Objetivo: Determinar si la localización y el tamaño de los adenomas de colon se asocian con la presencia de displasia de alto grado en los pacientes de un hospital peruano. Materiales y Métodos: Se realizó un estudio trasversal mediante la revisión de informes de colonoscopías de los años 2014-2015 del Hospital Nacional Daniel Alcides Carrión, incluyéndose los pólipos de pacientes mayores de 18 años; y excluyéndose los de pacientes con cáncer de colon, antecedente de cirugía oncológica, enfermedad inflamatoria intestinal y poliposis (6 o más). Se extrajeron los datos de localización (colon proximal y distal, división a partir del ángulo esplénico), tamaño (menos de 10 mm y 10 mm o más), forma (pediculados y sésiles) y grado de displasia (bajo y alto grado). Se calculó la fuerza de asociación mediante OR, se determinó si existía asociación a través de la prueba Chi cuadrado, con nivel de significancia menor a 0,05. Resultados: De un total de 1710 informes de colonoscopías revisadas, 378 personas tuvieron pólipos, calculando una tasa de detección de adenomas de 22,1%. De los 458 pólipos encontrados 254 fueron adenomas. Se demostró una asociación significativa entre la localización en colon distal y displasia de alto grado (OR 2,68 IC 1,12-6,42, p<0.05); asimismo, los adenomas mayores o iguales a 10 mm tuvieron más riesgo de displasia de alto grado (OR 7,75 IC 3,05-19,69, p<0.05). No se encontró asociación entre la forma de los adenomas y grado de displasia. Conclusión: Se concluye que el tamaño de 10 mm o más y la localización en colon distal se asocian a displasia de alto grado en los adenomas. / Objective: To determine whether localization and size are related to the presence of high-grade dysplasia of colon adenomas in patients of a Peruvian hospital. Materials and methods: This is a descriptive transversal study. We checked colonoscopy reports of 2014-2015 years of Hospital Daniel Alcides Carrion, we included the polyps found in patients older than 18 years old, and excluded reports from patients with colorectal cancer, an antecedent of oncological surgery, inflammatory bowel disease and polyposis (6 or more). We used data based on localization (proximal and distal colon, based on the splenic angle), size (less than 10 mm and 10 mm or more), shape (pediculate and sessile) and grade of dysplasia (low and high-grade). We calculated the strength of association by OR, and we determined whether there was association by Chi-square test with a significance value less than 0.05. Results: We reviewed a total of 1710 of colonoscopy reports, 378 patients had polyps, so the adenoma detection rate was 22.1%. There were 458 polyps, from which 254 were adenomas. From these adenomas, we found an association between distal colon localization and high-grade dysplasia (OR 2.68 IC 1.12-6.42, p<0.05); likewise, there was an association between the size of the adenomas and high-grade dysplasia (OR 7.75 IC 3.05-19.69, p<0.05). We did not find any association between the shape and grade of dysplasia. Conclusion: This study concludes that there is an association between the size of 10 mm or more and localization in the distal colon with high-grade dysplasia of adenomas.

M.Tech. (Homoeopathy) / The aim of this study was to determine the effectiveness of Argentum nitricum 6CH and Lycopodium clavatum 6CH in the individualised treatment of patients suffering from Irritable bowel syndrome. These two homoeopathic remedies are well known for their effect on the gastrointestinal system, especially when the gastrointestinal symptoms are associated with emotional stress. 60 subjects participated in this single blind, placebo controlled study. Each subject underwent an initial evaluation in order to ascertain their symptoms prior to treatment. They were then given their appropriate remedy to be administered three times daily for one month. The subject's symptoms were monitored through questionnaires completed at two week intervals. The homoeopathic medication appeared to reduce the Irritable bowel syndrome symptoms, with the Lycopodium clavatum group achieving slightly better results than the Argentum nitricum group. It is, however, recommended that further similar studies using a larger sample group for a longer duration be conducted in order to verify these findings.

No description available.

No description available.

