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Conservative management of a recurrent puerperal uterine inversion with bakri<sup>®</sup>balloon tamponade

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Open Journal of Obstetrics and Gynecology 2011年第4期1卷 197-201页

作者： Jesús Joaquín Hijona Elósegui francisco javier frutos arenas Antonio Carballo García Juan Antonio López López Gabriel Castilla Peinado Peinado Juan Manuel Torres Martí 不详

Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri? balloon (Cook Medical Incorporated) in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description;and the first one in a third degree recurrent puerperal uterine inversion.

关键词： Balloon Tamponade Intrauterine Management Postpartum Haemorrhage Uterine Inversion Review Treatment

Approximate Metric for a Rotating Deformed Mass

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International Journal of Astronomy and Astrophysics 2015年第1期5卷 1-10页

作者： francisco frutos-Alfaro Paulo Montero-Camacho Miguel Araya javier Bonatti-González Space Research Center and School of Physics University of Costa Rica San José Costa Rica Nuclear Research Center and School of Physics University of Costa Rica San José Costa Rica

A new Kerr-like metric with quadrupole moment is obtained by means of perturbing the Kerr spacetime. The form of this new metric is simple as the Kerr metric. By comparison with the exterior Hartle-Thorne metric, it is shown that it could be matched to an interior solution. This approximate metric may represent the spacetime of a real astrophysical object with any Kerr rotation parameter a and slightly deformed.

关键词： Approximate Solutions of Einstein Equations Kerr Metric Erez-Rosen Metric Quadrupole

Metric of a Slow Rotating Body with Quadrupole Moment from the Erez-Rosen Metric

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International Journal of Astronomy and Astrophysics 2013年第4期3卷 431-437页

作者： francisco frutos-Alfaro Edwin Retana-Montenegro Iván Cordero-García javier Bonatti-González School of Physics University of Costa Rica San Pedro Costa Rica

A metric representing a slowly rotating object with quadrupole moment is obtained using a perturbation method to include rotation into the weak limit of the Erez-Rosen metric. This metric is intended to tackle relativ... 详细信息

关键词： General Relativity Einstein Field Equations Quadrupole Moment Erez-Rosen Metric

A Computer Program for the Newman-Janis Algorithm

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Journal of Modern Physics 2015年第15期6卷 2226-2230页

作者： Carlos Gutiérrez-Chávez francisco frutos-Alfaro Iván Cordero-García javier Bonatti-González Technological Institute of Costa Rica Cartago Costa Rica Space Research Center and School of Physics University of Costa Rica San José Costa Rica School of Physics University of Costa Rica San José Costa Rica Nuclear Research Center and School of Physics University of Costa Rica San José Costa Rica

A REDUCE code for the Newman-Janis algorithm is described. This algorithm is intended to include rotation into nonrotating solutions of the Einstein field equations with spherically symmetry or perturbed spherically symmetry and has been successfully applied to many spacetimes. The applicability of the code is restricted to metrics containing potentials of the form 1/r.

关键词： General Relativity Newman-Janis Formalism Null Tetrads Complex Transformations

Translational pancreatic cancer research:a comparative study on patient-derived xenograft models

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World Journal of Gastroenterology 2018年第7期24卷 794-809页

作者： Mercedes Rubio-Manzanares Dorado Luis Miguel Marín Gómez Daniel Aparicio Sánchez Sheila Pereira arenas Juan Manuel Praena-Fernández Juan Jose Borrero Martín francisco Farfán López Miguel ángel Gómez Bravo Jordi Muntané Relat javier Padillo Ruiz Department of Hepatobiliary and Pancreatic Surgery Virgen del Rocio University Hospital Oncology Surgery Cell Therapy and Organ Transplantation Group Institute of Biomedicine of Seville (IBiS) Virgen del Rocio University Hospital University of Seville Statistics Methodology and Evaluation of Research Unit Virgen del Rocio University Hospital Pathology Department Virgen del Rocio University Hospital

AIM To assess the viability of orthotopic and heterotopic patient-derived pancreatic cancer xenografts implanted into nude *** This study presents a prospective experimental analytical follow-up of the development of tumours in mice upon implantation of human pancreatic adenocarcinoma samples. Specimens were obtained surgically from patients with a pathological diagnosis of pancreatic adenocarcinoma. Tumour samples from pancreatic cancer patients were transplanted into nude mice in three different locations(intraperitoneal, subcutaneous and pancreatic). Histological analysis(haematoxylin-eosin and Masson's trichrome staining) and immunohistochemical assessment of apoptosis(TUNEL), proliferation(Ki-67), angiogenesis(CD31) and fibrogenesis(α-SMA) were performed. When a tumour xenograft reached the target size, it was reimplanted in a new nude mouse. Three sequential tumour xenograft generations were generated(F1, F2 and F3).RESULTS The overall tumour engraftment rate was 61.1%. The subcutaneous model was most effective in terms of tissue growth(69.9%), followed by intraperitoneal(57.6%) and pancreatic(55%) models. Tumour development was faster in the subcutaneous model(17.7 ± 2.6 wk) compared with the pancreatic(23.1 ± 2.3 wk) and intraperitoneal(25.0 ± 2.7 wk) models(P = 0.064). There was a progressive increase in the tumour engraftment rate over successive generations for all three models(F1 28.1% vs F2 71.4% vs F3 80.9%, P < 0.001). There were no significant differences in tumour xenograft differentiation and cell proliferation between human samples and the three experimental models among the sequential generations of tumour xenografts. However, a progressive decrease in fibrosis, fibrogenesis, tumour vascularisation and apoptosis was observed in the three experimental models compared with the human samples. All three pancreatic patient-derived xenograft models presented similar histological and immunohistochemical *** In our experie

关键词： Immunohistological analysis Pancreatic cancer Patient-derived xenograft Animal model Nude mice

Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

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World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： Maria Jesús Fernández-Luque Luis María Sánchez-Gómez Vicente Pastor y Aldeguer Carmen Suárez-Fernández Belén Sierra-García Soledad Mayayo-Vicente Marta Ruiz-López ángela Gallego-arenas Rosa Sánchez Alcalde Pilar Loeches-Belinchón javier López-González francisco Rodríguez-Salvanés Blanca Novella-Arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías Sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases