a therapy is an issue and muscle fragmentation is suggested as a simple alternative.

The Danish anal sphincter rupture questionnaire: Validity and reliability

DEFF Research Database (Denmark)

Due, Ulla; Ottesen, Marianne

2008-01-01

Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have bee...

Resultados preliminares de um sistema computadorizado e estereoscópico para pupilometria in vivo Preliminary results of a computerized and stereoscopic system for in vivo pupillometry

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Luis Alberto Vieira de Carvalho

2008-12-01

Full Text Available OBJETIVOS: Desenvolver um sistema digital, com capacidade de induzir acomodação, para medida do diâmetro e formato da pupila para dez diferentes níveis de iluminação (LUX, variando do nível mesópico ao fotópico. MÉTODOS: Um sistema óptico para conjugar imagens da pupila iluminada por LED infravermelho e branco foi projetado e montado usando um capacete típico de oftalmoscópio e uma máscara típica de mergulhador como suporte e uma câmera CCD de alta resolução e sensibilidade. Algoritmos usando princípios de processamento de imagens foram implementados para leitura do arquivo de vídeo e a detecção automática do centro geométrico e diâmetro da pupila para cada quadro. RESULTADOS: Apresentamos dados preliminares deste sistema para um paciente voluntário. Os dados sobre posição horizontal (x, vertical (y do centro geométrico e do diâmetro da pupila foram exportados para arquivos texto que podem ser impressos usando um programa convencional de planilha (Excel. O processo de acomodação é garantido por uma mira virtual (LED branco localizada a 6 metros do olho do paciente e o nível de iluminação é precisamente controlado por uma placa eletrônica que alimenta o LED central que tem sua potência controlada pelo "software". CONCLUSÕES: Com o instrumento desenvolvido dados precisos da posição e tamanhos da pupila podem então ser obtidos estereoscopicamente (para ambas as pupilas e ao mesmo tempo para qualquer paciente. Acreditamos que tal instrumento possa ser útil em algumas práticas oftálmicas onde as características geométricas da pupila sejam importantes.PURPOSE: We developed a digital system with accommodation capacities for measurement of the diameter and shape of the in vivo pupil for 10 different levels of illumination intensity, varying from mesopic to photopic. METHODS: An optical system for conjugating images from an infrared and white light illuminated pupil was designed and mounted using an

Dominant Role of HPV16 E7 in Anal Carcinogenesis

Science.gov (United States)

Thomas, Marie K.; Pitot, Henry C.; Liem, Amy; Lambert, Paul F.

2011-01-01

Ninety percent of anal cancer is associated with human papilloma viruses (HPVs). Using our previously established HPV transgenic mouse model for anal cancer, we tested the role of the individual oncogenes E6 and E7. K14E6 and K14E7 transgenic mice were treated with dimethylbenz[a]anthracene (DMBA) to the anal canal and compared to matched nontransgenic and doubly transgenic K14E6/E7 mice. K14E7 and K14E6/E7 transgenic mice developed anal tumors (papillomas, atypias and carcinomas combined) at significantly higher rates (88% and 100%, respectively) than either K14E6 or NTG mice (18% and 19%, respectively). Likewise, K14E7 and K14E6/E7 transgenic mice developed frank cancer (carcinomas) at significantly higher rates (85% and 85%, respectively) than either K14E6 or NTG mice (18% and 10%, respectively). These findings indicate that E7 is the more potent oncogene in anal cancer caused by HPVs. PMID:21999991

Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

Energy Technology Data Exchange (ETDEWEB)

Durot, Carole; Hoeffel, Christine [Dept. of Radiology, Centre Hospitalo-Universitaire de Reims, Reims (France); Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe [Dept. of Abdominal Imaging, Hopital Lariboisiere-APHP, Paris(France); Servois, Vincent [Dept. of Radiology and Nuclear Medicine, Institut Curie, Paris (France)

2017-11-15

Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.

Cancer of the anal canal: Diagnosis, staging and follow-up with MRI

International Nuclear Information System (INIS)

Durot, Carole; Hoeffel, Christine; Dohan, Anthony; Boudiaf, Mourad; Soyer, Philippe; Servois, Vincent

2017-01-01

Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performance evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases

Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

DEFF Research Database (Denmark)

Hornung, Benjamin R; Telford, Karen J; Carlson, Gordon L

2017-01-01

with greater sensitivity and discriminatory ability than conventional anal manometry. OBJECTIVE: The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry. DESIGN: This was an age-matched study......BACKGROUND: Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function...... of continent and incontinent men. SETTINGS: The study was conducted at a university teaching hospital. PATIENTS: Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from...

Evaluación externa de la calidad analítica en hematología: una necesidad en América Latina

OpenAIRE

Fink Nilda E.; Fernández Alberti Alejandra; Mazziotta Daniel

1997-01-01

La garantía de calidad analítica de un laboratorio clínico se logra mediante un sistema de control de calidad interno complementado por un programa de evaluación externa. Esa garantía es la base que fundamenta la confiabilidad de los resultados obtenidos por los laboratorios y su uso en el diagnóstico y tratamiento de las enfermedades. En los países de América Latina hay muchos laboratorios que no cuentan con sistemas apropiados de evaluación y control de la calidad. Dada la importancia de lo...

Transtorno do pânico: investigação sobre alterações de relato em terapia analítico-comportamental.

OpenAIRE

Siebert, Graziela

2006-01-01

O Transtorno do Pânico é um dos mais freqüentes e incapacitantes problemas dentre os transtornos ansiosos, representando um dos motivos de maior procura dos serviços de saúde no Brasil e no mundo. A Terapia Analítico-Comportamental constitui uma proposta com resultados bastante satisfatórios para seu tratamento, e seu enfoque é o esclarecimento da relação entre os sintomas sentidos e descritos pelo cliente e as contingências em operação, das quais seus comportamentos são função. A completa re...

The anal verge: localization with multi-slice spiral CT

International Nuclear Information System (INIS)

Wang Wei; Tang Guangjian

2010-01-01

Objective: To determine and evaluate the method of localization of anal verge by multislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the Sth sacral vertebra (Lb), the inferior aperture of minor pelvis (Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the mid- sagittal images obtained by MPR. The averages, the standard deviations (s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ±1.96 s or ±1.28 s 0.05) between two different sex groups [male group, (10.0±1.2) mm], female group, (9.6±1.2) mm and between two age groups [young group, (9.6±1.2) mm, elderly group, (9.9±1.3) mm]. Conclusions: The lower margin of the basement of external anal sphincter was a useful anatomic landmark for localizing the anal verge, and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge. (authors)

Resultados electorales y orientación del voto en los comicios municipales de 1995

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IRENE DELGADO SOTILLOS

1999-01-01

Full Text Available El presente artículo pretende hacer un balance de las elecciones municipales de 1995 examinando desde dos perspectivas analíticas sus principales elementos. Se organiza el trabajo partiendo de un análisis agregado que explora los niveles de movilización, orientación del voto municipal y preferencias de los electores. Posteriormente, mediante técnicas multivariables, se determinan los elementos más influyentes en las opciones de voto a los dos partidos mayoritarios. La nacionalización de la convocatoria municipal y la fuerte partidificación son elementos que confirman la hipótesis de la peculiaridad de estas elecciones municipales con un alto contenido de "primarias". Ello condiciona sus resultados, que además han estado influidos por su ubicación en el calendario electoral, el clima de descontento político nacional y las posibilidades de alternancia política.

Anal sphincter complex: endoanal MR imaging of normal anatomy

NARCIS (Netherlands)

Hussain, S. M.; Stoker, J.; Laméris, J. S.

1995-01-01

To determine the normal anatomy of the anal sphincter complex on magnetic resonance (MR) images. Ten healthy volunteers (four men, six women; age range, 21-26 years) underwent MR imaging with an endoanal coil. The lower part of the anal canal contained the internal sphincter, the longitudinal muscle

Programa de ensino de facoemulsificação CBO/ALCON: resultados do Hospital de Olhos do Paraná

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Ana Flávia de Castro Fischer

2010-12-01

Full Text Available Objetivo: Analisar os resultados obtidos com a aplicação do programa de ensino de facoemulsificação CBO/ALCON no curso de especialização em oftalmologia do Hospital de Olhos do Paraná. Métodos: Realizou-se um estudo retrospectivo analítico dos resultados das cirurgias de catarata realizadas pelo programa de ensino de facoemulsificação CBO/ALCON que utiliza o método "reverso" em pacientes provenientes do ambulatório do SUS do Hospital de Olhos do Paraná. O programa consta da progressão dos alunos por cinco etapas chamadas de "check points", sendo analisadas as intercorrências per-operatórias em cada um deles, bem como as pós-operatórias. Resultados: Do total de 84 olhos operados, 77 (91,67% apresentaram acuidade visual (AV final de 20/40 ou melhor. Entre as intercorrências, a principal delas foi a rotura de cápsula posterior (RCP e ocorreu em 11 (13,09% dos 13 (15,48% olhos que apresentaram algum tipo de complicação. Conclusão: O método "reverso" proposto para o ensino de facoemulsificação pelo programa CBO/ALCON se mostra uma forma de ensino adequada, para o médico residente e seu instrutor, e principalmente para o paciente, devido ao baixo índice de complicações.

A manometria anorretal (método do balão no diagnóstico diferencial da doença de Hirschsprung Effectiveness of anorectal manometry using the balloon method to identify the inhibitory recto-anal reflex for diagnosis of Hirschsprung's disease

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Mauro Batista de Morais

2005-12-01

Full Text Available OBJETIVO: Apresentar os resultados dos exames de manometria anorretal realizados com um aparelho brasileiro computadorizado, que utiliza o método do balão para a caracterização do reflexo inibitório reto anal na investigação diagnóstica da doença de Hirschsprung, em crianças com constipação crônica. MÉTODOS: Foram analisados os resultados de 372 manometrias anorretais realizadas consecutivamente em pacientes com constipação crônica. O equipamento utilizado (Proctosystem-Viotti possui dois canais utilizados para registar as pressões do esfíncter anal e da ampola retal por meio de balões conectados por sonda aos transdutores de pressão. Os valores pressóricos são avaliados em computador utilizando software específico. A ausência do reflexo inibitório reto-anal foi considerada como sugestiva de doença de Hirschsprung, sendo o diagnóstico confirmado pelos métodos tradicionais. RESULTADOS: Em 14 (3,8% dos 372 exames não foi caracterizado o reflexo inibitório reto-anal. Em nove destes 14 pacientes o diagnóstico de doença de Hirschsprung foi confirmado pela caracterização de ausência de células ganglionares na avaliação anatomopatológica. Nos outros cinco pacientes não foi realizada a biópsia retal em função da evolução clínica satisfatória com o tratamento clínico da constipação, sendo que em quatro a presença de reflexo inibitório reto-anal foi caracterizada por exame de manometria anorretal realizado posteriormente. CONCLUSÃO: O equipamento utilizado foi apropriado para a realização da manometria anorretal permitindo descartar o diagnóstico de doença de Hirschsprung em 86,5% dos pacientes. Foi identificado um pequeno grupo de pacientes nos quais, em mais da metade, o diagnóstico definitivo de doença de Hirschsprung foi estabelecido.OBJECTIVE: to evaluate results of anorectal manometry performed with equipment made in Brazil for the screening of Hirschsprung's disease in children with

Development of a pulse height analizer

International Nuclear Information System (INIS)

Moreira, E.S.

1984-01-01

The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author) [pt

Leiomyoma of the anal canal: report of two cases.

Science.gov (United States)

Witz, M; Bernheim, J; Griffel, B; Dinbar, A

1986-10-01

Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

Squamous intraepithelial lesions of the anal squamocolumnar junction: Histopathological classification and HPV genotyping

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Omar Clavero

2017-06-01

Full Text Available Background: Human papillomavirus (HPV-related anal cancer lesions are often found adjacent to the squamocolumnar junction (SCJ. We have assessed the histopathology and associated HPV genotypes in anal SCJ lesions in surgically excised anal warts in HIV-negative and –positive patients. Methods: Histopathology identified 47 squamous intraepithelial lesions (SILs adjacent to the SCJ amongst a total of 145 cases of clinically diagnosed anal condylomata. The anal SCJ lesions were further analyzed with p16, CK7 and p63 immunohistochemistry and HPV genotyping. Results: Sixteen (16/47 of the excised anal wart lesions contained HSIL; Three were HSIL and exclusively associated with oncogenic HPVs. A further thirteen (13/47 were mixed lesions. Of these eight were HSILs with LSIL and six were HSILs with papillary immature metaplasia (PIM; Ten of the mixed lesions were associated with one or more oncogenic HPVs, while three cases were exclusively associated with HPV6. Conclusions: Clinically diagnosed anal warts cannot be assumed to be limited to low-grade lesions as anal warts of the SCJ often show heterogeneous lesions, with coexistence of LSIL, PIM, and HSIL. Lesions showing PIM, however, may mimic HSIL, because they are hypercellular, but lack the nuclear atypia and conspicuous mitotic activity of HSIL; and are p16 negative. Keywords: Anal squamocolumnar junction, Low-grade squamous intraepithelial lesion (LSIL, High-grade squamous intraepithelial lesion (HSIL, Papillary immature metaplasia (PIM, HPV, HIV

An integrative review of guidelines for anal cancer screening in HIV-infected persons.

Science.gov (United States)

Wells, Jessica S; Holstad, Marcia M; Thomas, Tami; Bruner, Deborah Watkins

2014-07-01

HIV-infected individuals are 28 times more likely than the general population to be diagnosed with anal cancer. An integrative review of recommendations and guidelines for anal cancer screening was performed to provide a succinct guide to inform healthcare clinicians. The review excluded studies that were of non-HIV populations, redundant articles or publications, non-English manuscripts, or nonclinical trials. The review found no formal national or international guidelines exist for routine screening of anal cancer for HIV-infected individuals. To date, no randomized control trial provides strong evidence supporting efficaciousness and effectiveness of an anal cancer screening program. The screening recommendations from seven international-, national-, and state-based reports were reviewed and synthesized in this review. These guidelines suggest anal cancer screening, albeit unproven, may be beneficial at decreasing the incidence of anal cancer. This review highlights the paucity of screening-related research and is an area of need to provide clear direction and to define standard of care for anal cancer screening in HIV-infected persons.

Diseño preliminar de un rotor de onda para motores con microturbina

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Gina P. Pérez B.

2009-01-01

Full Text Available Este trabajo presenta un analisis preliminar sobre los beneficios de ia implementacion de un rotor de onda en una micro-turbina convencional. Este estudio se enfoca en la consecución de un punto de disefio por medio de cálculos térmicos para así lograr una geometría adecuada, la cual podra ser evaluada por medio de Dinámica de Flujo Computacional CFD para determinar la viabilidad de la implementacion de este dispositive en un motor con micro-turbina a gas de 30 lb, de empuje.

Surgical Treatment of Anal Stenosis with Diamond Flap Anoplasty Performed in a Calibrated Fashion.

Science.gov (United States)

Gülen, Merter; Leventoğlu, Sezai; Ege, Bahadir; Menteş, B Bülent

2016-03-01

Regarding anoplasty for anal stenosis, it is not clear to what extent the final anal caliber should be targeted. The aim of this study was to investigate the results of diamond-flap anoplasty performed in a calibrated manner for the treatment of severe anal stenosis due to a previous hemorrhoidectomy. Prospectively prepared standard forms were evaluated retrospectively. Anoplasty with unilateral or bilateral diamond flaps was performed for moderate or severe anal stenosis, targeting a final anal caliber of 25 to 26 mm. The demographic characteristics, causes of anal stenosis, number of previous surgeries, anal stenosis staging (Milsom and Mazier), anal calibers (millimeter), the Cleveland Clinic Incontinence Score, and the modified obstructed defecation syndrome Longo score were recorded on pre-prepared standard forms, as well as postoperative complications and the time of return to work. From January 2011 to July 2013, 18 patients (12 males, 67%) with a median age of 39 years (range, 27-70) were treated. All of the patients had a history of previous hemorrhoidectomy. The number of previous corrective interventions was 2.1 ± 1.8 (range, 0-4), and 2 patients had a history of failed anoplasty. Five patients (28%) had moderate anal stenosis and 13 (72%) had severe anal stenosis. Preoperative, intraoperative, and 12-month postoperative anal calibration values were 9 ± 3 mm (range, 5-15), 25 ± 0.75 mm (range, 24-26), and 25 ± 1 mm (range, 23-27) (p < 0.0001, for immediate postoperative and 12-month postoperative anal calibers compared with the intraoperative). Preoperative and 12-month postoperative Cleveland Clinic Incontinence Scores were 0.83 ± 1.15 (range, 0-4) and 0.39 ± 0.70 (range, 0-2) (p = 1.0). The clinical success rate was 88.9%. No severe postoperative complications were observed. This study was limited because it was a single-armed, retrospective analysis of prospectively designed data. Diamond-flap anoplasty performed in a standardized and calibrated

A trial of radiofrequency ablation for anal intraepithelial neoplasia.

Science.gov (United States)

Goldstone, Robert N; Hasan, Shirin R; Drury, Steven; Darragh, Teresa M; van Zante, Annemieke; Goldstone, Stephen E

2017-03-01

Radiofrequency ablation (RFA) effectively treats esophageal high-grade dysplasia, but its efficacy in treating anal canal high-grade squamous intraepithelial lesions (HSILs) is unsubstantiated. This prospective study assessed the safety and efficacy of applying hemi-circumferential RFA to anal canal HSIL. Twenty-one HIV-negative participants with HSIL occupying ≤ half the anal canal circumference were treated with hemi-circumferential anal canal RFA. Participants were assessed every 3 months for 12 months with high-resolution anoscopy; recurrence in the treatment zone was re-treated with focal RFA. Twenty-one participants with a mean of 1.7 lesions (range 1-4) enrolled and completed the trial. Six (29 %) participants had recurrent HSIL within the treated hemi-circumference within 1 year. Four participants (19 %) had persistence of an index lesion at 3 months. One (2.9 %) index HSIL persisted again at 12 months. No participants had more than two RFA treatments. KM curve-predicted HSIL-free survival within the treatment zone at 1 year was 76 % (95 % CI 52-89 %). Comparing the first 7 and last 14 participants, the predicted 1-year HSIL-free survivals are 43 % (95 % CI 10-73 %) and 93 % (95 % CI 59-99 %), respectively (p = 0.008), suggesting a learning curve with the treating physician. Multivariable analysis showed decreased recurrence in the last 14 participants (HR 0.02; 95 % CI 0.001-0.63) while increasing BMI increased recurrence (HR 1.43, 95 % CI 1.01-2.01). No participants had device or procedure-related serious adverse events, anal stricture, or heavy bleeding. Hemi-circumferential RFA yielded a high rate of anal HSIL eradication in HIV-negative patients at 1 year with minimal adverse events. Lesion persistence was probably related to incomplete initial ablation.

Overdiagnosis and rising rate of obstetric anal sphincter injuries (OASIS): time for reappraisal.

Science.gov (United States)

Sioutis, D; Thakar, R; Sultan, A H

2017-11-01

To determine the accuracy of clinical diagnosis of obstetric anal sphincter injuries (OASIS) using three-dimensional (3D) endoanal ultrasound (EA-US) and to compare symptoms and anal manometry measurements between women with anal sphincters adequately repaired and those with persistent anal sphincter defects. The EA-US images of women with clinically diagnosed and repaired OASIS, defined as third- or fourth-degree perineal tear, who attended the perineal clinic at Croydon University Hospital over a 10-year period (2003-2013) were reanalyzed by a single expert blind to symptoms and the results of clinical examination. St Mark's Incontinence Scores (SMIS) and anal manometry measurements were obtained and compared between women with an intact anal sphincter and those with an anal sphincter scar and between those with an intact anal sphincter and those with a defect. Anal manometry measurements were compared between women with an external anal sphincter (EAS) defect and those with an internal anal sphincter (IAS) defect. The images of 908 women were reanalyzed. No evidence of OASIS was found in 64 (7.0%) women, an EAS scar alone was detected in 520 (57.3%) and an anal sphincter defect in 324 (35.7%). Of the 324 women with a defect, 112 had an EAS defect, 90 had an IAS defect and 122 had a combined IAS and EAS defect. SMIS results were significantly higher in women with an anal sphincter defect compared with those with no evidence of OASIS (P = 0.018), but there was no significant difference in scores between women with an intact sphincter and those with an EAS scar only. Women with a defect had a significantly lower maximum resting pressure (median (range), 44 (8-106) vs 55 (29-86) mmHg; P 40) vs 25 (10-40) mm; P = 0.003). Seven percent of women with a clinical diagnosis of OASIS were wrongly diagnosed. We believe that this rate may differ from that of other units but training methods and competency assessment tools for the diagnosis and repair of OASIS need

Viscoelastic assessment of anal canal function using acoustic reflectometry: a clinically useful technique.

Science.gov (United States)

Mitchell, Peter J; Klarskov, Niels; Telford, Karen J; Hosker, Gordon L; Lose, Gunnar; Kiff, Edward S

2012-02-01

Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis. The aim of this study was to assess whether the parameters measured in anal acoustic reflectometry are clinically valid between continent and fecally incontinent subjects. This was an age- and sex-matched study of continent and incontinent women. The study was conducted at a university teaching hospital. One hundred women (50 with fecal incontinence and 50 with normal bowel control) were included in the study. Subjects were age matched to within 5 years. Parameters measured with anal acoustic reflectometry and manometry were compared between incontinent and continent groups using a paired t test. Diagnostic accuracy was assessed by the use of receiver operator characteristic curves. Four of the 5 anal acoustic reflectometry parameters at rest were significantly different between continent and incontinent women (eg, opening pressure in fecally incontinent subjects was 31.6 vs 51.5 cm H2O in continent subjects, p = 0.0001). Both anal acoustic reflectometry parameters of squeeze opening pressure and squeeze opening elastance were significantly reduced in the incontinent women compared with continent women (50 vs 99.1 cm H2O, p = 0.0001 and 1.48 vs 1.83 cm H2O/mm, p = 0.012). In terms of diagnostic accuracy, opening pressure at rest measured by reflectometry was significantly superior in discriminating between continent and incontinent women in comparison with resting pressure measured with manometry (p = 0.009). Anal acoustic reflectometry is a new, clinically valid technique in the assessment of continent and incontinent subjects. This technique, which assesses the response of the anal canal to distension and relaxation, provides a detailed viscoelastic assessment of anal canal function. This technique

Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

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Darin Ruanpeng

Full Text Available Anal cancer, one of human papillomavirus (HPV related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM and HIV-infected (HIV+ persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL using Papanicolau (Pap screening among MSM in northern Thailand and its associated factors.Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification.Mean age was 27.2 years (range 18-54. Overall, 86 (43.0% had ASIL: 28 (14.2% with atypical cells of undetermined significance (ASCUS, 1 (0.5% with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 56 (28.4% with low-grade squamous intraepithelial lesion (LSIL, and 1 (0.5% with high-grade squamous intraepithelial lesion (HSIL. ASIL was associated by univariate analysis (p ≤0.05 with older age, gender identity other than bisexual (i.e., gay men and transgender women, rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002 and HIV infection (p = 0.01.ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA, not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

Science.gov (United States)

Ruanpeng, Darin; Chariyalertsak, Suwat; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

2016-01-01

Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report

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Noone Robert

2010-02-01

Full Text Available Abstract Introduction High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States. The treatment of choice is surgical resection with anal mapping. However, this disease often recurs or persists, requiring additional surgery for these patients. This can compromise the anal sphincter leading to leakage. In this case report, we discuss the efficacy of radiation therapy as a modality to treat post-excisional recurrent Bowen's disease, which may prevent sphincter compromise, leading to improved quality of life. Case presentation An 84-year-old Caucasian woman presented with post-excisional persistent/recurrent squamous cell carcinoma in-situ. The initial lesion measured 3 cm in diameter on the right lateral side of the anal margin. A standard surgery consisting of wide local excision with anal mapping was performed. The margins were clear and our patient was followed up. Our patient recurred with a 1.2 × 0.8 cm lesion on the left anal verge extending to the anal canal. A biopsy along with mapping was done, and 2 of the 17 mapping specimens were positive for carcinoma in-situ, one in the anal canal. Due to the location of the positive anal mapping, and in order to prevent sphincter compromise on re-excision, our patient was offered definitive radiation therapy. Two years after radiation therapy, our patient showed no signs of recurrent disease and had good sphincter control. Conclusion Although the main treatment modality for treating persistent/recurrent Bowen's disease is surgery, an alternative approach using external beam radiation for CIS may be enough to provide a cure for some patients with recurrent disease.

Relation between anal electrosensitivity and rectal filling sensation and the influence of age

NARCIS (Netherlands)

Broens, PMA; Penninckx, FM

PURPOSE: The aim of this study was to assess the effect of age and sex on the rectal filling sensation and anal electrosensitivity and to explore the relation between anal electrosensitivity and the parameters of the rectal filling sensation. METHODS: Anal mucosal electrosensitivity and anorectal

The identification of specialized pacemaking cells in the anal sphincters.

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Shafik, Ahmed; El Sibai, Olfat; Ahmed, Ismail

2006-07-01

Interstitial cells of Cajal (ICC) are claimed to generate the electrical activity in the colon and stomach. As the external (EAS) and internal (IAS) anal sphincters exhibit resting electrical activity, we hypothesized the presence of ICC in these sphincters. This hypothesis was investigated in the current study. Specimens from the EAS and IAS were taken from normal areas of the anorectum which had been surgically excised by abdominoperineal operation for rectal cancer of 28 patients (16 men, 12 women, mean age 42.2+/-4.8 years). The specimens were subjected to c-kit immunohistochemistry. Controls for the specificity of the antisera consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. Fusiform, c-kit positive, ICC-like cells were detected in the anal sphincters; they had dendritic processes. They were clearly distinguishable from the non-branching, c-kit negative smooth and striated muscle cells of the anal sphincters. The specimens contained also c-kit positive mast cells, but they had a rounded body with no dendritic processes. Immunoreactivity was absent in negative controls in which the primary antibody was omitted. We have identified, for the first time, cells in EAS and IAS with morphological and immunological phenotypes similar to ICCs of the gut. These cells appear to be responsible for initiating the slow waves recorded from the anal sphincters and for controlling their activity. A deficiency or absence of these cells may affect the anal motile activity. Studies are needed to explore the role of these cells in anal motility disorders.

Percepciones en salud bucal de los niños y niñas

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Catalina González-Penagos, Colombia.

2015-07-01

Full Text Available (analítico: Identificamos las necesidades de salud bucal de los niños y niñas de 2 a 5 años del programa Buen Comienzo-Fantasías de las Américas, desde la percepción de las agentes educativas en la ciudad de Medellín, en el año 2013. Realizamos un estudio cualitativo, con enfoque histórico hermenéutico; la población de estudio correspondió a 65 agentes educativas. Los resultados preliminares reflejan necesidades relacionadas con el acceso y oportunidad de atención odontológica, la deficiencia en las acciones de promoción de la salud y prevención de las enfermedades prevalentes en salud bucal, el desconocimiento y la falta de motivación de los hábitos de higiene bucal, su importancia en la prevención de las patologías bucales y su implicación con el crecimiento y desarrollo, y con la salud general de los menores y las menores.

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin.

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Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

2016-03-01

Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190-0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375-9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167-4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

International Nuclear Information System (INIS)

Oblak, Irena; Cesnjevar, Monika; Anzic, Mitja; Hadzic, Jasna But; Ermenc, Ajra Secerov; Anderluh, Franc; Velenik, Vaneja; Jeromen, Ana; Korosec, Peter

2016-01-01

Radiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal. One hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied. The 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015). The pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer

Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

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Yuzuru Tamaru

2015-04-01

Full Text Available The standard treatment approach for squamous cell carcinoma (SCC of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD. We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

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Marina Tayla Mesquita Aguiar

2014-04-01

Full Text Available Anal cancer is relatively rare; however, its incidence has increased in recent years. Several risk factors are associated with the development of anal cancer, including age older than 50 years, low-fiber diet, chronic anal fistulas, smoking, multiple partners, anal intercourse practice, Human Immunodeficiency Virus infection and immunosuppression. However, the presence of human papillomavirus represents the main risk factor for the development of anal cancer. The aim of this study was to evaluate the clinicopathological aspects of a series of patients with anal carcinomas diagnosed in Hospital Araújo Jorge, Goiânia-Goiás, as well as the prevalence of human papillomavirus genome in these tumors. Clinical, pathological and socio-demographic data were collected from the respective medical files and paraffin blocks containing anal carcinomas specimens were used for DNA extraction and detection of human papillomavirus, by means of polymerase chain reaction, using short PCR fragment primers. Forty-three cases were selected and had the data analyzed, while 38 cases were tested for human papillomavirus genome detection. Among the evaluated patients, 62.8% were women; 53.4% of tumors were squamous cell carcinoma and 46.5% of the patients were aged between 60 and 75 years. Risk factors, such as smoking (39.5% and alcoholism (20.9% were recorded in the studied group. Lymph node metastases were detected in 30.2% of cases and 7.0% had distant metastasis. The detection of human papillomavirus DNA was positive in 76% of cases assessed and this was significantly associated with squamous cell carcinomas. Aggressive behavior and advanced stage of anal cancer described in this study highlight the need for preventive measures that contemplate these tumors, including vaccination against human papillomavirus. Resumo: O câncer anal é relativamente raro, entretanto, sua incidência aumentou nos últimos anos. Vários fatores de risco são associados ao

Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy.

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Pascual, Marta; Pera, Miguel; Courtier, Ricard; Gil, Mariá José; Parés, David; Puig, Sonia; Andreu, Montserrat; Grande, Luis

2007-08-01

Anorectal pressure studies have demonstrated internal anal sphincter (IAS) hypertonia in patients with chronic anal fissure. It is unknown however, if these changes in IAS function are associated with any abnormality in sphincter morphology. The first aim was to investigate the clinical characteristics and the manometric and endosonographic findings of the IAS in a cohort of patients with chronic anal fissure. The second aim was to investigate the association between these findings and the outcome with topical Glyceryl trinitrate (GTN) therapy. All patients who presented with chronic anal fissure from November 1999 to May 2004 were included after failure of conservative therapy. Anorectal manometry and anal endosonography were performed before treatment with 0.2% GTN ointment twice daily was initiated. Patients were evaluated after 8 weeks. One hundred and twenty-four patients (66 women, mean age, 45.2 +/- 14.8 years) were included. Hypertonia of the IAS was found in 84 (68%) patients. The mean maximum IAS thickness was 3.6 +/- 0.76 mm (1.6-5.5). An abnormally thick IAS, adjusted by age, was observed in 113 (91.1%) patients. We found no correlation between resting pressure and IAS thickness (r = 0.074; p = 0.41). At 8 weeks, 52 patients (42%) had healed with complete symptoms resolution. No statistically significant differences were observed when clinical features and manometric and endosonographic findings were compared between healing and no-healing fissures. The majority of patients with chronic anal fissure present an abnormally thick IAS. Clinical, manometric and endosonographic features had no association with outcome after GTN treatment.

Anal canal plasmacytoma - An uncommon presentation site

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Antunes, M. I.; Bujor, L.; Grillo, I. M.

2011-01-01

Background: Extramedullary plasmacytomas (EMP) are rare plasma cell tumors that arise outside the bone marrow. They are most often located in the head and neck region, but may also occur in the other locations. The lower gastrointestinal EMP represents less than 5% of all cases, and location in the anal canal is exceedingly rare. Aim: We present an exceedingly rare case of anal canal plasmacytoma, aiming to achieve a better understanding of this rare entity. Methods: We report a case of a 61-year-old man with a bulky mass in the anal canal. The lesion measured about 6 cm and invaded in all layers of the anal canal wall. The biopsy was performed and revealed a round and plasmocitoid cell population with a solid growth pattern and necrosis. The tumoral cells have express CD79a and CD138 with lambda chains. There was no evidence of disease in other locations and these features were consistent with the diagnosis of an extra-osseous plasmacytoma. The patient was submitted to conformal radiotherapy 50.4 Gy total dose, 1.8 Gy per fraction. After 24 months, the patient is asymptomatic and the lesion has completely disappeared. Conclusions: EMP accounts for approximately 3% of plasma cell malignancies. The median age is about 60 years, and the majority of patients are male. The treatment of choice for extramedullary plasmacytoma is radiation therapy in a dosage of about 50 Gy. Patients should be followed-up for life with repeated bone marrow aspiration and protein studies to detect the development of multiple myeloma. (authors)

Avaliação da técnica de epifisiodese temporária com o uso das placas de Sherman: resultados preliminares Evaluation of the temporary epiphysiodesis procedure using the sherman plate: preliminary results

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José Antonio Pinto

2010-12-01

Full Text Available OBJETIVO: Avaliar os resultados preliminares da técnica de epifisiodese temporária utilizando-se as placas de Sherman no tratamento de distúrbios e deformidades dos membros inferiores. MÉTODOS: Foram avaliados, retrospectivamente, 27 pacientes submetidos à epifisiodese temporária do fêmur distal ou tíbia proximal com as placas de Sherman, em um total de 28 procedimentos. A idade média no momento da cirurgia foi de 11,2 anos (3-15 anos. Os implantes de dois furos eram confeccionados em liga de aço e apresentavam um orifício central para ser utilizado como guia. A fixação foi feita com dois parafusos canulados de 3,5mm. As indicações para o tratamento foram os desvios angulares dos membros inferiores em valgo (n = 10, varo (n = 2 e mistos (n = 1; discrepância do comprimento dos membros (n = 9; e contratura em flexo do joelho (n = 5. RESULTADOS: O tempo médio de seguimento foi de 11,78 meses (±4,07. Observamos apenas um evento adverso (migração do implante em um paciente submetido à epifisiodese anterior do fêmur distal para correção de flexo de joelho. Não houve nenhum caso de quebra do material ou fechamento fisário prematuro. CONCLUSÃO: A técnica de epifisiodese temporária com o uso das placas de Sherman mostrou ser de fácil execução e esteve envolvida com um baixo índice de complicações e custo inferior aos implantes similares em titânio. Por ser um procedimento de baixa morbidade, pode ser indicado em uma ampla faixa etária e para uma grande variedade de distúrbios do esqueleto imaturo.OBJECTIVE: To evaluate the preliminary results of a technique using temporary epiphysiodesis plates using a Sherman plate in the treatment of disorders and deformities of the lower limbs. METHODS: We retrospectively reviewed 27 patients who underwent temporary epiphysiodesis of the distal femur or proximal tibia with Sherman plates, comprising 28 procedures. The mean age at surgery was 11.2 years (3-15 years. The two

Desarrollo y validación de los métodos analíticos para el control de calidad del micocilén polvo

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Yania Suárez Pérez

2011-06-01

Full Text Available El micocilén es un medicamento que se presenta en forma de polvo. Contiene 2 ingredientes farmacéuticos activos: el ácido undecilénico y el undecilinato de zinc. Por su acción fungistática, se ha convertido en un producto de alta demanda en Cuba, ya que las micosis se favorecen en climas cálidos y húmedos. Se realizó el desarrollo y la validación de 2 métodos analíticos para el control de calidad sobre la base de la cuantificación de cada analito presente en la formulación. Se seleccionaron técnicas volumétricas por neutralización acuosa y complejometría. Los resultados fueron satisfactorios, ya que en ambos casos se obtuvo adecuada especificidad, linealidad, exactitud, precisión y robustez. Los métodos propuestos se compararon con los aplicados anteriormente y se obtuvieron resultados mucho más confiables, según resultados del análisis estadístico aplicado, sin diferencias significativas entre las réplicas de un mismo lote.

Los exámenes preliminares de la Corte Penal Internacional en América Latina: el caso colombiano y su impacto sobre futuras negociaciones de paz en la región

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Héctor Olásolo Alonso

2014-06-01

Full Text Available El artículo comienza analizando la función de la Fiscalía de la Corte Penal Internacional en la aplicación del principio de complementariedad, a través de los exámenes preliminares realizados durante los diez primeros años de funcionamiento de la Corte Penal Internacional. Se subraya la relevancia de los exámenes preliminares para fortalecer los órganos jurisdiccionales nacionales y el Estado de Derecho en los Estados afectados, y se constata que cada situación bajo examen requiere de una estrategia de actuación diferente debido a las particulares circunstancias que la rodean. A continuación, se analizan las características del fenómeno de la lesa humanidad en Colombia y las consecuencias de su configuración como crímenes internacionales de ius cogens. A la luz de lo anterior, se aborda el impacto del examen preliminar que la Fiscalía de la CPI viene desarrollando sobre la situación de Colombia para las actuales negociaciones de paz entre el Gobierno y las FARC. Para finalizar, el autor realiza algunas observaciones finales sobre la importancia de este examen preliminar más allá de Colombia para futuras negociaciones de paz en la región.

