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Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Open Journal of Anesthesiology 2014年第7期4卷 167-176页

作者： José Pomares gustavo mora-garcía Roberto Palomino Yéssika De León Claudio Gómez-Alegría Doris Gómez-Camargo Anesthesiology and Reanimation Department Faculty of Medicine University of Cartagena Cartagena de Indias Colombia Faculty of Medicine University of Cartagena Cartagena de Indias Colombia Pharmacy Department Faculty of Sciences National University of Colombia Bogotá Colombia Tropical Medicine Doctorate Program Faculty of Medicine University of Cartagena Cartagena de Indias Colombia

Background: Metabolic syndrome (MS) is a constellation of factors associated with increased risk of developing cardiovascular diseases and Diabetes Mellitus. Despite of the many studies related to MS, little is known about its impact on scenarios such as surgical anesthesia. Objective: To examine the correlation between demographic and metabolic variables with the occurrence of perioperative complications in patients with MS undergoing scheduled surgeries using a spinal anesthesia technique in the surgery department at the University Clinic San Juan de Dios in Cartagena de Indias, Colombia. Methods: Observational, analytical, cross-sectional, single-center study of 150 subjects with MS and 150 control subjects. Perioperative complications, socio-demographic, hemodynamic and respiratory variables were registered. Groups were compared using t test, Fisher’s exact test or Chi-square, as appropriate. We applied a logistic multiple regression model, adjusted by backward stepwise at 0.25 and forward at 0.05, to find possible incompatible associations. p value < 0.05 was considered significant. Results: There were significant differences between groups in age, American Society of Anesthesiologists physical status classification, frequency of diseases associated to MS and perioperative complications. There were no cases of mortality among patients. There was statistically significant difference between the two groups for intraoperative hypotension and hypertension with p values of <0.0001 and 0.034. Among postoperative complications there was statistically significant difference in pain (13.3% vs 5.3% in patients without MS) and nausea and/or postoperative vomiting (8% vs 2% in patients without MS) with a p value of 0.027 and 0.015 (by Fisher) respectively. Conclusions: Metabolic abnormalities in MS are a risk factor for developing complications in the perioperative period of patients scheduled for surgeries using the subarachnoid anesthesia technique. Accordingly, it is ap

关键词： Metabolic Syndrome X Insulin Resistance Spinal Anesthesia Abdominal Obesity Perioperative Period

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Genetic Structure of Cartagena de Indias Population Using Hypervariable Markers of Y Chromosome

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Open Journal of Genetics 2015年第1期5卷 27-41页

作者： Doris E. G.-Camargo Rafael Camacho-Mejorado Claudio Gómez-Alegría Angelo Alario Esther A. H.-Tobías gustavo mora- garcía Marco A. M.-Ríos Rocío Gómez Doctorado en Medicina Tropical Facultad de Medicina Universidad de Cartagena Cartagena de Indias Colombia Departamento de Toxicología Cinvestav-IPN México D.F. México Departamento de Farmacia Facultad de Ciencias Universidad Nacional de Colombia Bogotá Colombia Departamento Médico Facultad de Medicina Universidad de Cartagena Cartagena de Indias Colombia Departamento de Biomedicina Molecular Cinvestav-IPN México D.F. México

