To evaluate the overall survival rate and renal function in our series after radical nephrectomy (RN) and partial nephrectomy (PN) in renal tumors in an early stage.
We retrospectively reviewed the ...medical records of 229 patients who underwent RN or PN for renal cancer T1-T2N0M0 in our center between 1995 and 2015. We described demographic factors, first symptom, TNM, histology, post-surgery data, recurrence rate and renal function. We utilized Fisher test, Chi square test and T-Student and we considered statistical significance when p<0.05.
203 patients underwent RN and 26 PN. 39.4% of the tumors who received RN were T1bN0M0 and 76.92% of PN were T1aN0M0. We report nine complications grade II of modified Clavien System for RN and only one grade I for PN. We detected an 11.3% recurrence in RN and none in PN. 66%of patients from RN are alive today, 12.81% died as result of renal cancer and 22.7% suffered a non-cancer-specific death. No deaths were observed in PN group. We observed similar mean preoperative serum creatinine (Cr) in both groups. Creatinine after the first post-operative month was 1.81mg/dL and 1.06mg/dL for RN and PN, respectively; At one year post-operative we registered Cr 1.82mg/dL and Cr 0.97mg/dL, respectively.
Both methods provide excellent oncologic results for renal carcinoma in an early stage. PN is safe and reduces the incidence of renal dysfunction with a lower rate of non-cancer-specific death.
Resumen Objetivo Los objetivos principales de este estudio fue valorar la calidad de la información contenida, las características de las interconsultas (IC) y así como conocer la actuación realizada ...por el servicio de Urología en nuestro hospital. Material y métodos Se realizó un estudio descriptivo observacional donde fueron analizados los documentos de IC recogidos por el servicio de Urología durante 8 meses. Se utilizaron criterios de calidad previamente definidos por Irazábal et al (modificado) y Batista Miranda JE et al. Resultados Fueron recogidos un total de 411 IC, llegadas al servicio de forma consecutiva. Procedentes de 27 servicios hospitalarios. El 82,2% de los pacientes derivados fueron varones. La edad media de los pacientes fue de 63,25 años. 192 pacientes tenían antecedentes personales urológicos de interés (47%). Las IC se agruparon en 27 motivos diferentes. El motivo de consulta más frecuente fue el incidentaloma con 21,5%. Respecto al grado de cumplimiento del documento de IC: había constancia de datos de filiación (96,3%), una descripción de la sintomatología adecuada en el 68,2% y la exploración física aparecía reflejada en el 8,8% del total de las IC. Fueron solicitadas como IC normales el 63,4%, preferentes 25% y urgentes 11,7%. Los días de respuesta a las IC fueron de media de 1,45 días con desviación típica de 1,65 días. Según los criterios establecidos, para clasificar los documentos por nivel de adecuación, fueron catalogadas como inapropiadas al 32,9% de las IC (n=135). Fueron clasificadas en grado 1 el 44,6% (n=183), grado 2 el 20% (n= 82) y grado 3 el 2,4% (n=10). La actitud que se tomó: se remitió a Consultas Externas de Urología al 10,5% del total de las IC, al Centro de Atención Especializada al 7,8%, se solicitó pruebas complementarias al 7,8%, se remitió al Pruebas funcionales de Urología, para la realización de alguna prueba complementaria a 61 pacientes (14,9%), se presentó en Sesión Clínica de Urología al,6% de los pacientes, se trasladó al Servicio de Urología a 2 pacientes (0,5%) y se tomó alguna otra actitud terapéutica en el 19,6%, estos resultados tuvieron una significación de p=0,000. Conclusiones En nuestro estudio, observamos un alto porcentaje en cuanto a la constancia de los datos de filiación ligeramente inferior en la descripción de la sintomatología y considerados bajos en la exploración física. Un alto porcentaje de IC consideradas inapropiadas. Respecto a la actitud que tomó el Servicio de Urología, quizás hubo una infrautilización de la Unidad de Pruebas funcionales. Hasta el momento y bajo nuestro conocimiento sólo existe un estudio realizado en el ámbito de las IC realizadas al Servicio de Urología en un Hospital de tercer nivel y creemos que la realización de estudios mejoraría la calidad de la asistencia a los pacientes.
The main objectives of this study were to value the quality of the contained information, the characteristics of the consultants (IC) and as well as to know the performance carried out by the service ...of Urology in our hospital.