Instalação e resultados preliminares de programa de rastreamento populacional de câncer colorretal em município brasileiro Screening of colorectal cancer in a Brazilian town - preliminary results

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Rodrigo Oliva Perez

2008-03-01

, 3.640 exames foram analisados, o que corresponde a 43,7% da população alvo e 79,7% dos exames distribuídos. Foram obtidos 390 exames com resultado positivo (10,7% e 3.250 negativos (89,3%. Dos 245 pacientes positivos convocados a realizar colonoscopia, 33 (13,5% se recusaram. Das 212 colonoscopias realizadas foram diagnosticados: 53 pacientes com doença diverticular, 59 com 1 ou mais pólipos, 9 com adenocarcinomas e 91 colonoscopias normais. Os pacientes com adenocarcinoma, 3 foram tratados endoscopicamente por portarem lesão pequena e precoce, os outros 6 pacientes foram encaminhados para tratamento cirúrgico e quimioterápico. CONCLUSÕES: Os resultados preliminares são insuficientes para estimar qual foi o real efeito da campanha, contudo, pode-se antever redução da incidência de CCR a longo prazo, além de antecipação do diagnóstico e, portanto, do estádio da doença melhorando o prognóstico.BACKGROUND: The colorectal cancer accounts for about 500,000 deaths/year worldwide and ranks third in death by neoplasia. Patient mortality is directly related to its stage when diagnosed. Screening allows early diagnosis, reason why it turns out to be an effective tool to reduce mortality. AIM: To assess the impacts of the colorectal cancer prevention campaign in a Brazilian municipality, to estimate the disease occurrence and to forecast reduction of its incidence in the long term. METHODS: The Giant Colon, a replica of the human colon, created by ABRAPRECI, was exposed in the local Sports Gymnasium, in order to educate the population on the parts of the organ and the main diseases affecting it. Screening was then performed with the occult blood test kit, (Hemosure®, immunological type, in the population over 40 years of age, asymptomatic and without previous CRC screening. People with negative results were registered for annual control and those with positive result were referred to colonoscopy to determine the presence of neoplasic or pre

Estimulação cerebral profunda no núcleo subtalâmico para doença de Parkinson Deep brain stimulation of subthalamic nucleous in Parkinson's disease

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José Augusto Nasser

2002-03-01

Full Text Available OBJETIVO: Apresentamos os resultados preliminares da estimulação cerebral profunda crônica no núcleo subtalâmico para os sintomas motores da doença de Parkinson. MÉTODO: 8 pacientes com doença de Parkinson há mais de 5 anos, apresentando tremor incapacitante, oligocinesia e rigidez acentuada com predomínio unilateral, 3 à direita e um à esquerda, refratários �� medicação adequada, foram submetidos ao implante bilateral de eletrodo cerebral profundo permanente subtalâmico, Itrell 2. Estes pacientes foram avaliados segundo as escalas: UPDRS, Schwab e England. RESULTADOS: Os resultados preliminares (6 meses, mostraram melhora significativa dos sinais e sintomas avaliados pelas escalas acima. Não houve complicações com os procedimentos. CONCLUSÃO: Os resultados preliminares indicam que a estimulação subtalâmica é uma boa opção terapêutica, estando de acordo com os resultados da literatura.We present the preliminary results in patients well selected to be implanted by deep brain stimulation (DBS for Parkinsons's disease (PD. METHODS: 8 PD patients with disabled tremor, akinetic/bradikinetic and rigidity, in spite of best therapeutic assay with poor response were referred to surgery. It was implanted DBS Itrell 2. Theses patients were evaluated by the following scales: UPDRS, Schwab and England. RESULTS: The preliminary results in 6 months showed significant improvement of motor performance and it is shown by the scores. There were no complications so far with these procedures. CONCLUSION: The preliminary results indicate that DBS is highly effective, with benefit to those patients and it is according to literature.

Aspectos preliminares del manejo reproductivo en cautiverio de la doncella (Ageneiosus pardalis Lütken, 1874

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Pedro Contreras C.

2012-12-01

Full Text Available Objetivo. Evaluar procedimientos de manejo en cautiverio de ejemplares maduros de doncella Ageneiosus pardalis, con fines de reproducción y presentar una descripción preliminar del desarrollo embrionario y larvario para la especie. Materiales y métodos. Sobre ejemplares mantenidos en cautiverio se adelantaron dos ensayos de reproducción, así: a inducción con extracto de hipófisis de carpa EHC para la espermiación (4 mg/kg; una dosis intraperitoneal y para la ovulación (0.5 y 5 mg/kg; intraperitoneales, 0 y 12 horas; b inducción únicamente sobre hembras mantenidas en piletas, sin machos presentes, recolección y seguimiento de ovas. Resultados. Se comprobó la ovulación y la espermiación, pero no se avanzó en el desarrollo embrionario cuando se mezclaron los gametos y fueron incubados. Los ensayos con hembras inducidas, sin machos presentes, confirman el almacenamiento de esperma en los ovarios y los huevos obtenidos mostraron desarrollo embrionario completo, lográndose eclosión de larvas y el mantenimiento de alevinos. Conclusiones. El protocolo convencional de inducción fue efectivo en hembras y machos, pero la mezcla de los gametos no resultó ser un procedimiento viable para la producción de semilla en la especie. Se comprueba el almacenamiento de esperma en las hembras y la emisión espontánea de huevos fertilizados al medio cuando estas son sometidas a inducción. Tanto la forma y el tiempo de almacenamiento de esperma como los mecanismos fisiológicos que ocurren en la fecundación se desconocen.

Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

Science.gov (United States)

Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

2014-08-01

Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered. © 2014 Steunstichting ESOT.

Anal endosonographic findings in women after vaginal delivery

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Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

2011-04-15

Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia.

Science.gov (United States)

Mazeingia, Yohannes Teka; Olijjira, Lemessa; Dessie, Yadeta

2017-01-01

Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia. Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis. Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience. Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk

Comunicación preliminar sobre el uso de la penicilina nebulizada en algunas afecciones del aparato respiratorio

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Hernán Cortés Maal

1947-03-01

Full Text Available El objeto principal de esta comunicación preliminar sobre la terapéutica por las nebulizaciones de penicilina, es el de presentar al honorable cuerpo Médico de Colombia, un procedimiento nuevo en la aplicación de la penicilina, procedimiento que ya se ha generalizado y divulgado bastante en el estranjero y que entre nosotros se ha enmpleado muy poco.

El Cuestionario de Ansiedad Laboral (C.A.L.). Resultados preliminares

OpenAIRE

González-Romá, Vicente; Espejo Tort, Begoña; Lloret Segura, Susana

1993-01-01

La aceptación de la naturaleza multidimensional de la ansiedad ha llevado a su abandono como una entidad explicativa unitaria. Las dimensiones de la ansiedad comprenden las interacciones entre el ambiente y el comportamiento cognitivo y/o fisiológico y/o motor, y dado que los tres sistemas interactúan entre sí, es necesaria la medición de las tres dimensiones. Sin embargo, en muchas investigaciones solo se ha medido uno de los componentes de la ansiedad, como ocurre en el ámbito de las organi...

Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

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Cherie Amsale

2012-01-01

Full Text Available Abstract Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190 and that of anal sex was 4.3% (154. Of these 51.6% (98 had oral sex and 57.1% (87 had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2 and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5. Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4, and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7. Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to

Correlates of unprotected anal intercourse: the influence of anal sex position among men who have sex with men in Beijing, china.

Science.gov (United States)

Zhang, Heng; Lu, Hongyan; Pan, Stephen W; Xia, Dongyan; Zhao, Yuejuan; Xiao, Yan; He, Xiong; Yue, Hai; Sun, Zheya; Xu, Yunan; Ruan, Yuhua; Shao, Yiming

2015-02-01

Understanding barriers to consistent condom use among men who have sex with men (MSM) requires consideration of the context in which risk behaviors occur. Anal sex position is one such context. This pooled cross-sectional study used survey data from 1,230 MSM and their 2,618 reported male sexual partnerships. Overall, nearly half of the participants engaged in unprotected anal intercourse (UAI) with at least one of upto three partners in the past 6 months. "Insertive" men engaged in less UAI (39 %) than "receptive" (53 %) or "versatile" (51 %) men. Regardless of sexual position, UAI was associated with cohabiting with a male or female partner and perceiving great or moderate risk of HIV from male contact at the individual level, and steady (vs. casual) partnership at the dyad level. However, early MSM anal sex debut, high number of male partners, alcohol use, receiving and buying condoms, HIV testing, and MSM sex-seeking venues were found to be only statistically significantly correlated with UAI among some but not all sexual positions, implying that interventions to increase condom use should take into account how anal sex position may influence willingness and ability to engage in safer sex. Dyad level data appear to provide additional insight into the influence of sexual positions, and should be used to complement individual data for future intervention designs.

Samatähenduslike sünteetiliste ja analüütiliste verbide kasutamine

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Pille Eslon

2015-10-01

Full Text Available Huvi samatähenduslike sünteetiliste ja analüütiliste verbide vastu tekkis artikli esimesel autoril vene-eesti-vene tõlkesõnastikke toimetades, kui silma hakkasid regulaarsed valikud vene verbi grammatilise aspekti ning eesti keele sünteetiliste ja analüütiliste verbide vahel. Kuigi tegu on raskesti märgatava ja sugugi mitte sagedase nähtusega, tekitab see küsimusi: millal eelistab emakeelekõneleja kasutada sünteetilist, millal analüütilist verbi; kas lisaks samatähenduslikkusele ja vormilisele lihtsusele (sünteetiline verb koosneb ühest komponendist või keerukusele (analüütiline verb vähemalt kahest komponendist on veel tunnuseid, mis sünteetilise ja analüütilise verbi valikuid piiravad. Käesoleva uurimuse eesmärk on leida nendele küsimustele vastuseid. Analüüsitakse viit samatähendusliku sünteetilise ja analüütilise verbi paari (igatsema – igatsust tundma, lahkuma – ära minema, nõustuma – nõus olema, muretsema – muret tundma, töötama – tööd tegema, otsitakse mõlema verbi kasutusele omaseid keelestruktuure, analüüsitakse nende leksikaalsemantilise ja morfosüntaktilise varieerumise piire, võrreldakse verbide tähendusi. Nende tunnuste põhjal saab teha mõningaid järeldusi selle kohta, kas tegu võiks olla ühe verbi kahe vormiga või kahe erineva verbiga. Uurimuse empiiriline aspekt on seotud hüpoteesiga semantiliselt lähedaste sünteetiliste ja analüütiliste verbide tõmbumisest, millega kaasnevad ühelt poolt struktuursed, morfoloogilised, morfosüntaktilised ja leksikaalsemantilised kasutuspiirangud ning teisalt vaba varieerumine. Sisuliselt vastandlikud tendentsid – kinnistumine ja varieerumine – toimivad keele leksikaalgrammatilises perifeerias sama eesmärgi nimel, tagades keele pideva uuenemise ja säilimise.

Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

DEFF Research Database (Denmark)

Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli

2011-01-01

In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

The Danish anal sphincter rupture questionnaire: Validity and reliability

DEFF Research Database (Denmark)

Due, Ulla; Ottesen, Marianne

2008-01-01

Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have been...... main questions but one. Two questions needed further explanation. Seven women made minor errors. Conclusion. The validated Danish questionnaire has a good construct, content and face validity. It is a well accepted, reliable, simple and clinically relevant screening tool. It reveals physical problems...... offered pelvic floor muscle examination and instruction by a specialist physiotherapist. In relation to that, a non-validated questionnaire about anal and urinary incontinence was to be answered six months after childbirth. Method. The original questionnaire was revised and a pilot test was performed...

[Detection and analysis of the characteristic expression of microRNAs of anal fistula patients].

Science.gov (United States)

Qiu, Jianming; Yu, Jiping; Yang, Guangen; Xu, Kan; Tao, Yong; Lin, Ali; Wang, Dong

2016-07-01

To detect and analyze the characteristic miRNAs profile of anal fistula and explore their possible target genes and potential clinical significance. The anal mucosa close to the hemorrhoids were collected from three patients undergoing fistulectomy and hemorrhoidectomy (fistula group) as well as three patients receiving only hemorroidectomy(hemorrhoids group), matching with fistula group in age, gender and body weight. miRNA microarray was used to compare the expression of 1 285 human miRNAs of the anal mucosa between two groups. Cluster analysis was adopted to analyze the accumulation of the differentially expressed miRNAs(Pcharacteristic miRNAs profile in anal fistula patients, which may play a role in the occurrence and development of anal fistula.

Nuevas fuentes de evidencia para la paleoparasitología y la antropología biológica en Patagonia: resultados preliminares

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Fugassa, Martín H.

2007-01-01

Full Text Available La paleoparasitología ofrece una vía de análisis complementaria para la reconstrucción de la historia de las poblaciones humanas antiguas. Diversos materiales arqueológicos son examinados mediante la combinación de técnicas de parasitología clínica y técnicas paleoparasitológicas específicas. La exploración de nuevas técnicas y fuentes de evidencia representan una de las claves para el desarrollo de la disciplina. El examen paleoparasitológico de vestimenta aborigen, de pellets de regurgitación de aves y de pequeñas cantidades de sedimento alojados en los forámenes sacrales de esqueletos que forman parte de colecciones ha brindado nuevos resultados. Estos hallazgos remarcan el valor de la totalidad de los restos arqueológicos y la importancia de su conservación.

Tunni analüüs - mis see on? / Peep Leppik

Index Scriptorium Estoniae

Leppik, Peep

2001-01-01

Tunni analüüs, õppe-kasvatustöö eesmärgid. Tunni analüüs on hinnangu andmine protsessidele, mille kutsub esile õpetaja tegevus (või tegevusetus) tunnis. Tunni läbiviimise protsessi mõjutavad õpilaste koosseis klassis, erinevate õppevormide ja õppemeetodite kasutamine, kasutatud õppevõtete otstarbekus, erinevad metoodikad ja õppesüsteemid

HPV and anal cancer in HIV-infected individuals: a review

NARCIS (Netherlands)

Schim van der Loeff, Maarten F.; Mooij, Sofie H.; Richel, Oliver; de Vries, Henry J. C.; Prins, Jan M.

2014-01-01

HIV infection is one of the strongest risk factors for anal squamous cell cancer (ASCC). Most ASCC are caused by HPV, and most HPV-associated ASCC are caused by HPV-16. Anal HPV infections are very common in men who have sex with men (MSM), and nearly universal among HIV-infected MSM. High-grade

Setor de Bebidas no Brasil: Abrangência e Configuração Preliminar / Beverage Sector in Brazil: Preliminary Scope and Configuration

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Juliana Trombeta Reis

2015-07-01

Full Text Available A importância econômica gerada por diferentes bebidas no Brasil é inegável, assim buscou-se nesta pesquisa exploratória de caráter documental, contribuir para a compreensão da organização e abrangência do setor de bebidas no país. Recorreu-se ao levantamento de dados em fontes impressas e eletrônicas, além de contato pessoal com várias entidades, para descrever os principais segmentos de bebidas e explicar a atuação de diversos órgãos, associações e entidades que atuam no setor, como as indicações de procedência e o reconhecimento de regiões geográficas de bebidas. Propõe uma classificação inicial desses segmentos, unindo as visões do mercado e da academia, e apresenta um diagrama preliminar do setor com a indicação da participação de entidades e órgãos. Os resultados revelaram um setor complexo que permeia diversas áreas, cuja configuração preliminar mostrou ações e iniciativas de diferentes atores, ao lado de oportunidades de negócios e estudos estratégicos ao seu desenvolvimento. Palavras-chave: Hospitalidade. Setor de Bebidas. Características das Bebidas. Brasil. Beverage Sector in Brazil: Preliminary Scope and Configuration - The economic importance generated by different beverages in Brazil is undeniable, therefore this exploratory research of documental character, seeks to contribute to the understanding of the organization and scope of the beverage industry in the country. Survey data in printed and electronic sources, as well as personal contact with various entities, were used to describe the main segments of beverages and to describe the role of different associations and organizations working in the sector. This study proposes an initial classification of these segments, combining the views of the market and academia. It also presents a preliminary diagram of the industry indicating the participation of associations, entities and government organs. The results revealed a complex sector that

The anal canal as a risk organ in cervical cancer patients with hemorrhoids undergoing whole pelvic radiotherapy.

Science.gov (United States)

Jang, Hyunsoo; Baek, Jong Geun; Jo, Sunmi

2015-01-01

Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. The anal verge was located an average of 1.2 cm (range -0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range -0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.

Anal HPV infection in HIV-positive men who have sex with men from China.

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Lei Gao

Full Text Available BACKGROUND: Anal HPV infection, which contributes to the development of anal warts and anal cancer, is well known to be common among men who have sex with men (MSM, especially among those HIV positives. However, HIV and anal HPV co-infection among MSM has not been addressed in China. METHODS: A cross-sectional study was conducted in Beijing and Tianjin, China. Study participants were recruited using multiple methods with the collaboration of local volunteer organizations. Blood and anal swabs were collected for HIV-1 serological test and HPV genotyping. RESULTS: A total of 602 MSM were recruited and laboratory data were available for 578 of them (96.0%. HIV and anal HPV prevalence were 8.5% and 62.1%, respectively. And 48 MSM (8.3% were found to be co-infected. The HPV genotypes identified most frequently were HPV06 (19.6%, HPV16 (13.0%, HPV52 (8.5% and HPV11 (7.6%. Different modes of HPV genotypes distribution were observed with respect to HIV status. A strong dose-response relationship was found between HIV seropositivity and multiplicity of HPV genotypes (p<0.001, which is consistent with the observation that anal HPV infection was an independent predictor for HIV infection. CONCLUSIONS: A high prevalence of HIV and anal HPV co-infection was observed in the MSM community in Beijing and Tianjin, China. Anal HPV infection was found to be independently associated with increased HIV seropositivity, which suggests the application of HPV vaccine might be a potential strategy to reduce the acquisition of HIV infection though controlling the prevalence of HPV.

Determinação analítica da performance da irrigação por sulcos abertos e em declive

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Aristides Fraga Lima Filho

2015-06-01

Full Text Available Uma solução analítica foi desenvolvida, para avaliar sulcos abertos e em declive, com base na teoria de Balanço de Volume de Walker e Skogerboe (1987. Essa metodologia é capaz de obter, matematicamente, a performance de um sistema, dispensando a construção de gráficos que definem os parâmetros de avaliação. A solução matemática é baseada no ajuste de equações ao modelo potencial, no cálculo das áreas sob as curvas definidas no ajuste e na intercessão de curvas, obtendo-se, assim, a performance de sistemas de irrigação por sulcos abertos e em declive. Para validação da metodologia, foi realizado um experimento de campo, na Fazenda Experimental da Universidade Federal do Ceará, situada no município de Pentecoste, pertencente ao Centro de Ciências Agrárias. Os dados de campo foram submetidos à análise pelas duas metodologias. Os resultados mostraram que a metodologia analítica pode ser usada para avaliar a irrigação por sulcos abertos e em declive.

HIV-positive MSM's knowledge of HPV and anal cancer self-sampling: A scoping review.

Science.gov (United States)

Poon, M K L; Wong, J P H; Li, A T W; Manuba, M; Bisignano, A; Owino, M; Vahabi, M

2018-02-01

Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases. Available research has also shown high prevalence of anal hpv infection among men who have sex with men (msm). However, hpv vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of hpv and anal cancer among hiv-positive msm and (2) the acceptability of hpv and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates ( n= 40) and unmet criteria ( n= 754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that hiv-positive msm have limited knowledge regarding the risks of anal cancer associated with hiv and hpv coinfection. Furthermore, there is limited research on hpv and anal cancer self-sampling in this population. However, the review of available studies suggested that hiv-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach hiv-positive msm regarding anal cancer education and self-screening.

Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

Science.gov (United States)

Kamm, M A; Hoyle, C H; Burleigh, D E; Law, P J; Swash, M; Martin, J E; Nicholls, R J; Northover, J M

1991-03-01

A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. Constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. In vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance P, calcitonin gene-related peptide, galanin, neuropeptide Y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.

Avaliação in vivo do efeito hipocolesterolêmico e toxicológico preliminar do extrato bruto hidroalcoólico e decocção da Vitex megapotamica (Spreng Moldenke (V. montevidensis Cham.

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Anna Paula Brandt

Full Text Available As doenças cardiovasculares (DC estão, de modo geral, associadas a elevados níveis séricos de lipídeos, atingindo homens e mulheres, sem distinção de idade. Entre as propriedades atribuídas pela medicina popular à Vitex megapotamica (Spreng Moldenke (V. montevidensis Cham -Tarumã estão a de reduzir os níveis séricos de colesterol e triglicerídeo. O principal objetivo do presente estudo foi avaliar o potencial hipocolesterolêmico e hipolipidêmico da V. megapotamica, bem como fazer um estudo toxicológico preliminar. Para tanto, foi realizada indução hiperlipidêmica usando um modelo que preconiza o emprego de propiltiuracil 1,25 mg/300 g de peso e colesterol 200 mg/kg de peso, aplicados via oral em ratos machos pesando 300 ± 10 g. Foi administrado, por via oral, aos animais hiperlipidêmicos previamente induzidos 300 mg/kg de extrato hidroalcoólico das folhas de V. megapotamica ou 300 mL da decocção da casca da planta. Após o final de cada tratamento, o perfil lipídico foi ensaiado, bem como os níveis de glicose, quando relevante. Nossos resultados confirmaram o efeito hipolipidêmico do extrato hidroalcoólico e da decocção pela redução dos níveis séricos de colesterol e triacilglicerol nas concentrações, via e forma utilizadas. Além disso, foi possível verificar que não houve lesão cardíaca, hepática ou renal pelo extrato e decocção utilizados nas avaliações toxicológicas preliminares ensaiadas.

Anal carcinoma in HIV-infected patients in the period 1995-2009

DEFF Research Database (Denmark)

Legarth, Rebecca; Helleberg, Marie; Kronborg, Gitte

2013-01-01

Abstract Background: Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis...... 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma....... Results: Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased...

Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

Science.gov (United States)

García-Montes, M J; Argüelles-Arias, Federico; Jiménez-Contreras, S; Sánchez-Gey, S; Pellicer-Bautista, F; Herrerías-Gutiérrez, J M

2010-01-01

To assess the efficiency of endorectal ultrasound (ERUS) in the study of chronic idiopathic anal pain (CIAP). This is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz) was used. One patient could not tolerate the examination. In 8 patients (20% of cases) alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women) internal anal sphincter (IAS) hypertrophy, and in 5 patients (4 women and 1 man) a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman). ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

Indicação da anuscopia de alta resolução e citologia anal na prevenção de HPV e câncer colorretal em pacientes portadores de HIV Indication of high resolution anoscopy and anal cytology for prevention of HPV and colorectal cancer in HIV patients

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Hugo Leonardo Madeiro Arcanjo Silva

2010-12-01

Full Text Available OBJETIVO: Rastreamento do papilomavírus humano (HPV assim como sua correlação com a neoplasia anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV por meio da anuscopia de alta resolução (AAR e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de anatomia patológica para coloração e posterior análise. RESULTADOS: Verificamos 22 pacientes do sexo masculino e 9 do sexo feminino entre 20 e 67 anos. Dos 31 analisados, quatro encontravam-se em estágio de imunodepressão, 23 utilizavam terapia antirretroviral, 16 com passado de sexo anal receptivo e 12 com passado de condiloma acuminado. À AAR 11 pacientes tinham alterações e 7 foram confirmados pela citologia. Verificamos ainda oito pacientes com alterações à citologia os quais possuíam ausência de alterações à AAR. À citologia apresentaram três células escamosas atípicas de significância (Ascus, do inglês atypical squamous cells of undetermined significance, cinco com paraceratose e/ou hiperceratose, seis lesões intraepiteliais de baixo grau e uma lesão intraepitelial de alto grau. CONCLUSÃO: Sugerimos a utilização da AAR aliada à citologia anal para rastreamento nos pacientes portadores do HIV, visto que esses exames complementam-se para a detecção de lesões que estejam relacionadas ao câncer anorretal.OBJECTIVE: Screening for HPV as well as its correlation with anorectal cancer in patients carrying the human immuno deficiency virus (HIV through high-resolution anoscopy (HRA and anal cytology. METHODS: We developed an observational study, double-blind attended by 31 patients with HIV independent proctologic complaints. Patients underwent HRA and anal cytology slides were sent to which sector pathology staining and

ESTUDIOS MACRO Y MICROSCOPICO DEL SACO ANAL DEL COIPO (Myocastor coypus)

OpenAIRE

Rafasquino, Marta E.; Ramos, Pablo A.; Alonso, Cristina R.; Idiart, Julio R.

1998-01-01

RESUMEN:Fue realizada la disección del saco anal de 44 coipos, de ambos sexos, de distintas edades y procedencias, observándose algunas características similares a los sacos anales del perro y gato, aunque es impar y está ubicado en ventral del ano. Es ovoídeo o piriforme, siendo más grande en los adultos y, entre éstos, más aún en los machos que en las hembras; posee un conducto que desemboca en el canal anal a un centímetro del ano y que se exterioriza en el momento de secretar el producto ...

Situación actual y perspectivas profesionales de los estudiantes de medicina de nueve países de Latinoamérica, 2008: estudio preliminar

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Percy Mayta-Tristán

2010-01-01

Full Text Available Objetivos: explorar, en forma preliminar, la situación actual y perspectivas profesionales de estudiantes de medicina de Latinoamérica. Diseño: Análisis secundario de datos de un estudio transversal para validación de dos escalas. Lugar: 19 escuelas de medicina de nueve países de Latinoamérica. Participantes: Estudiantes de medicina de primer a sexto año que estaban matriculados en el primer semestre académico del 2008. Intervenciones: Encuesta autoadministrada. Principales medidas de resultados: Frecuencias absolutas y relativas de los diversos indicadores del perfil estudiantil. Resultados: Se incluyó 443 estudiantes, 55% fueron varones con edad promedio de 21,5 ± 2,6 años, 4,5% tiene hijos, 37% estudia en una ciudad diferente a la que nació, 39% fue hospitalizado antes de ingresar a la carrera, 20,3% refiere haber sido influenciados por sus padres para elegir la carrera, 7% no está seguro si es su vocación y 22,9% ha pensado retirarse. 82% se proyecta trabajar en labor hospitalaria y 2,3% en un centro de salud, 47,6% refiere que la remuneración que perciben los médicos en sus países es insuficiente, 40,1% quiere ejercer su carrera fuera de su país (Brasil 12,5%, Chile 18,5%, Honduras 26,5%, Venezuela 31,3%, Ecuador 37,5%, Paraguay 38,3%, Perú 47,7%, Colombia 47,8% y El Salvador 59,1%, 15,4% de ellos refiere no regresar a su país. Conclusiones: Los estudiantes de medicina tienen diferentes motivaciones y expectativas sobre su futuro profesional, que deben tenerse en cuenta para futuras intervenciones o políticas que permitan orientar la formación médica según los requerimientos de cada país.

Primary radiation therapy in the treatment of anal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

1983-09-01

From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

Primary radiation therapy in the treatment of anal carcinoma

International Nuclear Information System (INIS)

Cantril, S.T.; Green, J.P.; Schall, G.L.; Schaupp, W.C.

1983-01-01

From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N 0 patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease

Presence of skin metastasis related to an epidermoid carcinoma of anal canal

International Nuclear Information System (INIS)

Danta Fundora, Debora; Collado Otero, Juan Carlos; Vazquez Gonzalez, Jose Manuel; Paredes Lopez, Dagmar

2009-01-01

Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum

Avaliação do tratamento de fissura anal crônica com isossorbida tópica a 1% Evaluation of the treatment of chronic anal fissure with topical isosorbide 1%

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Ana Carolina Lisboa Prudente

2010-12-01

Full Text Available INTRODUÇÃO: Fissuras anais crônicas são úlceras benignas, dolorosas, profundas. Ocorrem devido a trauma das fezes, hipertonia esfincteriana e pobre vascularização. Cirurgia é mais efetiva, porém com efeitos adversos (incontinência anal. Terapia conservadora consegue decréscimo transitório da pressão de repouso, cicatrizando muitas lesões, sem dano muscular. MÉTODOS: Objetivando avaliar tratamento de fissuras crônicas com isossorbida (ISO a 1% tópica, foi realizado um ensaio clínico, duplo-cego em pacientes do Serviço de Coloproctologia da Universidade Federal de Sergipe (UFS - Aracaju, Sergipe, durante um ano. Foram estudados 24 pacientes: 14 no Grupo 1 - creme com ISO, e 10 no Grupo 2 - placebo. Avaliaram-se comportamento da pressão de repouso, melhora da dor e grau de cicatrização das feridas com e sem ISO. RESULTADOS: Resultados mostraram que a fissura acometeu mais mulheres, a constipação foi observada em 58,3%. Quanto à dor, obteve-se menor intensidade no Grupo 2, mas sem significância. A cicatrização ao fim de 60 dias foi igual nos dois grupos (50%. Quanto às médias de pressão de repouso com 30 e 60 dias, houve queda no padrão em ambos os grupos, porém sem significância. Observou-se que pacientes curados foram os de maior redução de pressão de repouso. CONCLUSÃO: Concluiu-se que a ISO não modificou o padrão de resposta manométrica; todavia, houve melhora clínica importante nos dois grupos, cuja taxa de cicatrização foi equivalente.INTRODUCTION: Chronic anal fissures are deep, benign and painful ulcers. The involved factors are local trauma, sphinter hypertonia and poor blood flow. Surgery is gold standard treatment, but it causes fecal incontinence. Medical non-surgical therapy gets transitory resting pressure reduction and cure of lesions, without muscular damage. METHODS: In order to evaluate the treatment of chronic anal fissures using topical isossorbide (ISO 1%, a randomizated and double

Testing for and the role of anal and rectal sensation.

Science.gov (United States)

Rogers, J

1992-03-01

The rectum is insensitive to stimuli capable of causing pain and other sensations when applied to a somatic cutaneous surface. It is, however, sensitive to distension by an experimental balloon introduced through the anus, though it is not known whether it is the stretching or reflex contraction of the gut wall, or the distortion of the mesentery and adjacent structures which induces the sensation. No specific sensory receptors are seen on careful histological examination of the rectum in humans. However, myelinated and non-myelinated nerve fibres are seen adjacent to the rectal mucosa, but no intraepithelial fibres arise from these. The sensation of rectal distension travels with the parasympathetic system to S2, S3 and S4. The two main methods for quantifying rectal sensation are rectal balloon distension and mucosal electrosensitivity. The balloon is progressively distended until particular sensations are perceived by the patient. The volumes at which these sensations are perceived are recorded. Three sensory thresholds are usually defined: constant sensation of fullness, urge to defecate, and maximum tolerated volume. The modalities of anal sensation can be precisely defined. Touch, pain and temperature sensation exist in normal subjects. There is profuse innervation of the anal canal with a variety of specialized sensory nerve endings: Meissner's corpuscles which record touch sensation, Krause end-bulbs which respond to thermal stimuli, Golgi-Mazzoni bodies and pacinian corpuscles which respond to changes in tension and pressure, and genital corpuscles which respond to friction. In addition, there are large diameter free nerve endings within the epithelium. The nerve pathway for anal canal sensation is via the inferior haemorrhoidal branches of the pudendal nerve to the sacral roots of S2, S3 and S4. Anal sensation may be quantitatively measured in response to electrical stimulation. The technique involves the use of a specialized constant current generator

Should anorectal ultrasonography be included as a diagnostic tool for chronic anal pain?

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M. J. García-Montes

Full Text Available Objective: to assess the efficiency of endorectal ultrasound (ERUS in the study of chronic idiopathic anal pain (CIAP. Material and method: this is a prospective and descriptive study in which 40 patients, 18 men and 22 women with an average of 47 years, were included. They had chronic anal pain of at least 3 months' duration. A complete colonoscopy was performed in all patients, which found no abnormalities to explain clinical symptoms. Patients with anal fissure and internal hemorrhoids of any degree, perianal suppurative processes, and pelvic surgery were excluded from the study. An ALOKA ProSound SSD-4000 ultrasound console attached to a multifrequency radial transductor ASU-67 (7.5 and 10 MHz was used. Results: one patient could not tolerate the examination. In 8 patients (20% of cases alterations were detected during ultrasonography: in 4 patients (10% of the cases; 1 man and 3 women internal anal sphincter (IAS hypertrophy, and in 5 patients (4 women and 1 man a torn sphincter complex. A tear in the upper IAS canal and hypertrophy of the middle anal canal were observed in one patient (1 woman. Conclusions: ERUS is a simple, economic and useful test to study anorectal pathologies. Although in most studied cases no damage to the anal canal or rectal wall was detected, in a considerable number of patients we observed a thickening of the IAS, a probable cause of anal pain. Therefore, we understand that ERUS should be included in the study of CIAP.

Emprego da sondagem elétrica vertical integrada às análises químicas e microbiológicas no diagnóstico preliminar da contaminação do solo e da água subterrânea no cemitério municipal da cidade de Rio Claro (SP

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Fernanda Vieira Xavier

2018-03-01

Full Text Available RESUMO Necrochorume é um efluente gerado a partir da decomposição de corpos. Em cemitérios, a principal causa de poluição subsuperficial é a sua percolação, que altera significativamente o solo, impedindo-o de realizar suas funções naturais. Particularmente no Brasil, pela falta de planejamento consequente do histórico cultural, os cemitérios se localizam totalmente integrados à malha urbana, representando um problema de saúde pública. O risco de contaminação está associado à presença de elementos, como compostos nitrogenados, metais pesados, vírus e bactérias, com riscos inerentes à saúde humana. Na literatura, esses contaminantes têm sido constantemente identificados no ambiente geológico a partir de resultados analíticos de água e solo quando comparados a uma área não impactada. A presente pesquisa objetivou investigar eventuais alterações no meio físico subsuperficial do cemitério municipal da cidade de Rio Claro, São Paulo, por meio dos resultados analíticos dos poços, apoiados por dados obtidos da técnica geofísica da sondagem elétrica vertical (SEV. Os resultados apontaram boa correlação com a evolução espacial e temporal da ocupação do cemitério ao longo de sua história.

Preliminary clinical outcomes from the Peruvian National Cataract Elimination Plan Resultados clínicos preliminares del Plan Nacional de Lucha contra la Ceguera por Catarata del Perú

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Tomasz P. Stryjewski

2010-10-01

Full Text Available OBJECTIVE: To evaluate the clinical outcomes of a publicly funded cataract elimination program. METHODS: Outcomes of all patients (186 who received extracapsular cataract extraction (ECCE surgery free of charge at the Instituto Regional de Oftalmología in northern Peru in the first year (August 2008 to July 2009 of the Peruvian National Cataract Elimination Plan were compared retrospectively with the outcomes of all patients (68 who paid in the highest charge tier for ECCE surgery during the same period. Preoperatively, the median uncorrected visual acuity (UCVA of National Plan patients was Hand Motion; the UCVA of paying patients was Counting Fingers (P = 0.09. Complication frequency and visual acuity (uncorrected visual acuity, pinhole visual acuity, and best correct visual acuity were the primary outcome measures. The World Health Organization (WHO Vision 2020 goal is for 85% of operated eyes to achieve 20/60 vision; the Ministerio de Salud del Perú goal is for 75% of eyes to achieve 20/50. RESULTS: One month postoperatively, only 24% of National Plan patients achieved a UCVA of 20/60. The median UCVA for both groups was 20/100 (P = 0.23. Intraoperative complications occurred in 27% of all patients; postoperative complications occurred in 39%. Patients more likely to have a poor outcome (UCVA OBJETIVO: Evaluar los resultados clínicos de un programa de lucha contra la ceguera por catarata con financiamiento público. MÉTODOS: Los resultados obtenidos de todos los pacientes (186 sometidos a una operación gratuita de extracción extracapsular de catarata (EECC en el Instituto Regional de Oftalmología del norte del Perú, durante el primer año (de agosto del 2008 a julio del 2009 de la ejecución del Plan Nacional de Lucha contra la Ceguera por Catarata del Perú, se compararon retrospectivamente con los resultados de los pacientes (68 que pagaron los honorarios más elevados por una operación quirúrgica de EECC durante el mismo per

Squamous cell carcinoma of the anal canal.

LENUS (Irish Health Repository)

Martin, F T

2012-01-31

Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

Diseño de un circuito integrado analógico básico: amplificadror operacional (OPAMP) compensado de dos etapas con tecnología CMOS de 1.5 um

OpenAIRE

Bernal Carrillo, Iván

1994-01-01

Se presenta el proceso de diseño de un circuito integrado analógico con tecnología CMOS de 1.5 um, sin entrar en detalles de fabricación ni de cálculo. Se enfoca principalmente el principio de operación del circuito diseñado, un amplificador operacional de transconductancia (OTA) compensado de dos etapas. Se presenta el "layout" del circuito integrado diseñado y resultados obtenidos con los prototipos fabricados a través del proyecto multiusuario iberoamericano (PNU del CYTED).

[Proctalgia fugax. Differential diagnosis and therapy of fleeting anal cramp].

Science.gov (United States)

Staude, G

1992-05-30

Proctalgia fugax--short-lived anal spasm--is a common, extremely unpleasant, painful condition that occurs completely unexpectedly, often waking the victim at night. Scientific assessment is difficult on account of the functional nature of the condition and its multifactorial genesis. Before the patient is labeled "anal neurotic", however, he/she should be investigated by a specialist. The results of treating the rarely absent pathological organic findings give rise to optimism.

Assertividade e autocontrole: interpretação analítico-comportamental

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Vívian Marchezini-Cunha

Full Text Available Questões relacionadas à assertividade têm recebido atenção por parte de terapeutas comportamentais há mais de três décadas. É mais recente, porém, o esforço de terapeutas analítico-comportamentais para examinar problemas dessa ordem com os mesmos recursos conceituais e metodológicos empregados por seus pares da pesquisa básica e conceitual. O presente trabalho tem como objetivo oferecer uma interpretação analítico-comportamental para padrões de comportamento assertivos, agressivos e passivos. Recuperamos algumas definições de assertividade/agressividade/passividade e examinamos os fenômenos correspondentes enquanto relações comportamentais; discutimos alguns aspectos da abordagem analítico-comportamental para o autocontrole; e sugerimos que as relações comportamentais definidas como assertividade/agressividade/passividade podem ser interpretadas enquanto instâncias de autocontrole ou impulsividade. A abordagem pode abrir novas perspectivas de investigação clínica de habilidades sociais sob um enfoque analítico-comportamental.

Correlates of anal sex roles among Malay and Chinese MSM in Kuala Lumpur, Malaysia.

