Syndemic and syndemogenesis of low back pain in Latin-American population: a network and cluster analysis

Clinical Rheumatology - Although low back pain (LBP) is a high-impact health condition, its burden has not been examined from the syndemic perspective. To compare and assess clinical,...     

Valve replacement using an artificial ball prosthesis manufactured in Mexico

This report documents our early experience with a cage ball valve manufactured in Mexico. Between May 1985 and March, 1986, 25 consecutive replacements have been performed in 23 patients, 14 underwent aortic valve replacement, 9 received a mitral valve, and 2 received both aortic and mitral valves. Their mean age was 32 years. Most of the patients had rheumatic heart disease. Their functional class prior to operation was as follows: six patients fell into class II, 15 into class III and 2 into class IV. One case died in the operative period. All patients have been followed for a mean period of 5 months. Late mortality has not occurred in any patient. Valve-related complications were not present. The post-operative NYHA functional class was as follows: seventeen (80%) fell into class I and five (20%) fell into class II. The actuarial survival rate 10 months after operation was 96.0%. Our study suggests that the cage ball valve has a good performance, the clinical results justify continuing investigation of this prosthesis.     

Oleuropein,a Secoiridoid Derived from Olive Tree,Inhibits the Proliferation of Human Colorectal Cancer Cell Through Downregulation of HIF-1α

Oleuropein (OL) is the most prominent phenolic compound in the fruit of olive tree. Although OL has shown powerful anticancer activity the underlying action mechanism remains largely unknown. The present study evaluated the effects of OL on hydroxityrosol (HT)-29 human colon adenocarcinoma cells in comparison to hydroxytyrosol, its hydrolysis product, and to elucidate the underlying anticancer molecular mechanisms involved. Cell proliferation was determined using SRB assay. Cell cycle and apoptosis were assessed by flow cytometry and changes in MAPK cascade protein expression, HIF-1α, p53, PPARγ, and NFKβ signaling pathways by Western blot. Although OL showed less potency than HT, in terms of cell growth inhibition, induced significant changes in cell cycle analysis and caused a significant increase in the apoptotic population. Both compounds produced a remarkable decrease in HIF-1α protein and an upregulation of p53 protein expression. However, no significant changes in IkB-α and MAPK cascade protein expressions were observed. HT produced a significant upregulation in peroxisome proliferator-activated receptor gamma (PPARγ) expression whereas OL failed. PPARγ upregulation may be one of the principal mechanisms of the tumor shrinkage by HT. Our novel findings demonstrate that OL limits the growth and induces apoptosis in HT-29 cells via p53 pathway activation adapting the HIF-1α response to hypoxia.     

Spontaneous extraperitoneal bladder perforation in an elderly patient with genitalia prolapse

There are many etiologic reasons which explain the bladder perforation. Bladder injuries happen most commonly in poli-traumatisms (traffic accident), blunt trauma, penetrating injury and iatrogenic injury (surgery, laparoscopic...). However, there is not always a vigorous, direct, extern and blunt agent causing the rupture. In the case reported the extraperitoneal bladder rupture started after a smooth perineal injury caused when the patient seated down. The patient already suffered from a cystocele III/IV plus uterine prolapse for a long time ago.     

Cisplatin-based chemotherapy and hyperfractionated radiotherapy for stage III non-small cell lung cancer: survival and patterns of failure after long follow-up

The main purpose of this prospective non randomized trial was to analyse whether induction chemotherapy and hyperfractionated radiotherapy combined with cisplatin can improve the long-term survival of patients with locally advanced non small cell lung cancer. From 1992 to 1995, 70 patients received the programmed treatment scheme with: one cycle of induction chemotherapy with mitomycin 10 mg/m²/day 1, cisplatin 100 mg/m² day 1 and vindesine 3 mg/m²/days 1, 8 and 15, followed after 4 weeks of hyperfractionated radiotherapy (1.2 Gy twice/day, five days per week, until total dose of 69.6 Gy) concomitant with cisplatin 20 mg/m²/day by continuous infusion, for 5 days in the first and fifth weeks of radiotherapy. Patients with stage IIIA, good performance status and radiological partial response were candidated to surgical rescue. Thirty-two patients (45.7%) developed severe toxicity (WHO grade 5–4). Complete radiological response was observed in 9 patients (12.8%). Overall median survival time was 14 months, 2-year survival of 20% and 5-year survival of 12%. The cause of dead was by local progression in 42%, distant metastases in 40%, simultaneous relapse in 10% and intercurrent disease in 8%. Patients with stage IIIA (n=16, 7 with surgical rescue) had a 5-year survival of 52%, and patients with stage IIIB (n=54) of 6%. Long-term results with this treatment scheme are disappointing, only patients with stage IIIA and surgical rescue showed an improvement on survival. In spite of chemotherapy and high radiation dose, local-regional progression and distant metastases remain significant patterns of failure and dead of these patients.