It was carried out an observational descriptive study where the documents of IC picked up by the service of Urology during 8 months were analyzed. Previously defined approaches of quality were used by Irazábal et al (changed) and Batista Miranda JE et al.
They were picked up a total of 411 IC, arrivals to the service in a serial way. Coming from 27 hospital services. 82.2% of the derivatived patients were male. The half age of the patients was of 63, 25 years. 192 patients had personal urological records of interest (47%). The IC grouped in 27 different reasons. The reason of more frequent consultation was the incidentaloma with 21.5%. Regarding the grade of execution of the document of IC: there was perseverance of filiation data (96.3%), a description of the symptoms was in 68.2% and the physical examination appeared reflected in 8.8% of the total of the IC. They were requested as normal IC 63.4%, preferent 25% and urgent 11.7%. The days of answer to the IC it was of stocking of 1,45 days with typical deviation of 1,65 days. According to the established approaches, to classify the documents for adaptation level, they were classified as inappropriate to 32.9% of the IC (n = 135). They were classified in grade 1 the 44.6% (n = 183), grade 2 20% (n = 82) and grade 3 2.4% (n = 10). The attitude that was taken: it was remitted to External Consultations of Urology to 10.5% of the total of the IC, to the Center of Specialized Attention to 7.8%, it was requested complementary tests to 7.8%, it was remitted to the functional Tests of Urology, for the realization of some complementary test to 61 patients (14.9%), it was presented in Clinical Session of Urology to 5,6% of the patients, he/she moved to the Service of Urology to 2 patients (0.5%) and he/she took some other therapeutic attitude in 19.6%, these results had a p = 0.000 significance.
In our study, we observe a high percentage as for the perseverance of the data of lightly inferior filiation in the description of the symptoms and considered low in the physical exploration. A high percentage of inappropriate considered IC. Regarding the attitude that took the Service of Urology, maybe had a low used of the Functional Unit. Until the moment and under our knowledge a study carried out in the environment from the realized IC to the Service of Urology in a Hospital of third level only exists and we believe that the realization of studies would improve the quality from the attendance to our patients.
The growing degree-days (GDD) provide an estimate of the accumulated thermal energy available for the development of a crop. The use of GDD allows measuring the heat requirements associated with the ...phenological stages of the crop, which allows in turn, to predict when a certain plant stage will occur knowing the daily temperatures. The aim of this study was to establish relationships among the effect of degree days (DD) to vegetative growth, first flowering and fructification (VG, Fl and Fr), on total yield per plant (TY/P) of eggplant grown under open-field conditions employing a randomized complete block design with 15 genotypes and four replicates. The results showed that: 1) The genotypes that initiated fruit production in less time required fewer GDD (892.14-1,077.71 °C) for this phenological phase, obtaining higher productivity. 2) The genotypes C035 and C040 had an average yield higher than the national average with values of 83.75 and 84.86 t ha-1, being identified as future varieties to be produced in the Caribbean region. 3) The Caribbean region is suitable for the establishment of the crop as there were no events with limiting temperatures for this species (higher than 35 °C and lower than 15 °C). 4) The principal component analysis showed associations among the variable YT/P with the genotypes C011, C042, and C015; meanwhile, C032, C025, and C028 were associated with the variables DD to VG, Fl, and Fr. These results would be useful in developing a model to estimate yield with DD.