Science.gov (United States)

Dangerfield, Derek T; Gravitt, Patti; Rompalo, Anne M; Tai, Raymond; Lim, Sin How

2016-03-01

Identifying roles for anal sex is an important issue for populations of MSM. We describe the prevalence of identifying as being 'top', 'bottom', 'versatile', or 'don't know/not applicable' among Malay and Chinese MSM in Kuala Lumpur, Malaysia, and behavioural outcomes according to these labels for sexual role identity. Data analysis was conducted on a survey administered during weekly outreach throughout Kuala Lumpur in 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of MSM who reported roles for anal sex. Binary logistic regression was used to explore the odds of behavioural outcomes among MSM who identified as 'bottom', 'versatile,' and 'don't know' compared to MSM who reported that 'top' was their sexual role. Labels for anal sex roles were significantly associated with condom use for last anal sex. Among MSM who used labels for anal sex roles, MSM who identified as 'bottom' had highest level of not using condoms for last anal sex (24.1%, p = .045). In binary logistic regression model, identifying as 'top' was significantly associated with reporting using a condom during last anal sex and reported consistent condom use for anal sex in the past six months (p = .039 and .017, respectively). With regard to sexual role identity, some MSM may be a part of a special subgroup of at-risk men to be targeted. Future research should evaluate the origins, meanings, and perceptions of these labels, and the developmental process of how these MSM identify with any of these categories. Research should also uncover condom use decision making with regard to these labels for sexual positioning. © The Author(s) 2016.

Negociación y documentos preliminares en la contratación internacional

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Jorge Oviedo Albán

2012-06-01

Full Text Available Con el fin de establecer la relevancia de los principios de la buena fe y de libertad de formas, la doctrina y la jurisprudencia han establecido ciertas pautas que deben tenerse en cuenta en el proceso de formación del contrato internacional, así, en estas páginas se fija el análisis de las negociaciones preliminares en los contratos internacionales, en particular el estudio de la Convención de las Naciones Unidas sobre los Contratos de Compraventa Internacional de Mercaderías, y los Principios de Unidroit sobre los Contratos Comerciales Internacionales, apelando no solo al análisis doctrinal de las disposiciones involucradas, sino también al de los casos relevantes fallados por tribunales estatales y arbitrales.

Negociación y documentos preliminares en la contratación internacional

Directory of Open Access Journals (Sweden)

Jorge Oviedo Albán

2012-06-01

Full Text Available Con el fin de establecer la relevancia de los principios de la buena fe y de libertad de formas, la doctrina y la jurisprudencia han establecido ciertas pautas que deben tenerse en cuenta en el proceso de formación del contrato internacional, así, en estas páginas se fija el análisis de las negociaciones preliminares en los contratos internacionales, en particular el estudio de la Convención de las Naciones Unidas sobre los Contratos de Compraventa Internacional de Mercaderías, y los Principios de Unidroit sobre los Contratos Comerciales Internacionales, apelando no solo al análisis doctrinal de las disposiciones involucradas, sino también al de los casos relevantes fallados por tribunales estatales y arbitrales

Anal canal duplication and triplication: a rare entity with different presentations.

Science.gov (United States)

Palazon, P; Julia, V; Saura, L; de Haro, I; Bejarano, M; Rovira, C; Tarrado, X

2017-05-01

Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication. Its treatment should be surgical excision, to avoid complications such as abscess, fistulization, or malignization. Anal canal triplication has never been described before.

Resultados preliminares da pesquisa no sambaqui sob rocha Casa de Pedra, São Francisco do Sul, Santa Catarina, Brasil

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Dione da Rocha Bandeira

Full Text Available Resumo A baía da Babitonga possui um patrimônio arqueológico riquíssimo, constituído por um conjunto numeroso de sambaquis, relacionados a pescadores-caçadores-coletores pré-coloniais. O projeto em desenvolvimento volta-se para um sambaqui localizado sob uma gruta no litoral leste de São Francisco do Sul, Santa Catarina, Brasil: o sambaqui sob rocha Casa de Pedra. O sítio apresenta camada arqueológica de 38 cm de espessura e área de 27 m2, e vem sendo escavado desde 2015, com rebaixamento em níveis artificiais de 5 cm de profundidade, em 30 setores de 1 x 1 m. A matriz é composta predominantemente por fragmentos ósseos de ictiofauna e por material conquiológico. Foram encontrados ossos humanos esparsos, alguns queimados, nas primeiras camadas. Osso humano e conchas a 3 cm e 20-25 cm de profundidade apresentaram datação de 4.460 ± 30 e 5.470 ± 30 anos AP, respectivamente. Porém, datações do sedimento da base do sítio apresentaram 4.330 ± 700 e 5.670 ± 850 anos AP, levando-nos a questionar a origem da matriz arqueológica e a sua posição em contexto temporal. Nas paredes internas da gruta, verificaram-se pinturas rupestres, que, após resultados mais concretos, poderão ser o primeiro registro no estado deste tipo de manifestação associada a sambaquis.

[Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population].

Science.gov (United States)

Padilla-España, Laura; Repiso-Jiménez, Bosco; Fernández-Sánchez, Fernando; Frieyro-Elicegui, Marta; Fernández-Morano, Teresa; Pereda, Teresa; Rivas-Ruiz, Francisco; Redondo, Maximino; de-Troya Martín, Magdalena

2014-11-01

The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades. A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping. Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology. Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

Science.gov (United States)

Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

2015-01-01

Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

Science.gov (United States)

Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

2016-01-01

Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. © 2015 Society for Public Health Education.

Prevalence of Anal HPV Infection Among HIV-Positive Men Who Have Sex With Men in India.

Science.gov (United States)

Hernandez, Alexandra L; Karthik, Rajiv; Sivasubramanian, Murugesan; Raghavendran, Anantharam; Gnanamony, Manu; Lensing, Shelly; Lee, Jeannette Y; Kannangai, Rajesh; Abraham, Priya; Mathai, Dilip; Palefsky, Joel M

2016-04-01

India has a large population of HIV-positive individuals, including men who have sex with men (MSM), and the incidence of human papillomavirus (HPV)-related cancers is high. In developed countries, HIV-positive MSM exhibit the highest prevalence of anal HPV infection and incidence of anal cancer. Little is known about anal HPV infection in HIV-positive Indian MSM. We evaluated 300 HIV-positive MSM from 2 cities in India. Men were tested for anal HPV infection using L1-HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. CD4 level and plasma HIV viral load were measured. Participants completed an interviewer-administered questionnaire including a sexual history. The prevalence of anal HPV was 95% (95% confidence interval: 91% to 97%). The 3 most common types were HPV 35 (20%), HPV 16 (13%), and HPV 6/11 (13%). History of taking antiretroviral medications decreased risk of anal HPV 16 infection [relative risk (RR): 0.6 (0.4-1.0)]. Having an increased number of vaginal sex partners lowered risk of any anal HPV infection. Ever having receptive sex increased risk of any anal HPV [RR: 1.2 (1.1-1.4)] and anal HPV 16 [RR: 6.5 (1.8-107)]. Almost all Indian HIV-positive MSM had anal HPV infection. The prevalence of HPV 16 was lower and the prevalence of other oncogenic HPV types was higher than in similar populations in North America and Europe. Vaccine-based prevention strategies for HPV infection in India should consider potential differences in HPV type distribution among HIV-infected MSM when designing interventions.

Resisting the "Condom Every Time for Anal Sex" Health Education Message

Science.gov (United States)

Adams, Jeffery; Neville, Stephen

2012-01-01

Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were…

Anal sphincter electromyography in patients with Anorectal Dysfunctions

International Nuclear Information System (INIS)

Trinchet Soler, Rafael; Hidalgo Marrero, Yanet; Espichicoque Megret, Arianne; Manzano Suarez, Jianeya; Perez Gonzales, Ruth Maite

2009-01-01

The purpose of this work is to evaluate the electromyography value of anal sphincter in patients with anorectal dysfunctions. Anorectal dysfunctions are frequent reason of pediatric consultation in children, especially with anal incontinence. A study of series of cases in patient with anorectal dysfunctions was carried out from January 2002 to January of 2006. 65 patients were studied. Anorectal malformations (ARM) represented the predominant affection with 38 patients (58.5%), prevailing the male sex in 25 patients (65.8%). Encopresis and intestinal agagliosis dicrease was observed. Sphincter was found before surgical treatment through electromyography in patients with anorectal malformations and colostomy; in those with definitive operation and open colostomy, it avoided the operation in a patient that did not have muscular activity of the external sphincter. In children already operated and with closed colostomy several electromyography changes were observed in correspondence with different incontinence grades. In encopresis cases the study was useful to rule out sphincter functional alterations. Electromyography was pathological in all the operated patients of intestinal aganglionosis. This procedure was very useful for anal incontinence study that helped to determine and establish the prognosis. (author)

Associação de agenesia sacrococcígea e atresia anal em gato sem raça definida Sacrococcygeal agenesis association and anal atresia in mixed breed cats

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Felipe Purcell de Araújo

2009-09-01

Full Text Available O presente trabalho teve como objetivo descrever o caso de um felino, que desde o nascimento apresentou atresia anal, ausência de cauda e malformação dos membros pélvicos. Ao exame radiográfico, pôde-se observar presença de agenesia da sétima vértebra lombar, sacro e vértebras coccígeas, espinha bífida, meningocele, hiperflexão dos joelhos e desvio valgo dos tarsos, diagnosticando-se agenesia sacrococcígea associada à atresia anal.This paper has the objective to report a case of a cat that since birth had anal atresia, absence of tail and malformation of the pelvic member. The radiographic examination revealed agenesis of the seventh lumbar vertebra, sacral and coccygeal vertebrae, spina bifida, meningocele, hyperflexion of the knees and tarsal valgus deviation, diagnosing sacrococcygeal agenesis associated with anal atresia.

Estapedotomia totalmente endoscópica: técnica e resultados preliminares Fully endoscopic stapes surgery (stapedotomy: technique and preliminary results

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João Flávio Nogueira Júnior

2011-12-01

Full Text Available Estapedotomias são realizadas atualmente com o auxílio de microscópios cirúrgicos. Entretanto, o uso do microscópio possui algumas limitações, podendo causar algumas complicações, como lesão no nervo corda do tímpano. Há poucos casos e nenhuma série publicada sobre a utilização de endoscópios nasossinusais na realização de estapedotomias. OBJETIVOS: a Investigar o uso do endoscópio nasossinusal em estapedotomias, com foco na visualização de estruturas importantes. b Mostrar os resultados iniciais, discutindo as possíveis vantagens e desvantagens deste instrumento. METODOLOGIA: 15 pacientes com otosclerose foram selecionados para realizar estapedotomias em 2010. Os dados e vídeo cirúrgico foram analisados retrospectivamente (estudo de série de casos. As condições anatômicas do nicho da janela oval e passos cirúrgicos foram descritos para avaliar possíveis benefícios do procedimento endoscópico. RESULTADOS: As cirurgias foram realizadas exclusivamente com endoscópios e todas as estruturas com relevância anatômica, visualizadas sem maiores dificuldades. Nenhuma complicação foi observada e 14 dos 15 pacientes referiram melhora auditiva, confirmada com exames audiológicos pós-operatórios. CONCLUSÃO: Estapedotomias totalmente endoscópicas são tecnicamente viáveis, seguras e promissoras. Nesta pequena série as principais vantagens foram: praticamente nenhum trauma no nervo corda do tímpano e excelente campo de visão. As desvantagens foram falta de visão estereoscópica, trabalho unimanual e curva de aprendizado.Stapedotomies are perfomed with the aid of surgical microscopes. However, the microscope has some limitations and may cause complications such as damage to the chorda tympani nerve. There are just a few cases and no series published on the use of sino-nasal endoscopes in stapedotomies. OBJECTIVES: a To investigate the feasibility of using sino-nasal endoscopes in stapedotomies, focusing on the

Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

Index Scriptorium Estoniae

Paas, Marge, 1976-

2015-01-01

Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

Science.gov (United States)

Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

2010-03-01

To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

DEFF Research Database (Denmark)

Haas, S; Brock, C; Krogh, K

2016-01-01

. DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

Alterações neuropsicológicas em dependentes de cocaína/crack internados: dados preliminares Neuropsychological impairments in crack cocaine-dependent inpatients: preliminary findings

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Paulo J Cunha

2004-06-01

Full Text Available OBJETIVO: Embora o uso de cocaína seja um problema significativo de saúde pública, há uma relativa escassez de dados científicos sobre as conseqüências neurocognitivas decorrentes da exposição à substância. MÉTODOS: Esse estudo avaliou a associação entre dependência de cocaína e crack e desempenho cognitivo. Uma ampla bateria de testes neuropsicológicos foi aplicada a 15 dependentes de cocaína, em abstinência por duas semanas, em tratamento em regime de internação, e em 15 sujeitos controles, não usuários de drogas, pareados por idade, sexo, escolaridade, nível sócio-econômico, lateralidade e QI. RESULTADOS: Os resultados preliminares mostraram significação estatística (pOBJECTIVE: Although cocaine use is a significant public health problem, there is relative paucity of scientific data on long-term neurocognitive consequences of the exposure to the substance. METHODS: This study examined the association between crack cocaine dependence and neuropsychological performance. An extended battery of neuropsychological tests was administered to 15 abstinent cocaine abusers, inpatients in abstinence for two weeks, and 15 non-drug-using control subjects matched for age, gender, education, socio-economic status, handedness and IQ. RESULTS: The preliminary findings showed statistical significance (p<0,05 on differences of performance in attention, verbal fluency, verbal memory, visual memory, learning ability and executive functions. CONCLUSIONS: These results represent evidences that cocaine abuse is associated with decrements in cognitive functioning, similar to cognitive disorders associated to prefrontal and temporal brain impairments. Knowledge of specific cognitive deficits in cocaine abusers may be useful for designing more effective substance abuse prevention and treatment programs.

Anal carcinoma and HIV infection: is it time for screening?

Science.gov (United States)

Herranz-Pinto, P; Sendagorta-Cudós, E; Bernardino-de la Serna, J I; Peña-Sánchez de Rivera, J M

2014-03-01

A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented? Copyright © 2013 Elsevier España, S.L. All rights reserved.

O terapêutico e o analítico em Freud

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Vinicius Anciães Darriba

2013-06-01

Full Text Available Este artigo tem como objetivo investigar, na obra de Freud, a demarcação que se institui entre o terapêutico e o analítico. Tal investigação enfoca, primeiramente, a passagem da hipnose à associação livre e o direcionamento do autor à questão da causa, o que estabelece uma visada para a cura analítica em confluência com o que se desdobra da exploração do campo do inconsciente e da consideração de um domínio pulsional. Delimitados por esta via os objetivos terapêuticos e analíticos, interroga-se, em seguida, como a dimensão do terapêutico se veria reintroduzida nos termos da nova direção de cura proposta por Freud.

Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis

DEFF Research Database (Denmark)

Mark-Christensen, A; Erichsen, R; Brandsborg, S

2018-01-01

BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulc......BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients......-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved....

Estudio comparativo de dos programas de entrenamiento de la memoria en personas mayores con quejas subjetivas de memoria: un análisis preliminar

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Julia García-Sevilla

2014-01-01

Full Text Available Introducción: A pesar del declive cognitivo que se produce con la edad, numerosos estudios han demostrado la eficacia que tienen los programas de entrenamiento de la memoria para mejorar diversas áreas neurocognitivas en las personas mayores. Objetivo: analizar de forma preliminar el efecto diferencial de dos programas de entrenamiento de la memoria en personas mayores sobre diversas funciones cognitivas. Método: 18 sujetos entre 61 y 81 años han participado, o bien en un programa de entrenamiento en estrategias de memoria, o bien en un programa de entrenamiento en olvidos cotidianos. En todos ellos se evaluó la percepción subjetiva de la memoria, así como el desempeño cognitivo antes y después del entrenamiento. Resultados: se encontró una mejoría estadísticamente significativa en el cuestionario de quejas subjetivas de memoria en ambos grupos, y sólo se encontró cierta mejoría en memoria de trabajo visoespacial (test Corsi inverso y en razonamiento (Analogías en el grupo que recibió un entrenamiento en olvidos cotidianos. Conclusiones: los programas de entrenamiento de la memoria mejoran la percepción subjetiva que tienen las personas mayores del funcionamiento de la memoria, y ello es independiente de la metodología de entrenamiento utilizada.

Analýza sportovního areálu vybranými metodami

OpenAIRE

Jelínek, Vojtěch

2014-01-01

Bakalářská práce se zabývá analýzou sportovního areálu U Hrocha, který má být dokončen v roce 2014. Obsahuje teoretická východiska, která jsou následně implementována do skutečné reality podniku, a to prostřednictvím PESTLE analýzy, Porterovy analýzy a SWOT analýzy. Závěrem je vyhodnocena situace a jsou navržena řešení pro optimalizaci chodu sportovního areálu. This bachelor´s thesis deals with analysis of the sports complex U Hrocha, which will be completed in 2014. It contains theoretica...

El análisis de datos en enfoques biográficos-narrativos: desde los métodos hacia una intencionalidad analítica

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Marcela Cornejo Cancino

2017-01-01

Full Text Available El análisis de datos es una etapa crucial en investigaciones cualitativas, influyendo la calidad y aplicabilidad de los resultados obtenidos. Los textos sobre análisis de datos suelen indicar principios generales a seguir, escaseando descripciones detalladas de los procedimientos involucrados. Los investigadores cualitativos privilegian difundir resultados de investigación, presentando muy someramente cómo se realizó el análisis y qué fundamentos epistemológicos lo sustentaron. En este artículo, se presentan tres investigaciones que utilizaron procedimientos analíticos desde enfoques biográficos-narrativos: sobre memoria colectiva de la dictadura militar chilena; transmisión transgeneracional del trauma en nietos de víctimas de prisión política y tortura durante la dictadura chilena; y procesos de transformación de subjetividades en pobladores de sectores populares en Santiago. Se presenta en detalle cómo fue diseñado, ejecutado y recreado el análisis de datos en el desarrollo de los procesos investigativos, problematizando epistemológica y metodológicamente las decisiones tomadas en cada fase. Se propone la intencionalidad analítica como una forma de enfrentar el análisis, considerando tres dimensiones: la reflexividad del investigador y su equipo; una escucha polifónica, la que abre nuevas y múltiples opciones de análisis; y el ejercicio sistemático de escritura como una forma de construcción y divulgación del conocimiento. Estas dimensiones pueden contribuir a dotar de sentido al trabajo el análisis de datos en la investigación cualitativa. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1701160

Construcción y caracterización de un nuevo nebulizador múltiple para técnicas analíticas basadas en plasma (ICP-OES, ICP-MS y MP-AES).

OpenAIRE

Lúñez Fernández, Claudia

2016-01-01

En la siguiente memoria, se presenta la metodología para la construcción de un nuevo nebulizador múltiple, resultado de una serie de nebulizadores anteriores, los cuales se han ido mejorando para optimizar las características del aerosol generado y con ello los parámetros analíticos de calidad en la espectrometría de emisión atómica con plasma de microondas (MP-AES) y espectrometría de emisión óptica con plasma de acoplamiento inductivo (ICP-OES). Este nuevo nebulizador multiconducto presenta...

Regiones urbanas turísticas costeras: conceptualización y resultados preliminares para la construcción de un modelo de análisis

OpenAIRE

Olivares González, Adriana Inés; De Paolini, Marco F.

2011-01-01

A partir de los años 80 como resultado de la caída del fordismo y la globalización de la economía y el desarrollo tecnológico, se aplicaron en México un conjunto de estrategias que en el ámbito urbano detonaron procesos que dieron lugar a la formación de la región urbana, un modelo espacial que se ha manifestado en las ciudades de mayor dimensión e importancia del país, que sin embargo ya había sido reconocido en determinadas ciudades anglosajonas desde los años 60. En este artículo se pre...

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

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Felicidad Gimenez

2011-06-01

Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

Primena cost-benefit-benefit analize u vrednovanju i izboru javnih projekata (ekonomski aspekt

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Dragana N. Petrović

2013-10-01

Full Text Available Cost-benefit analiza je celovita analiza koristi i troškova koje jedan projekat donosi samom vlasniku projekta i društvu u celini (uključujući i investitora. Izbor najbolje investicione alternative ostvaruje na osnovu finansijske i ekonomske analize, kao dva integralna dela cost-benefit analize. Prvu od ovih analiza obradila je ista grupa autora u članku „Primena cost-benefit analize u vrednovanju i izboru javnih projekata (finansijski aspekt“, objavljenom u prethodnom broju časopisa Vojnotehnički glasnik. Predmet obrade ovog rada je ekonomska analiza, kao logički nastavak prethodnog rada. Zbog toga se na brojne oznake tabela, uključenih u sadržaj finansijske analize (1-–5, nadovezuju (prema hronološkom redu oznake tabela koje pripadaju ekonomskoj analizi (6–8 Sprovođenje ekonomske analize ostvaruje se prema određenoj, dosta složenoj proceduri, a završava se utvrđivanjem kriterijuma ekonomske (društvene isplativosti projekta. U radu su obrađeni osnovni pokazatelji ekonomskog (društvenog prinosa projekta,  kao što su: neto sadašnja vrednost novčanih tokova i cost-benefit koeficijent.

Rare case of gastrointestinal stromal tumor of the anal canal

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Madhu Kumar

2013-01-01

Full Text Available Gastrointestinal stromal tumor (GIST is a rare mesenchymal neoplasm of the gastrointestinal tract. GIST of anal canal is very rare representing only 3% of all anorectal mesenchymal tumors. We report an extremely rare case of GIST of the anal canal in 60-years-old man with history of irregular bowel habits with dark colored stool mixed with blood and constipation from 6 month. Diagnosis was made on the basis of histomorphological and immunohistochemical examination.

Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands

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Priya Subashchandrabose

2015-01-01

Full Text Available Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

Anal Papilloma: An Exceptional Presentation of Fibrocystic Disease in Anogenital Mammary-Like Glands.

Science.gov (United States)

Subashchandrabose, Priya; Esakkai, Muthuvel; Venugopal, Palani; Kannaiyan, Ilavarasan; Srinivasan, Chitra; Reddy, Punuru Tejashwini; Ebenezer, Evelyn Elizabeth

2015-01-01

Previously ectopic breast tissue was thought to be derived from the caudal remnants of the primitive embryonic milk ridges; anogenital mammary-like glands are presently considered as normal constituents of the anogenital region. We report a case of young female, who presented with an anal papilloma. Histopathological examination revealed extensive fibrocystic changes in anogenital mammary-like glands. To date, a lot of benign changes and a wide range of benign and malignant neoplasms have been reported in these glands. However, extensive fibrocystic change of these glands in anal region is very rare. In addition, fibrocystic disease of anal mammary glands, masquerading clinically as an anal papilloma, has not been reported in literature. Hence, it is essential for clinicians and the pathologists to be aware of such a rare presentation. The features of fibrocystic disease in perianal region are also discussed.

Para Compreender Competiçâo e Cooperaçâo nas Organizaçoes. Reflexôes Preliminares

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Zilá Mesquita

1999-01-01

Full Text Available A partir del desarrollo investigado por Piaget de la cooperación y competición en los distintos estadios de juegos, se buscó establecer paralelos en situaciones de cooperación y competición en organizaciones. Para ello fueron realizadas entrevistas con consultores y gerentes da RH y comparadas con la literatura utilizada. Las inferencias preliminares aquí presentadas subsidiarán futuros trabajos.

La Biblioteca Virtual de Salud de la provincia Holguín: un diagnóstico preliminar

OpenAIRE

Cañedo Andalia, Rubén; Santiesteban Santiesteban, Mirtha; Sao Avilés, Augusto; Ríos Hidalgo, Nancy; Torres Acosta, Rafael; Díaz Ricardo, Oscar; Rojas García, Yaima; Montejo Castells, Marilis; La O Zaldívar, Juana; Peña Rodríguez, Karen

2003-01-01

Con el objetivo de iniciar el desarrollo de la Biblioteca Virtual de Salud de la provincia Holguín, se realizó un diagnóstico preliminar de las condiciones existentes en el territorio para su implementación. Se exponen los conceptos fundamentales relacionados con la biblioteca virtual, se identifican las instituciones con mayor potencial científico en el área, así como los productos y servicios de información con condiciones para trasladarse a un entorno de red. Se establece una estrategia pa...

Anal microbiota profiles in HIV-positive and HIV-negative MSM.

Science.gov (United States)

Yu, Guoqin; Fadrosh, Doug; Ma, Bing; Ravel, Jacques; Goedert, James J

2014-03-13

Because differences in anal microbial populations (microbiota) could affect acquisition of HIV or other conditions, especially among MSM, we profiled the microbiota of the anal canal, assessed its stability, and investigated associations with diversity and composition. Microbiota profiles in anal swabs collected from 76 MSM (52 in 1989, swab-1; 66 1-5 years later, swab-2) were compared by HIV status (25 HIV-positive), T-cell subsets, and questionnaire data. Bacterial 16S rRNA genes were amplified, sequenced (Illumina MiSeq), and clustered into species-level operational taxonomic units (QIIME and Greengenes). Regression models and Wilcoxon tests were used for associations with alpha diversity (unique operational taxonomic units, Shannon's index). Composition was compared by Adonis (QIIME). Most anal bacteria were Firmicutes (mean 60.6%, range 21.1-91.1%) or Bacteroidetes (29.4%, 4.1-70.8%). Alpha diversity did not change between the two swabs (N = 42 pairs). In swab-2, HIV-positives had lower alpha diversity (P ≤ 0.04) and altered composition, with fewer Firmicutes and more Fusobacteria taxa (P ≤ 0.03), not completely attributable to very low CD4(+) cell count (median 232 cells/μl), prior AIDS clinical diagnosis (N = 17), or trimethoprim-sulfamethoxazole use (N = 6). Similar but weaker differences were observed in swab-1 (HIV-positive median 580 CD4(+) cells/μl; no trimethoprim-sulfamethoxazole). Associations with T-cell subsets, smoking, and sexual practices were null or inconsistent. The anal microbiota of MSM was relatively stable over 1-5 years. However, with uncontrolled, advanced HIV infection, the microbiota had altered composition and reduced diversity partially attributable to antibiotics. Investigations of microbial community associations with other immune perturbations and clinical abnormalities are needed.

Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

International Nuclear Information System (INIS)

Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

2008-01-01

Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer

Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

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Carey Kate B

2011-10-01

Full Text Available Abstract Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.

Zombi: una arquitectura para el análisis de información que integra procesamiento analítico en línea con minería de datos

OpenAIRE

González Rosas, Leopoldo

2005-01-01

Cada año se generan grandes volúmenes de datos en diferentes medio magnéticos, convertir esos datos en información para la toma de decisiones es un reto que muchas organizaciones están enfrentando. Se construyen almacenes de datos y se utilizan herramientas de procesamiento analítico en línea ("OLAP") y minería de datos para obtener resultados de valor para los negocios, el trabajo para lograrlo ha tomado años en muchos casos. Una arquitectura que integre esas tecnologías para análisis de ...

Symptom outcomes important to women with anal incontinence: a conceptual framework.

Science.gov (United States)

Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

2014-05-01

To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

Infección asintomática por el virus influenza H1N1 (2009 en personal sanitario. Estudio Marbegrip. Resultados preliminares

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Julián Olalla Sierra

2011-01-01

Full Text Available Fundamento: La proporción de individuos asintomáticos que se infectan por gripe AH1N1v varía según las series. Los sanitarios están expuestos al virus de la gripe AH1N1v por su condición laboral, por lo que cabe esperar una prevalencia elevada de individuos con serología positiva sin presentar cuadro clínico asociado. El objetivo del estudio fue determinar la prevalencia de sanitarios asintomáticos con serología positiva para el virus de la gripe AH1N1v. Métodos: Se propuso un estudio prospectivo de cohortes en personal hospitalario en función de un hipotético gradiente decreciente de exposición al virus: personal de urgencias, área médica, área quirúrgica y celadores no de urgencias. Se extrajo sangre de los participantes en septiembre- octubre de 2009, noviembre-diciembre de 2009 y en abril-mayo de 2010, junto con la extracción se rellenaba un cuestionario de salud. Se ofreció la participación voluntaria a los miembros de los diferentes servicios. En sangre se procedió a determinar anticuerpos específicos frente al virus de la gripe AH1N1v por medio de inhibición de la hemaglutinación. Participaron 18 hospitales con un total de 1.371 participantes. Resultados: Se dispone de cuestionario de salud y de resultados serológicos de cuatro hospitales. Se observó una proporción variable de sanitarios asintomáticos con serología positiva sin haber sido vacunados (entre el 5,6! y el 83!. Sólo se vacunaron un 19,4! de los sanitarios, con un porcentaje de serologías positivas también variable (entre un 18,8! y 64,7!. El porcentaje de serologías positivas fue significativamente menor entre los celadores y el resto de categorías profesionales. La vacunación fue mayor entre los médicos que en el resto de estamentos profesionales. Conclusiones: Existe un porcentaje variable de individuos con serología positiva sin haber sufrido síntomas, con claras diferencias geográficas. Se observan también diferencias en la

SIMPOSIO "ASPECTOS MÉDICOS DE LA ERUPCIÓN DEL NEVADO DEL RUIZ". CONCLUSIONES PRELIMINARES

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Academia Nacional de Medicina

1986-12-01

Full Text Available

El Comité Organizador del Simposio "' Aspéctos Medicos de la Erupción Volcanica del Nevado del Ruiz". confor­mado por los doctores Pablo Gomez Martinez, Jose Felix Patino, Valentin Malagón, German Fernandez. Ivan Munera y Luis Jorge Perez, se permite informar a la opinion publica, las conclusiones preliminares a las que ha llegado despues de haber analizado todas las ponencias presentadas por las personas y entidades que atendieron sobrevivientes de la catastrofe de noviembre de 1985.

1. Aspectos geológicos

Colombia está situada en el area denominada Cinturón de Fuego, que envuelve el Oceano Pacifico y en su conformación geográfica se encuentran 30 volcanes, situados en su mayorla en la Cordillera Central. De estos, 11 están en mayor o menor actividad y 7 tienen historia de erupciones. Las capas geol6ógicas sobre las cuales se extiende el pals presentan zonas de elevada sismicidad

Las caracterlsticas de la erupción del Nevado del Ruiz permiten clasificarlo como un volcan de tipo "'Pliniano- explosivo". que puede emitir enorme cantidad de gases y fragmentos sólidos a grandes velocidades y altas tempe­raturas, como tambien lodo caliente, con deshielo de las nieves perpetuas cuyo resultado es Ia formación del "lahar" que sepultó las poblaciones y cubrió extensas zonas de terreno. Estas erupciones se presentan de manera intermitente y su comportamiento es impredecible. Existe siempre la posibilidad de erupciones late­rales que aumentan su peligro y radio de acción.

El "lahar" fue una avalancha de lodo que cubrió a la poblacion de Armero; lo componían materiales inorgánicos provenientes del volcan, mezclados con los materiales orgánicos presentes en las tierras fertiles dedicadas a la agricultura y la ganadería. Estudios microbiológicos demostraron la presencia de una rica flora bacteriana y de hongos...

Anal sphincter responses after perianal electrical stimulation

DEFF Research Database (Denmark)

Pedersen, Ejnar; Klemar, B; Schrøder, H D

1982-01-01

By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were...... not fatigued by repeated stimulation, were most dependent on placement of stimulating and recording electrodes, and always had a higher threshold than the third response. The third response was constantly present in normal subjects. It had the longest EMG response and the latency decreased with increasing...... stimulation to a minimum of 30-60 ms. This response represented the clinical observable spinal reflex, "the classical anal reflex". The latencies of the two first responses were so short that they probably do not represent spinal reflexes. This was further supported by the effect of epidural anaesthesia which...

High-Resolution Anoscopy: Clinical Features of Anal Intraepithelial Neoplasia in HIV-positive Men

NARCIS (Netherlands)

Richel, Olivier; Hallensleben, Nora D. L.; Kreuter, Alexander; van Noesel, Carel J. M.; Prins, Jan M.; de Vries, Henry J. C.

2013-01-01

BACKGROUND: High-resolution anoscopy is increasingly advocated to screen HIV+ men who have sex with men for anal cancer and its precursor lesions, anal intraepithelial neoplasia. A systematic comparison between clinical features and the histopathology of suspect lesions is lacking. OBJECTIVE: This

Estudio preliminar. Patologías digitales más frecuentes en el pie de la bailaora de flamencoe

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José Manuel Castillo López

2010-05-01

Full Text Available Este estudio tiene como objetivos, en primer lugar, dar a conocer las principales deformidades digitales de los pies, asociadas -por su alta incidencia- a la práctica profesional del baile flamenco femenino. Así como, poner de manifiesto la necesidad de llevar a cabo estudios de mayor magnitud para determinar si existe una relación estadísticamente significativa entre la práctica del baile flamenco con las deformidades y patologías podológicas descritas, y la importancia de la investigación en el campo de la medicina del deporte, y de la ortopodología y biomecánica en pos de hallar tratamientos preventivos y/o paliativos en su caso.En este estudio epidemiológico preliminar, llevado a cabo con la colaboración de la Universidad de Sevilla-Área Clínica de Podología y Departamento de Podología- Agencia Andaluza para el Desarrollo del Flamenco, Fundación Cristina Heeren de Arte Flamenco, Centro de Baile Flamenco Ana Moya, y el Centro de Investigación de Flamenco Telethusa, se han evaluado a 28 bailaoras profesionales activas en la provincia de Sevilla, con una actividad mínima de 20h semanales. En dicha muestra se han determinado las patologías podológicas presentes, sintomatología, hábitos de uso de calzado específico, y hábitos podológicos. Los resultados muestran una alta incidencia de patologías digitales como el H.A.V. (juanetes, dedos en garra, y onicopatías.

Does endoscopic ultrasound improve detection of locally recurrent anal squamous-cell cancer?

Science.gov (United States)

Peterson, Carrie Y; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Garcia-Aguilar, Julio; Patil, Sujata; Temple, Larissa K

2015-02-01

Evaluating patients for recurrent anal cancer after primary treatment can be difficult owing to distorted anatomy and scarring. Many institutions incorporate endoscopic ultrasound to improve detection, but the effectiveness is unknown. The aim of this study is to compare the effectiveness of digital rectal examination and endoscopic ultrasound in detecting locally recurrent disease during routine follow-up of patients with anal cancer. This study is a retrospective, single-institution review. This study was conducted at an oncologic tertiary referral center. Included were 175 patients with nonmetastatic anal squamous-cell cancer, without persistent disease after primary chemoradiotherapy, who had at least 1 posttreatment ultrasound and examination by a colorectal surgeon. The primary outcomes measured were the first modality to detect local recurrence, concordance, crude cancer detection rate, sensitivity, specificity, and predictive value. Eight hundred fifty-five endoscopic ultrasounds and 873 digital rectal examinations were performed during 35 months median follow-up. Overall, ultrasound detected 7 (0.8%) mesorectal and 32 (3.7%) anal canal abnormalities; digital examination detected 69 (7.9%) anal canal abnormalities. Locally recurrent disease was found on biopsy in 8 patients, all detected first or only with digital examination. Four patients did not have an ultrasound at the time of diagnosis of recurrence. The concordance of ultrasound and digital examination in detecting recurrent disease was fair at 0.37 (SE, 0.08; 95% CI, 0.21-0.54), and there was no difference in crude cancer detection rate, sensitivity, specificity, and negative or positive predictive values. The heterogeneity of follow-up timing and examinations is not standardized in this study but is reflective of general practice. Endoscopic ultrasound did not provide any advantage over digital rectal examination in identifying locally recurrent anal cancer, and should not be recommended for

Questionário de qualidade de vida na epilepsia: resultados preliminares Protocol of quality of life in epilepsy: first results

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Elisabete Abib Pedroso de Souza

2001-09-01

Full Text Available Crises epilépticas acontecem por breves períodos de tempo, mas os sentimentos de ansiedade e desamparo, adaptação às restrições impostas aos estilos de vida e uma variedade de outros problemas afetam mais a qualidade de vida (QV dos portadores de epilepsia. Este estudo propõe um protocolo que contempla os objetivos de uma avaliação de QV na saúde e seja aplicado a uma população que frequenta um hospital universitário. Consta de 65 itens e avalia o funcionamento psicossocial, limitações físicas, aspecto cognitivo, percepção de controle, auto-conceito, bem como percepção de saúde e QV. Os resultados de validação e confiabilidade são discutidos.Seizures happen for brief periods of time, but the feelings of anxiety and helplessness, adaptation to the restrictions impose by the life-style and variety of other problems affect more the quality of life in epilepsy. This study proposes a protocol that regards the objectives of a quality of life assessment in health and is applied to a population that attends a university hospital. It contains 65 items and assesses the psychosocial performance, physical limitation, cognitive aspects, perception of control, self-concept, as well as perception of health and quality of life. The results of reliability and validity are discussed.

Association of Human Papillomavirus Infection and Abnormal Anal Cytology among HIV-Infected MSM in Beijing, China

Science.gov (United States)

Zhang, Zhihui; Qian, Han-Zhu; Ruan, Yuhua; Zhou, Feng; Gao, Cong; Li, Mufei; Jin, Qi; Gao, Lei

2012-01-01

Background In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM) have been observed in China. Human papillomavirus (HPV) infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. Methods HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. Results Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9%) showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US) in 19 (20.0%), atypical squamous cells but cannot exclude HSIL (ASC-H) in 1 (1.1%), low-grade squamous intraepithelial lesion (LSIL) in 15 (15.8%), and high-grade squamous intraepithelial lesion (HSIL) in 1 (1.1%). HPV6 (20.0%), HPV16 (10.9%), HPV56 (10.9%), HPV52 (9.1%) and HPV39 (9.1%) were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%), HPV16 (19.4%), HPV45 (16.7%), HPV52 (16.7%) and HPV18 (11.1%). In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04). Conclusions High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology. PMID:22558293

Association of human papillomavirus infection and abnormal anal cytology among HIV-infected MSM in Beijing, China.

