Factores de riesgo relacionados con la infección de la herida quirúrgica en cirugía dermatológica. Estudio prospectivo en un hospital de tercer nivel

Introduction and objectivesDermatological surgery usually has few complications, the most frequent being surgical site infection (SSI), with an incidence of < 5%. Our objective is to determine complications related to dermatological surgery and to analyze the factors associated with SSI.Materials and methodsWe conducted a prospective observational study that included patients treated with dermatological surgery between June 2013 and May 2014 in a third level public hospital. Clinical characteristics of patients, lesions removed as well as surgical procedure information were collected. For statistical analysis, χ² was used for categorical variables, and then a multivariate analysis using logistic regression was performed. A p-value < 0.5 was considered significant.Results1,131 patients underwent 1,335 surgical excisions. The overall complication rate was 5.84%, with the SSI being the most frequent (3.1%). The presence of an active neoplasm, the removal of more than one lesion in the same surgical act, and the use of subcutaneous sutures was associated with a higher rate of infections in the univariate analysis. Still, only the latter maintained statistical significance in the multivariate analysis (p < 0.001, OR 4.42, 95% CI 2.09–9.65). Nagelkerke's R² 0.157.ConclusionsOur study's SSI rate is comparable to that of other similar published studies (< 5%). The use of subcutaneous suture was associated with a higher rate of SSI; however, only 15% of SSIs would be justified by the use of this type of suture.     

Endoscopic removal of foreign bodies:A retrospective study in Japan

BACKGROUND The ingestion of foreign bodies(FBs) and food bolus impaction(FBI) in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success rate.However,to date,no studies have evaluated the endoscopic management of FBs in Japan.AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018.Data were collected from medical charts,and endoscopic details were collected from an endoscopic reporting system.Procedures performed with a flexible gastrointestinal endoscope were only taken into account.Patients who underwent a technique involving FB or FBI from the digestive tract were only included.Data on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed retrospectively.RESULTS Among the 215 procedures,136(63.3%) were performed in old adults(≥ 60 years),180(83.7%) procedures were performed in outpatients.The most common type of FBs were press-through-pack(PTP) medications [72(33.5%) cases],FBI[47(21.9%)],Anisakis parasite(AP) [41(19.1%) cases].Most FBs were located in the esophagus [130(60.5%) cases] followed by the stomach [68(31.6%) cases].AP was commonly found in the stomach [39(57.4%) cases],and it was removed using biopsy forceps in 97.5% of the cases.The most common FBs according to anatomical location were PTP medications(40%) and dental prostheses(DP)(40%) in the laryngopharynx,PTP(48.5%) in the esophagus,AP(57.4%) in the stomach,DP(37.5%) in the small intestine and video capsule endoscopy device(75%) in the colon.A transparent cap with grasping forceps was the most commonly used device [82(38.1%) cases].The success rate of the procedure was100%,and complication were observed in only one case(0.5%).CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.     

多发性硬化患者脑脊液标本收集和标本库建立的方案

<正> 迄今,多发性硬化(MS)脑脊液生物学标志物中用于临床的仅有寡克隆区带和IgG鞘内合成率,其最重要的制约因素为:生物学标志物研究所需的样本量很大,单一研究中心很难达到,因此多方合作已成为趋势。脑脊液标本的采集和保存很重要。2007年3月,欧洲MS生物学标志物协作网(BioMS-eu)在伦敦召开会议,拟定了MS患者脑脊液采集、分装、储存以及相关数据收集的方案,并于2009年12月1日在Neurology杂志发表。现简要介绍如下。 1 脑脊液标本收集及注意事项 (1) 采集量:至少12mL,采集此量不会引起低颅压。因不同段脑脊液蛋白质浓度不同,建议取最初2mL用于常规检查,其余部分混匀后     

Molecular cloning of a cDNA encoding canine factor IX

Factor IX (F.IX) is a vitamin K-dependent plasma protein, a deficiency of which results in hemophilia B. A canine model of hemophilia B exists; attempts to use this model for gene transfer experiments or characterization of the hemophilic defect require elucidation of normal canine F.IX structure. We report the isolation and characterization of the coding region for canine F.IX cDNA. Canine F.IX possesses 86% identity at the amino-acid level with human F.IX. The leader peptide, Gla domain, EGF domains, and the carboxy-terminal portion of the heavy chains show extensive sequence conservation between the canine and human. All Glu residues undergoing gamma-carboxylation in humans are conserved in canines. The complete coding sequence for canine F.IX has been determined, and the derived translation product has been analyzed. A similar approach should allow identification of the causative mutation in canine hemophilia B. Furthermore, this clone may prove a valuable resource in gene transfer experiments for this disease.