Los grados días de desarrollo (GDD) proporcionan una estimación de la energía térmica acumulada disponible para el desarrollo de un cultivo. El uso de los GDD permite medir los requerimientos de ...calor asociados a las etapas fenológicas del cultivo, lo que a su vez permite predecir cuándo ocurrirá una determinada etapa de la planta conociendo las temperaturas diarias. Este estudio tuvo como objetivo determinar las relaciones entre el efecto de los grados días (GD) hasta el crecimiento vegetativo, la primera floración y fructificación (CV, Fl y Fr) sobre el rendimiento total por planta (RT/P) de berenjena cultivada en campo abierto bajo un diseño de bloques completos al azar con 15 genotipos y cuatro repeticiones. Los resultados mostraron que: 1) Los genotipos que inician producción de frutos en menor tiempo requieren menos grados días (892,14-1.077,71 °C) para está fase fenológica, obteniendo una mayor producción. 2) Los genotipos C035 y C040 tuvieron un rendimiento promedio superior al promedio nacional con valores de 83,75 y 84,86 t ha-1, identificándose como futuras variedades a producir en la región del Caribe. 3) La región Caribe es apta para el establecimiento del cultivo, debido a que no hubo eventos limitantes de temperatura para la especie (temperaturas mayores a 35 °C y menores a 15 °C). 4) El análisis de componentes principales mostro asociación entre los genotipos C011, C042 y C015 con las variables RT/P, y los genotipos C011, C025 y C028 con los GD a CV, Fl y Fr. Estos resultados serían útiles para desarrollar un modelo para estimar el rendimiento con base en los GD. The growing degree-days (GDD) provide an estimate of the accumulated thermal energy available for the development of a crop. The use of GDD allows measuring the heat requirements associated with the phenological stages of the crop, which allows in turn, to predict when a certain plant stage will occur knowing the daily temperatures. The aim of this study was to establish relationships among the effect of degree days (DD) to vegetative growth, first flowering and fructification (VG, Fl and Fr), on total yield per plant (TY/P) of eggplant grown under open-field conditions employing a randomized complete block design with 15 genotypes and four replicates. The results showed that: 1) The genotypes that initiated fruit production in less time required fewer GDD (892.14-1,077.71 °C) for this phenological phase, obtaining higher productivity. 2) The genotypes C035 and C040 had an average yield higher than the national average with values of 83.75 and 84.86 t ha-1, being identified as future varieties to be produced in the Caribbean region. 3) The Caribbean region is suitable for the establishment of the crop as there were no events with limiting temperatures for this species (higher than 35 °C and lower than 15 °C). 4) The principal component analysis showed associations among the variable YT/P with the genotypes C011, C042, and C015; meanwhile, C032, C025, and C028 were associated with the variables DD to VG, Fl, and Fr. These results would be useful in developing a model to estimate yield with DD.
INTRODUCTIONAttention-deficit/hyperactivity disorder (ADHD) and its comorbidities have an impact on the social anxiety of children and adolescents, but there are practically no studies addressing ...this topic in adolescence. Our objective was to assess the degree of social anxiety and to analyse the presence of psychiatric comorbidities (PSCs) in adolescents with ADHD. METHODOLOGYWe conducted a cross-sectional observational study in patients aged 12 to 18 years with a confirmed diagnosis of ADHD (DSM-5). We collected data on the presence and type of PSCs and assessed social anxiety by means of the Social Anxiety Scale for Adolescents (SAS-A). RESULTSForty-six child and adolescent psychiatrists and paediatric neurologists participated in the study and recruited 234 patients. Of the total patients, 68.8% (159) were male and 31.2% (72) female, with a mean age in the sample of 14.9 years (95% CI, 14.6-15.1). The type of ADHD was combined type (C) in 51.7% (121), predominantly inattentive (PI) in 37.2% (87), and predominantly hyperactive-impulsive (PH) in 9% (21). Of all patients, 97.9% (229) received pharmacological therapy: 78.6% (184) methylphenidate, 15% (35) lisdexamfetamine and 4.3% (10) atomoxetine.We found PSCs in 50.4% of the patients (118), of which the most frequent were learning and communication disorders (20.1%, n=47) and anxiety disorders (19.2%, n=45). The patients scored significantly higher in the SAS-A compared to reference values in the healthy population. The scores in the SAS-A were less favourable in adolescents with the PI type compared to those with the PH type (P=.015). The presence of a comorbid anxiety disorder was associated with worst scores in SAS-A (P<.001) showing an increased social anxiety. CONCLUSIONAdolescents with ADHD classified as PI and those with comorbid anxiety had a higher degree of social anxiety as measured by the SAS-A. This psychological aspect must be identified and controlled in adolescents with ADHD to promote their social adaptation.
Attention-deficit/hyperactivity disorder (ADHD) and its comorbidities have an impact on the social anxiety of children and adolescents, but there are practically no studies addressing this topic in ...adolescence. Our objective was to assess the degree of social anxiety and to analyse the presence of psychiatric comorbidities (PSCs) in adolescents with ADHD.
We conducted a cross-sectional observational study in patients aged 12–18 years with a confirmed diagnosis of ADHD (DSM-5). We collected data on the presence and type of PSCs and assessed social anxiety by means of the Social Anxiety Scale for Adolescents (SAS-A).