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Yu Yang

Full Text Available BACKGROUND: In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM have been observed in China. Human papillomavirus (HPV infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. METHODS: HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs were collected for examining cytology and HPV genotypes. RESULTS: Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9% showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US in 19 (20.0%, atypical squamous cells but cannot exclude HSIL (ASC-H in 1 (1.1%, low-grade squamous intraepithelial lesion (LSIL in 15 (15.8%, and high-grade squamous intraepithelial lesion (HSIL in 1 (1.1%. HPV6 (20.0%, HPV16 (10.9%, HPV56 (10.9%, HPV52 (9.1% and HPV39 (9.1% were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%, HPV16 (19.4%, HPV45 (16.7%, HPV52 (16.7% and HPV18 (11.1%. In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04. CONCLUSIONS: High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology.

Impact of hypothyroidism on primary anal malignant melanoma: A rare entity

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Siddharth Singh

2014-01-01

Full Text Available Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

Impact of hypothyroidism on primary anal malignant melanoma: a rare entity.

Science.gov (United States)

Singh, Siddharth; Verma, Satyajeet; Kala, Sanjay

2014-01-01

Primary melanoma of the anal canal is rare and highly malignant condition, which is 1% of all invasive tumors in this site. This condition is often mistaken for benign conditions as either hemorrhoids or rectal polyp. Thyroid-stimulating hormone stimulation causes high proliferation of malignant melanoma. The association of hypothyroidism with primary malignant melanoma of anal canal is very rare. We are reporting such a very rare case.

Estudio de la fisiología del esfínter anal interno porcino y de la rata, y de la fisiopatología de las alteraciones de la motilidad del esfínter anal interno en pacientes con fisura anal

OpenAIRE

Opazo Valdés, Álvaro Javier

2011-01-01

Descripció del recurs: el 01 setembre 2012 Las patologías anorectales benignas (fisura anal, incontinencia fecal, hemorroides) presentan una elevada prevalencia. De forma general, se desconoce la fisiopatología de estas enfermedades en las que se producen diversas alteraciones del esfínter anal interno (EAI). Los objetivos para esta tesis fueron: 1º Caracterizar los mecanismos y neurotransmisores implicados en el control del tono, la relajación y la contracción del EAI en dos modelos anima...

Analysis and description of disease-specific quality of life in patients with anal fistula.

Science.gov (United States)

Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

2018-04-01

In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Differential gene expression in patients with anal fistula reveals high levels of prolactin recepetor

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Song Yi-Huan

2017-01-01

Full Text Available Background/Aim. There are limited data examining variations in the local expression of inflammatory mediators in anal fistulas where it is anticipated that an improved understanding of the inflammatory milieu might lead to the potential therapeutic option of instillation therapy in complicated cases. The aim of the present study was to examine prolactin receptors (PRLR as inflammatory markers and to correlate their expression with both the complexity of anal fistulas and the likelihood of fistula recurrence. Methods. Microarray was used to screen the differentially expressed gene profile of anal fistula using anal mucosa samples with hemorrhoids with ageand sex-matched patients as controls and then a prospective analysis of 65 patients was conducted with anal fistulas. PRLR immunohistochemistry was performed to define expression in simple, complex and recurrent anal fistula cases. The quantitative image comparison was performed combining staining intensity with cellular distribution in order to create high and low score PRLR immunohistochemical groupings. Results. A differential expression profile of 190 genes was found. PRLR expression was 2.91 times lower in anal fistula compared with control. Sixty-five patients were assessed (35 simple, 30 complex cases. Simple fistulas showed significantly higher PRLR expression than complex cases with recurrent fistulae showing overall lower PRLR expression than de novo cases (p = 0.001. These findings were reflected in measurable integrated optical density for complex and recurrent cases (complex cases, 8.31 ± 4.91 x 104 vs simple cases, 12.30 ± 6.91 x 104; p < 0.01; recurrent cases, 7.21 ± 3.51 x 104 vs primarily healing cases, 8.31 ± 4.91 x 104; p < 0.05. In univariate regression analysis, low PRLR expression correlated with fistula complexity; a significant independent effect maintained in multivariate analysis odds ratio [(OR low to high PRLR expression = 9.52; p = 0.001]. Conclusion. PRLR

Ultra B2 - Promoção de ligações covalentes do colágeno corneal (Corneal cross-linking) no tratamento de ceratocone: resultados preliminares

OpenAIRE

Jankov, Mirko R; Hafezi, Farhad; Beko, Maja; Ignjatovic, Zora; Djurovic, Branislav; Markovic, Vujica; Schor, Paulo

2008-01-01

OBJETIVO: Apresentar os resultados visuais e ceratométricos, seis meses após tratamento foto-terapêutico com luz ultravioleta (UV) e vitamina B2 (Ultra B2), em pacientes com ceratocone progressivo. MÉTODOS: Vinte e cinco olhos de 20 pacientes (15 homens e 5 mulheres) com ceratocone progressivo, determinado pelo aumento de curvatura em exames seriados de topografia corneal, nos últimos seis meses foram avaliados. Acuidade visual não corrigida (UVA), acuidade visual melhor corrigida com óculos ...

Conversor analógico digital basado en oscilador controlado por tensión

OpenAIRE

Cardes García, Fernando

2012-01-01

Convencionalmente, los micrófonos dan una salida analógica debida a la variación de presión que produce el sonido, y esta señal se digitaliza por medio de conversores analógico digitales tradicionales. En este proyecto se aborda el diseño de un sistema que obtenga como salida un código digitalizado a partir del sonido recibido por la cápsula microfónica. La principal ventaja de utilizar este sistema es que el circuito analógico que acondiciona la señal se simpli ca considerable...

Ferramenta SIG para Modelos de Propagação de Ondas. Desenvolvimentos Preliminares

OpenAIRE

Zózimo, A. C.; Charneca, N.; Gonçalves, A.; Fortes, C. J. E. M.

2005-01-01

SIMAR é um Sistema Integrado de Modelação da Agitação maRítima, para estudos de propagação e deformação da agitação marítima em zonas costeiras e portuárias. Este Sistema é baseado num Sistema de Informação Geográfica (SIG) e inclui um conjunto de módulos correspondentes aos modelos de propagação e deformação de ondas. A comunicação entre o SIG e os módulos é efectuada por uma interface gráfica construída para o efeito. Nesta comunicação, apresenta-se uma versão preliminar do SIMAR e das s...

Frequency of operative trauma to anal sphincters: evaluation with endoanal ultrasound.

Science.gov (United States)

Stamatiadis, Apostolos; Konstantinou, Evangelos; Theodosopoulou, Eleni; Mamoura, Konstantinia

2002-01-01

Sphincter trauma after anorectal surgery is usually asymptomatic. Frequency of trauma cannot be established with the clinical examination only. The frequency of operative sphincter defects and their correlation with disorders of continence was evaluated with the endoanal ultrasound. This study includes 123 subjects who had undergone anorectal surgery in the past and were examined with endoanal ultrasound for various indications such as continence disorders, recurrent fistula, idiopathic perineal pain, or simple postoperative follow-up. No subjects had isolated external anal sphincter defects. Nineteen of 123 patients (15%) had minor or major continence disorders, 55 patients (45%) had no sphincter defects, 42 (34%) had only internal anal sphincter (IAS) defects, and 26 (21%) had simultaneously external and internal anal sphincter (EAS) defects. The incidence of IAS and EAS trauma after Milligan-Morgan hemorrhoidectomy was 1/18 (5.5%) and 0/18 respectively; after fistula repair, 24/42 (57%) and 12/42 (29%); and after anal dilatation, 13/17 (76%) and 4/17 (24%). Sixteen of 26 patients (62%) with EAS trauma and 51/68 patients (75%) with IAS trauma did not report any disorders of continence. In patients with two or more operations, the frequency of IAS trauma was 74%, 30% for EAS trauma, and 26% for continence disorders.

Evaluation of radiotherapy and chemoradiotherapy for anal canal epidermoid cancer in our center

International Nuclear Information System (INIS)

Obara, Kunihiko; Sahara, Rikisaburo; Yamana, Tetsuro; Okamoto, Kinya; Takahashi, Tomoko; Furukawa, Satomi; Okada, Daisuke; Kaneko, Yasushi; Matsumoto, Atsuo

2008-01-01

The efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT) for anal canal epidermoid cancer were evaluated. Twenty-four patients with anal canal epidermoid cancer were treated in our center between 1988 and 2006, consisting of 13 patients treated by RT and 11 by CRT. In these patients, the efficacy and safety of RT and CRT were evaluated in terms of adverse events, 5-year local control rates, 5-year disease-free survival rates, and 5-year survival rates. No grade 3 or higher adverse events were noted in patients receiving RT. In contrast, anorexia, diarrhea, neutropenia, and anemia were observed in 33.3%, 10%, 33.3%, and 10%, respectively, of the patients receiving CRT. The anal preserving rate, 5-year local control rate, 5-year disease-free survival rate, and 5-year survival rate were 66.7%, 73%, 77.5%, and 88.4%, respectively. RT and CRT for anal canal epidermoid cancer should be first-line treatments because of their safety and efficacy. (author)

Avaliação da qualidade de vida na incontinência anal: validação do questionário FIQL (Fecal Incontinence Quality of Life Evaluation of quality of life in anal incontinence: validation of the questionnaire FIQL (Fecal Incontinence Quality of Life

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Sonia Ahlaim Ibrahim Yusuf

2004-09-01

Full Text Available RACIONAL: A incontinência anal acarreta incapacitação física e psicológica, determinando impacto na qualidade de vida. Para quantificar esse impacto em nosso meio, não existem instrumentos específicos validados. OBJETIVOS: Avaliar a qualidade de vida na incontinência anal, através da validação do questionário "Fecal Incontinence Quality of Life" (FIQL, que é composto por 29 questões distribuídas em 4 domínios: estilo de vida, comportamento, depressão e constrangimento, sua escala de pontuação varia de 1 a 4 com exceção das questões 1 e 4 que variam de 1 a 5 e 1 a 6, respectivamente. MATERIAL E MÉTODO: Após tradução e adaptação cultural, estudou-se a validação do instrumento através das propriedades de medida de reprodutibilidade e validade. Para a avaliação da reprodutibilidade aplicou-se o questionário em 50 pacientes com incontinência anal por dois examinadores, sendo reaplicado por um dos examinadores após período de 7 a 10 dias. A validade construtiva foi testada através da comparação do FIQL e o SF-36, questionário genérico de qualidade de vida e entre o FIQL e um índice de incontinência anal. O índice de incontinência anal utilizado foi o de Jorge-Wexner, que varia de 0 (continência perfeita a 20 (incontinência total. A validade discriminativa foi avaliada através da aplicação do FIQL em dois grupos controle: indivíduos voluntários hígidos e portadores de constipação intestinal. RESULTADOS: Verificou-se que o FIQL apresentou correlação significativa com outros instrumentos (SF-36 e índice de incontinência e que a qualidade de vida no portador de incontinência anal está comprometida em todos os domínios: estilo de vida: 2,4 comportamento: 2,0, depressão: 2,5 e constrangimento: 1,9, quando comparado com os indivíduos voluntários hígidos (3,9, 3,9, 4,1 e 4,0, e pacientes com constipação intestinal (3,7, 3,8, 3,6 e 3,8, respectivamente. CONCLUSÃO: O FIQL é útil para a

Validación del método analítico para la determinación de 3 vitaminas hidrosolubles en un suplemento vitamínico

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Iverlis Díaz Polanco

2000-08-01

Full Text Available Se presentan los resultados obtenidos en la validación de un método analítico por cromatografía líquida de alta resolución, para la determinación de tiamina mononitrato, piridoxina clorhidrato y nicotinamida en el suplemento nutricional neovitamin II, el cual se diseñó para separar las vitaminas entre sí, con la utilización de una columna RP-18 de 25 cm y un detector UV-Visible. Dicho método se empleó para el control de la calidad y la estabilidad de este producto. El método fue validado siguiendo una metodología de trabajo elaborada previamente en un Protocolo de Validación, donde se analizaron diferentes parámetros como son: linealidad, exactitud, precisión, selectividad, límites de detección y cuantificación, adecuación del sistema y estabilidad de las soluciones. Se obtuvieron resultados satisfactorios y se comprobó de esta forma la validez del método analítico.The results obtained in the validation of an anlytical method by high resolution liquid chromatography for the determination of thiamine mononitrate, pyridoxine hydrochloride and nicotinamide in the Neovitamin dietary supplement are presented. It was designed to separate vitamins among themselves, using a RP-18 column of 25 cm and a UV Visible detector. This method was used for controlling the quality and stability of the product. This method was validated according to a working methodology that was previously prepared in a Validation Protocol where paramaters such as lineality, accuracy, precision, selectivity, limits of detection and quantitation, system adequacy and the solution stability were analyzed. The results were satisfactory and the validity of the analytical method was proved.

Calculo Preliminar de la Tasa de Meteorización del Batolito Antioqueño, Cordillera Central, Colombia

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Carolina Garcia

2004-12-01

Full Text Available Este trabajo es una estimación preliminar del tiempo necesario para generar la espesa capa de saprolito que caracteriza el perfil de meteorización actual de un batolito cuarzodiorítico cretácico que aflora en altiplanos de la Cordillera Central de Colombia, entre 5º50' y 7º00' de latitud Norte y 74º50' y 75º35' de longitud Oeste y a alturas entre 750 y 2700 m.Se utilizan datos obtenidos previamente mediante el análisis de la composición química de las aguas superficiales de cuatro cuencas con áreas diferentes, ubicadas sobre el Batolito Antioqueño, al este de Medellín. Los cáculos se hicieron con el método basado en la pérdida de componentes en solución utilizando diferentes valores de solutos. Al utilizar la pérdida de sílice se obtiene un tiempo de meteorización de unos 6 x 10 6 años, comparable con el obtenido mediante la datación de las cenizas volcánicas mas antiguas que recubren la topografía actual y que indican la fecha mínima de configuración de la superficie de erosión.A pesar de resultar de una serie de suposiciones simplificadoras, este resultado es interesante y justifica la realización de determinaciones mas detalladas. Confirma la larga preservación de superficies de erosión antiguas conformadas sobre un saprolito que desde hace varios millones de años no ha sido sometido a una erosión profunda, fenómeno poco común en una zona tectónicamente activa como la estudiada.

Rigidez do papelão ondulado: comparação entre resultados experimentais e os obtidos por cálculo analítico Bending stiffness evaluation of cardboard: comparison between experimental and analytically results

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Paulo G. Magalhães

2006-04-01

Full Text Available Embalagens de papelão ondulado para produtos hortícolas têm como função principal a proteção do produto. O dimensionamento de uma embalagem de papelão requer o conhecimento da rigidez à flexão, que depende dos módulos de elasticidade dos elementos que o constituem. Este trabalho teve por objetivo calcular, a partir da caracterização física do papelão em laboratório, o módulo de elasticidade por diferentes métodos, comparando os resultados com os valores obtidos experimentalmente. Dez corpos de prova de cada um dos papéis selecionados para este estudo foram testados na direção de fabricação e na direção transversal. A resistência à tração dos papéis, capa e miolo, utilizada para calcular a rigidez, foi determinada em máquina universal de ensaios. Para a obtenção da rigidez à flexão, foi realizado o teste de quatro pontos. Foi observada expressiva variação entre os métodos pelos quais se obtêm os módulos de elasticidade que reflete nos valores de rigidez da estrutura. Os valores de rigidez obtidos experimentalmente foram sempre superiores aos valores obtidos por cálculos analíticos. Essa diferença pode ser atribuída a dois fatores conjugados: o processo de fabricação que confere maior rigidez do que os componentes isoladamente, e o outro componente é a adição de camada adesiva que não é levada em consideração nos cálculos analíticos.Cardboard packing for horticultural products has as main function to protect them. The design of a cardboard packing request the knowledge of the bending stiffens which is depending on the modulus of elasticity. The objective of this work was to calculate the cardboard modulus of elasticity from data obtained in laboratory using physical characterization test, with different methods, and comparing the results with the values obtained experimentally. Ten samples of each cardboard selected for this study were tested in the paper fabrication direction and in its

Sequential treatment for proctalgia fugax: Mid-term follow-up Tratamiento secuencial para la proctalgia fugaz: Resultados a medio plazo

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J. A. Gracia Solanas

2005-07-01

internal anal sphyncter myectomy.Introducción: la proctalgia fugaz (PF es una patología benigna, autolimitada, caracterizada por dolor anorrectal intenso, a intervalos frecuentes, sin causa orgánica aparente. Su etiología no está clara, a pesar de ser conocida desde hace un siglo y existen pocos artículos publicados sobre esta patología, con escaso número de pacientes, aplicando tratamientos variados con mayor o menor fortuna. El propósito de este trabajo ha sido estudiar a una serie de pacientes aquejados de esta patología y aplicar a todos ellos un tratamiento de manera secuencial en dependencia de su respuesta al mismo. Material y métodos: realizamos un estudio descriptivo prospectivo de pacientes aquejados de dolor perianal brusco, < 30 min de duración, sin lesión orgánica concomitante ni intervención previa perianal desde 1996-2002 en nuestro Servicio, sometiéndoles a un tratamiento de manera secuencial, basado en 3 escalones terapéuticos (1. información, baños de asiento, tranquilizantes; 2. nifedipino 10 mg sublingual, o nitroglicerina tópica 0,1% en el momento de la crisis; y 3. esfinterotomía lateral interna si hipertrofia del esfínter anal interno y no mejoría con los otros escalones. Definimos mejoría significativa cuando se producía un importante distanciamiento de los episodios (disminución nº crisis a la mitad y/o disminución del dolor en un 50%. Resultados: quince pacientes con un seguimiento medio de 4 años. Mediante ecografía endoanal se pudo demostrar la existencia de hipertrofia del esfínter anal interno (EAI en 5 casos. Tras la aplicación del escalón 1 mejoraron 7 pacientes y curó 1 paciente; con el escalón 2 mejoraron 3 pacientes y 1 curó, y se aplicó el escalón 3 a 3 pacientes que presentaban hipertrofia del EAI mejorando 1 y curando otro paciente. Conclusión: la curación de la PF no siempre es factible, pero sí es posible aliviar los síntomas, así como su frecuencia. Casi el 50% de los pacientes de nuestra

Risk factors of recurrent anal sphincter ruptures

DEFF Research Database (Denmark)

Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

2012-01-01

Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

Determinantes de la Calidad del Resultado

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Carmen Pineda González

2000-06-01

Full Text Available El concepto de calidad del resultado hace referencia a la posibilidad de que el resultado contable sea percibido por los usuarios de la información contable por encima o por debajo de su cuantificación numérica, o, de otro modo, a la posibilidad de percibir como diferentes los resultados de varias compañías aun cuando en términos cuantitativos sean de igual valor; de forma que será de mayor calidad aquél resultado que en mayor medida contribuya a limitar o a reducir el riesgo inherente al proceso de toma de decisiones. Este concepto general, sin embargo, ha tenido diferentes concreciones que requieren un estudio detallado. En consecuencia, el objetivo de este trabajo es revisar las diferentes definiciones de calidad del resultado que recoge la bibliografía contable y analizar los factores que la determinan, es decir; las decisiones empresariales, las normas contables, la manipulación, la estabilidad, el contenido monetario y los componentes permanentes del resultado. The concept of earnings quality refers to the possibility that accounting results are valued either above or below their numerical quantification, or; put another way, to the possibility of detecting differences in the results of various companies even though in quantitative terms they are of equal value, such that the results of the highest quality will be those which limit, or reduce, to the greatest extent the risk inherent in the decision making process. This general concept, however; has had different forms that require detailed study. In consequence, this paper aims both to review the different definitions of earnings quality present in the accounting literature, and to analyse the factors that determine earnings quality including: corporate decisions, accounting standards and the manipulation, stability, monetary content and permanent components of earnings.

Carcinoma epidermoide del margen anal contra calidad de vida

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Miguel A Reyes Argudín

Full Text Available La calidad de vida de los pacientes debe tenerse en cuenta. Esta representa el resultado final de la actuación médica desde la perspectiva del paciente. En ocasiones solo nos basamos en este criterio para tomar decisiones terapéuticas ante determinadas enfermedades, como el carcinoma epidermoide de margen anal en estadío terminal. El tratamiento y conducta con fines paliativos tiene como objetivo mejorar la calidad de vida de estas personas. Presentamos el caso de paciente varón de 48 años de edad que acude a consulta por presentar lesión en el ano que no le permitía sentarse y después de realizársele todo el estudio necesario para determinar su diagnóstico definitivo (carcinoma epidermoide de ano evaluarlo y determinar el tratamiento requerido para el grado de la enfermedad, nos percatamos que el tratamiento radical no cambiaba la evolución de su estado y se decide tratamiento paliativo para mejorar la calidad de vida. En ocasiones acuden a consulta pacientes que al culminar su estudio, obtienen el diagnóstico de una enfermedad avanzada y es, a partir de este momento, que nuestro pensamiento médico debe cambiar y encaminar nuestros esfuerzos a mejorar la calidad de vida y no llevarlos a un final tormentoso con el objetivo de revertir la evolución de una enfermedad que no tiene regresión.

Projeto e desenvolvimento de uma unidade didática de apoio ao ensino da teoria clássica de controle PID

OpenAIRE

Kleber Batistela Pereira

2012-01-01

Este trabalho foi concebido inicialmente através de projeto, montagem e ensaios preliminares de uma unidade analógica, para propósito didático, composta de um servomecanismo controlado pelas clássicas estratégias Proporcional, Integral e Derivativa (PID). Com este equipamento foi demonstrado os conceitos fundamentais da engenharia de controle com seus ensaios e medidas que permitem exemplificar, de forma simples e bastante pedagógica, o funcionamento e os limites operacionais de um control...

De mundejarismo de los Anales Toledanos Segundos

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Felipe MAÍLLO SALGADO

2009-12-01

Full Text Available Como es sabido los Anales Toledanos (Primeros, Segundos y Terceros, compuestos en su mayor parte durante el siglo XIII en distintos momentos y por diferentes manos, son piezas importantes de la historiografía medieval hispánica, tanto por recoger gran cantidad de noticias —por más que éstas sean escuetas— cuanto por estar todas ellas rigurosamente fechadas; de ahí que sean de gran utilidad para el historiador.De estos tres anales, los Segundos (A.T.II tienen unas peculiaridades que los distinguen fuertemente de los otros; sin embargo, en una primera hojeada el lector poco avisado vería que, por su aspecto formal, nada difieren de otros escritos del mismo género, un género éste cuya condición esencial radica en la consignación del evento fechado, esto es, se presenta en párrafos que comienzan o terminan —como es aquí el caso— con una fecha determinada. Nuestro imaginario lector, por otra parte, se encontraría con las peladas noticias típicas del género analístico, a saber: una serie de referencias que dan cuenta de fenómenos naturales (como son las sequías prolongadas o las excesivas lluvias, las heladas intempestivas, los terremotos, los eclipses..., que informan de las épocas de hambre o carestía, de los precios de los artículos, de prodigios, de acontecimientos locales, etc.; el todo amalgamado con noticias de carácter político-militar.

HIV infection connected to rising anal cancer rates in men in the U.S.

Science.gov (United States)

Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

OCCULT ANAL SPHINCTER INJURIES (OASIS IN DEPARTMENT OF PERINATOLOGY IN LJUBLJANA – INCIDENCE AND RISK FACTORS

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Katja Jakopič

2018-02-01

Full Text Available Background: Vaginal delivery is the most important risk factors for development of faecal incontinence, which significantly affects quality of life. Foreign studies show OASIS occur at 20 to 40 % of vaginal deliveries. In Slovenia we recognize sphincter injuries at 1.7 % of deliveries, while true incidence of OASIS in our population remains unknown. Caesarean section prevents anal sphincter injuries. Known risk factors in foreign studies include prolonged second stage of labour, fetal weight > 3500 g, malpresentation, forceps delivery, maternal age more than 35 years at the time of first delivery, first delivery. Few women complain about defecatory problems in puerperium unless they are directly asked about them, so true incidence of such injuries is grossly underestimated. Previously compensated anal sphincter dysfunction can clinically manifest as late as in menopause. The most probable cause is atrophy of muscle and fibrous tissue of pelvic floor and anal sphincter due to lack of estrogen support in this period. With anal ultrasound we tried to determine the incidence of occult damage to anal sphincter in primiparas after vaginal delivery and the relation of injury to symptoms 6 weeks after delivery and identify possible risk factors in our population. We also tried to find out how many patients with anal sphincter injury become symptomatic immediately after deliv- ery. Methods: From January to June 2009 we examined 26 primiparas after vaginal delivery in the Ljubljana Maternity Hospital with anal ultrasound and compared various data about the delivery from our national delivery form. We excluded all patients with caesarean section, recognized anal sphincter injury at the time of the delivery or previous anorectal surgery, history of irritable bowel syndrome or pre-existing inflammatory bowel disease. All patients completed a bowel-function questionnaire, which included questions about faecal urgency and involuntary passing of gas, liquid or

A case of anal canal cancer which developed fournier's syndrome after chemoradiotherapy

International Nuclear Information System (INIS)

Momma, Tomoyuki; Kikuchi, Daiki; Watanabe, Yohei; Onozawa, Hisashi; Suzuki, Satoshi; Nakamura, Izumi; Ohki, Shinji; Takenoshita, Seiichi; Yoshida, Noriyuki

2013-01-01

Fournier's syndrome is an acute necrotizing fasciitis of the perineum which progresses rapidly, resulting in poor prognosis if not treated appropriately at an early stage. Here we report a case of anal canal cancer which developed Fournier's syndrome after chemoradiotherapy (CRT). A 79-year-old man with anal canal cancer received a double-barrel sigmoid colostomy followed by concurrent CRT (50.4 Gy) with S-1 (100 mg/body). Although the patient was discharged after CRT, he developed a fever at 10 days after discharge and visited our hospital complaining of pain in the anal region. He was hospitalized with a diagnosis of Fournier's syndrome. Extensive drainage, administration of antibiotics, additional drainage and continuous irrigation of the affected region improved the symptoms of Fournier's syndrome. Multiple liver metastases were found on a CT scan at 3 months after onset of Fournier's syndrome, and the patient was transferred to another hospital for systemic chemotherapy. There have been no reports on the onset of Fournier's syndrome after CRT for rectal cancer with anal canal involvement; we report this case with a review of the literature. (author)

La cueva de Linatzeta (Lastur, Deba, Gipuzkoa Un nuevo contexto para el estudio del Mesolítico en Gipuzkoa.

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Tapia Sagarna, Jesus

2008-01-01

Full Text Available Se presentan los resultados preliminares del proyecto de excavación de la cueva de Linatzeta ( Lastur, Deba, Gipuzkoa. Desde su descubrimiento en 1999, hemos documentado un nivel de ocupación mesolítico y dos niveles sepulcrales. Los resultados obtenidos hasta el momento convierten a este yacimiento en un contexto importante para el estudio de los modos de vida de los últimos cazadores-recolectores en la región.

Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation.

Science.gov (United States)

Soares, F A; Regadas, F S P; Murad-Regadas, S M; Rodrigues, L V; Silva, F R S; Escalante, R D; Bezerra, R F

2009-11-01

The study aimed to verify the role of parity, age and bowel function in the pathogenesis of anorectocele. A cross-sectional study was conducted regarding age, obstetrical history, Cleveland Clinic Constipation Score (CCCS), cinedefecography and anal manometry findings. Forty-five adult women complaining of obstructed defecation were evaluated; the median age was 46 years and median CCCS, 13. Fifteen patients were nulliparous and 23 multiparous (median parity 2). Eighteen had a history of episiotomy, fourteen delivered large babies and two had forceps-assisted delivery. Statistical analysis was performed using Spearman's correlation test and Fisher's exact test. Anal hypertonia was found in 14 (31.1%) patients, anal hypotonia in eight (17.8%), anismus in 13 (28.9%) and anorectoceles in 34 (75.6%) [median size 2.8 cm (0-6.4)]. There were no correlations between anorectocele and anal hypertonia (P = 0.7171), anismus (P = 0.4666), parity comparing nulliparous and multiparous patients (P = 1.000), episiotomy (P = 1.0000), forceps assistance (P = 1.0000), delivery of a large baby (P = 1.0000) anal resting pressure (P = 0.0883), anal voluntary pressure (P = 0.7327), parity (P = 0.4987) and age (P = 0.8603). There were correlations between anorectocele and the CCCS (P = 0.0082) and anal hypotonia (P = 0.0141). Anorectocele is not correlated with parity, age, episiotomy, delivery of a large baby and anismus. It was more frequent in patients with severe constipation and less common in patients with anal hypotonia.

Preliminary experiments with a solid-state ionization chamber; Experiences preliminaires au moyen d'une chambre d'ionisation a milieu solide; Predvaritel'nye opyty s tverdoj ionizatsionnoj kameroj; Experimentos preliminares con una camara de ionizacion en estado solido

Energy Technology Data Exchange (ETDEWEB)

Griffiths, R J; Batty, C J [National Institute for Research and Nuclear Science, Harwell (United Kingdom); Gibbons, P E; Northrop, D C [Service' s Electronics Research Laboratory, Baldock, Didcot (United Kingdom)

1962-04-15

A solid-state ionization chamber has been made by diffusing phosphorus into high-resistivity silicon to form ohmic contacts. Such a detector has been successfully used to detect 30-MeV protons. Preliminary results are given and discussed. (author) [French] Une chambre d'ionisation a milieu solide a ete realisee par diffusion de phosphore dans du silicium de haute resistivite pour former des contacts ohmiques. Un detecteur de cette nature a ete utilise avec succes pour detecter des protons de 30 MeV. Les auteurs presentent les resultats preliminaires obtenus. (author) [Spanish] Se ha construido una camara de ionizacion en estado solido, por difusion de fosforo en silicio de elevada resistividad para formar contactos ohmicos. Con esta camara se han logrado detectar protones de 30 MeV. Los autores presentan y examinan los resultados preliminares obtenidos. (author) [Russian] Tverdaya ionizatsionnaya kamera izgotovlena putem vklyucheniya fosfora v kremnij s vysokoj udel'noj soprotivlyaemost'yu dlya obrazovaniya omicheskikh kontaktov. Takoj detektor uspeshno primenyaetsya dlya obnaruzheniya protonov v 30 mehv. Predstavleny i obsuzhdayutsya predvaritel'nye rezul'taty. (author)

Paradoxical Impact of Ileal Pouch-Anal Anastomosis on Male and Female Fertility in Patients With Ulcerative Colitis.

Science.gov (United States)

Pachler, Frederik R; Brandsborg, Søren B; Laurberg, Søren

2017-06-01

Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. This was a retrospective registry-based cohort study that was performed over a 30-year period. Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits. All data were prospectively registered. All patients with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis between 1980 and 2010 were identified in Danish national databases. The primary outcomes measured were birth rates in females and males with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis. We included 27,379 patients with ulcerative colitis (12,812 males and 14,567 females); 1544 had ileal pouch-anal anastomosis (792 males and 752 females). Patients with ulcerative colitis have slightly reduced birth rates (males at 40.8 children/1000 years, background population 43.2, females at 46.2 children/1000 years, background population 49.1). After ileal pouch-anal anastomosis, males had increased birth rates at 47.8 children/1000 years in comparison with males with ulcerative colitis without ileal pouch-anal anastomosis (40.5 children/1000 years), whereas females had reduced birth rates at 27.6 children/1000 years in comparison with females with ulcerative colitis without ileal pouch-anal anastomosis (46.8 children/1000 years). Only birth rates were investigated and not fecundability. Furthermore, there is a question about misattributed paternity, but this has previously been shown to be less than 5%. Ulcerative colitis per se has little impact on birth rates in both sexes, but ileal pouch-anal anastomosis surgery leads to a reduction in birth rates in females and an increase in birth rates in males. This has clinical

Valoración de la calidad de vida relacionada con la salud en la enfermedad renal crónica terminal mediante un cuestionario de resultados percibidos por los pacientes

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Mireia Adell Lleixà

Full Text Available Objetivos: Valorar la Calidad de Vida Relacionada con la Salud de los pacientes con Enfermedad Renal Crónica Terminal e identificar las diferencias más significativas según el sexo y tratamiento recibido. Material y métodos: Estudio observacional, analítico y transversal; realizado a pacientes en tratamiento con Hemodiálisis de Alto Flujo o Hemodiafiltración "en línea". Realizamos estadística descriptiva e inferencial y se consideraron significativos aquellos resultados en que el grado de significación resultó igual o inferior al 5% (p≤0.05. Resultados: Obtuvimos diferencias estadísticamente significativas en: valores de albúmina sérica según la técnica de diálisis y dosis de tratamiento adecuado (Kt/V según el sexo. En las dimensiones del test de calidad de vida: síntomas/problemas, situación laboral, función sexual, función física, dolor y vitalidad (según sexo. Y según la técnica en: sueño, actitud del personal de diálisis y función física. En el análisis multivariante, las únicas variables clínicas y sociodemográficas que resultaron ser predictores significativos en algunas de las dimensiones de las escalas KDQOL-SF fueron el sexo, el nivel de estudios y la técnica de diálisis. Conclusiones: Las variables sociodemográficas, analíticas, el sexo y técnicas de diálisis influyen sobre la percepción de la calidad de vida de los pacientes con enfermedad renal crónica terminal.

Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial Efeito da pimenta vermelha nos sintomas de pacientes com fissuras anais agudas

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Pravin J. Gupta

2008-06-01

Full Text Available BACKGROUND: Red-hot chili pepper and other spices have been blamed for causing or exacerbating symptoms of anal pathologies like anal fissure and hemorrhoids. AIM: To determine if consumption of chilies increases symptoms of acute anal fissures. METHODS: Individual patients were randomized to receive capsules containing chili or placebo for one week in addition to analgesics and fiber supplement. Patients were asked to note score for symptoms like pain, anal burning, and pruritus during the study period. After 1 week, cross over treatment was administered to the same group of patients with the same methodology and results were noted at the end of 2 weeks. RESULTS: Fifty subjects were recruited for this study. Forty three of them completed the trial (22 in the chili group and 21 in the placebo group. The daily mean pain score was significantly lower in the placebo group in the study period. Score 2.05 in chili group and 0.97 in placebo group. There was a significant burning sensation experienced by the patients in the chili group (score 1.85 for the chili group vs 0.71 for the placebo group. Patient’s mean recorded improvement score was significantly higher after taking placebo. Eighty one point three percent patients preferred placebo while 13.9% preferred chilies. Two patients had no preference. CONCLUSION: Consumption of chili does increase the symptoms of acute anal fissure and reduces patient compliance.RACIONAL: A pimenta vermelha e outras especiarias têm sido responsabilizadas por agravar a sintomatologia das doenças anais, tais como fissuras e hemorróidas. OBJETIVO: Determinar se o consumo de pimentas vermelhas aumentaria os sintomas em fissuras anais agudas. MÉTODOS: Pacientes foram recrutados e randomizados para receber cápsulas contendo pimenta ou placebos por 1 semana, somadas a analgésicos e suplementos de fibras. Foi solicitado que anotassem um escore de sintomas, tais como dor, queimação anal, prurido durante o per

Conservative management of anal and rectal cancer

International Nuclear Information System (INIS)

Gerard, J.P.; Romestaing, P.; Montbarbon, X.

1989-01-01

The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

PENGARUH GROUP INVESTIGATION BERBASIS OUTDOOR STUDY TERHADAP KEMAMPUAN BERPIKIR ANALITIS SISWA

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Valeriana Rasweda

2016-02-01

Full Text Available The purpose of research is to find out the Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability. The type of research is PretestPosttest Control Group Design. The research was conducted at Lawang 1st Public Senior High School Malang Regency with experiment class X-IIS 1 and control class X-IIS 2. The data is an analytichal thinking ability. Data analysis was done by comparing the gain score student’s analytichal thinking ability using SPSS 17.0 for Windows. The results showed that Group Investigation outdoor study-based having an affect on student’s analytichal thinking ability.  Tujuan penelitian ini adalah untuk mengetahui apakah model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa. Penelitian ini merupakan jenis penelitian eksperimen semu (quasi experiment yang termasuk penelitian kuantitatif. Rancangan penelitian yang dikembangkan adalah Pretest-Posttest Control Group Design. Penelitian dilaksanakan di SMA Negeri 1 Lawang Kabupaten Malang. Kelas ekperimen ialah kelas X-IIS 1 dan kelas kontrol ialah kelas X-IIS 2. Data yang digunakan dalam penelitian ini adalah kemampuan berpikir analitis. Analisis data dilakukan dengan membandingkan gain score kemampuan berpikir analitis siswa menggunakan bantuan program SPSS 17.0 for Windows. Hasil dari penelitian ini menunjukkan bahwa model Group Investigation berbasis outdoor study berpengaruh terhadap kemampuan berpikir analitis siswa.

LA EXCEPCIÓN PRELIMINAR: FALTA DE COMPETENCIA DE LA CORTE INTERAMERICANA ¿UN MECANISMO EFECTIVO DE DEFENSA ESTATAL?

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Andrés González Serrano

2011-01-01

El presente artículo demostrará que la excepción preliminar "falta de competencia en razón a la materia", sí es un mecanismo de defensa estatal efectivo. Sin embargo, también se podrá evidenciar que este mecanismo se ha tornado ineficaz debido que los agentes estatales de los diferentes Estados Parte de la Convención, son quienes han restado importancia a la excepción, al interponerla de forma no adecuada ante la Corte Interamericana de Derechos Humanos.

Oral and Anal vaccination against enteric red mouth disease protection against yersiniosis

DEFF Research Database (Denmark)

Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

dose of ERM bacterin fully protected rainbow trout when they are vaccinated anally. Oral vaccination can also induce full protection but the dose of the bacterin has to be 100 times higher than if the fish was to be vaccinated anally. This indicates that much of the oral feed bacteria is digested...... in the stomach of rainbow trout. This work has shown that it is possible to vaccinated orally against ERM, but the bacteria has to be coated in order to avoid digestion. Protection mechanisms will be discussed....... fish. The objective for this project is to investigate whether oral and anal vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge.The rainbow trout were given oral...