Ethnicity has been associated with the incidence of diseases and consequently it is a cornerstone in medical genetic studies. It is mainly important in admixture populations, where the population stratification can produce spurious results that lead to erroneous conclusions. Consequently, population stratification has become one of the most important confounding factors in population-based genetic association studies, especially in Latino populations. Cartagena de Indias is a cosmopolitan city with dissimilar ancestry proportions due to recent miscegenation. This population mainly exhibits African and Amerindian matrilineal ancestries. Nevertheless, important asymmetries in the paternal genetic history related to the complex patterns of migration in the colonial period increase the male genetic diversity in this population. As a result of this recent admixture, population stratification has arisen, where each subpopulation is not equally represented. Consequently, the allele differences between cases and controls could be related with different frequencies among different population strata rather than the association of the genes with the disease. In order to define the patrilineal substructure of the Cartagena’s population, a total of 130 unrelated men were ancestrally studied using 15 Y-STR loci routinely employed in anthropological, forensic and population genetics. Our results show that Cartagena is an admixture population consisting of European (80%), Amerindian (10%) and African ancestries (10%), which are represented by haplogroups R1b and I2a (xI2a1), Q-M242/Q-M3, and E1b1a/E1b1b, respectively. Complex genetic patterns found in Cartagena’s population emphasize the importance to know the genetic variation in order to diminish the inconsistence for future genetic association studies. In addition, our findings illustrate the complex genetic background of Cartagena population and reinforce the need to encompass more geographic regions to generate more robust dat

关键词： Population Genetics Y-Chromosome Microsatellites Cartagena Colombia

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A Th2-score in the tumor microenvironment as a predictive biomarker of response to Bacillus Calmette Guérin in patients with non-muscle invasive bladder carcinoma:A retrospective study

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Oncology Research 2023年第2期31卷 207-220页

作者： gustavo MARTÍN VILLOLDO MARÍA TERESA POMBO MARIANA ARIS JOAQUÍN CHEMI PABLO MANDÓ SUPRIYA NAGARAJU JUAN CAMEAN ADRIÁN BURIONI DEBORAH EGEA mora AMAT JOSÉLEÓN MELLADO JOSÉMORDOH ALBERTO VILLARONGA MARÍA MARCELA BARRIO Urology Department Instituto Alexander FlemingCiudad Autónoma de Buenos Aires1426Argentina Immunohistochemistry Department Instituto Alexander FlemingCiudad Autónoma de Buenos Aires1426Argentina Centro de Investigaciones Oncológicas Fundación Cáncer FUCACiudad Autónoma de Buenos Aires1426Argentina Urology Department MD Anderson Cancer CenterHoustonTX77030USA Pathology Department Instituto Alexander FlemingCiudad Autónoma de Buenos Aires1426Argentina

Intravesical Bacillus Calmette Guerin(BCG)is the gold standard therapy for intermediate/high-risk nonmuscle invasive bladder cancer(NMIBC).However,the response rate is~60%,and 50%of non-responders will progress to muscle-invasive *** induces massive local infiltration of inflammatory cells(Th1)and ultimately cytotoxic tumor *** searched for predictive biomarker of BCG response by analyzing tumor-infiltrating lymphocyte(TIL)polarization in the tumor microenvironment(TME)in pre-treatment ***-treatment biopsies from patients with NMIBC who received adequate intravesical instillation of BCG(n=32)were evaluated retrospectively by *** polarization was assessed by quantifying the T-Bet+(Th1)and GATA-3+(Th2)lymphocyte ratio(G/T),and the density and degranulation of EPX+*** addition,PD-1/PD-L1 staining was *** results correlated with BCG *** most non-responders,Th1/Th2 markers were compared in pre-and post-BCG *** was 65.6%in the study *** responders had a higher G/T ratio and a greater number of degranulated EPX+*** combined into a Th2-score showed a significant association with higher scores in responders(p=0.027).A Th2-score cut-off value>48.1 allowed discrimination of responders with 91%sensitivity but lower ***-free survival was significantly associated with the Th2-score(p=0.007).In post-BCG biopsies from recurring patients,TILs increased Th2-polarization,probably reflecting BCG failure to induce a pro-inflammatory status and,thus,a lack of ***-L1/PD-1 expression was not associated with the response to *** results support the hypothesis that a preexisting Th2-polarized TME predicts a better response to BCG,assuming a reversion to Th1 polarization and antitumor activity.

关键词： Non-muscle invasive bladder cancer BCG predictive biomarkers Lymphocyte polarization

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