Forty-six child and adolescent psychiatrists and paediatric neurologists participated in the study and recruited 234 patients. Of the total patients, 68.8% (159) were male and 31.2% (72) female, with a mean age in the sample of 14.9 years (95% CI, 14.6–15.1). The type of ADHD was combined type (C) in 51.7% (121), predominantly inattentive (PI) in 37.2% (87), and predominantly hyperactive-impulsive (PH) in 9% (21). Of all patients, 97.9% (229) received pharmacological therapy: 78.6% (184) methylphenidate, 15% (35) lisdexamfetamine and 4.3% (10) atomoxetine.We found PSCs in 50.4% of the patients (118), of which the most frequent were learning and communication disorders (20.1%, n=47) and anxiety disorders (19.2%, n=45). The patients scored significantly higher in the SAS-A compared to reference values in the healthy population. The scores in the SAS-A were less favourable in adolescents with the PI type compared to those with the PH type (P=.015). The presence of a comorbid anxiety disorder was associated with worst scores in SAS-A (P<.001) showing an increased social anxiety.
Adolescents with ADHD classified as PI and those with comorbid anxiety had a higher degree of social anxiety as measured by the SAS-A. This psychological aspect must be identified and controlled in adolescents with ADHD to promote their social adaptation.
El trastorno por déficit de atención con hiperactividad (TDAH) y su comorbilidad repercuten en la ansiedad social de niños y adolescentes, no obstante, apenas hay estudios que aborden este tema en la adolescencia. El objetivo era evaluar el grado de ansiedad social y analizar la presencia de comorbilidades psiquiátricas (CPS).
Estudio observacional transversal en el que se incluyeron pacientes de 12-18 años con diagnóstico confirmado de TDAH (DSM-5). Se recogió información sobre la presencia y tipo de CPS y se evaluó la ansiedad social mediante la escala Social Anxiety Scale for Adolescents (SAS-A).
Participaron 46 especialistas de psiquiatría del niño y del adolescente o neuropediatría, que incluyeron a 234 pacientes. El 68,8% (159) eran varones y el 31,2% (72) mujeres, con edad media de 14,9 años (IC 95%: 14,6-15,1). El 51,7% (121) tenía TDAH de tipo combinado (TC), el 37,2% (87) con predominio del déficit de atención (TDA) y el 9% (21) con predominio hiperactivo-impulsivo (TH). El 97,9% (229 pacientes) recibía tratamiento farmacológico: metilfenidato en el 78,6% (184), lisdexanfetamina en el 15% (35) y atomoxetina en el 4,3% (10).
El 50,4% (118) presentaba alguna CPS, con predominio de los trastornos del aprendizaje y de la comunicación (47, 20,1%) y los trastornos de ansiedad (45, 19,2%). Se observó un grado de ansiedad social significativamente mayor en comparación con los valores normales de la escala en la población sana. Los adolescentes con TDA presentaron peores puntuaciones en la escala SAS-A en comparación con adolescentes con TH (p=0,015). La presencia de trastornos de ansiedad comórbidos se relacionó con peores puntuaciones en la escala SAS-A, reflejando una mayor ansiedad social en estos pacientes (p<0,001).
Los adolescentes con diagnóstico de TDA y aquellos con comorbilidades psiquiátricas de tipo ansiedad presentaron un mayor grado de ansiedad social según su puntuación en la escala SAS-A. Este aspecto psicológico debería ser detectado y controlado en los adolescentes con TDAH para favorecer su adaptación social.
Se sabe que la gastroenteritis eosinofílica (GE) es un desorden raro donde existe una infiltración parcheada y variable de la pared del tracto gastrointestinal por eosinófilos maduros y los síntomas ...se correlacionan con el patrón de infiltración y el sitio afectado. Se hallan, con frecuencia, pacientes con formas mixtas de la enfermedad, el patrón menos común es la forma predominantemente subserosa, encontrada en menos del 10 % de los casos, con un líquido ascítico rico en eosinófilos. Aunque su patogénesis no está del todo clara, varias características sugieren alergia alimentaria. Se presentó una paciente de 59 años con cuadro de ascitis eosinofílica, dolor abdominal, vómitos y diarreas; tuvo pruebas cutáneas de alergia a alimentos positiva y títulos elevados de IgE. Se excluyeron otras causas de ascitis eosinofílicas y se llegó a la conclusión que se trataba de GE (Klein tipo III). Se explicó la relación entre eosinófilos y distintas citoquinas, así como la función de mediadores de la inflamación producidos por ellos en este modelo de enfermedad
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