Insectos acuáticos de la Meseta del Somuncura, Patagonia, Argentina. Inventario preliminar

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Javier MUZÓN

2005-01-01

Full Text Available Se brinda un inventario preliminar de los insectos acuáticos de la Meseta del Somuncura y su área de influencia (Patagonia, Argentina realizado sobre la base de colecciones y registros previos de especies pertenecientes a los órdenes Ephemeroptera, Odonata, Hemiptera (Heteroptera, Trichoptera, Diptera (familias Ceratopogonidae, Culicidae y Psychodidae y Coleoptera. Se han relevado diversos tipos de ambientes en 14 localidades. El número de especies registrado asciende a 78, agrupadas en 51 géneros y 26 familias, de las cuales 33 se citan por primera vez del área. De los taxa registrados 83% de los géneros corresponden a grupos de amplia distribución (neotropicales, americanos o cosmopolitas, mientras que 41% de las especies presentan una distribución patagónica o andina.

Diversity of human papillomavirus in the anal canal of men: the HIM Study.

Science.gov (United States)

Sichero, L; Nyitray, A G; Nunes, E M; Nepal, B; Ferreira, S; Sobrinho, J S; Baggio, M L; Galan, L; Silva, R C; Lazcano-Ponce, E; Giuliano, A R; Villa, L L

2015-05-01

Human papillomavirus (HPV) infections are associated with the development of anogenital lesions in men. There are no reports describing the distribution of non-α HPV types in the anal canal of a sexually diverse group of men. The HPV Infection in Men (HIM) Study is a multicentre study on the natural history of HPV infection in Brazil, Mexico, and the USA. At baseline, 12% of anal canal PCR HPV-positive specimens were not typed by the Roche Linear Array, and were considered to be unclassified. Our goals were to characterize HPVs among these unclassified specimens at baseline, and to assess associations with participant socio-demographic and behavioural characteristics. Unclassified HPVs were typed by sequencing of amplified PGMY09/11 products or cloning of PGMY/GP + nested amplicons followed by sequencing. Further analysis was conducted with FAP primers. Of men with unclassified HPV in the anal canal, most (89.1%) were men who have sex with women. Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. Eighteen, 26 and three different α-HPV, β-HPV and γ-HPV types were detected, respectively. α-HPVs were more commonly detected among young men (18-30 years) than among older men (45-70 years), whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than among non-heterosexual men. All β-HPVs detected among non-heterosexual men were β2-HPV types. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Endosonographic appearance of the anal sphincters in patients following colostomy

International Nuclear Information System (INIS)

Sudol-Szopinska, I.; Jakubowski, W.; Szczepkowski, M.; Panorska, A.

2002-01-01

Background. The aim of the study was to visualize, by anal ultrasound (AUS), the suspected defects of the anal sphincters in the patients after colostomy and to analyze possible factors that could have led to such defects. Patients and methods. AUS, using a 7.0 MHz endorectal probe, was performed in a group of 25 patients with colostomy. The internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis muscle (PR) were visualized and the defects within them were qualified and quantified. For statistical analysis, the analysis of variance (ANOVA) was used. Results. The IAS was thin in all but three patients (22 patients; 88 %) with the mean thickness of 1.62 mm. A circular reduction of the thickness along the entire length of the IAS was seen in 20 patients (90.9 %). The echogenicity of the IAS was increased in 15 patients (60 %), and in 10 of them (66.6%), this defect embraced the whole length and circumference of the IAS. The margins of the IAS were not well-defined in 10 patients (40%). A significant correlation was found between the length of the patient's life with the stoma and the IAS echogenicity defect (p-value = 0.0001). No significant correlation was found between the dynamic examination, the IAS thickness and the IAS borders definition. Conclusion. The reduced thickness, increased echogenicity and borders definition defect of the IAS are seen in the patients after colostomy. The only significant correlation was confirmed between the length of the patient's life with the stoma and the IAS echogenicity defect. (author)

Incontinence after primary repair of obstetric anal sphincter tears is related to relative length of reconstructed external sphincter

DEFF Research Database (Denmark)

Norderval, S; Røssaak, K.; Markskog, A

2012-01-01

To determine if anatomic primary repair with end-to-end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared...

Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men

NARCIS (Netherlands)

Richel, O.; Wieland, U.; de Vries, H. J. C.; Brockmeyer, N. H.; van Noesel, C.; Potthoff, A.; Prins, J. M.; Kreuter, A.

2010-01-01

Background Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV) induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). So far, only a few prospective studies have been performed on the topical

Prolonged-Release Oxycodone/Naloxone Improves Anal Sphincter Relaxation Compared to Oxycodone Plus Macrogol 3350

DEFF Research Database (Denmark)

Poulsen, Jakob Lykke; Brock, Christina; Grønlund, Debbie

2017-01-01

/naloxone or PR oxycodone plus macrogol 3350. Resting anal pressure, anal canal distensibility, and relaxation of the internal sphincter to rectal distension were evaluated before treatment (baseline) and on day 5. The Patient Assessment of Constipation Symptom (PAC-SYM) questionnaire, stool frequency, and stool...

Fractal dimension and image statistics of anal intraepithelial neoplasia

International Nuclear Information System (INIS)

Ahammer, H.; Kroepfl, J.M.; Hackl, Ch.; Sedivy, R.

2011-01-01

Research Highlights: → Human papillomaviruses cause anal intraepithelial neoplasia (AIN). → Digital image processing was carried out to classify the grades of AIN quantitatively. → The fractal dimension as well as grey value statistics was calculated. → Higher grades of AIN yielded higher values of the fractal dimension. → An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

Thermal responses of shape memory alloy artificial anal sphincters

Science.gov (United States)

Luo, Yun; Takagi, Toshiyuki; Matsuzawa, Kenichi

2003-08-01

This paper presents a numerical investigation of the thermal behavior of an artificial anal sphincter using shape memory alloys (SMAs) proposed by the authors. The SMA artificial anal sphincter has the function of occlusion at body temperature and can be opened with a thermal transformation induced deformation of SMAs to solve the problem of severe fecal incontinence. The investigation of its thermal behavior is of great importance in terms of practical use in living bodies as a prosthesis. In this work, a previously proposed phenomenological model was applied to simulate the thermal responses of SMA plates that had undergone thermally induced transformation. The numerical approach for considering the thermal interaction between the prosthesis and surrounding tissues was discussed based on the classical bio-heat equation. Numerical predictions on both in vitro and in vivo cases were verified by experiments with acceptable agreements. The thermal responses of the SMA artificial anal sphincter were discussed based on the simulation results, with the values of the applied power and the geometric configuration of thermal insulation as parameters. The results obtained in the present work provided a framework for the further design of SMA artificial sphincters to meet demands from the viewpoint of thermal compatibility as prostheses.

Apontamentos sobre a psicologia analítica de Carl Gustav Jung

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Luís Marcelo Alves Ramos

2002-01-01

Full Text Available O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psychologist and swiss psychiatrist Carl Gustav Jung: it defines the concept of Analytical Psychology, brings a summarized biography of Carl Gustav Jung, indicates the main differences between Analytical Psychology and the Psychoanalysis, describes the structure and the functioning of psyche and, finally, presents synthetically the characteristics of the types of personalities traced by Jung.

3D deformation in strike-slip systems: Analogue modelling and numerical restoration Deformación 3D en sistemas de rumbo: modelación analógica y restauración numérica

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Daniel González

2012-05-01

Full Text Available Regional and local strike-slip systems in Chile are complex and pose interesting questions, such as the interaction between strike-slip and reverse faults, how they evolve, and the relationship between shortening, rotation and uplift. Within this context, we developed a new analytical method based on analogue and numerical modelling applied to 3D, pure and transtensional-transpressional strike-slip systems. Analogue modelling results indicate that in restraining stepovers of strike-slip fault systems, where antiformal pop-up structures are usually formed, pre-existent basement structures with a high angle to the main strike-slip fault will generate a higher rotation of blocks. However, when these structures are oriented at a high angle with respect to the main stress convergence vector, the rotation will be less and therefore a higher tendency to uplift will be produced. These results were applied to NW- and SE-striking basement faults oblique to N-S mega-thrust faults in central Chile (32°-35°S, for which we propose a simultaneous development based on the analogue model results. Moreover, we propose that strike-slip movement occurred on thrust faults in central Chile. Furthermore, we performed a numerical restoration of an analogue experiment which modeled a pure strike-slip system, and concluded that the restoration is very sensitive to shortening data as well as to rotational data. These results are extremely important for future numerical and regional analysis of strike-slip systems.Los sistemas de rumbo regionales y locales en Chile son complejos y plantean interesantes preguntas, tales como la interacción entre fallas de rumbo y fallas inversas, cómo evolucionan ellas, y la relación entre acortamiento, rotación y alzamiento. En este contexto, desarrollamos un nuevo método analítico basado en modelamiento analógico y numérico de sistemas de rumbo de cizalle puro y sistemas transpresionales-trantensionales en 3D. Los resultados del

Inspección preliminar de algunas características de toxicidad en el agua potable domiciliaria, Bogotá y Soacha, 2012

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Elizabeth Silva

2015-08-01

Full Text Available Introducción. La distribución y el almacenamiento del agua después de su potabilización, pueden originar cambios significativos en su calidad, por lo que es necesario conocer las características finales del agua domiciliaria que consumen los usuarios. Objetivo. Evaluar de forma preliminar las sustancias químicas tóxicas en el agua de tanques y grifos de viviendas abastecidas por el acueducto de Bogotá. Materiales y métodos. Se hizo un estudio descriptivo en 26 viviendas localizadas en Bogotá y Soacha. Se hicieron dos muestreos: uno en época de lluvias y otro en temporada seca, y en ambos se aplicó una encuesta y se recolectaron muestras de agua de los tanques de almacenamiento y los grifos. Las muestras se sometieron a ensayos fisicoquímicos básicos, a una prueba de tamización de sustancias orgánicas e inorgánicas, y a pruebas de determinación de metales pesados y de residuos de plaguicidas organofosforados y carbamatos. Resultados. La conductividad, el color y los nitratos presentaron valores permisibles; el pH y la turbiedad tuvieron una ligera tendencia a presentar niveles altos y, el cloro residual, niveles bajos. Hubo trazas de aluminio en el 94 % de las muestras. En el período seco, 8 % de las muestras presentó compuestos orgánicos y, en el período lluvioso, 66,7 %. Solo hubo un resultado positivo para las sustancias inorgánicas. En el 11,5 % de las viviendas, el nivel de riesgo fue medio, en el 61,5 %, bajo, y en el 27 % no se registró riesgo. Conclusiones. Se evidenció deterioro de la calidad del agua domiciliaria debido a la presencia de sustancias orgánicas en tanques y sobre todo en las redes, presumiblemente a causa de la formación de biopelículas o a la presencia de polímeros orgánicos. Los niveles de aluminio cercanos al máximo aceptable pueden explicarse por los remanentes de los coagulantes utilizados durante el tratamiento.

Hemorrhoids and anal fissures in inflammatory bowel disease.

Science.gov (United States)

D'Ugo, S; Stasi, E; Gaspari, A L; Sileri, P

2015-12-01

Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.

Análisis factorial confirmatorio de la Escala de Estilos de Crianza de Steinberg: validez preliminar de constructo

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César Merino Soto

2013-09-01

Full Text Available Se estudió la validez de constructo y confiabilidad interna de la Escala de Estilos de Crianza de L. Steinberg que se administró a una muestra de 224 adolescentes entre 11 y 19 años de un colegio público en Lima. Mediante el análisis factorial confirmatorio de grupo múltiple, la estructura de tres subescalas (Compromiso, Autonomía Psicológica y Control Conductual/Supervisión se mantuvo en general estable, aunque la agrupación teórica de los ítems tendió a estar influenciada por la distribución de los ítems. La confiabilidad alfa para las subescalas solo alcanzó niveles marginales de aceptación y se reconoció el probable impacto del error de medición aleatorio. Los resultados muestran que el instrumento utilizado es una herramienta potencial para la investigación, pero estos hallazgos son preliminares y se requieren estudios adicionales para evaluar la generalización del análisis efectuado. The present study tried to find evidences of construct validity and internal reliability for the Parenting Styles Scale of L. Steinberg. The instrument was applied in a sample of 224 adolescents from 11 to 19 years old from a public school of Lima. With a strategy of multiple group confirmatory factor analysis, the three-subscale structure (Commitment, Psychological Autonomy and Behavior Control/Supervision was in general stable, although the theoretical grouping of the items was influenced by the distribution of the item. The alpha reliability reached marginal levels and the probable impact of the random error was recognized. Results show that this instrument is a potential tool for research, but these findings are preliminary and additional studies are required to evaluate the generalization of the analysis.

Incidence and survival patterns of rare anal canal neoplasms using the surveillance epidemiology and end results registry.

Science.gov (United States)

Metildi, Cristina; McLemore, Elisabeth C; Tran, Thuy; Chang, David; Cosman, Bard; Ramamoorthy, Sonia L; Saltzstein, Sidney L; Sadler, Georgia Robins

2013-10-01

Small cell, neuroendocrine tumors, and melanoma of the anus are rare. Limited data exist on the incidence and management for these rare tumors. A large, prospective, population-based database was used to determine incidence and survival patterns of rare anal neoplasms. The Surveillance, Epidemiology and End Results registry was queried to identify patients diagnosed with anal canal neoplasms. Incidence and survival patterns were evaluated with respect to age, sex, race, histology, stage, and therapy. We identified 7078 cases of anal canal neoplasms: melanoma (n = 149), neuroendocrine (n = 61), and small cell neuroendocrine (n = 26). Squamous cell carcinoma (SCC) (n = 6842) served as the comparison group. Anal melanoma (AM) demonstrated the lowest survival rate at 2.5 per cent. Neuroendocrine tumors (NETs) demonstrated similar survival as SCC (10-year survival for regional disease of 25 and 22.3%, respectively). Ten-year survival of small cell NETs resembled AM (5.3 vs 2.5%). Age 60 years or older, sex, black race, stage, and surgery were independent predictors of survival. This study presents the largest patient series of rare anal neoplasms. NETs of the anal canal demonstrate similar survival patterns to SCC, whereas small cell NETs more closely resemble AM. Accurate histologic diagnosis is vital to determine treatment and surgical management because survival patterns can differ among rare anal neoplasms.

El juego simbólico una alternativa en las dilataciones anales

OpenAIRE

Aguinaga B. Oscar William

1993-01-01

"Las malformaciones ano-rectales están entre las más comunes de las malformaciones de tipo congénito causadas por anormalidades del desarrollo, aproximadamente uno de cada cinco mil partos con producto vivo, en Estados Unidos". Clasificaciones existen muchas, pero la de uso más generalizado y tenida en cuenta en el Hospital de la Misericordia, servicio de quirúrgicas, es: Estenosis anal congénita, agenecia anal, atresia rectal, fístula rectoperineal, fístula rectovaginal.

Epidemiology of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico.

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Vivian Colón-López

Full Text Available Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico.We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR, and multiple anal HPV infection.The mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8% of participants reported being men who had sex with men (MSM. MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05. Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9-10.7], HR (OR = 3.4; [95%CI: 1.1-10.3 and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5-9.1. HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0-11.0.Anal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.

Frequency of post-operative faecal incontinence in patients with closed and open internal anal sphincterotomy

International Nuclear Information System (INIS)

Ghayas, N.G.; Younus, S.M.; Mirani, A.J.; Ghayasuddin, M.

2015-01-01

Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Parks operation (open method) for chronic anal fissure. Methods: This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A and B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. Results: There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp±14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. Conclusion: CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity. (author)

Influência da extensão da artrodese lombossacra nos resultados clínicos e funcionais Influencia de la extensión de la artrodesis lumbosacra en los resultados clínicos y funcionales Influence of the extent of lumbosacral arthrodesis in clinical and functional outcomes

Directory of Open Access Journals (Sweden)

Alberto Ofenhejm Gotfryd

2012-01-01

Full Text Available OBJETIVO: Verificar a influência da extensão da fusão póstero-lateral lombossacra e seu impacto nos resultados clínicos e funcionais. MÉTODOS: Foram avaliados 22 pacientes portadores de estenose central, foraminal ou hérnia de disco lombar, associadas a instabilidade segmentar, submetidos ao tratamento cirúrgico para a descompressão neural e artrodese póstero-lateral. Os pacientes foram divididos em dois grupos, de acordo com quantidade de níveis artrodesados: Grupo 1: fusão em um nível e Grupo 2: fusão em dois ou mais níveis. Os pacientes preencheram questionários referentes ao acompanhamento pós-operatório (uso de medicamentos analgésicos e satisfação com o tratamento e escala analógica visual de dor lombar e ciática. Além disto, foram aplicados os questionários Oswestry e SF-36 para avaliação da qualidade de vida. RESULTADOS: Os resultados do SF-36 mostraram bons níveis de qualidade de vida em ambos os grupos, com exceção do domínio "Aspectos Físicos". Não houve correlação significativa entre a extensão da artrodese e os desfechos clínicos. CONCLUSÕES: Os pacientes submetidos à artrodese póstero-lateral apresentaram qualidade de vida satisfatória, exceto pela diminuição da aptidão física. Entretanto, o maior número de níveis artrodesados não teve impacto negativo sobre os aspectos clínicos e funcionais.OBJETIVO: Investigar la influencia del grado de la fusión posterolateral lumbosacral y su impacto en los resultados clínicos y funcionales. MÉTODOS: Se evaluaron 22 pacientes con estenosis central, foraminal o hernia de disco lumbar, asociadas a inestabilidad segmentaria; se sometieron a cirugía para la descompresión neural y la artrodesis posterolateral. Los pacientes fueron divididos en dos grupos según el número de niveles fusionados: Grupo 1: la fusión en un nivel, y Grupo 2: la fusión en dos o más niveles. Los pacientes completaron cuestionarios sobre seguimiento posoperatorio (uso

LA EXCEPCIÓN PRELIMINAR: FALTA DE COMPETENCIA DE LA CORTE INTERAMERICANA ¿UN MECANISMO EFECTIVO DE DEFENSA ESTATAL?

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Andrés González Serrano

2011-01-01

Full Text Available El presente artículo demostrará que la excepción preliminar "falta de competencia en razón a la materia", sí es un mecanismo de defensa estatal efectivo. Sin embargo, también se podrá evidenciar que este mecanismo se ha tornado ineficaz debido que los agentes estatales de los diferentes Estados Parte de la Convención, son quienes han restado importancia a la excepción, al interponerla de forma no adecuada ante la Corte Interamericana de Derechos Humanos.

Excavació en la Cova de les Cendres (Teulada-Moraira: Campanya del 2007

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Valentín Villaverde

2007-01-01

Full Text Available La excavación de los niveles paleolíticos de la coca de les Cendres se realiza de forma anual desde el año 1995. En este texto realizamos un breve repaso a los resultados preliminares de la campaña del alto 2007.

Analüütikud soovitavad Eesti Energia börsile viia / Piret Reiljan

Index Scriptorium Estoniae

Reiljan, Piret, 1983-

2008-01-01

Kohalikud analüütikud soovitavad viia Eesti Energia börsile, kuna see elavdaks aktsiaturgu ja tõmbaks ligi välisinvestoreid. Vt. samas: Raivo Vare: raske aeg töötab Eesti Energia börsiletoomise kasuks; Analüüs ootab pääsu valitsuskabinetti; Juhid ei püsi enam Eesti Energias. Diagrammid: Majandusnäitajad; Varade maht

Calculo Preliminar de la Tasa de Meteorización del Batolito Antioqueño, Cordillera Central, Colombia

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Carolina Garcia; Michel Hermelin

2004-01-01

Este trabajo es una estimación preliminar del tiempo necesario para generar la espesa capa de saprolito que caracteriza el perfil de meteorización actual de un batolito cuarzodiorítico cretácico que aflora en altiplanos de la Cordillera Central de Colombia, entre 5º50' y 7º00' de latitud Norte y 74º50' y 75º35' de longitud Oeste y a alturas entre 750 y 2700 m.Se utilizan datos obtenidos previamente mediante el análisis de la composición química de las aguas superficiales d...

A prática analítica atual e a problemática do poder La practica analítica actual y la problemática del poder Current analytic practice and the question of power

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Norberto Carlos Marucco

2004-12-01

Full Text Available Os autores enfocam a prática psicanalítica atual sob o vértice do poder, e o diferenciam em poder nos sentidos verbal e substantivo. O poder verbal é a aptidão de realizar alguma coisa no sentido de "ser capaz". O poder substantivo é o domínio, a supremacia, a autoridade ou, ainda, a força, a pujança. Se o poder for substantivo ou verbal, disso resultará uma diferença de significado e também de significante. Os autores, a seguir, enunciam o poder como categoria antropológica, psíquica e social. Em continuidade, definem o que é a prática analítica atual a partir de três aproximações: os diferentes esquemas referenciais, as patologias atuais (psicossomáticas, borderline, anorexia e bulimia, etc. e a atualidade sociocultural. Depois de demarcado o campo conceitual, os autores discorrem sobre o abuso de poder por parte do analista, que é acompanhado de uma progressiva supressão de Eros, ou seja, de uma difusão pulsional. Quando isso ocorre, a pulsão de morte se expressa através de uma idealização da transferência, que equivale ao poder substantivo, não ao poder verbal. A hipnose é o melhor exemplo desse fenômeno: o enamoramento, a transferência idealizada. Quando, ao contrário, esse poder no sentido substantivo está do lado do paciente, o analista, via contratransferência, se vê obrigado a renunciar à sua sexualidade. O analista, então, deverá proceder ao desmantelamento dessa situação infantil na qual um objeto poderoso anula o nascimento da sexualidade dentro do cenário da prática analítica. Os autores finalizam afirmando que o resultado iatrogênico do apego a um objeto, quando se instala na análise, é impedir o desenvolvimento da pulsão sexual como amor de transferência, e que a anulação da sexualidade vai gerando, na dupla analítica, relações de poder. Se isso ocorre, não importa quem triunfe, a prática analítica será inundada pela pulsão de morte.Los autores enfocan la pr

Genetic Architecture of the Variation in Male-Specific Ossified Processes on the Anal Fins of Japanese Medaka.

Science.gov (United States)

Kawajiri, Maiko; Fujimoto, Shingo; Yoshida, Kohta; Yamahira, Kazunori; Kitano, Jun

2015-10-28

Traits involved in reproduction evolve rapidly and show great diversity among closely related species. However, the genetic mechanisms that underlie the diversification of courtship traits are mostly unknown. Japanese medaka fishes (Oryzias latipes) use anal fins to attract females and to grasp females during courtship; the males have longer anal fins with male-specific ossified papillary processes on the fin rays. However, anal fin morphology varies between populations: the southern populations tend to have longer anal fins and more processes than the northern populations. In the present study, we conducted quantitative trait locus (QTL) mapping to investigate the genetic architecture underlying the variation in the number of papillary processes of Japanese medaka fish and compared the QTL with previously identified QTL controlling anal fin length. First, we found that only a few QTL were shared between anal fin length and papillary process number. Second, we found that the numbers of papillary processes on different fin rays often were controlled by different QTL. Finally, we produced another independent cross and found that some QTL were repeatable between the two crosses, whereas others were specific to only one cross. These results suggest that variation in the number of papillary processes is polygenic and controlled by QTL that are distinct from those controlling anal fin length. Thus, different courtship traits in Japanese medaka share a small number of QTL and have the potential for independent evolution. Copyright © 2015 Kawajiri et al.

Tratamiento quirúrgico de la rizartrosis: evaluación de resultados de distintas técnicas

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Francisco-Javier García-Bernal

Full Text Available Introducción y Objetivo. Larizartrosis o artrosis de la articulación trapeciometacarpiana (TMC es uno de los principales motivos de consulta en una Unidad de Cirugía de Mano. Ante el fracaso del tratamiento conservador, recomendamos el tratamiento quirúrgico. Existen distintas opciones terapéuticas y la elección debe ser individualizada para cada paciente en función de varios factores: edad, grado de artrosis, demanda funcional, etc. En este trabajo analizamos los resultados obtenidos en nuestra práctica con las distintas técnicas. Material y Método. Entre abril de 2011 y febrero de 2015 intervinimos 97 casos de rizartrosis. La edad media de los pacientes fue de 54.01 años, con claro predominio del sexo femenino (85.5%. La técnica más frecuentemente empleada fue la artroplastia con reconstrucción ligamentaria y suspensión según técnica de Weilby, con 79 casos. En 9 casos realizamos una artroplastia artroscópica (ATK; en 4 una artrodesis TMC; y en 5 una ligamentoplastia. Resultados. De los 97 pacientes pudimos controlar postoperatoriamente a 49, con un seguimiento medio de 18,3 meses. Los pacientes experimentaron una mejoría de la fuerza de pinza del 24.28% con la técnica de Weilby; del 18.74% con la ATK; del 45.75% con la artrodesis TMC; y del 31.42% con la ligamentoplastia. Respecto al dolor, valorado según una escala visual analógica (0-10 la mejoría fue de 5.50, 5.1, 6.34 y 6.33 puntos respectivamente, en relación a la situación preoperatoria. Conclusiones. Los resultados obtenidos nos confirman la utilidad de la artroplastia de suspensión-interposición como técnica de elección para el paciente habitual de rizartrosis. En determinados casos, factores como la edad, la demanda funcional o el grado de degeneración articular nos encaminaran a elegir otras técnicas, buscando satisfacer las necesidades de cada paciente en concreto.

Morphologic changes of the anal sphincter musculature during and after temporary stool deviation.

Science.gov (United States)

Sailer, M; Fein, M; Fuchs, K H; Bussen, D; Grun, C; Thiede, A

2001-04-01

Temporary stool deviation, using a stoma, is a well-known surgical principle to protect low colorectal or coloanal anastomoses. The purpose of this study was to evaluate any morphologic changes with regard to the anal sphincter muscles during and after temporary ileostomy. Forty-four patients with rectal carcinomas were studied prospectively. All patients underwent low anterior resection. Reconstruction was performed using either a coloanal pouch or a straight end-to-end anastomosis. A protective stoma was fashioned in all 44 patients (ileostomy n=41; colostomy n=3). Stoma closure was carried out after a median of 85 days (41-330 days). Using a standard protocol, anal-sphincter thickness [m. puborectalis, external anal sphincter (EAS) and internal anal (IAS) sphincter] was assessed by means of endoanal ultrasonography preoperatively, at the time of stoma closure, and every 3 months thereafter for 1 year. The diameter of the puborectal muscle decreased from a median preoperative value of 6.3 mm to 5.7 mm at the time of stoma closure (P=0.03). After 3 months, 6.2 mm was measured. This value remained stable for the complete follow-up period. Similar results were recorded for the EAS. The IAS thickness remained stable throughout the study period, measuring between 2.1 mm and 2.4 mm. Temporary stool deviation does lead to morphologic changes of the anal sphincter. While the smooth muscle remains unchanged, the striated counterpart undergoes atrophic transformation. However, after passage reconstruction, i.e., stoma closure, a rapid regeneration of the voluntary muscles is observed.

Desarrollo de metodología analítica para la determinación de contaminantes basada en el cálculo por deconvolución de perfiles isotópicos

OpenAIRE

Fabregat Cabello, Neus

2015-01-01

El análisis por dilución isotópica y espectrometría de masas (IDMS) es reconocido como una de las técnicas más potentes para obtener resultados altamente fiables y de gran calidad metrológica en el campo de la química analítica. IDMS destaca como la forma de cuantificación más adecuada ante determinaciones realizadas en matrices de alta complejidad, siendo por ello ampliamente utilizado durante el acoplamiento de las técnicas de cromatografía a la espectrometría de masas. Además IDMS también ...

High Prevalence of Anal Human Papillomavirus-Associated Cancer Precursors in a Contemporary Cohort of Asymptomatic HIV-Infected Women.

Science.gov (United States)

Heard, Isabelle; Etienney, Isabelle; Potard, Valérie; Poizot-Martin, Isabelle; Moore, Catherine; Lesage, Anne-Carole; Ressiot, Emmanuelle; Crenn-Hebert, Catherine; Fléjou, Jean-François; Cubie, Heather; Costagliola, Dominique; Darragh, Teresa M

2015-05-15

Although human immunodeficiency virus (HIV)-infected women are at high risk for anal cancer, few data have been published on prevalence of and risk factors for anal precancer and potential screening strategies in this risk group. A cross-sectional anal screening study was nested in a gynecological cohort of HIV-infected women. Anal swab specimens were collected for cytology and human papillomavirus (HPV) testing. High-resolution anoscopy, with biopsy when indicated, was systematically performed. Among the 171 enrolled women, median age was 47.3 years and 98% were receiving combination antiretroviral therapy. Median CD4(+) count was 655 cells/µL and HIV load was associated with increased risk of HG-AIN+. Abnormal anal cytology and HPV-16 infection performed best as a screening strategy for HG-AIN+ histology, with positive likelihood ratios of 3.4 (95% CI, 2.3-5.1) and 4.7 (95% CI, 2.5-8.7) and negative likelihood ratios of 0.2 (95% CI, .07-.8) and 0.4 (95% CI, .2-.9), respectively. HIV-infected women with a history of HPV-associated cervical disease are at increased risk for HG-AIN+ and should be offered anal cancer screening. Anal cytology and HPV-16 genotyping had the best screening performance. Anal cytology is easy to perform routinely; it may be the best candidate for screening for HG-AIN among HIV-infected women. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Altmetrics Beauties. ¿Cuáles son los trabajos científicos con mayor impacto en las redes sociales?

OpenAIRE

Torre-Salinas, Daniel

2017-01-01

Presentación para el I Congreso Internacional “Territorios Digitales”, en el marco del proyecto Knowmetrics, en el que se presentan los resultados preliminares de la identificación y análisis de los trabajos científicos de universidades españolas con mayor impacto en redes sociales.

Cuestionario de afrontamiento del estrés (CAE) : validación en una muestra mexicana

OpenAIRE

González Ramírez, Mónica Teresa; Landero Hernández, René

2007-01-01

El artículo describe los resultados de la aplicación del Cuestionario de Afrontamiento del Estrés (San-dín, B. y Chorot, P. (2003). Cuestionario de Afrontamiento del Estrés (CAE): Desarrollo y validación preliminar. Revista de Psicopatología y Psic

Assessing the impact of FDG-PET in the management of anal cancer

International Nuclear Information System (INIS)

Nguyen, Brandon T.; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Rykers, Kym; Kai, Cynleen; Zupan, Eddy; Scott, Andrew

2008-01-01

Purpose: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. Methods and materials: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. Results: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. Conclusions: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies

PRE-LIMINAR JUDGMENT OF PROCEDENCE IN REPLICATION SUITS BY MAGISTRATES: A VIABLE ALTERNATIVE AGAINST PROCESS DELAYS IN CIVIL STATE COURTS

OpenAIRE

Souza, Roberta Kelly Silva; Universitá di Pisa, UNIPI, Itália; Seixas, Bernardo Silva de; Universitá di Pisa, UNIPI, Itália

2015-01-01

Laws 9099/95, 10259/01 and 12152/09, which respectively regulate the Special State, Federal and Fiscal Courts, were published so that access to justice in Brazil may be broadened. However, after twenty years of the establishment of State Special Civil Courts, they are so full up with suits that they have not served their function to de-bureaucratize justice and provide a fast access to justice to the Brazilian population. Current study demonstrates that the application of pre-liminar judgment...

Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States.

Science.gov (United States)

Leichliter, Jami S; Chandra, Anjani; Liddon, Nicole; Fenton, Kevin A; Aral, Sevgi O

2007-12-15

Heterosexual anal and oral sex are related to the acquisition of sexually transmitted infections, including human immunodeficiency virus infection. We examined the correlates of heterosexual anal and oral sex in the general population, using data from the National Survey of Family Growth. The sample included 12,571 men and women aged 15-44 years (79% response rate). One-third of men and women had ever had anal sex, and three-quarters had ever had oral sex. Condom use during last oral or anal sex was relatively uncommon. In separate models for men and women, having ever had anal sex was associated with white race, age of 20-44 years, and having had a non-monogamous sex partner. White race, age of 20-44 years, being married, and having higher numbers of lifetime sex partners were related to having ever given oral sex in men and women. Giving oral sex was associated with having a non-monogamous sex partner in men. Ever receiving oral sex was associated with white race and a non-monogamous sex partner in men and women. It would be beneficial to track the prevalence of heterosexual anal and oral sex and associated condom use on a more frequent basis.

The impact of anal sphincter injury on perceived body image.

Science.gov (United States)

Iles, David; Khan, Rabia; Naidoo, Kristina; Kearney, Rohna; Myers, Jenny; Reid, Fiona

2017-05-01

Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed. Multivariate regression analyses were performed to examine variables influencing self-reported change in body image. Questionnaires and operation notes were analysed from 422 women who attended at a median of four months after delivery. 222 (53%) reported a change in body image with 80 (19%) reporting lower self-esteem and 75 (18%) a change in their personality due to the change in body image. 248 (59%) perceived an anatomical change due to the delivery. Factors associated with increased likelihood of reporting a change in body image were reporting a perceived change in anatomy due to the delivery, adjusted OR 6.11 (3.56-10.49), anal incontinence, OR 1.97 (1.16-3.36), and delivery by forceps, OR 2.59 (1.23-5.43). This is the first study to quantify body image changes in women after anal sphincter injury sustained in childbirth. These were found to be very common, affecting up to 50% of women. The study has several limitations but it does highlight the significant psychosocial problems of negative self-esteem and personality changes associated with a perceived change in body image that has not previously been reported. It also outlines the further research questions that need to be addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluación y estandarización del análisis por activación neutrónica según el método del k-sub cero en el reactor nuclear RP-10: Estudio preliminar empleando irradiaciones cortas

OpenAIRE

Montoya Rossi, Eduardo Haroldo

1995-01-01

Se ha estandarizado una posición de irradiación del reactor nuclear RP-10 para el uso del análisis por activación neutrónica según el método del k sub cero, empleando la convención de Högdahl y se ha evaluado el comportamiento de dicho método respecto a la exactitud y precisión de los resultados obtenidos en el análisis multielemental cuantitativo de diversos materiales certificados de referencia. Para comprobar que el método analítico se encuentra totalmente bajo control estadístico, se ha e...

Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

Science.gov (United States)

Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

2017-01-01

Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men.

Directory of Open Access Journals (Sweden)

Ashlyn Swift-Gallant

Full Text Available Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333 completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role. In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles.

Handedness is a biomarker of variation in anal sex role behavior and Recalled Childhood Gender Nonconformity among gay men

Science.gov (United States)

Swift-Gallant, Ashlyn; Coome, Lindsay A.; Monks, D. Ashley; VanderLaan, Doug P.

2017-01-01

Developmental theories of the biological basis of sexual orientation suggest that sexually differentiated psychological and behavioural traits should be linked with sexual orientation. Subgroups of gay men delineated by anal sex roles differ according to at least one such trait: gender expression. The present study assessed the hypothesis that handedness, a biologically determined sexually differentiated trait, corresponds to differences in subgroups of gay men based on anal sex role. Furthermore, it assessed whether handedness mediates the association between gender nonconformity and male sexual orientation. Straight and gay men (N = 333) completed the Edinburgh Inventory of Handedness and the Recalled Childhood Gender Nonconformity Scale. Gay men also completed measures of anal sex role preference. As in previous studies, gay men showed greater non-right-handedness and gender nonconformity than straight men. Also, among gay men, bottoms/versatiles (i.e., gay men who take a receptive anal sex role, or who take on both a receptive and insertive anal sex role) were more gender-nonconforming than tops (i.e., gay men who take an insertive anal sex role). In support of the hypothesis, bottoms/versatiles were more non-right-handed than tops and handedness mediated the male sexual orientation and anal sex role differences in Recalled Childhood Gender Nonconformity. Together, these findings suggest that developmental processes linked to handedness underpin variation among men in sexual orientation and gender nonconformity as well as variation among subgroups of gay men that are delineated by anal sex roles. PMID:28234947

NMR imaging of the anal levator and sphincter muscles in anorectal malformations

International Nuclear Information System (INIS)

Aoyagi, Hiroshi; Takahashi, Hideyo; Maie, Masahiko; Ohnuma, Naomi; Etoh, Takao; Iwai, Jun

1986-01-01

Magnetic resonance imaging (MRI) of the anal levater and sphincter muscles was obtained on 4 normal volunteers and 11 patients with postoperative anorectal malformations (including 8 supra-levator type and 3 low type). Balloon catheter were inserted into the rectum and marked it as the center of a anal canal. Four normal subjects revealed the levater and sphincter muscles were thick and well developed in all sections (Sagittal, Transevse, Coronal). In most of the supra-levator type of anorectal malformations, thin levator and sphincter muscles were observed by Sagittal and Coronal scans. Transeverse scan revealed that the neorectum was not effectively pull-throughed into the puborectal muscle in one patient. Coronal scan showed the dameged external sphincter muscle. In three low types of anorectal malformations, the levator and the sphincter muscles were all well developed, but in one patient the external sphincter muscle existed at the posterior part of the anal canal. These observations were usefull in managing the postoperative care of anorectal malformations. (author)

SIA „Origami” saimnieciskās darbības analīze

OpenAIRE

Skalbiņš, Verners

2014-01-01

Bakalaura darba tēma ir „SIA „Origami” saimnieciskās darbības analīze”. Darbā apskatītais uzņēmums ir poligrāfijas nozares uzņēmums, kas specializējas lielformāta drukas jomā. Darba mērķis ir identificēt uzņēmuma stiprās un vājās puses, un izstrādāt priekšlikumus tā attīstībai un uzlabošanai. Mērķa sasniegšanai izvirzīti sekojoši uzdevumi: izpētīt uzņēmuma analīzes veikšanai nepieciešamo teorētisko bāzi, uz tās balstoties veikt uzņēmuma analīzi, kā arī izstrādāt secinājumus par līdzšinējo ...

Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

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Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

2013-03-01

Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

Detekce útoku DNS Amplification z pasivní analýzy DNS provozu

OpenAIRE

Míšaný, Daniel

2014-01-01

Táto práce je zaměřená na analýzu a detekci útoku DNS amplification, který patří mezi útoky typu DoS. Úvod práce je zaměřený na základní teorii zahrnující počítačové sítě, službu DNS a útoky typu DoS. Větší část práce se zabývá analýzou útoku DNS amplification, návrhem a implementací nástroje pro detekci v jazyce C++. Závěr je věnovaný analýze výsledků detekčního nástroje. This thesis is focused on the analysis and detection of DNS Amplification attack which is type of the DoS attack. Intr...

Võlur Ozi eksperimentide kogumine ja partneri algatatud paranduste analüüs

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Siiri Pärkson

2011-05-01

Full Text Available 2009. aastal viidi Eestis läbi teine võlur Ozi kirjalike eksperimentide seeria ning käesolev artikkel annab ülevaate eksperimentide korraldamisest ning kogutud dialoogide partneri algatatud paranduste analüüsimise tulemustest. Katseisikutel paluti testida interneti veebilehel asuvat programmi Aivo, mis on suuteline suhtlema inimesega kirjalikus eesti keeles. Tegelikkuses vastas inimeste küsimustele interneti vahendusel eksperimendi läbiviija (võlur Oz. Kogutud dialooge on analüüsitud toetudes vestlusanalüüsi meetodi mõistestikule. Tartu Ülikoolis välja töötatud dialoogiaktide tüpoloogia järgi jaguneb partneri algatatud parandus üleküsimiseks, ümbersõnastamiseks ja mittemõistmiseks. Artiklis analüüsitakse näidetele toetudes eelnimetatud kolme partneri algatatud paranduse esinemist kogutud dialoogides, pidades silmas tulevikus loodavaid reaalseid dialoogsüsteeme, mis suudaksid arvutikasutajaga suhelda loomulikus eesti keeles. http://dx.doi.org/10.5128/ERYa7.12

Significance of the thickness of the anal sphincters with age and its relevance in faecal incontinence.

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Papachrysostomou, M; Pye, S D; Wild, S R; Smith, A N

1994-08-01

Ultrasonographic studies in healthy volunteers showed that the external anal sphincter (EAS) and internal anal sphincter (IAS) thicknesses were inversely related at rest. The functional importance of the two sphincters in continence control was demonstrated in the relationship between the sum of the thicknesses of the two sphincters and the anal canal resting pressure. The aims of the present study were to assess the morphometric appearance of the anal sphincters by endosonography in faecally incontinent patients and to contrast this with that of older healthy subjects. Twenty-eight female patients with neurogenic faecal incontinence (FI) were studied. An older group of 7 healthy women, aged 41-75 years, and a young group of 11 nulliparous healthy women, aged 20-23 years, served as control groups. Anal endosonography was performed with a radial rotating endoprobe, with the subject in the left lateral position. Conventional anal manometry was performed in all subjects. The EAS in the FI group was thicker than the EAS in the old (p IAS thickness in the FI group did not differ from that in the older group. In both these groups the IAS was thicker than in the young women (p IAS in the FI group does not seem to compensate for function and results in a failure of the sphincter mechanism to maintain continence, whereas in healthy elderly subjects the increased IAS thickness appears to be compensatory and important for continence control.

Balance de carbono en un bosque novedoso de Castilla elastica: resultados preliminares

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Ariel E. Lugo; Jessica Fonseca da Silva; Alejandra María. Sáez Uribe

2008-01-01

During June 17 and 18, 2008, a Castilla elastica forest located in El Tallonal, municipality of Arecibo, functioned as a carbon sink. The net photosynthetic rate ranged from 14.28 (native species) and 21.96 (C. elastica) g C m-1 day-1 and respiration of leaves, stems, and soil varied from 13.76 (native species) and 16.88 (C. elastica) g C m-1 day-1. The net...

Patterns of repeated anal cytology results among HIV-positive and HIV-negative men who have sex with men

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Hilary A. Robbins

2018-06-01

Full Text Available Background: Men who have sex with men (MSM are at increased risk for anal cancer. In cervical cancer screening, patterns of repeated cytology results are used to identify low- and high-risk women, but little is known about these patterns for anal cytology among MSM. Methods: We analyzed Multicenter AIDS Cohort Study (MACS data for MSM who were offered anal cytology testing annually (HIV-positive or every 2 years (HIV-negative for 4 years. Results: Following an initial negative (normal cytology, the frequency of a second negative cytology was lower among HIV-positive MSM with CD4 ≥ 500 (74% or CD4 < 500 (68% than HIV-negative MSM (83% (p < 0.001. After an initial abnormal cytology, the frequency of a second abnormal cytology was highest among HIV-positive MSM with CD4 < 500 (70% compared to CD4 ≥ 500 (53% or HIV-negative MSM (46% (p = 0.003. Among HIV-positive MSM with at least three results, 37% had 3 consecutive negative results; 3 consecutive abnormal results were more frequent among CD4 < 500 (22% than CD4 ≥ 500 (10% (p = 0.008. Conclusions: More than one-third of HIV-positive MSM have consistently negative anal cytology over three years. Following abnormal anal cytology, a repeated cytology is commonly negative in HIV-negative or immunocompetent HIV-positive men, while persistent cytological abnormality is more likely among HIV-positive men with CD4 < 500. Keywords: Anal cancer, Anal cytology, HIV, MSM, Anal cancer screening

Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries.

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Frost, Jonathan; Gundry, Rowan; Young, Helen; Naguib, Adel

2016-08-01

To determine whether the introduction of a multidisciplinary intrapartum perineal-care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012-2013) a multidisciplinary training program was implemented was compared with the rate after (2013-2014) implementation using logistic regression analysis. The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493-0.899; P = 0.008). The integration of intrapartum perineal-care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The increasing incidence of anal cancer: can it be explained by trends in risk groups?

NARCIS (Netherlands)

van der Zee, R. P.; Richel, O.; de Vries, H. J. C.; Prins, J. M.

2013-01-01

Anal cancer incidence is gradually increasing. The cause of this increase is not exactly known. This systematic literature review aimed to investigate the trend in time of anal cancer incidence and to find an explanation for the supposed increase. The TRIP database and PubMed were searched for

Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada.

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Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

2016-08-01

This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called "sex drugs," i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.

Estudo fitoquímico preliminar e bioensaio toxicológico frente a larvas de Artemia salina Leach. de extrato obtido de frutos de Solanum lycocarpum A. St.-Hill (Solanaceae

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Marcelo Gonzaga de Freitas Araújo

2010-11-01

Full Text Available

Neste trabalho avaliou-se o perfil fitoquímico e a toxicidade preliminar frente a larvas de Artemia salina do extrato etanólico de frutos de Solanum lycocarpum. O extrato foi submetido à analise fitoquímica preliminar para identificação das principais classes de metabolitos secundários presentes e testado frente a larvas de A. salina para obtenção das concentrações letais médias (CL50%. Os testes fitoquímicos demonstraram a presença de fenóis, taninos, saponinas, alcalóides e esteróides e triterpenos livres. O extrato foi fracionado em diferentes solventes para a avaliação da toxicidade frente à A. salina, apresentando considerável citotoxicidade encontrada na fração hidroalcoólica (CL50% = 285,546 µg/mL. Palavras-chave: Solanum lycocarpum, Artemia salina, triagem fitoquímica preliminar. ABSTRACT The phytochemical profile of ethanolic extract of Solanum lycocarpum fruits was analyzed and preliminary toxicity tests were performed against brine shrimp larvae. The extract was subjected to preliminary phytochemical analysis to identify the main classes of secondary metabolites and tested against the larvae of A. salina to obtain the median lethal concentrations (LC50%. The phytochemical tests showed the presence of phenols, tannins, saponins, alkaloids and free steroids. The extract was fractionated with various solvents for toxicity testing against the larvae and the hydroalcoholic fraction showed considerable cytotoxicity (CL50% = 285.546 g/mL. Keywords: Solanum lycocarpum, Artemia salina, phytochemical screening

Caracterización preliminar de la jalea de propóleos al 10 % para uso estomatológico

OpenAIRE

Padró-Rodríguez, Lourdes; Chil-Núñez, Idelsys

2014-01-01

El propóleos constituye la base de muchas formulaciones farmacéuticas. El presente trabajo propone la caracterización preliminar de una jalea de propóleos para el tratamiento de la gingivitis. Se realizó un estudio en el Laboratorio de Tecnología Farmacéutica de la Universidad de Oriente en el periodo marzo-mayo 2013; por medio del empleo del método de incorporación se procedió a la elaboración de la jalea, a la cual se le evaluaron los parámetros de calidad establecidos. Los mismos mostraron...

Resultados preliminares do estudo da compreensão em sujeitos disatricos A preliminary investigation on language assessment outcome in dysarthria

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Michele Devido dos Santos

2011-10-01

Full Text Available OBJETIVO: apresentar estudo sobre a compreensão de linguagem em sujeitos disártricos. MÉTODO: estudo retrospectivo, descritivo, de caráter qualitativo e quantitativo com 60 sujeitos com idade entre 40 a 70 anos. Foi realizado o cruzamento das tarefas de compreensão do protocolo Montreal Toulouse (versão alfa: compreensão de palavras orais (CPO e escritas (CPE; frases simples orais (CFSO e escritas(CFSE; frases complexas orais (CFCO e escritas (CFCE. RESULTADOS: com respeito à comparação entre a compreensão oral e a escrita, quanto maior a CPO maior a CPE; quanto maior a CFSO, maior CFSE e vice-versa; relativamente à compreensão oral e escrita, quanto maior a CP, maior CF; quanto maior a CFS, maior CFC e vice-versa; em relação à comparação de idade, gênero, e CFCO e CFCE, não se observa relações significativas. CONCLUSÃO: nos pacientes deste estudo, verificou-se que a compreensão das estruturas mais simples favorece a compreensão das mais complexas; a dificuldade de compreensão de estruturas simples apresenta relação direta com a dificuldade de compreensão de estruturas complexas.PURPOSE: to study language comprehension in dysarthric subjects. METHOD: a retrospective, descriptive and qualitative-quantitative study involving 60 subjects, age ranging from 40-70 years. Data crossing was carried out including sub-tests of comprehension related to: spoken words (SWC, written words (WWC, spoken simple phrases (SSPC, written simple phrases (WSPC, spoken complex phrases (SCPC and written complex phrases (WCPC. RESULTS: the higher the SWC, the higher the WWC; the higher the SSPC, the higher the WSPC, and vice-versa; the higher the WC, the higher the PC; the higher the SPC, the higher the CPC, and vice-versa. No associations with age, gender, SCPC and WCPC were observed. CONCLUSION: both comprehension and difficulty in comprehension are associated with the degree of complexity of linguistic structure.

Uso de simulações na determinação de cores intrínsecas de estrelas no infravermelho

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Rembold, S. B.; Ribeiro, D.; Ducati, J. R.; Bevilacqua, C.

2003-08-01

Apresentamos o método e alguns resultados preliminares da aplicação de simulações na determinação das cores intrínsecas de estrelas no infravermelho. A simulação consiste em gerar diagramas cor versus temperatura efetiva de estrelas sinteticas, para uma faixa de valores iniciais da cor intrínseca para cada tipo espectral. Os diagramas gerados sinteticamente são comparados com diagramas gerados a partir de observacoes e, com isso, extrai-se a cor intrínseca que melhor descreve as observações. Mostramos tabelas preliminares de cores intrínsecas e comparamos seu comportamento com determinações prévias e de outros autores.

As transformações no mundo do trabalho e a questão da saúde: algumas reflexões preliminares Las transformaciones en el mundo del trabajo y la salud: algunas reflexiones preliminares The transformations in the world of work and health: some preliminary reflections

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Luciane Prado Kantorski

1997-04-01

Full Text Available Neste artigo realizo algumas reflexões preliminares sobre as transformações no mundo do trabalho e a saúde. Para isto inicio o estudo colocando algumas dimensões essenciais do trabalho como categoria central para analisar a sociedade, a partir da concepção marxista. A seguir resgato nas transformações do mundo do trabalho a especificidade da saúde refletindo sobre a questão do cuidado e da organização dos trabalhadores de saúde.En este artículo realizo algunas reflexiones preliminares sobre las transformaciones en el mundo del trabajo y la salud. Para esto, inicio el estudio colocando algunas dimensiones esenciales del trabajo como categoría central, para analisar la sociedad, a partir de la concepción marxista. Enseguida rescato en las transformaciones del mundo del trabajo la especificidad de la salud trayendo para la reflexión el cuidado y la organización de los trabajadores de la salud.In this work, I make some preliminary reflections about the transformations in the world of work and health. For this purpose, I start this study discussing essential dimensions of the work like the central category to analyse the society based on the Marxist conception. Following, I investigate transformations in the world of work and the specificity of health to the related reflection about care and the organization of health workers.

Histopathologic observations of anorectal abnormalities in anal atresia.

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Meier-Ruge, W A; Holschneider, A M

2000-01-01

Over the years from 1992 to 1997, 41 anorectal malformations (ARM) with histopathologic alterations were investigated to determine which morphologic abnormalities of the distal rectum accompany ARMs. Three other cases showed normal neuromuscular morphology; 9 further cases could not be evaluated owing to scanty biopsies. All resected specimens were caudocranially coiled and cryostat cut at -20 degrees C into serial sections, which were stained with a lactic dehydrogenase, succinic dehydrogenase, nitroxide synthase, and acetylcholinesterase reaction as well as hemalum and sirius red. Ten low, 15 intermediate, and 10 high forms of anal atresia (AA) were studied. In addition, six cloacal abnormalities were investigated. In 7 cases (17%) (5 intermediate, 2 low AAs), the characteristics of Hirschsprung's disease were observed. Oligoneuronal hypoganglionosis of the myenteric plexus proximal to the anal floor was diagnosed in 7 AAs (12%). In 10 children with high-type AA and resection of 1-5 cm distal rectum and in all cloacal anomalies (n = 6) defects of the muscularis propria were seen in the rectal-atresia sac. These defects were characterized by hypoplasia of the circular-muscle layer and/or the internal anal sphincter (IAS). Intestinal neuronal dysplasia of the submucous plexus was most frequently observed (12%) in high-type AA. A correlation between innervation anomalies or anomalies of the muscularis propria and the type of fistula could not be seen. In conclusion, all cases with high-type AA and cloacal anomalies were characterized by anomalies of the muscularis propria and/or IAS but this was not the case in intermediate and low-type AAs. Anomalies of the enteric nervous system were diagnosed in 60% of AAs.

Prevalence of cutaneous beta and gamma human papillomaviruses in the anal canal of men who have sex with women

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Vitaly Smelov

2017-06-01

Full Text Available Background: Data regarding anal cutaneous HPV detection among HIV-positive and HIV-negative persons largely relies on studies among men who have sex with men in limited geographical settings. Understanding the distribution, determinants, and potential human health effects of anal cutaneous HPV types among men who have sex with women (MSW is important. Methods: Anal canal swab samples from 415 Russian MSW (384 HIV-negative and 31 HIV-positive were tested for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Results: β-HPV was detected in 24.4% and γ-HPV in 15.9% of anal samples of all Russian MSW. In total, 34 β-HPV and 19 γ-HPV types were detected, with the most commonly detected β-HPV types being 110, 22 and 124 and the most common γ-HPV types being 95, 132 and 50. For both genera, being HIV-positive at the time of testing was a significant determinant of detection (74.2% for β-HPVs and 48.4% for γ-HPVs compared to 20.1% and 12.5% in HIV-negative MSW, respectively. Conclusions: A wide spectrum and moderate prevalence of anal β-HPV and γ-HPV types was found in our MSW study sample, suggesting that routes other than penile-anal intercourse may be important in cutaneous HPV transmission. Keywords: Anal cutaneous HPV, Beta-HPV, Gamma-HPV, HIV-negative MSW, Penile-anal, HPV transmission

Clinical application of continent anal plug in bedridden patients with intractable diarrhea.

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Kim, J; Shim, M C; Choi, B Y; Ahn, S H; Jang, S H; Shin, H J

2001-08-01

Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

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Semple, Shirley J; Strathdee, Steffanie A; Pitpitan, Eileen V; Chavarin, Claudia; Patterson, Thomas L

2015-05-01

Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.

Protocolo de validación de métodos analíticos para la cuantificación de fármacos

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Beatriz Castillo Aguilar

1996-04-01

Full Text Available Se presenta un resumen de las consideraciones generales para la confección del protocolo de validación de métodos analíticos utilizados en la determinación cuantitativa de fármacos en forma de materia prima o en formulaciones y en estudios de estabilidad. Se describe detalladamente el proceso de validación que incluye los requisitos exigidos para la utilización de las materias primas, materiales de referencia, equipamiento, personal y determinación de los parámetros de linealidad, precisión, exactitud y selectividad (con el procesamiento estadístico de los resultados experimentales y criterios de aceptación, así como la presentación de los resultados en el informe final de la validación.A summary of the general considerations fot the formulation of a validation protocol of the analytical methods used in drug quantitative determination in a raw material form, or in formulations and firmness studies. The validation process is fully described; it includes the necessary requirements for the usage of raw materials, reference materials, supplying, personnel, and determination of linearity, preciseness, exactness, and selectiveness (with the statistical processing of experimental results, and acceptance criteria, as well as the presentation of outcomes in the validation final report.

Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

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Andrew Austin Gassman

2012-01-01

Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

Uptake and Predictors of Anal Cancer Screening in Men Who Have Sex With Men

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D'Souza, Gypsyamber; Rajan, Shirani D.; Bhatia, Rohini; Cranston, Ross D.; Plankey, Michael W.; Silvestre, Anthony; Ostrow, David G.; Wiley, Dorothy; Shah, Nisha; Brewer, Noel T.

2013-01-01

Objectives. We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM). Methods. Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression. Results. A history of anal Pap screening was uncommon among non–HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was “not a big deal” or “not as bad as expected,” and 3% reported that it was “scary.” Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status. Conclusions. This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non–HIV-infected MSM across 4 US sites. PMID:23865658

Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women.

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Robison, Katina; Cronin, Beth; Bregar, Amy; Luis, Christine; DiSilvestro, Paul; Schechter, Steven; Pisharodi, Latha; Raker, Christina; Clark, Melissa

2015-12-01

To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia. A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus-positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy. There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (PHuman immunodeficiency virus-negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women. II.

Modelo analítico del efecto de PRS sobre satélites GPS

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Meza, A.; Brunini, C.; Usandivaras, J. C.

El sistema GPS (Global Position System) es, hoy en día, la herramienta de navegación y posicionamiento más potente y lo será sin duda en la próxima década. Gran parte de su valiosa utilidad se debe a la alta precisión que permite lograr y ésta, a su vez, depende, entre otras causas, de la precisión con que se conocen las órbitas de los satélites. La presión de radiación solar (PRS) fija el límite de la precisión con que pueden calcularse en la actualidad las efemérides satelitarias. El objetivo de este trabajo es proponer una mejor resolución de este fenómeno. El modelo analítico aquí presentado, se basa en el análisis del comportamiento de los residuos de un ajuste por mínimos cuadrados en el que se utiliza el modelo de PRS propuesto por Beutler. El mismo consiste en un modelo determinista del fenómeno con dos parámetros libres. Los resultados obtenidos ponen de manifiesto que, aún después de aplicar dichos parámetros, prevalecen en los residuos efectos semidiurnos en las componentes radial,tangencial y normal. Estos resultados obtenidos se comparan con los de un trabajo desarrollado por el Instituto de Berne (Beutler et al., 1994), en el que se utilizaron como pseudo-observaciones las órbitas precisas del IGS (CODE). El intervalo de integración escogido por este centro fueron las semanas 680 y 681. En resumen se tienen arcos de 14 días para todos los satélites, donde las efemérides precisas de los mismos para los 14 días fueron utilizados como pseudo-observaciones. El modelo de fuerza que empleó dicho centro fue básicamente el tradicional en lo que respecta al modelo de las fuerzas gravitacionales, y para la PRS utilizo el modelo standard de Beutler. Los parámetros de este modelo junto con las 6 condiciones iniciales (posición y velocidad) fueron ajustados por el método general de mínimos cuadrados. Los residuos en la componente radial, tangencial y normal, para los satélites con un buen comportamiento, presentan una

Estudo preliminar toxicológico, antibacteriano e fitoquímico do extrato etanólico das folhas de Jatropha mollissima (Pohl Baill. (pinhão-bravo, Euphorbiaceae, coletada no Município de Tauá, Ceará, Nordeste Brasileiro

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I.D. BRAQUEHAIS

Full Text Available RESUMO A cada dia, cepas bacterianas estão tornando-se resistentes a diversos antibióticos, o que faz necessária a busca de novas substâncias eficazes para o tratamento de doenças. Desta forma, este trabalho reporta o estudo preliminar toxicológico, antibacteriano e fitoquímico do extrato etanólico das folhas de Jatropha mollissima (pinhão-bravo, Euphorbiaceae, coletada no Município de Tauá, Ceará, Nordeste Brasileiro. Inicialmente, realizou-se o teste de toxicidade do extrato contra Artemia salina. Na sequencia, foi realizado o ensaio antibacteriano contra quatro cepas bacterianas Gram-negativas (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Hafnia alvei ATCC 51873, Klebsiella pneumoniae ATCC 13883 e uma cepa Gram-positiva (Enterococcus faecalis ATCC 29212. Finalmente, fez-se a análise fitoquímica preliminar do extrato ativo para detecção das principais classes de metabólitos especiais. Como resultado, o extrato etanólico das folhas de J. mollissima se mostrou tóxico para Artemia salina, pois apresentou CL50 igual a 406,02 μg/mL. Quanto à ação antibacteriana, o extrato se mostrou ativo contra a bactéria Gram-positiva Enterococcus faecalis ATCC 29212, apresentando moderada atividade antibacteriana (halo de inibição igual a 7,03 mm. Evidenciou-se no extrato bioativo a presença de cumarinas, fenóis, taninos, flavonoides (flavonóis e flavanonas, alcaloides e esteroides, ambas as classes reportadas como antimicrobianos. Portanto, esse extrato tem potencial para ser usado na produção de fármacos contra infecções causadas por bactérias Gram-positivas. No entanto, as informações direcionam estudos futuros para o isolamento e identificação dos compostos bioativos, monitorados sob a ação antibacteriana mais expressiva.

Intensity-modulated radiation therapy for anal carcinoma

International Nuclear Information System (INIS)

Peiffert, D.; Moreau-Claeys, M.V.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V.

2011-01-01

Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this 'complex U shaped' volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control. (authors)

Analüütilised voolud psühholoogias ja nende rakendamine pedagoogikas / Aleksander Elango

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Elango, Aleksander, 1902-2004

2001-01-01

Analüütise psühholoogia kolm koolkonda - S.Freudì koolkond e. päris-psühhoanalüüs, A.Adlerì koolkond e. individuaalpsühholoogia ja C.G.Jungì psühhoanalüüsi ja individuaalpsühholoogia sünteesi luua püüdev koolkond. Analüütise psühholoogia koolkondade ja pedagoogika suhetest

Resultados das cirurgias "floppy nissen rossetti" e "floppy nissen longa " realizadas por videolaparascopia em pacientes com esôfago de barrett: estudo prelimilar

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Delta Madureira Filho

Full Text Available OBJETIVO: Com base na literatura e estatística pessoal sobre os resultados da Fundoplicatura "Nissen Rossetti" sem ligadura dos vasos curtos(FNR no tratamento cirúrgico de pacientes com Doença do Refluxo Gastro-esofágico(DRGE e Esôfago de Barrett (EB, idealizou-se este trabalho com o objetivo de comparar, através de pH metria prolongada pós-operatória e dados clínicos, os resultados desta cirurgia com os alcançados com a Fundoplicatura de Nissen "Longa" com ligadura dos vasos curtos (FNL. MÉTODO: Durante o período de maio de 2000 e março de 2003, foram avaliados, no pós operatório, 28 pacientes com DRGE e EB, dos quais 12 submetidos a FNR(grupo I e 16 a FNL(grupo II. Valorizou-se os sintomas, surgimento de disfagia pós-operatória e a persistência do refluxo ácido após a cirurgia, medido através da pH metria pós-operatória. RESULTADOS: Ambas as cirurgias aliviaram os sintomas de pirose e regurgitação no segundo dia de pós-operatório. A disfagia transitória ocorreu mais frequentemente nos casos de FNR que FNL, 41%(6 e 6,25%(1 respectivamente. Disfagia permanente não foi observada em nenhum dos dois grupos. A pH metria pós- operatória seis meses após as cirurgias mostrou que os pacientes do grupo I não ficaram totalmente protegidos do refluxo, com 25% de pH metrias positivas, enquando os do grupo II ficaram quase que totalmente protegidos, com 6,25% de exames positivos. CONCLUSÕES: Embora seja um estudo preliminar e com um período curto de observação, chamamos a atenção para a lembrança do perigo que representa o refluxo persistente após a cirurgia, para um paciente com esôfago de Barrett e apresentamos uma proposta de fundoplicatura longa e frouxa, ou seja diferente da tendência atual(válvula curta e frouxa para o tratamento cirúrgico dos pacientes com esôfago de Barrett, que acreditamos merecer uma reflexão por parte dos cirurgiões e estudiosos do assunto.

De chirurgische betekenis van de inwendige kringspier van het anale kanaal : een klinisch en manometrisch onderzoek

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W.R. Schouten (Ruud)

1990-01-01

textabstractThe high pressure zone within the anal canal is largely due to the activity of the internal anal sphincter and provides an effective barrier against rectal pressure. The continuous contraction of the internal sphincter also has a congesting effect on the vascular cushions, thereby

Design of sEMG assembly to detect external anal sphincter activity: a proof of concept.

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Shiraz, Arsam; Leaker, Brian; Mosse, Charles Alexander; Solomon, Eskinder; Craggs, Michael; Demosthenous, Andreas

2017-10-31

Conditional trans-rectal stimulation of the pudendal nerve could provide a viable solution to treat hyperreflexive bladder in spinal cord injury. A set threshold of the amplitude estimate of the external anal sphincter surface electromyography (sEMG) may be used as the trigger signal. The efficacy of such a device should be tested in a large scale clinical trial. As such, a probe should remain in situ for several hours while patients attend to their daily routine; the recording electrodes should be designed to be large enough to maintain good contact while observing design constraints. The objective of this study was to arrive at a design for intra-anal sEMG recording electrodes for the subsequent clinical trials while deriving the possible recording and processing parameters. Having in mind existing solutions and based on theoretical and anatomical considerations, a set of four multi-electrode probes were designed and developed. These were tested in a healthy subject and the measured sEMG traces were recorded and appropriately processed. It was shown that while comparatively large electrodes record sEMG traces that are not sufficiently correlated with the external anal sphincter contractions, smaller electrodes may not maintain a stable electrode tissue contact. It was shown that 3 mm wide and 1 cm long electrodes with 5 mm inter-electrode spacing, in agreement with Nyquist sampling, placed 1 cm from the orifice may intra-anally record a sEMG trace sufficiently correlated with external anal sphincter activity. The outcome of this study can be used in any biofeedback, treatment or diagnostic application where the activity of the external anal sphincter sEMG should be detected for an extended period of time.

Preoperative Therapy for Lower Rectal Cancer and Modifications in Distance From Anal Sphincter

International Nuclear Information System (INIS)

Gavioli, Margherita; Losi, Lorena; Luppi, Gabriele; Iacchetta, Francesco; Zironi, Sandra; Bertolini, Federica; Falchi, Anna Maria; Bertoni, Filippo; Natalini, Gianni

2007-01-01

Purpose: To assess the frequency and magnitude of changes in lower rectal cancer resulting from preoperative therapy and its impact on sphincter-saving surgery. Preoperative therapy can increase the rate of preserving surgery by shrinking the tumor and enhancing its distance from the anal sphincter. However, reliable data concerning these modifications are not yet available in published reports. Methods and Materials: A total of 98 cases of locally advanced cancer of the lower rectum (90 Stage uT3-T4N0-N+ and 8 uT2N+M0) that had undergone preoperative therapy were studied by endorectal ultrasonography. The maximal size of the tumor and its distance from the anal sphincter were measured in millimeters before and after preoperative therapy. Surgery was performed 6-8 weeks after therapy, and the histopathologic margins were compared with the endorectal ultrasound data. Results: Of the 90 cases, 82.5% showed tumor downsizing, varying from one-third to two-thirds or more of the original tumor mass. The distance between the tumor and the anal sphincter increased in 60.2% of cases. The median increase was 0.73 cm (range, 0.2-2.5). Downsizing was not always associated with an increase in distance. Preserving surgery was performed in 60.6% of cases. It was possible in nearly 30% of patients in whom the cancer had reached the anal sphincter before the preoperative therapy. The distal margin was tumor free in these cases. Conclusion: The results of our study have shown that in very low rectal cancer, preoperative therapy causes tumor downsizing in >80% of cases and in more than one-half enhances the distance between the tumor and anal sphincter. These modifications affect the primary surgical options, facilitating or making sphincter-saving surgery possible

High prevalence and incidence of HPV-related anal cancer precursor lesions in HIV-positive women in the late HAART era.

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Hidalgo-Tenorio, Carmen; de Jesus, Samantha E; Esquivias, Javier; Pasquau, Juan

2017-12-02

Anal cancer is one of the most common non-AIDS defining malignancies, especially in men who have sex with men and women living with HIV (WLHIV). To evaluate the prevalence and incidence of precursor lesions (high-grade squamous intraepithelial lesions [HSIL]) and anal cancer in our cohort of women and to compare them to cervical lesions; to calculate the percentage of patients that acquire and clear oncogenic genotypes (HR-HPV) in the anal canal; and to determine predictive factors for anal HPV infection. Prospective-longitudinal study (May 2012-December 2016). At baseline (V1) and follow up visits, anal mucosa samples were taken in liquid medium for cytology and HPV PCR. In cases of abnormal anal cytology and/or positive HR-HPV PCR results, a high resolution anoscopy was performed. Patients were also referred to the gynaecologist. Ninety five women with an average age of 43.7years were included. At baseline, 11.6% had cervical abnormalities (4.1% CIN1, 2.2% CIN2/3, 1.1% cervical cancer), 64.3% anal abnormalities (50% LSIL/AIN1, 9.5% HSIL/AIN2/3 and 2.4% anal cancer) and 49.4% had HR-HPV genotypes. During 36months of follow up, the incidence of anal HSIL was 16×1,000 person-years; 14.8% acquired HR-HPV genotypes and 51.2% cleared them, P=.007. No patients presented CIN1/2/3/ or cervical cancer. In the multivariate analysis we found the following predictive factors for HR-HPV infection: smoking (RR: 1.55, 95%CI: 0.99-2.42), number of sexual partners >3 (RR: 1.69; 95%CI: 1.09-2.62), cervical and anal dysplasia (RR: 1.83; 95%CI: 1.26-2.67) and (RR: 1.55; 95%CI: 1.021-2.35), respectively. Despite clearance rates of anal oncogenic genotypes being higher than acquisition rates, prevalence and incidence of HSIL were still high and greater than cervical HSIL. Therefore, screening for these lesions should perhaps be offered to all WLHIV. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights

Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

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Donà Maria

2012-10-01

Full Text Available Abstract Background The incidence of anal cancer, a Human Papillomavirus (HPV-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM. Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years. Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL. Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23, and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81. A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among

Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection.

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Donà, Maria Gabriella; Benevolo, Maria; Vocaturo, Amina; Palamara, Guido; Latini, Alessandra; Giglio, Amalia; Moretto, Domenico; Rollo, Francesca; Impara, Giampaolo; Ensoli, Fabrizio; Pimpinelli, Fulvia; Di Carlo, Aldo; Giuliani, Massimo

2012-10-16

The incidence of anal cancer, a Human Papillomavirus (HPV)-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM). Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. A total of 346 MSM were recruited (median age 32 years). Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL). Presence of ASC-US+ was strongly associated with infection by any HPV type (OR = 4.21, 95% CI: 1.97-9.23), and particularly by HPV 16 and/or 18 (OR = 5.62, 95% CI: 2.33-13.81). A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among MSM to protect them from the development of HPV

Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

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Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

2004-01-01

Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

DIAGNÓSTICO PRELIMINAR, BASE PARA LA CONSTRUCCIÓN DE UN PROGRAMA DE MANEJO DE RESIDUOS SÓLIDOS EN LA UNIVERSIDAD DE SAN BUENAVENTURA, CARTAGENA

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RÍOS MONTES KARINA ANDREA

2012-07-01

Full Text Available Los residuos sólidos pueden generar impactos negativos al ambiente y al ser humano por causa de un manejo inadecuado. Las universidades deben contemplar su manejo en las etapas de generación, recolección y disposición final, e incluir su valoración. Se realizó un estudio descriptivo de corte transversal, cuyo objetivo fue realizar un diagnóstico preliminar sobre el manejo de residuos sólidos, incluyendo percepción, conocimiento y recomendaciones dadas por la comunidad universitaria, para contribuir con la elaboración final de un programa de manejo integral de residuos sólidos en la institución.Se aplicó un instrumento a una muestra probabilística, conformada por una población de estudiantes (84%, docentes (8,8% y personal administrativo (7,1%. Los resultados indican que el 59,9% conoce el manejo de RS, y sólo el 29,8% recicla. Los medios masivos de comunicación, con un 49,8%, son el principal canal para conocer de éstos. El 72,1% recicla por conciencia o compromiso ambiental, siendo el papel/cartón (23,5% y plástico (22,6% los más reciclados. El 42,1% recomienda actividades de educación ambiental, el 40,1% rotulación de canecas; y la responsabilidad de su manejo debe incluir a toda la comunidad universitaria, siendo estudiantes- docentes (82,8% y directivos- administrativos (57,6% los pioneros en liderar el proceso.  

Un método cuantitativo para analizar redes neuronales marcadas por histoquímica para acetilcolinesterasa

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Luz H. Camargo

2004-12-01

Full Text Available El análisis cualitativo de las redes neuronales por histoquímica enzimática se usa comúnmente en los estudios morfológicos tradicionales. Una limitante de este tipo de estudios consiste en la dificultad de obtener resultados cuantitativos. Este artículo presenta dos técnicas originales de procesamiento de imágenes para realizar estudios cuantitativos y un análisis comparativo entre ellas. Los resultados preliminares presentados permiten verificar la utilidad de la metodología aplicada.

Prevalence of and risk factors for anal human papillomavirus infection in men who have sex with women: a cross-national study.

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Nyitray, Alan G; Smith, Dan'elle; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Papenfuss, Mary; Giuliano, Anna R

2010-05-15

Although the primary cause of anal cancer is human papillomavirus (HPV) infection in the anal canal, little attention has been paid to the epidemiology of anal HPV infection in men who have sex with women (MSW). Exfoliated cells from the anal canal of 902 MSW in Brazil (São Paulo), Mexico (Cuernavaca), and the United States (Tampa) were tested for HPV DNA. The prevalence of HPV infection in the anal canal (12.0%) was similar among MSW in each city (P=.77), whereas 7.0% had infection with oncogenic types. Men in Tampa had a 4-fold higher prevalence of infection with HPV type 16 (HPV-16) than that among men in São Paulo or Cuernavaca (PMen who have a larger lifetime number of female sex partners, who are in a sexual relationship of men were most likely to have an anal HPV infection.

Time-dose considerations in the treatment of anal cancer

International Nuclear Information System (INIS)

Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; Kaufman, Donald S.; DeLaney, Thomas F.

1997-01-01

Purpose: To analyze the impact of patient and treatment parameters in concurrent chemoradiation treatment for anal carcinoma. Methods and Materials: Retrospective review of 50 MO anal cancer patients treated from 1984-1994. Most patients received concurrent 5-FU, mitomycin, and radiation. Local control and disease-free/overall survival were determined and analyzed according to patient and treatment parameters. Results: With 43 month median follow-up, projected overall survival is 66% at 5 and 8 years. Disease-free survival is 67% at 5 years and 59% at 8 years. Local control is 70% at 5 and 8 years. Doses of ≥54 Gy are associated with improved 5-year survival (84 vs. 47%, p = 0.02), disease-free survival (74 v. 56%, p = 0.09), and local control (77 vs. 61%, p = 0.04). Although local control, disease-free survival, and overall survival were improved in patients whose overall treatment time was <40 days, this was not statistically significant. Outcome in the four patients with pretreatment hemoglobin (Hgb) <10 appeared worse with 3-year overall survival 50 vs. 68% (p = 0.07), disease-free survival 0 vs. 67% (p = 0.11), and local control 0 vs. 74% (p = 0.05). Projected 5-year overall survival, relapse-free survival, and local control in 4 HIV (+) patients is 0, 75, and 75%. Multivariate analysis reveals that dose (p 0.02) and Hgb (p = 0.05) independently affect local control, dose (p = 0.02) affects disease-free survival, and dose (p = 0.01), Hgb (p = 0.03), T-stage (p = 0.03), and HIV-status (0.07) independently influence overall survival. Conclusion: Radiation doses of ≥54 Gy are associated with significantly improved survival and local control in anal cancer patients treated with chemoradiation. Overall treatment times of less than 40 days are associated with a trend towards improved outcome, but this is not significant. Pretreatment hemoglobin <10 is associated with worse treatment outcome. Survival of HIV (+) patient is poor, but the majority of such patients

PRODUCCIÓN DE BEBIDAS USANDO SORGO MALTEADO COMO MATERIA PRIMA PARA ENFERMOS CELIACOS

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Irenia Gallardo

2013-01-01

Full Text Available La presente investigación trata los principales aspectos relacionados con la enfermedad celíaca, que es la que estimula a trabajar en la búsqueda de alternativas para producir alimentos a partir de otras fuentes que no sean los cereales tradicionales. El trabajo aborda el estudio de la obtención de dos bebidas, cerveza sin alcohol (malta y cerveza, a partir de sorgo blanco UDG-110 malteado. Para la producción de maltina, se hicieron experimentos basados en resultados preliminares, donde se determinaron las mejores relaciones de Malta Clara/Solución, Malta Clara/Malta total y Caramelo/Malta Total. Para la obtención de cerveza se hace un estudio preliminar a partir de la combinación de malta de sorgo y enzimas amilasas. Los resultados son satisfactorios, ya que las bebidas obtenidas tienen propiedades similares a las que se venden en el mercado, permitiendo acotar los parámetros para establecer una tecnología para la obtención de maltina y cerveza.

Determinação de elementos próprios dos asteróides troianos: comparação entre as teorias semi-analítica e sintética

Science.gov (United States)

Roig, F.; Beaugé, C.

2003-08-01

Além do cálculo semi-analítico de elementos próprios dos asteróides Troianos (Beaugé & Roig 2001, Icarus 153, 391), recentemente foi apresentado um novo conjunto destes elementos próprios determinado através de uma teoria sintética (Knenezevic & Milani 2003, comunicação pessoal). As bases de dados contendo estas determinações estão disponiveis na pagina web do Asteroid Dynamical Site (http://hamilton.dm.unipi.it/cgi-bin/astdys/astibo). Nesta comunicação apresentamos os primeiros resultados de um estudo comparativo entre ambos conjuntos de elementos próprios, analisando suas vantagens e desvantagens, assim como os limites de precisão de cada conjunto. Mostramos que os elementos próprios sintéticos são mais precisos que os smi-analíticos para grandes amplitudes de libração do ângulo s = l-lJup, embora acontece o contrario para os corpos cuja amplitude de libração é muito pequena. Finalmente discutimos a influencia destes erros na determinação de familias de asteroides e da estrutura resonante em torno dos pontos Lagrangeanos L4 e L5.

Uma contribuição para a construção de instrumentos analítico-sintéticos de representação do conhecimento

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Lígia Café

Full Text Available Foram investigados critérios lingüísticos adotados em modelos de representação do conhecimento para a recuperação da informação. Para isso, a validação do modelo de predicação sintático-semântico proposto por Café (1999 foi testada, para a construção de sistemas analítico-sintéticos de representação do conhecimento. Aplicou-se, de forma experimental, esse modelo de predicação na construção de esquemas de representação do conhecimento, usando-se, para isso, do corpus recolhido da terminologia específica da Biotecnologia de Plantas, com o intuito de identificar as relações conceituais nele existentes e a determinação de suas facetas. Observou-se, na pesquisa, que algumas regras se firmaram como constantes no decorrer das análises, revelando a constituição de padrões científicos precisos de classificação. Além disso, percebeu-se tanto a ocorrência de resultados qualitativos, quanto a de resultados quantitativos a respeito da interpretação referente ao corpus. Tratou-se dos mesmos aspectos em ambos, proporcionando, assim, uma análise densa dos dados. Dessa forma, pela adoção do modelo é possível identificar as relações conceituais, e determinar as categorias fundamentais, as facetas e os seus indicadores, indispensáveis na construção de classificações analítico-sintéticas. Concluiu-se que a interpretação do corpus analisado resulta na validação da proposta de Café (1999 como um modelo de predicação para a aplicação em instrumentos de representação do conhecimento voltados para a recuperação da informação.

Analytic and clinical performance of cobas HPV testing in anal specimens from HIV-positive men who have sex with men.

Science.gov (United States)

Wentzensen, Nicolas; Follansbee, Stephen; Borgonovo, Sylvia; Tokugawa, Diane; Sahasrabuddhe, Vikrant V; Chen, Jie; Lorey, Thomas S; Gage, Julia C; Fetterman, Barbara; Boyle, Sean; Sadorra, Mark; Tang, Scott Dahai; Darragh, Teresa M; Castle, Philip E

2014-08-01

Anal human papillomavirus (HPV) infections are common, and the incidence of anal cancer is high in HIV-infected men who have sex with men (MSM). To evaluate the performance of HPV assays in anal samples, we compared the cobas HPV test (cobas) to the Roche Linear Array HPV genotyping assay (LA) and cytology in HIV-infected MSM. Cytology and cobas and LA HPV testing were conducted for 342 subjects. We calculated agreement between the HPV assays and the clinical performance of HPV testing and HPV genotyping alone and in combination with anal cytology. We observed high agreement between cobas and LA, with cobas more likely than LA to show positive results for HPV16, HPV18, and other carcinogenic types. Specimens testing positive in cobas but not in LA were more likely to be positive for other markers of HPV-related disease compared to those testing negative in both assays, suggesting that at least some of these were true positives for HPV. cobas and LA showed high sensitivities but low specificities for the detection of anal intraepithelial neoplasia grade 2/3 (AIN2/3) in this population (100% sensitivity and 26% specificity for cobas versus 98.4% sensitivity and 28.9% specificity for LA). A combination of anal cytology and HPV genotyping provided the highest accuracy for detecting anal precancer. A higher HPV load was associated with a higher risk of AIN2/3 with HPV16 (P(trend) < 0.001), HPV18 (P(trend) = 0.07), and other carcinogenic types (P(trend) < 0.001). We demonstrate that cobas can be used for HPV detection in anal cytology specimens. Additional tests are necessary to identify men at the highest risk of anal cancer among those infected with high-risk HPV. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model.

Science.gov (United States)

Hu, Jiafen; Budgeon, Lynn R; Cladel, Nancy M; Balogh, Karla; Myers, Roland; Cooper, Timothy K; Christensen, Neil D

2015-12-01

Noninvasive and practical techniques to longitudinally track viral infection are sought after in clinical practice. We report a proof-of-principle study to monitor the viral DNA copy number using a newly established mouse papillomavirus (MmuPV1) mucosal infection model. We hypothesized that viral presence could be identified and quantified by collecting lavage samples from cervicovaginal, anal and oral sites. Nude mice infected at these sites with infectious MmuPV1 were tracked for up to 23 weeks starting at 6 weeks post-infection. Viral DNA copy number was determined by SYBR Green Q-PCR analysis. In addition, we tracked viral DNA load through three complete oestrous cycles to pinpoint whether there was a correlation between the DNA load and the four stages of the oestrous cycle. Our results showed that high viral DNA copy number was reproducibly detected from both anal and cervicovaginal lavage samples. The infection and disease progression were further confirmed by histology, cytology, in situ hybridization, immunohistochemistry and transmission electron microscopy. Interestingly, the viral copy number fluctuated over the oestrous cycle, with the highest level at the oestrus stage, implying that multiple sampling might be necessary to provide a reliable diagnosis. Virus DNA was detected in oral lavage samples at a later time after infection. Lower viral DNA load was found in oral samples when compared with those in anal and vaginal tracts. To our knowledge, our study is the first in vivo study to sequentially monitor papillomavirus infection from mucosal anal, oral and vaginal tracts in a preclinical model.

The male bulbospongiosus muscle and its relation to the external anal sphincter.

Science.gov (United States)

Peikert, Kevin; Platzek, Ivan; Bessède, Thomas; May, Christian Albrecht

2015-04-01

The bulbospongiosus muscle is part of the superficial muscular layer of the perineum and pelvic floor. Its morphology remains controversial in the literature. Therefore, we reinvestigated the fascial arrangement and fiber courses of the bulbospongiosus muscle and its topographical relation to the external anal sphincter. The perineum was dissected in 9 male cadavers (mean ± SD age 78.3 ± 10.7 years). Select samples were obtained for histology and immunohistochemistry. In 43 patients (mean age 60.7 ± 12 years) the topographical relation between the bulbospongiosus muscle and the external anal sphincter was determined by magnetic resonance imaging. The perineum contains several fascial layers consisting of elastic and collagen fibers as well as bundles of smooth muscle cells. The bulbospongiosus muscle was subdivided into a ventral and dorsal portion, which developed in 4 variants. The ventral insertion formed a morphological unity with the ischiocavernous muscle while the dorsal origin had a variable relation to the external anal sphincter (5 variants). A muscle-like or connective tissue-like connection was frequently present between the muscles. However, in some cases the muscles were completely separated. We suggest a concept of variations of bulbospongiosus muscle morphology that unifies the conflicting literature. Its ventral fiber group and the ischiocavernosus muscle form a functional and morphological unity. While the bulbospongiosus muscle and the external anal sphincter remain independent muscles, their frequent connection might have clinical implications for perineal surgery and anogenital disorders. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

FDG-PET/CT in the evaluation of anal carcinoma

International Nuclear Information System (INIS)

Cotter, Shane E.; Grigsby, Perry W.; Siegel, Barry A.

2006-01-01

Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was with standard Nigro regimen. Results: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [ 18 F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination

Evaluación analítica de óvulos de quitina Analytical evaluation of chitin pessaries

Directory of Open Access Journals (Sweden)

Yania Suárez Pérez

2008-12-01

Full Text Available Los óvulos de quitina constituyen nuevos productos en fase de investigación. Para la evaluación analítica de estos, se desarrolló un método gravimétrico directo para supositorios vaginales de diferente dosificación. La técnica se basa en la separación de la quitina de los demás componentes de la formulación según sus diferencias de solubilidad, con el empleo de la filtración al vacío. El método se validó para control de calidad, y se obtuvieron resultados satisfactorios en los parámetros evaluados: linealidad, precisión, exactitud y selectividad.Chitin pessaries are new products under research. For their analytical evaluation, a direct gravimetric method for vaginal suppositories of various dosing was designed. This technique was based on separation of chitin from the rest of the formulation components according to their solubility characteristics, by using vacuum filtering. The method was validated for quality control and the results were satisfactory in terms of the evaluated parameters such as linearity, precision, accuracy and selectivity.

Cause-specific colostomy rates after radiotherapy for anal cancer: a Danish multicentre cohort study.

Science.gov (United States)

Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli; Havsteen, Hanne; Buntzen, Steen; Thorlacius-Ussing, Ole; Laurberg, Søren

2011-09-10

In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy rates. We examined this in a cohort study. Through national registries and review of medical records, we identified patients with anal cancer diagnosed from 1995 to 2003 who had curative-intent radiotherapy or chemoradiotherapy in four Danish centers. We computed cumulative incidence of tumor-related colostomy and therapy-related colostomy, treating colostomy and death as competing events. Follow-up started at completion of radiotherapy and continued throughout 2008. We used competing risk regression to compute hazard ratios (HRs) to compare the cumulative incidence of cause-specific colostomies between age, sex, tumor size, chemotherapy, and local excision before radiotherapy. We included 235 patients with anal cancer. The 5-year cumulative incidences of tumor-related and therapy-related colostomy were 26% (95% CI, 21% to 32%) and 8% (95% CI, 5% to 12%), respectively. Tumor size greater than 6 cm versus less than 4 cm was a risk factor for tumor-related colostomy (adjusted HR, 3.8; 95% CI, 1.7 to 8.1), and local excision before radiotherapy was a risk factor for therapy-related colostomy (adjusted HR, 4.5; 95% CI, 1.5 to 13.5). After curative-intent radiotherapy or chemoradiotherapy, one third of patients had a colostomy, of which one third were related to therapy. Large tumor size was associated with a higher risk of tumor-related colostomy, whereas history of prior excision was associated with an increased incidence of therapy-related colostomy.

Gender Nonconformity and Birth Order in Relation to Anal Sex Role Among Gay Men.

Science.gov (United States)

Swift-Gallant, Ashlyn; Coome, Lindsay A; Monks, D Ashley; VanderLaan, Doug P

2018-05-01

Androphilia is associated with an elevated number of older brothers among natal males. This association, termed the fraternal birth order effect, has been observed among gay men who exhibit marked gender nonconformity. Gender nonconformity has been linked to gay men's preferred anal sex role. The present study investigated whether these two lines of research intersect by addressing whether the fraternal birth order effect was associated with both gender nonconformity and a receptive anal sex role (243 gay men, 91 heterosexual men). Consistent with previous research, we identified the fraternal birth order effect in our sample of gay men. Also, gay men were significantly more gender-nonconforming on adulthood and recalled childhood measures compared to heterosexual men. When gay men were compared based on anal sex role (i.e., top, versatile, bottom), all groups showed significantly greater recalled childhood and adult male gender nonconformity than heterosexual men, but bottoms were most nonconforming. Only gay men with a bottom anal sex role showed evidence of a fraternal birth order effect. A sororal birth order effect was found in our sample of gay men, driven by versatiles. No significant associations were found between fraternal birth order and gender nonconformity measures. These results suggest that the fraternal birth order effect may apply to a subset of gay men who have a bottom anal sex role preference and that this subgroup is more gender-nonconforming. However, there were no significant associations between fraternal birth order and gender nonconformity at the individual level. As such, based on the present study, whether processes underpinning the fraternal birth order effect influence gender nonconformity is equivocal.

Validação preliminar de uma versão do Caregiver Reaction Assessment em um contexto de pacientes oncológicos em internação

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Suzane Pereira Busatta

2014-09-01

Full Text Available Objetivo Adaptar para o Brasil uma versão portuguesa do Caregiver Reaction Assessment (CRA e gerar indicadores preliminares de validade e fidedignidade para sua aplicação em cuidadores de pacientes oncológicos internados. Métodos Participaram voluntariamente 53 cuidadores, que responderam a um questionário sociodemográfico, ao CRA e à Escala de Bem-Estar Psicológico (EBEP. A unidimensionalidade e a homogeneidade dos escores do CRA foram avaliadas por meio de análise de componentes principais e de consistência interna, respectivamente. Correlações de Pearson entre escores do CRA e EBEP foram examinadas e utilizadas como indicadores de validade divergente e de construto. Resultados As cinco escalas que compõem o CRA apresentaram bons níveis de unidimensionalidade e homogeneidade, porém as escalas de impacto nas finanças e impacto na saúde obtiveram alfas insuficientes (< 0,7. O escore total do CRA apresentou alfa elevado (0,886. Correlações entre o CRA e a EBEP produziram coeficientes teoricamente interpretáveis, com magnitudes variando entre nulas e moderadas. Conclusão O CRA apresentou bons indicadores de validade e fidedignidade. Algumas adaptações em relação ao conteúdo de determinados itens se mostram, todavia, necessárias, a fim de serem calibradas ao contexto de pessoas atendidas por serviços subsidiados pelo Sistema Único de Saúde.

Un modelo de redes neuronales para complementariedad no lineal

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Favián Arenas

2016-01-01

Full Text Available En este artí ulo presentamos un modelo de red neuronal para resolver el problema de omplementariedad no lineal. Para ello, reformulamos este problema omo uno de minimiza ión sin restri iones usando una familia uniparamétri a de fun iones de omplementariedad. Demostramos resultados de existen ia y onvergen ia de la traye toria de la red neuronal, así omo resultados de estabilidad en el sentido de Lyapunov, estabilidad asintóti a y exponen ial. Además, presentamos resultados numéri os preliminares que ilustran un buen desempeño prá ti o del modelo.

Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States.

Science.gov (United States)

Sudenga, Staci L; Nyitray, Alan G; Torres, B Nelson; Silva, Roberto; Villa, Luisa; Lazcano-Ponce, Eduardo; Abrahamsen, Martha; Baggio, Maria Luiza; Salmeron, Jorge; Quiterio, Manuel; Giuliano, Anna R

2017-07-01

Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence

NARCIS (Netherlands)

Terra, Maaike P.; Deutekom, Marije; Beets-Tan, Regina G. H.; Engel, Alexander F.; Janssen, Lucas W. M.; Boeckxstaens, Guy E. E.; Dobben, Annette C.; Baeten, Cor G. M. I.; de Priester, Jacobus A.; Bossuyt, Patrick M. M.; Stoker, Jaap

2006-01-01

PURPOSE: External anal sphincter atrophy at endoanal magnetic resonance imaging has been associated with poor outcome of anal sphincter repair. We studied the relationship between external anal sphincter atrophy on endoanal magnetic resonance imaging and clinical, functional, and anatomic

Estudio de caracterización de la calidad microbiológica y fisicoquímica del agua utilizada en la industria de alimentos, Colombia, 2007

Directory of Open Access Journals (Sweden)

Elizabeth Silva

2010-09-01

Conclusión. Aunque es un estudio preliminar, los resultados indican que el agua utilizada en la mayoría de las industrias participantes puede producir deterioro de los alimentos y ser una vía de transmisión de microorganismos patógenos; por lo tanto, es importante organizar un programa continuo de seguimiento y control.

Resultados do tratamento artroscópico das rupturas do manguito rotador Outcomes of arthroscopic treatment for rotator cuff tears

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Carlos Henrique Ramos

2010-01-01

Full Text Available OBJETIVO: Analisar os resultados do reparo artroscópico das rupturas do manguito rotador. MÉTODOS: Realizado estudo retrospectivo com avaliação dos resultados da técnica em 42 pacientes operados entre 2002 e 2006. O seguimento médio foi de 31 meses e a média de idade foi de 57 anos, sendo o lado dominante operado em 73,8% dos casos. Para avaliação foram usadas escalas de UCLA e Escala Visual Analógica da dor no pós-operatório. RESULTADOS: Os resultados foram satisfatórios em 85,7% (59,5% excelentes e 26,2% bons respectivamente e insatisfatórios em 14,3% dos pacientes. Nos casos com lesões associadas, a mais frequente foi no tendão da porção longa do bíceps (57,1%. Associação com outras lesões não comprometeu o resultado. O mesmo aconteceu com relação a idade e tempo de acompanhamento pós-cirurgia. Quanto ao tamanho da lesão, diferença significativa ocorreu nos casos de lesões grandes e maciças demonstrando resultados inferiores em relação às pequenas e médias. A função foi inferior principalmente nos casos de lesão maciça. CONCLUSÃO: A reparação artroscópica das lesões do manguito rotador (MR proporciona baixa morbidade cirúrgica e possibilita diagnóstico de lesões articulares associadas. O benefício do procedimento foi confirmado principalmente pela melhora significativa da dor, mesmo nos casos de lesões maiores.OBJECTIVE: To evaluate the results of arthroscopic treatment for rotator cuff tears. METHODS: A retrospective study was carried out demonstrating the results of this technique in 42 patients operated between 2002 and 2006. The mean follow-up was 31 months and average age was 57 years. The dominant limb was operated in 73.8% of cases. Function and pain were evaluated using criteria of UCLA Score System and Visual Analogic Scale respectively. RESULTS: The results were satisfactory in 85.7% (59.5% excellent and 26.2% good, with 14.3% unsatisfactory. The most frequent associated lesion was the

coloproctectomie avec anastomose colo-sus-anale pour tumeur ...

African Journals Online (AJOL)

Une coloproctectomie fut réalisée le 30/06/2014 avec anastomose colo-anale, colostomie de protection sous-couvert d'une transfusion sanguine. L'examen histologique du segment colorectal prélevé objectiva une rectocolite granulomateuse autour de nombreux oeufs de schistosomes. En effet, le patient a vécu à Pahou, ...

Estrategias funcionales emergentes de promoción por parte de los ejecutivos del negocio bancario: Estudio preliminar a la Banca en Maracaibo

OpenAIRE

Emmanuel Borgucci; Roberto Cubillán

2003-01-01

En esta investigación de carácter preliminar, se trata de demostrar la existencia de estrategias funcionales emergentes por parte de los ejecutivos de negocios bancarios. Se diseñó una investigación de tipo descriptivo y se aplicó un cuestionario semiestructurado y validado con el procedimiento del pretest-test a 16 ejecutivos del área petrolera pertenecientes a 10 bancos ubicados en Maracaibo (Venezuela). Se concluye que sobre la base de una serie de habilidades personales y oper...

Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats.

Science.gov (United States)

Chen, Sung-Lang; Huang, Yu-Hui; Kao, Yu-Lin; Chen, Gin-Den; Cheng, Chen-Li; Peng, Hsien-Yu; Liao, Jiuan-Miaw; Huang, Pei-Chen; Tsai, Shih-Jei; Lin, Tzer-Bin

2008-10-01

The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 microM, 10 microl) and d-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, 100 microM, 10 microl]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 microM, 10 microl) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [gamma-aminobutyric acid (GABA) A receptor antagonist, 100 microM, 10 microl] but not hydroxysaclofen (GABAB receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch.

Postpartum two- and three-dimensional ultrasound evaluation of anal sphincter complex in women with obstetric anal sphincter injury.

Science.gov (United States)

Ros, C; Martínez-Franco, E; Wozniak, M M; Cassado, J; Santoro, G A; Elías, N; López, M; Palacio, M; Wieczorek, A P; Espuña-Pons, M

2017-04-01

To compare the sensitivity and specificity of two- (2D) and three- (3D) dimensional transperineal ultrasound (TPUS) and 3D endovaginal ultrasound (EVUS) with the gold standard 3D endoanal ultrasound (EAUS) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). External (EAS) and internal (IAS) anal sphincters were evaluated by the four ultrasound modalities in women with repaired OASIS. 2D-TPUS was evaluated in real-time, whereas 3D-TPUS, 3D-EVUS and 3D-EAUS volumes were evaluated offline by six blinded readers. The presence/absence of any tear in EAS or IAS was recorded and defects were scored according to the Starck system. Sensitivity, specificity and predictive values were calculated, using 3D-EAUS as reference standard. Inter- and intraobserver analyses were performed for all 3D imaging modalities. Association between patients' symptoms (Wexner score) and ultrasound findings (Starck score) was calculated. Images from 55 patients were analyzed. Compared with findings on 3D-EAUS, the agreement for EAS evaluation was poor for 3D-EVUS (κ = 0.01), fair for 2D-TPUS (κ = 0.30) and good for 3D-TPUS (κ = 0.73). The agreement for IAS evaluation was moderate for both 3D-EVUS (κ = 0.41) and 2D-TPUS (κ = 0.52) and good for 3D-TPUS (κ = 0.66). Good intraobserver (3D-EAUS, κ = 0.73; 3D-TPUS, κ = 0.78) and interobserver (3D-EAUS, κ = 0.68; 3D-TPUS, κ = 0.60) agreement was reported. Significant association between Starck and Wexner scores was found only for 3D-EAUS (Spearman's rho = 0.277, P = 0.04). 2D-TPUS and 3D-EVUS are not accurate modalities for the assessment of anal sphincters after repair of OASIS. 3D-TPUS shows good agreement with the gold standard 3D-EAUS and a high sensitivity in detecting residual defects. It, thus, has potential as a screening tool after primary repair of OASIS. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG

Tendinopatia patelar: resultados tardios do tratamento cirúrgico

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Marcos Henrique Frauendorf Cenni

2015-10-01

Full Text Available resumo Objetivo: Avaliar os resultados tardios do tratamento cirúrgico na tendinopatia patelar (TP com o uso do escore Visa (Victorian Institute of Sport Tendon Study Group e o método de Verheyden. Métodos: Estudo retrospectivo que avaliou os resultados pós-operatórios de 12 pacientes, ou 14 joelhos, entre julho de 2002 e fevereiro de 2011. Foram incluídos os pacientes com tendinopatia patelar refratários ao tratamento conservador e que não apresentavam outras lesões cirúrgicas concomitantes. Pacientes que não foram devidamente acompanhados no período pós-operatório foram excluídos. Resultados: Pelo método de Verheyden, nove pacientes foram considerados muito bons, dois bons e um ruim. Em relação ao Visa, a média foi de 92,4 pontos, com apenas dois pacientes abaixo de 70 pontos (66 e 55 pontos. Conclusão: O tratamento cirúrgico da tendinopatia patelar, quando corretamente indicado, tem bons resultados em longo prazo.

Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial.

Science.gov (United States)

Renzi, Adolfo; Izzo, Domenico; Di Sarno, Giandomenico; Talento, Pasquale; Torelli, Francesco; Izzo, Giuseppe; Di Martino, Natale

2008-01-01

This prospective, randomized, controlled trial was designed to compare the clinical, functional, and morphologic results of pneumatic balloon dilatation with lateral internal sphincterotomy for the treatment of chronic anal fissure. All patients with symptomatic chronic anal fissure were randomly assigned to pneumatic balloon dilatation or lateral internal sphincterotomy and invited to complete a standardized questionnaire inquiring about their symptoms. Anal ultrasonography and anal manometry were performed before and six months after surgery. A proctologic examination was performed between the fifth and sixth postoperative weeks. Anal continence, scored by using a validated continence grading scale, was evaluated preoperatively at 1 and 6 weeks and at 12 and 24 months. Fifty-three patients, who satisfied selection criteria, were enrolled in the trial. Four patients (7.5 percent) were lost to follow-up. Twenty-four patients (11 males; mean age, 42 +/- 8.2 years) underwent pneumatic balloon dilatation and 25 patients (10 males; mean age, 44 +/- 7.3 years) underwent lateral internal sphincterotomy. Fissure-healing rates were 83.3 percent in the pneumatic balloon dilatation and 92 percent in the lateral internal sphincterotomy group. Recurrent anal fissure was observed in one patient (4 percent) after lateral internal sphincterotomy. At anal manometry, mean resting pressure decrements obtained after pneumatic balloon dilatation and lateral internal sphincterotomy were 30.5 and 34.3 percent, respectively. After pneumatic balloon dilatation, anal ultrasonography did not show any significant sphincter damage. At 24-month follow-up, the incidence of incontinence, irrespective of severity, was 0 percent in the pneumatic balloon dilatation group and 16 percent in the lateral internal sphincterotomy group (P < 0.0001). As lateral internal sphincterotomy, pneumatic balloon dilatation grants a high anal fissure-healing rate but with a statistically significant reduction in

Radiochemotherapy in Anal Cancer: cCR, clinical outcomes and quality of life using two different treatment schedules.

Science.gov (United States)

Di Santo, Sara; Trignani, Marianna; Neri, Matteo; Milano, Angelo; Innocenti, Paolo; Taraborrelli, Maria; Augurio, Antonietta; Vinciguerra, Annamaria; Di Tommaso, Monica; Ursini, Lucia Anna; Di Pilla, Angelo; Di Nicola, Marta; Genovesi, Domenico

2015-01-01

Main endpoint was a response rate to therapy; secondary endpoints were disease-free survival, overall survival, acute and late toxicities, specially in terms of anorectal and urinary continence. Radiochemotherapy for anal cancer achieves a good clinical response, locoregional control, anal function preservation. However, oncologic outcomes can differ using radiotherapy plus fluorouracil and mytomicin vs. cisplatin and fluorouracil. Between 2000 and 2012, 27 anal cancer patients receiving radiotherapy combined with two different radiochemotherapy schedules, fluorouracil and mytomicin (group A) and cisplatin plus fluorouracil (group B). The Kaplan-Meier method was also used to estimate local control, overall survival and disease free survival. Statistical significance between curves was evaluated using the Log-rank test. Complete pathological response was found in 85.2% of patients, with higher rates of response in the group A (100% vs. 63.6%, p = 0.039). No significantly difference was found between the two groups for the other endpoints. Low rates of both acute and late toxicities were recorded. Radiotherapy plus fluorouracil and mytomicin provide a better complete pathological response than radiotherapy plus cisplatin and fluorouracil and a greater rate of anal sphincter function preservation. Globally, radiochemotherapy of the anal cancer provides excellent clinical outcomes with a good profile of acute and late toxicity, without difference between the two groups studied.

Design and Psychometric Evaluation of the Quality of Life in Patients With Anal Fistula Questionnaire.

Science.gov (United States)

Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Angel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

2017-10-01

Quality of life is often considered when deciding and evaluating the treatment strategy for patients diagnosed with anal fistula. The purpose of this study was to develop and psychometrically test the Quality of Life in Patients with Anal Fistula Questionnaire. This was an observational cross-sectional study for the development and validation of a psychometric tool. The study was conducted at a general hospital in the southeast of Spain. A convenience sample included 54 patients diagnosed with anal fistula. The reliability of the tool was assessed through its internal consistency (Cronbach α) and temporal stability (Spearman correlation coefficient (r) between test-retest). The content validity index of the items and the scale was calculated. Correlation analysis and an ordinal regression analysis between the developed tool and the Short Form 12 Health Survey examined its concurrent validity. Principal component analysis and known-group analysis using the Kruskal-Wallis test examined its construct validity. The reliability of the developed questionnaire was very high (α = 0.908; r = 0.861; p questionnaire to detect expected differences in patients presenting with different symptomatology. The major limitations of this study were the use of a small sample of Spanish-speaking patients, not including patients in the initial development of the questionnaire, and developing the scoring system using a summation method. The Quality of Life in Patients with Anal Fistula Questionnaire has proven to be a valid, reliable, and concise tool that could contribute to the evaluation of quality of life among patients with an anal fistula. See Video Abstract at http://links.lww.com/DCR/A368.

Radiological diagnosis in constipation and anal incontinence due to changes in the pelvic floor and sphincter apparatus of the anus

International Nuclear Information System (INIS)

Bistolfi, F.; Grillo Ruggeri, F.; Siragusa, A.

1987-01-01

Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincterial apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusion: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially is allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteral apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualization of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincterial apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter

Caudal léxico en alumnos universitarios : Implicancias para la interacción textual

OpenAIRE

Piatti, Vanesa; Fernicola, Alfredo; Melillo, Oscar Roberto; Peralta, Diego

2011-01-01

En este trabajo se comunican los resultados preliminares de una investigación en curso. Específicamente se refiere a los resultados encontrados en pruebas de que examinan el caudal léxico, por el interés de sus relaciones con la interacción textual. En razón de ello en la elaboración de esta comunicación se ha tenido particularmente en cuenta el modelo de comprensión lectora proporcionado por Kintsch y Rawson (2005) sobre los diferentes niveles de procesamiento cuando se lee. Los autores d...

La percepción del riesgo en las redes sociales entre la juventud inmigrada en España

OpenAIRE

Hernández Fernández, Coral

2014-01-01

La presente comunicación sistematiza los resultados de la búsqueda documental especializada en medios online sobre Juventud, Inmigración, Redes sociales y Riesgos, junto a los resultados preliminares obtenidos en el trabajo de campo de la investigación “Las relaciones sociales de los jóvenes migrantes en Internet desde la perspectiva de la interculturalidad” (CSO2011- 24376), proyecto de I+D financiado por el Ministerio de Ciencia e Innovación del Gobierno de España. La búsqueda documental se...

Rectocele and anal sphincter defect – surgical anatomy and ...

African Journals Online (AJOL)

carefully directed translabial ultrasound scan of the rectum and anal sphincters. The ultrasound examination was performed by a radi- ologist with specific understanding of the pathology. Conventional two-dimensional ultrasound imaging was performed using a 4 - 8. MHz curved array probe. The patient was in the left ...

Clinical Application of F-18 FDG PET (PET/CT) in Colo-rectal and Anal Cancer

International Nuclear Information System (INIS)

Kim, Byung Il

2008-01-01

In the management of colo-retal and anal cancer, accurate staging, treatment evaluation, early detection of recurrence are main clinical problems. F-18 FDG PET (PET/CT) has been reported as useful in the management of colo-rectal and anal cancer because that PET has high diagnostic performance comparing to conventional studies. In case of liver metastases, for confirmation of no extrahepatic metastases, in case of high risk of metastasis, for avoiding unnecessary operation, PET (PET/CT) is expected more useful. In anal cancer, PET is expected useful in lymph node staging. For the early prediction of chemotherapy or radiation therapy effect PET has been reported as useful, also. In early detection of recurrence by PET, cost-benefit advantages has been suggested, also. PET/CT is expected to have higher diagnostic performance than PET alone

Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

International Nuclear Information System (INIS)

Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

2011-01-01

We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

Anal carcinomas: the role of endoanal ultrasound and magnetic resonance imaging in staging, response evaluation and follow-up

Energy Technology Data Exchange (ETDEWEB)

Parikh, Jyoti; Shaw, Aidan; Griffin, Nyree [Guys and St. Thomas' Hospital, Department of Radiology, London (United Kingdom); Grant, Lee A. [Royal Marsden Hospital, Department of Radiology, London (United Kingdom); Schizas, Alexis M.P.; Datta, Vivek; Williams, Andrew B. [Guys and St. Thomas' Hospital, Department of General Surgery, London (United Kingdom)

2011-04-15

Anal carcinoma is an important but rare condition, managed in specialist centres. Both endoanal ultrasound and magnetic resonance imaging (MRI) can be used in the locoregional staging and follow-up of patients with anal cancer, and both may assist in treatment planning and prognosis. Recent guidelines published by the European Society for Medical Oncology have recommended MRI as the technique of choice for assessment of locoregional disease. This paper describes the techniques for both endoanal ultrasound and MRI, and compares the relative merits and disadvantages of each in the local assessment of anal carcinoma. (orig.)

Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

Science.gov (United States)

Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok

2009-03-01

Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.

The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

Energy Technology Data Exchange (ETDEWEB)

Roos, A.-M., E-mail: annemarie.roos@gmail.com [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom); Abdool, Z. [Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria (South Africa); Sultan, A.H.; Thakar, R. [Department of Obstetrics and Gynaecology, Mayday University Hospital, Croydon (United Kingdom)

2011-07-15

Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study

International Nuclear Information System (INIS)

Roos, A.-M.; Abdool, Z.; Sultan, A.H.; Thakar, R.

2011-01-01

Aim: To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. Materials and methods: One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B and K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. Results: On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Conclusion: Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect.

Hereditary vacuolar internal anal sphincter myopathy causing proctalgia fugax and constipation: a new case contribution.

Science.gov (United States)

de la Portilla, Fernando; Borrero, Juan José; Rafel, Enrique

2005-03-01

Hereditary anal sphincter myopathy is rare. We present a family with one affected member with proctalgia fugax, constipation and internal anal sphincter hypertrophy. Ultrastructural findings show vacuolization of smooth muscle cells without the characteristic polyglucosan inclusion. Further relief of symptoms was obtained using an oral calcium antagonist. Based on clinical presentation, endosonography and morphological findings, we consider our case is a histological variant of the vacuolar myopathy originally described.

Exploración del potencial de la espectroscopía Raman portátil en la caracterización de los vinos

OpenAIRE

Rodríguez Gutiérrez, José Ángel

2016-01-01

Las técnicas espectroscópicas presentan grandes ventajas para el estudio de la naturaleza físico-química de los materiales (composición-estructura) por su rapidez analítica, su carácter no destructivo y su versatilidad de uso. A pesar de esto, no han sido muy utilizadas en la caracterización de vinos y licores, sin embargo, por lo apuntado más arriba, el potencial de estas para el uso en esta área es enorme. En este trabajo, se tratará de hacer un estudio preliminar de vinos y licores usando ...

Prevalence of anal infection due to high-risk human papillomavirus and analysis of E2 gene integrity among women with cervical abnormalities.

Science.gov (United States)

Gonzalez-Losa, María Del Refugio; Puerto-Solís, Marylin; Ayora-Talavera, Guadalupe; Gómez-Carvallo, Jesús; Euán-López, Alejandra; Cisneros-Cutz, José I; Rosado-López, Ariel; Echeverría Salazar, Jesúa; Conde-Ferráez, Laura

2018-04-01

High-risk human papillomaviruses (HR-HPV) infection has been associated with 90% of anal cancer cases. Women with abnormal cytology are a high-risk group to develop anal neoplasia. The aim of this study is to describe the prevalence and epidemiology of HR-HPV 16, 18, 45, and 58 anal infections in women with cervical abnormalities, as well as to assess E2 gene integrity. A cross-sectional study was performed on 311 cervical and 311 anal samples from patients with abnormal cytology in two colposcopy clinics in Yucatan, Mexico. A specific PCR for oncogenes was performed in order to identify HVP 16, 18, 45 and 58. Real time PCR was used to amplify the whole HPV 16, 18, and 58 E2 gene to verify its integrity in anal samples. High risk HPV 16, 18, 58, and/or 45 were found in 41.47% (129/311) of cervical samples, and in 30.8% (96/331) of anal samples, with 18% (57/311) of the patients being positive in both samples. The same genotypes in both anatomical sites were observed in 11.25% (35/311). The E2 gene was disrupted in 82% of all tested samples. The frequency of genome disruption viral integration in anal samples by genotype was: HPV 58 (97.2%); HPV 16 (72.4%), and HPV 18 (0%). Women with cervical disease have HR-HPV anal infections, and most of them have the E2 gene disrupted, which represents a risk to develop anal cancer. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

LA FALTA DE AGOTAMIENTO DE RECURSOS INTERNOS COMO EXCEPCIÓN PRELIMINAR ANTE LA COMISIÓN INTERAMERICANA DE DERECHOS HUMANOS

Directory of Open Access Journals (Sweden)

Ángela Patricia Bernal Guzmán

2012-01-01

Full Text Available El presente artículo analizará la excepción preliminar "Falta de agotamiento de recursos internos" como mecanismo de defensa estatal invocada ante la Comisión Interamericana de Derechos Humanos (CIDH. Se demostrarán las falencias o errores cometidos por los agentes estatales en la argumentación de la excepción, la cual ha sido superflua y equivoca al entregar argumentos definidos de forma previa por el órgano interamericano como improcedentes, en razón a su contradicción con los estándares internacionales de protección de los Derechos Humanos en el sistema regional.

Unsatisfactory exfoliative anal cytology samples, 15-year experience with histologic, cytologic, and molecular follow-up.

Science.gov (United States)

Khattab, Ruba; McMeekin, Emily; Taege, Alan J; Hekman, James M; Brainard, Jennifer A; Underwood, Dawn; Procop, Gary W; Sturgis, Charles D

2018-02-01

The incidence of anal carcinoma has risen in recent decades. Exfoliative cytology screening of selected high risk patients is performed in many centers. Unsatisfactory cytology results are frustrating to patients, clinicians, and laboratorians. The aim of this study is to ascertain outcomes of patients with non-diagnostic anal cytology. A retrospective review of anal cytology testing performed at the Cleveland Clinic between 01/01/2001 and 12/31/2015 was performed. All cases were received as liquid-based samples and processed as ThinPreps (Hologic, Marlborough, MA). Co-testing for HR-HPV DNA was performed using Hybrid Capture 2® (Qiagen, Germantown, MD) in the majority of patients. Of 1,276 ThinPrep anal cytology samples, 130 (10%) were deemed unsatisfactory. 77% of patients were HIV positive. 85% were males. Of the unsatisfactory cases, 116 (89%) were co-tested for HR-HPV DNA. Of those, 40 patients (34%) had a simultaneous positive HR-HPV DNA. Adequate follow up cytology within a one year and a two year period revealed that 18/130 (14%) and 26/130 (20%) of patients had ASC or SIL respectively. Histologic follow-up within one and two years showed 3 patients (2%) and 8 patients (6%) with HSIL or worse. High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology. © 2017 Wiley Periodicals, Inc.

Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

Science.gov (United States)

Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

2015-01-01

In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, pSingapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

[Clinical significance of detection of internal anal sphincter in children with functional constipation].

Science.gov (United States)

Hou, Xiang-yu; Wang, Ling-yun; Wang, Wei-lin; Li, Yong; Bai, Yu-zuo

2011-10-01

To investigate the structural and functional changes of internal anal sphincter (IAS) in children with functional constipation (FC), and to evaluate the association between the thickness of IAS and the severity of clinical symptoms. A total of 35 children with FC(constipation group,17 with incontinence) between June 2008 and December 2008 at the Shengjing Hospital of China Medical University were evaluated using anal manometry and endosonography. These patients were compared to 23 hospitalized children who were excluded for digestive and endocrinal diseases(control group). A validated symptom score(SS) was used to assess the severity of symptoms. The sum of SS ranged between 0 and 65. Anorectal manometry showed reflex relaxation of IAS in response to distension of rectal balloon in all patients. Rectal perceptional threshold in FC group was significantly higher than that in the controls[(42.4 ± 19.5) ml vs.(29.1 ± 15.6) ml, PIAS was significantly higher than that in the controls [(55.6 ± 31.6) ml vs.(30.5 ±13.8) ml, PIAS was noted in all the patients[(3.8 ± 1.7) mm vs.(2.5 ± 1.0) mm, P0.05]. The median symptom score was 9.3 ± 4.3 in the FC group. The thickness of IAS correlated significantly with total symptom severity score(r=0.407, PIAS and age, sex, or duration of disease(P>0.05). Structural and functional changes of internal anal sphincter exist in children with functional constipation. The thickness of internal anal sphincter correlates significantly with symptom severity.

Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer

DEFF Research Database (Denmark)

Rønde, Heidi S; Wee, Leonard; Pløen, John

2017-01-01

PURPOSE/OBJECTIVE: Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multipl...... that preference-informed dose planning is feasible for clinical studies utilizing shared decision making....... dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS: Retrospective plans.......7%-points; (0.3; 30.6); p decision space available in anal cancer radiotherapy to incorporate preferences, although tradeoffs are highly patient-dependent. This study demonstrates...

Identification of episomal human papillomavirus and other DNA viruses in cytological anal samples of HIV-uninfected men who have sex with men.

Directory of Open Access Journals (Sweden)

Maria Gabriella Donà

Full Text Available To date, there have been only few studies that investigated integration of anal Human Papillomavirus (HPV. Most of them were conducted on HIV-infected individuals and mainly analyzed samples from high-grade lesions and invasive cancer. We aimed to investigate HPV physical status in HIV-negative men who have sex with men (MSM with a detectable anal HPV infection, irrespective of the presence of lesions. We also sought to explore the presence of other circular DNA viruses in the anal region. Study participants were attendees of an STI screening program, which were also screened for anal HPV infection and cytological abnormalities. HPV physical status was assessed using multiply-primed RCA. HPV16-positive samples were also analyzed using E2/E6 multiplex PCR, qRT-PCR and APOT assay. RCA and virus-specific PCR were employed to investigate the presence of other DNA viruses. Anal HPV infection was detected in 76.9% of the 230 MSM enrolled. The anal cytological reports were: 129 NILM, 37 ASC-US and 28 L-SIL (36 samples were inadequate for interpretation. HPV physical status was evaluated in the 109 anal specimens that harbored one or two different HPV genotypes. Integration was observed only in one HPV16-positive sample (0.9%, in which integrate-derived viral transcripts of type B were detected. Integration occurred in chromosome 14 q. In 22 of the 53 (41.5% mucosal HPV-negative samples, RCA restriction results would seem to indicate the presence of circular DNA viruses. Indeed, cutaneous HPV (4 samples, MCPyV (5 samples and TTV (4 samples were detected. In conclusion, anal HPV integration was rarely evidenced in HIV-uninfected MSM with no or mild anal cytological abnormalities, although the integration rate may have been underestimated because of the limitations of the employed assays. Other DNA viruses were detected in the anal samples of these individuals, although the significance of this occurrence needs to be assessed.

Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

International Nuclear Information System (INIS)

Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin

2011-01-01

Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

Quality of life outcomes in patients with anal cancer after combined radiochemotherapy

Energy Technology Data Exchange (ETDEWEB)

Welzel, Grit; Haegele, Verena; Wenz, Frederik; Mai, Sabine Kathrin [Universitaetsklinikum Heidelberg, Mannheim (Germany). Dept. of Radiation Oncology

2011-03-15

Purpose: To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. Patients and Methods: A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). Results: As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. Conclusion: The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being. (orig.)

Treatment results in anal cancer: non-operative treatment versus operative treatment

Energy Technology Data Exchange (ETDEWEB)

Chie, Eui Kyu; Park, Jae Gahb; Bang, Yung Jue; Heo, Dae Seog; Kim, Noe Kyeong [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ha, Sung Whan [Medical Reasearch Center, Seoul National University, Seoul (Korea, Republic of)

2002-03-15

This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy plus radiotherapy versus abdominoperineal resection and postoperative radiotherapy for anal cancer. Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy (APR + RT {+-} CT), and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil (1,000 mg/m{sup 2} bolus on D1 {approx} 5) and cisplatin (60 mg/m{sup 2} bolus on D1) followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Overall five-year survival rates were 80.3%, 88.9% and 79.4% for entire patients, APR + RT {+-} CT group, and the CRT group, respectively. No significant difference was found between the two groups ({rho} = 0.49). Anus preservation rate for the CRT group was 86.7%. Age ({rho} = 0.0164) and performance status ({rho} = 0.0007) were found to be significant prognostic factors by univariate analysis. Age ({rho} = 0.0426), performance status ({rho} = 0.0068), and inguinal lymph node metastasis ({rho} = 0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of

Estudio Preliminar del Género Hevea en Colombia

Directory of Open Access Journals (Sweden)

Evans Schultes Richard

1946-04-01

Full Text Available Aunque en el territorio colombiano se han venido explotando los árboles caucheros del género Hevea durante casi medio siglo, solo ha sido en los últimos años cuando los botánicos han podido estudiar científicamente las especies en este país. En el presente artículo me limito a exponer de manera suscinta la identificación específica y la distribución geográfica del género Hevea en Colombia, valiéndome de las identificaciones botánicas preliminares que se han hecho hasta ahora, así como de los datos que he recogido personalmente y las informaciones que me han sido suministradas en fuentes fidedignas. Es de lamentarse la falta de exploración botánica en la hoya del río Inírida y sus afluentes que por ser, junto con el Guaviare, la región situada más al noreste de la zona de extensión del género Hevea, deja una laguna en los conocimientos que actualmente poseemos sobre la distribución geográfica de este género botánico. Igualmente carecemos de datos botánicos respecto de los ríos de menor importancia tales como el Yarí, el Cahuinarí y el Cotuhé, aunque sí los tenemos de las regiones mencionadas, lo mismo de otras vastas extensiones de la Amazonía Colombiana, podremos completar a satisfacción el estudio cuyo esbozo provisional presento en este trabajo.

Doenças anais concomitantes à doença hemorroidária: revisão de 1.122 pacientes Anal diseases associated to hemorrhoids: review of 1.122 patients

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Geraldo Magela Gomes da Cruz

2006-12-01

Full Text Available Em 34.000 pacientes coloproctológicos foi feito o diagnóstico de doença hemorroidária (DH, como doença coloproctológica principal, em 9.289 pacientes (27,3%, dos quais 1.122 (12,1% eram portadores de doenças anais concomitantes à DH (DAC. Dos 9.289 portadores de DH, 2.417 foram operados de DH (26,0% e destes, 729 foram operados, ao mesmo tempo, de DAC (30,2%. Assim, dos 1.122 portadores de DAC, 729 foram operados delas (65,0%. Em relação aos 9.289 portadores de DH, a DAC mais comum foi a fissura anal (541 casos, 5,8%, seguida de hipertrofia de papilas anais (312 casos, 3,4%, fístulas anais (117 casos, 1,3%, hipotonia anal com incontinência parcial (112 casos, 1,2%, condilomas anais acuminados (37 casos, 0,4% e tumores anais (3 casos, 0,03%; e a mesma ordem foi verificada em relação às 1.122 DAC: fissura anal (48,2%, hipertrofia de papilas anais (27,8%, fístulas anais (10,4%, hipotonia anal com incontinência parcial (10,0%, condilomas anais acuminados (3,3% e tumores anais (0,3%. Em relação à cirurgia, das 1.122 DAC 729 foram operadas (65,0% nesta ordem: fissura anal (317 casos, 28,3%, hipertrofia de papilas anais (267 casos, 23,8%, fístulas anais (89 casos, 7,9%, hipotonia anal com incontinência parcial (31 casos, 2,8%, condilomas anais acuminados (22 casos, 1,9% e tumores anais (3 casos 0,3%; e em relação às próprias DAC as incidências de cirurgias foram: tumor anal (100,0%, hipertrofia de papilas anais (85,6%, fístulas anais (76,0%, condilomas anais acuminados (59,6%, fissuras anais (58,6% e hipotonia com incontinência anal parcial (25,8%. A confirmação dos diagnósticos das DAC pelo exame histopatológico foi de 72,8%, em ordem decrescente: condilomas anais e fístulas anais (100,0%, hipertrofia de papilas anais (79,0%, fissuras anais (68,5% e tumores anais (66,7%.In a 38-year period of practice in Coloproctology, the author had the opportunity to attend 34,000 patients and the diagnosis of hemorrhoid as the

Diseño, fabricación y aplicaciones analíticas de nanocelulosa y sus híbridos

OpenAIRE

Ruiz-Palomero, Celia

2017-01-01

El gran avance nanotecnológico que ha experimentado la Química Analítica en los últimos años ha sido un indicador del grado de bienestar de la sociedad. La multidisciplinaridad de la Nanociencia y Nanotecnología ha sido esencial para el avance de los métodos y herramientas analíticas, así como para llevar a cabo la automatización, simplificación y miniaturización de los procesos analíticos integrados en los laboratorios [1]. En este campo, son muchos los nanomateriales explorados por sus ...

Congenital anorectal atresia: MR imaging of late post-operative appearances in adult patients with anal incontinence

International Nuclear Information System (INIS)

Gartner, Louise; Peiris, Chand; Marshall, Michele; Taylor, Stuart A.; Halligan, Steve

2013-01-01

To describe the MR imaging findings in adults presenting with anal incontinence following pull-through perineoplasty for anorectal atresia. 15 adults (12 male, 3 female; age 22-52 years) with anal incontinence following a prior perineal pull-through procedure as an infant for anorectal atresia were identified retrospectively. MR imaging was performed using either an endoanal coil or body coil. MR images were reviewed by three observers who noted whether pelvic floor and sphincter muscles were present and, if so, whether they were thinned or not. Data were tabulated and raw frequencies determined. Images were unavailable for one patient, leaving 14 for analysis. Anal stenosis prevented endoanal coil placement in 5. The pull-through was anatomically correct in 12 (86 %) patients but was misdirected in 2. Thinned muscle was seen in 11 (79 %) patients. External sphincter thinning was commonest (present in 10 patients), with levator plate thinning least common (present in 4 patients). Only one patient had thinning of all muscle groups. MR imaging may be used to determine the extent and quality of residual pelvic floor and anal sphincter muscle in adults who have functional disability following pull-through perineoplasty for anorectal agenesis. (orig.)

High rates of incident and prevalent anal human papillomavirus infection among young men who have sex with men.

Science.gov (United States)

Glick, Sara Nelson; Feng, Qinghua; Popov, Viorica; Koutsky, Laura A; Golden, Matthew R

2014-02-01

There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM). We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a 1-year prospective study of 94 YMSM (mean age, 21 years) in Seattle. Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 were detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1000 person-months and 15.3 per 1000 person-months for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all 4 HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥ 2 partners. Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naive to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.

Influence of human papillomavirus and p16INK4a on treatment outcome of patients with anal cancer

International Nuclear Information System (INIS)

Koerber, Stefan Alexander; Schoneweg, Clara; Slynko, Alla; Krug, David; Haefner, Matthias F.; Herfarth, Klaus; Debus, Juergen; Sterzing, Florian; Knebel Doeberitz, Magnus von

2014-01-01

Background: The purpose of this study was to evaluate HPV-DNA and p16 INK4a (p16) expression as prognostic markers for outcome in patients with anal cancer. Methods: From January 2000 to December 2011 a cohort of 105 anal cancer patients was treated with definitive chemoradiation at our institution. Tumor biopsies from 90 patients were analyzed for HPV-DNA by polymerase chain reaction and for p16 expression by immunohistochemistry. Results: Median follow-up was 48.6 months (range 2.8–169.1 months). HPV-DNA or p16-expression was found in 75 anal cancers each (83.3%), concordance was detectable in 70 tumors (77.8%). Significantly improved overall survival (OS) [77.1% vs. 51.4%, p = 0.005], progression-free survival (PFS) [64.0% vs. 35.0%, p < 0.001] and improved local control [81.0% vs. 55.9%, p = 0.023] was found for concomitant HPV- and p16-positive anal carcinomas (cHPPAC) in univariate analysis. Multivariate analysis showed better OS [p = 0.015] and PFS [p = 0.002] for cHPPAC. Conclusion: The combination of HPV-DNA and p16 can be used as an independent prognostic parameter in anal cancer patients

[Evaluation of the quality of Anales Españoles de Pediatría versus Medicina Clínica].

Science.gov (United States)

Bonillo Perales, A

2002-08-01

To compare the scientific methodology and quality of articles published in Anales Españoles de Pediatría and Medicina Clínica. A stratified and randomized selection of 40 original articles published in 2001 in Anales Españoles de Pediatría and Medicina Clínica was made. Methodological errors in the critical analysis of original articles (21 items), epidemiological design, sample size, statistical complexity and levels of scientific evidence in both journals were compared using the chi-squared and/or Student's t-test. No differences were found between Anales Españoles de Pediatría and Medicina Clínica in the critical evaluation of original articles (p > 0.2). In original articles published in Anales Españoles de Pediatría, the designs were of lower scientific evidence (a lower proportion of clinical trials, cohort and case-control studies) (17.5 vs 42.5 %, p 0.05), sample sizes were smaller (p 0.003) and there was less statistical complexity in the results section (p 0.03). To improve the scientific quality of Anales Españoles de Pediatría, improved study designs, larger sample sizes and greater statistical complexity are required in its articles.

Anal lymphogranuloma venereum infection screening with IgA anti-Chlamydia trachomatis-specific major outer membrane protein serology.

Science.gov (United States)

de Vries, Henry J C; Smelov, Vitaly; Ouburg, Sander; Pleijster, Jolein; Geskus, Ronald B; Speksnijder, Arjen G C L; Fennema, Johannes S A; Morré, Servaas A

2010-12-01

Anal lymphogranuloma venereum (LGV) infections, caused by Chlamydia trachomatis biovar L (Ct+/LGV+), are endemic among men who have sex with men (MSM). Anal non-LGV biovar Ct infections (Ct+/LGV-) can be eradicated with 1 week doxycycline, whereas Ct+/LGV+ infections require 3-week doxycycline. To differentiate Ct+/LGV+ from Ct+/LGV- infections, biovar-specific Nucleic Acid Amplification Test (NAAT) are standard, but also expensive and laborious. A chlamydia-specific serological assay could serve as an alternative test. MSM were screened for anal Ct+/LGV+ and Ct+/LGV- infections with a commercial nonspecific NAAT and an in house biovar L-specific NAAT. Serum samples were evaluated with chlamydia-specific anti-Major Outer Membrane Protein (MOMP) and antilipopolysaccharide assays of IgA and IgG classes. Asymptomatic patients were identified as: (1) no anal complaints or (2) no microscopic inflammation (i.e., <10 leucocytes per high power field in anal smears). The best differentiating assay was subsequently evaluated in 100 Ct+/LGV+ and 100 Ct+/LGV- MSM using different cut-off points. The anti-MOMP IgA assay was the most accurate to differentiate Ct+/LGV+ (n = 42) from Ct+/LGV- (n = 19) with 85.7% sensitivity (95% confidence interval [CI], 72.2-93.3) and 84.2% specificity (95% CI, 62.4-94.5), even among asymptomatic patients. In a population comprising 98 Ct+/LGV+ and 105 Ct+/LGV- patients, the anti-MOMP IgA assay scored most accurate when the cut-off point was set to 2.0 with 75.5% (95% CI, 65.8-83.6) sensitivity and 74.3% (95% CI, 64.8-82.3) specificity. The IgA anti-MOMP assay can identify a considerable proportion of the (asymptomatic) anal LGV infections correctly. Yet, biovar L-specific NAAT are still the preferred diagnostic tests in clinical settings.

The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study.

Science.gov (United States)

Roos, A-M; Abdool, Z; Sultan, A H; Thakar, R

2011-07-01

To determine the accuracy and predictive value of transperineal (TPU) and endovaginal ultrasound (EVU) in the detection of anal sphincter defects in women with obstetric anal sphincter injuries and/or postpartum symptoms of faecal incontinence. One hundred and sixty-five women were recruited, four women were excluded as they were seen years after their last delivery. TPU and EVU, followed by endonanal ultrasound (EAU), were performed using the B&K Viking 2400 scanner. Sensitivity and specificity, as well as predictive values with 95% confidence intervals, for detecting anal sphincter defects were calculated for EVU and TPU, using EAU as the reference standard. On EAU a defect was found in 42 (26%) women: 39 (93%) had an external (EAS) and 23 (55%) an internal anal sphincter (IAS) defect. Analysable images of one level of the EAS combined with an analysable IAS were available in 140 (87%) women for EVU and in 131 (81%) for TPU. The sensitivity and specificity for the detection of any defect was 48% (30-67%) and 85% (77-91%) for EVU and 64% (44-81%) and 85% (77-91%) for TPU, respectively. Although EAU using a rotating endoprobe is the validated reference standard in the identification of anal sphincter defects, it is not universally available. However while TPU and/or EVU with conventional ultrasound probes can be useful in identifying normality, for clinical purposes they are not sensitive enough to identify an underlying sphincter defect. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Comparação das contagens das células de Langerhans de tecidos contendo carcinoma anal em doentes com e sem infecção pelo HIV Comparison of Langerhans cells counts from tissues containing anal carcinoma of patients with and without HIV infection

Directory of Open Access Journals (Sweden)

Sidney Roberto Nadal

2006-09-01

Full Text Available INTRODUÇÃO: As células de Langerhans (LC são derivadas da medula óssea e constituem-se nas principais apresentadoras de antígeno da pele.conferindo desta forma, a resposta imune cutânea. Seu número está reduzido nos imunodeprimidos, incluindo na infecção pelo HIV, e a presença do tumor inibe sua migração, impedindo que os linfócitos T promovam regressão das células neoplásicas. OBJETIVO: Conhecer as diferenças entre as contagens de LC no tecido tumoral de doentes de carcinomas anais com e sem AIDS. MÉTODO: Avaliamos 24 doentes, sendo 14 com HIV e 10 outros sem HIV . O tratamento para o carcinoma foi semelhante nos dois grupos. Cortes retirados de blocos parafinados submetidos ao teste imunoistoquímico com anticorpo anti-CD68. Contamos as LC com método da histometria e os comparamos aos números obtidos com amostras previamente conhecidas de doentes sem doença infecciosa anorretal ou infecção pelo HIV. Revisamos também a evolução e as contagens séricas de linfócitos T CD4+ de doentes HIV-positivos. RESULTADOS: Observamos que o carcinoma anal foi mais freqüente em mulheres HIV-negativas e em homens HIV-positivos e que esses ultimos eram mais jovens. As LC foram menos numerosas nos doentes HIV-positivos e as maiores contagens estavam associadas com pior evolução. Os doentes HIV-positivos com os níveis mais baixos de linfócitos T CD4+ também tiveram as piores evoluções. CONCLUSÃO: Concluímos que as LC estavam diminuídas nos doentes HIV-positivos, portadores de carcinoma anal, quando comparados aos soronegativos.Langerhans cells (LC are bone marrow derived dendritic cells that represent the major antigen-presenting cells (APC in the skin, thus representing an integral part of the cutaneous immune response. Immunossupression decreases their number, including HIV infection, and skin tumors products are sufficient to immobilize LC within the tumor, preventing their migration to lymph nodes. This reduces the

Pelvic floor ultrasound and anal incontinence in primiparous women

DEFF Research Database (Denmark)

Sakse, Abelone Elisabeth

2010-01-01

Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

Manejo dos portadores das neoplasias intraepiteliais anais Managment of anal intra-epithelial neoplasia patients

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Sidney Roberto Nadal

2008-12-01

Full Text Available Acredita-se que a neoplasia intraepitelial anal (NIA, provocada pelo HPV, seja a lesão precursora do carcinoma anal. Segundo a literatura, são encontradas entre 11% e 52% dos homens infectados pelo HIV, entre 6% a 20% dos homens e 1% a 2,8% das mulheres sem essa infecção. Entre 8,5% e 13% das NIA de alto grau evoluirão para carcinoma invasivo, indicando a necessidade do rastreamento e do seguimento desses doentes para prevenção. Não há tratamento satisfatório com baixos índices de morbidez e a recidiva é comum. Em geral, as formas de tratamento podem de ser divididas em tópicas, entre elas, ácido tricloroacético, podofilina, podofilotoxina, imiquimod, terapia fotodinâmica, e ablativas, ou seja, excisão cirúrgica, ablação pelo LASER, coagulação pelo infravermelho e eletrofulguração. Há, ainda, os que consideram aceitável a conduta expectante. O tratamento tópico se justifica pelo caráter multifocal da lesão e os ablativos têm taxas de complicação e recidiva muito semelhantes. De qualquer forma, doentes com qualquer anormalidade histológica necessitam de seguimento adequado, principalmente com colposcopia e citologia anal.Anal intra-epithelial neoplasia (AIN, provoked by HPV, is considered as an anal cancer precursor. Some articles noticed that it occurred among 11% and 52% of men who have sex with men (MSM infected with HIV and, among seronegatives, from 6% to 20% of men and from 1% to 2.8% of women. From 8.5% to 13% of high grade AIN will evolve to invasive carcinoma, needing follow-up and screening for prevention. There is no satisfactory treatment with low morbidity and recurrence is frequent. There are two main forms of treatment: topics (trichloroacetic acid, podophylin, podophylotoxin, imiquimod, photodynamic therapy and ablatives (chirurgical excision, LASER, infrared, eletrocautery. Others consider acceptable an expectant management. Topical therapy is justified because of multifocal presentation of HPV

Comentarios sobre dibujo analítico

OpenAIRE

Mata Botella, Elena

2004-01-01

Cuaderno de apoyo a la docencia del DIBUJO DE ARQUITECTURA que pretende hacer reflexionar al alumno (de primero o segundo de carrera) sobre un tipo de dibujo que aquí se ha llamado “dibujo analítico”. Un dibujo que a través de operaciones gráficas y conceptuales como la esquematización y la selección de información, tiende a alejarse de la descripción del objeto arquitectónico para adentrarse en determinados aspectos o dimensiones que subyacen en el proyecto arquitectónico. Unas notas intr...

Penile duplication and two anal openings; report of a very rare case.

Science.gov (United States)

Bakheet, Mohamed Abdel Al M; Refaei, Mohammad

2012-03-01

Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. A 21 days old Egyptian neonate is reported with complete penile duplication and two scrotums with each one carrying two palpable testes. Both penises have normal shaft with normally located meatus. Clear urine voids from both meati spontaneously. The child had also a fold of redundant skin about 4×5 cm at the anal region in which two separate anal openings are present. In rectal examination we found two normal anuses passing stool spontaneously. Ascending (voiding) cystourethrography revealed two penises with two separate meatuses and one bladder from which the two urethras go out separately. Intravenous pyelogram (IVP) revealed two normal kidneys and ureters. Barium study revealed duplication of rectum and colon, otherwise normal GIT. In our review of the literature, we did not come across any other case of this variety of the penile duplication and congenital presence of two anuses. Unfortunately the patient expired before any surgical correction.

Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry

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Sthela Maria Murad-Regadas

2010-12-01

Full Text Available CONTEXT: Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. OBJECTIVE: To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. METHODS: Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. RESULTS: In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135 in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001 in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30 for G-I and 84% (16/19 for G-II. CONCLUSION: Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with

Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry.

Science.gov (United States)

Murad-Regadas, Sthela Maria; Regadas, Francisco Sérgio P; Barreto, Rosilma Gorete Lima; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Lima, Doryane Maria dos Reis

2010-01-01

Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135) in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001) in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30) for G-I and 84% (16/19) for G-II. Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with normal relaxation or paradoxical contraction.

Has F.D.G. PET/CT an impact on the management of patients with anal carcinoma?

International Nuclear Information System (INIS)

Vercellino, L.; Nataf, V.; Kerrou, K.; Huchet, V.; Pascal, O.; Montravers, F.; Talbot, J.N.; De Parades, V.; Bauer, P.; Touboul, E.

2010-01-01

Purpose: To evaluate the impact of F.D.G. PET/C Ton the management of patients referred for the staging and/or the follow-up of anal carcinoma, and PET/CT on patient management. Patients and methods: We included patients referred to our department for anal carcinoma whose therapeutic management was evaluable thanks to follow-up data during at least 6 months. Results: Data of 44 patients were analysed: 22 had PET/CT for initial staging and 36 during follow-up. PET/CT had impact in nine patients out of 44 (20%) and it was relevant in eight of them. Conclusion: F.D.G. PET/CT is an accurate imaging modality in anal cancer, its impact on patient management is more obvious when persistence or recurrence of disease is suspected. (authors)

Nanopartículas como herramientas analíticas y estudios toxicológicos asociados

OpenAIRE

Caballero-Díaz, E.

2014-01-01

Las nanopartículas (NPs) exhiben unas magníficas propiedades fisicoquímicas que las hacen ser excelentes candidatas para su uso en numerosos campos de aplicación incluyendo el ámbito de la Química Analítica. Con este fin, las NPs pueden emplearse como materiales sorbentes en los métodos de tratamiento de muestra que constituyen la primera etapa de la mayoría de los procedimientos analíticos [1]. La enorme habilidad de adsorción superficial que muestran hacia numerosos compuestos tanto orgánic...

Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males.

Science.gov (United States)

Orlando, Giovanna; Beretta, Rosangela; Fasolo, M Michela; Amendola, Antonella; Bianchi, Silvia; Mazza, Francesca; Rizzardini, Giuliano; Tanzi, Elisabetta

2009-05-29

Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes. Since HPVs involved in disease progression are reported to vary by geographical regions, this study focuses on HPV genotypes spectrum in 289 males attending a Sexual Transmitted Diseases (STD) unit according to their nationality. Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006. FB people were younger (median 32y-IQR 27-35 vs 36y-IQR 31-43, respectively; Mann-Whitney test por=atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) (p=0.032; OR 3.61; 95% CI 1.04-1.23). HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed. The probability of infection from high-risk HPVs was higher in FB (OR 1.69; 95% CI 1.07-2.68) and is due to a higher rate of HPV-58 (OR 4.98; 95% CI 2.06-12.04), to a lower rate of HPV-11 (OR 0.35; 95% CI 0.16-0.77), to the presence of other high-risk genotypes (HPV-45, HPV-66, HPV-69). Multiple infections rate was high and comparable between IT and FB people. The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development.

Rectal squamous cell carcinoma in immunosuppressed populations: is this a distinct entity from anal cancer?

Science.gov (United States)

COGHILL, Anna E.; SHIELS, Meredith S.; RYCROFT, Randi K.; COPELAND, Glenn; FINCH, Jack L.; HAKENEWERTH, Anne M.; PAWLISH, Karen S.; ENGELS, Eric A.

2015-01-01

Objective Squamous cell carcinoma (SCC) of the rectum is rare, but as with anal cancer, risk may be increased among immunosuppressed individuals. We assessed risk of rectal SCC in HIV-infected people. Design Population-based registry Methods We utilized the HIV/AIDS Cancer Match, a linkage of US HIV and cancer registries (1991–2010), to ascertain cases of anal SCC, rectal SCC, rectal non-SCC, and colon non-SCC. We compared risk in HIV-infected persons to the general population using standardized incidence ratios (SIRs) and evaluated risk factors using Poisson regression. We reviewed cancer registry case notes to confirm site and histology for a subset of cases. Results HIV-infected persons had an excess risk of rectal SCC compared to the general population (SIR=28.9; 95%CI 23.2–35.6), similar to the increase for anal SCC (SIR=37.3). Excess rectal SCC risk was most pronounced among HIV-infected men who have sex with men (MSM, SIR=61.2). Risk was not elevated for rectal non-SCC (SIR=0.88) or colon non-SCC (SIR=0.63). Individuals diagnosed with AIDS had higher rectal SCC rates than those with HIV-only (incidence rate ratio=1.86; 95%CI 1.04–3.31). Based on available information, one-third of rectal SCCs were determined to be misclassified anal cancer. Conclusions HIV-infected individuals, especially with advanced immunosuppression, appear to have substantially elevated risk for rectal SCC. As for anal SCC, rectal SCC risk was highest in MSM, pointing to involvement of a sexually transmitted infection such as human papillomavirus. Site misclassification was present, and detailed information on tumor location is needed to prove that rectal SCC is a distinct entity. PMID:26372482

Oral and Anal Vaccination Confers Full Protection against Enteric Redmouth Disease (ERM) in Rainbow Trout

Science.gov (United States)

Ohtani, Maki; Strøm, Helene Kragelund; Raida, Martin Kristian

2014-01-01

The effect of oral vaccines against bacterial fish diseases has been a topic for debate for decades. Recently both M-like cells and dendritic cells have been discovered in the intestine of rainbow trout. It is therefore likely that antigens reaching the intestine can be taken up and thereby induce immunity in orally vaccinated fish. The objective of this project was to investigate whether oral and anal vaccination of rainbow trout induces protection against an experimental waterborne infection with the pathogenic enterobacteria Yersinia ruckeri O1 biotype 1 the causative agent of enteric redmouth disease (ERM). Rainbow trout were orally vaccinated with AquaVac ERM Oral (MERCK Animal Health) or an experimental vaccine bacterin of Y. ruckeri O1. Both vaccines were tested with and without a booster vaccination four months post the primary vaccination. Furthermore, two groups of positive controls were included, one group receiving the experimental oral vaccine in a 50 times higher dose, and the other group receiving a single dose administered anally in order to bypass the stomach. Each group was bath challenged with 6.3×108 CFU/ml Y. ruckeri, six months post the primary vaccination. The challenge induced significant mortality in all the infected groups except for the groups vaccinated anally with a single dose or orally with the high dose of bacterin. Both of these groups had 100% survival. These results show that a low dose of Y. ruckeri bacterin induces full protection when the bacterin is administered anally. Oral vaccination also induces full protection, however, at a dose 50 times higher than if the fish were to be vaccinated anally. This indicates that much of the orally fed antigen is digested in the stomach before it reaches the second segment of the intestine where it can be taken up as immunogenic antigens and presented to lymphocytes. PMID:24705460

Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up

NARCIS (Netherlands)

Visscher, A.P.; Lam, T.J.; Hart, N.; Felt-Bersma, R.

2014-01-01

Introduction and hypothesis: Our aim was to evaluate alterations in anorectal function after anal sphincteroplasty for third-degree obstetric anal sphincter injury (OASI) in relation to clinical outcome. Methods: In this retrospective, descriptive, cross-sectional study conducted between 1998 and

MOMIAS Y HUESOS EN LA NECRÓPOLIS DEL ESPIGÓN (PUNTALLANA, LA PALMA. ESTUDIO BIOANTROPOLÓGICO PRELIMINAR DE UNA CULTURA DESAPARECIDA

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Nuria Álvarez Rodríguez

2017-02-01

Full Text Available El Barranco del Espigón ocupa un lugar sobresaliente dentro de la etapa prehispánica palmera debido al hallazgo de una importante necrópolis en la que aparecieron restos humanos momificados, siendo estos los únicos de estas características que hoy en día se conoce su procedencia exacta. Este artículo intentará hacer un breve recorrido sobre las formas de vida de los benahoaritas en el Barranco del Espigón así como un pequeño estudio preliminar de los restos óseos humanos encontrados.

Tipos de especies de insectos descritas de la Comunidad de Madrid, conservados en el Museo Nacional de Ciencias Naturales. Inventario Preliminar

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Martín Albaladejo, C.

2006-05-01

Full Text Available This paper offers a list of insect species described from Comunidad de Madrid whose types are kept in the Collection of Entomology of the Museo Nacional de Ciencias Naturales (MNCN. This preliminary inventory includes 505 species and subspecific taxa.

Este trabajo ofrece una relación de las especies de insectos que han sido descritas de la Comunidad de Madrid y cuyos ejemplares tipo se conservan en la Colección de Entomología del Museo Nacional de Ciencias Naturales (MNCN. Este inventario preliminar recoge 505 especies y táxones subespecíficos.

Estudio preliminar de PEP-3 como instrumento de evaluación funcional de niños con Trastorno del Espectro Autista

OpenAIRE

Orobal Císcar, Paloma

2013-01-01

En el presente estudio, además de traducir, adaptar lingüísticamente y realizar una aplicación preliminar de un instrumento de evaluación funcional del Trastorno del Espectro Autista (TEA) llamado PEP-3 (Perfil Psicoeducativo-3ªEdición); se han realizado dos aplicaciones del instrumento a un grupo de 10 niños y niñas con TEA atendidos en un Centro de Atención Temprana de Valencia con el objetivo de analizar la sensibilidad del instrumento para medir cambios tras tres meses de intervención bas...

Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

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Tolga Dinç

2014-03-01

Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

Otosclerose: resultados de estapedotomias

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Testa José Ricardo Gurgel

2002-01-01

Full Text Available Introdução: Otospongiose ou otosclerose é uma moléstia heredo-degenerativa da cápsula labiríntica relativamente comum e que ocorre principalmente em mulheres entre 20 e 30 anos de idade. Nas últimas décadas a estapedotomia tem sido uma técnica preferida por muitos cirurgiões para o tratamento da otosclerose. Assim, esse trabalho analisa os resultados de 59 estapedotomias realizadas no Hospital Paulista de Otorrinolaringologia nos últimos 7 anos. Forma de estudo: Clínico randomizado. Materiais e Métodos: Estudo retrospectivo de 59 pacientes com otosclerose, submetidos a estapedotomia por um mesmo cirurgião, e com seguimento clínico e audiométrico. Resultados: Melhora auditiva comprovada pelo fechamento do gap na audiometria em 53 pacientes (90%. Complicações ocorridas são relacionadas por ordem decrescente de freqüência: deslocamento da prótese (7%, alterações no paladar (7%, paralisia facial (3%, vertigem (3%, extrusão total da prótese (1,5%, tinnitus persistente (1,5%, perfuração da membrana timpânica (1,5%. Conclusão: A estapedotomia vem se mostrando uma boa opção terapêutica, já que, em geral, apresenta baixa morbidade e altas taxas de sucesso, proporcionando melhor qualidade de vida para os portadores de otosclerose.

Loovutatava isiku õigused loovutamismenetluses. Kohtupraktika analüüs / Marje Allikmets

Index Scriptorium Estoniae

Allikmets, Marje, 1989-

2013-01-01

Euroopa vahistamismääruse alusel toimuvast loovutamismenetlusest. Loovutatava isiku õiguste kaitse probleemidest. Artikkel põhineb autori 2013. a. Tartu Ülikooli õigusteaduskonnas kaitstud magistritööl "Loovutatava isiku õigused loovutamismenetluses - kohtupraktika analüüs"

Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS).

Science.gov (United States)

Eisenberg, Vered H; Valsky, Dan V; Yagel, Simcha

2018-03-24

Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women 1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39% 2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult. Having sustained an OASI may impact significantly on women's physical and emotional health. Missed OASI, inadequate repair or lack of follow up are potential sources of litigation 4 . The reported incidence of OASI may be as high as 4-6.6% 4 , averaging 2.9% in the UK 3 . The incidence is higher in primiparae (6.1%) than in multiparae (1.7%) 3 . Recent years are seeing an increased awareness and structured training programs, which appear to have resulted in an increase in the detection rate of OASI 3 . The following risk factors have been identified with varying risk rates reported 3 : Asian ethnicity (OR 2.27, 95% CI 2.14-2.41), nulliparity (relative risk [RR] 6.97, 95% CI 5.40-8.99), birth weight greater than 4 kg (OR 2.27, 95% CI 2.18-2.36), shoulder dystocia (OR 1.90, 95% CI 1.72-2.08), occipito-posterior position (RR 2.44, 95% CI 2.07-2.89), prolonged second stage of labor (up to RR 2.02, 95% CI 1.62-2.51 after four hours duration). Instrumental deliveries and episiotomy use have been extensively studied resulting in the following evidence: Vacuum delivery without episiotomy (OR 1.89, 95% CI 1.74-2.05); vacuum delivery with episiotomy is protective (OR 0.57, 95% CI 0.51-0.63); forceps delivery without episiotomy carries the highest potential risk (OR 6.53, 95% CI 5.57-7.64); and forceps delivery with episiotomy (OR 1.34, 95% CI 1.21-1.49). Other potential risk factors have been suggested with varying evidence such as advanced maternal age at