As céluals tumorais estão constantemente expostas a flutuações nas concentrações de nutrientes e oxigênio no microambiente tumoral. Através da ativação de diferentes vias de sinalização, as células tumorais sofrem uma reprogramação metabólica a fim de suportar as condições hostis impostas pelo microambiente tumoral. Uma das vias de sinalização ativada nessas condições é a autofagia, a qual tem sido considerada um dos principais mecanismos de sobrevivência celular em condições de estresse. Além disso, muitos medicamentos anti-câncer, como os agentes alquilantes, tem sido implicados na indução de autofagia. Apesar da autofagia contribuir com a sobrevivência da célula, uma superativação da via autofágica por períodos prolongados pode contribuir com a morte celular, o que faz com que o papel da autofagia no câncer seja ainda bastante debatido. Neste trabalho, buscou-se avaliar o papel da autofagia induzida em células de câncer colorretal da linhagem HCT116 continuamente cultivadas em baixa concentração de glicose e submetidas ao tratamento com o agente alquilante oxaliplatina. Os resultados demonstraram que a autofagia induzida em células HCT116 nessas condições exerce um papel citoprotetor, contribuindo para a resistência ao tratamento com oxaliplatina. A ativação da autofagia pelo tratamento com oxaliplatina em baixa concentração de glicose foi capaz de manter os níveis intracelualres de ATP e de reduzir a morte celular por apoptose. A utilização de inibidores ou de um ativador farmacológico da via autofágica, em combinação com a oxaliplatina, foi capaz de sensibilizar células HCT116 tratadas em baixa concentração de glicose, aumentando a morte celular por apoptose. Além disso, a indução de autofagia pela oxaliplatina foi mediada pela ativação de AMPK e inibição de mTOR. Estes dados demonstram que a ativação da autofagia em células de câncer colorretal HCT116 expostas a baixa concentração de glicose contribui para resistência ao tratamento com oxaliplatina. Estes dados também sugerem que a manipulação da via autofágica, pela sua inibição ou superativação, pode fornecer um maneira eficiente de limitar a progressão do tumor e aumentar a eficiência dos regimes quimioterápicos. / Tumor cells are constantly exposed to nutrients and oxygen concentration fluctuations at tumor microenvironment. Through activation of different signaling pathways, tumor cells undergo metabolic reprogramming to tolerate hostile conditions imposed by tumor microenvironment. One of the activated signaling pathways in such conditions is autophagy, which has been considered one of the central mechanisms of cell survival in stress conditions. Furthermore, many anticancer drugs, like alkylanting agents, have been implicated in autophagy induction. Despite autophagy contribution to cell survival, the autophagic pathway activation for prolonged periods may contribute to cell death, which creates extensively debates about the role of autophagy in cancer. In the present work we intended to evaluate the role of autophagy induced in colorectal cancer cells HCT116 grown continuously in low glucose concentration and treated with the alkylating agent oxaliplatin. Our results showed that autophagy induced in HCT116 cells in these conditions plays a cytoprotective role, contributing to oxaliplatin resistance. The activation of autophagy by oxaliplatin in low glucose concentration was able to maintain the intracellular levels of ATP and to reduce apoptotic cell death. The combined use of pharmacologic inhibitors or an activator of autohophagy with oxaliplatin was capable to sensitize HCT116 cells treated in low glucose concentration, increasing apoptotic cell death. Moreover, autophagy induction by oxaliplatin was mediated by the activation of AMPK and inhibition of mTOR. Our data demonstrate that autophagy activation in colorectal cancer cells HCT116 exposed to low glucose concentration contributes to the tolerance of oxaliplatin. These data also suggest that the manipulation of autophagic pathway, through its inhibition or hyperstimulation, may provide an effective manner of limiting tumor progression and increase chemotherapy effectiveness.

Thesis (M.A.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Evidence that dietary fats influence carcinogenesis comes from both epidemiological and experimental data. Previous experimental studies suggest that dietary fat acts as a promoter in chemically induced carcinogenesis and this effect depends on the degree of saturation and concentration of dietary fat. [TRUNCATED] / 2031-01-01

No description available.

El presente trabajo tiene la intención de dar a conocer, la casuistica y las técnicas quirúrgicas realizados en los pacientes que han ingresado por el servicio de emergencia del Hospital Alberto Hurtado Abadia, con el diagnóstico de vólvulo, en el lapso de 10 años, de enero de 1991 a Diciembre del 2001, por tal motivo se han revisado un total de 208 Historias clínicas que corresponden a un total de pacientes que han ingresado con diagnóstico de obstrucción intestinal, se seleccionaron los casos de vólvulo de colon

M.A. / The purpose of this study is to investigate the effects of an individualized holistic psychotherapy and synergistic stress management programme for the treatment of Irritable Bowel Syndrome (IBS) and stress, both of which are common disorders in this present day and age. IBS is a functional bowel disorder of the gastrointestinal tract that leads to change in bowel habits with the additional features of abdominal pain and distension (Drossman, 1994b). This functional disorder has been associated with stress since time immemorial and it is only recently that research has begun to examine how and by what mechanisms IBS and stress are related. A review of the literature suggests a resurgent interest in IBS and stress. Tantalizing questions like ‘IBS – irritable bowel, irritable body, irritable brain or irritable mind?’ gives one an idea of the genesis from which the disorder has come, the complications in which it has been mired and the directions in which it is aspiring to go (Farthing, 1995). Using both the historical context and the present level of understanding in the research literature, one becomes aware of the shifting paradigm from the dualistic Cartesian-Newtonian biomedical perspective, to the biopsychosocial and integrative mind-body approaches which reflect the move to a holistic and non-linear quantum scientific worldview. The ecosystemic paradigm on which the present study is based, represents this shift whereby systemic changes in cyclical rhythmic patterns within the psychophysiology of clients reflect new ways of conceptualizing psychosomatic (mind-body) ill-health (Weiner, 1992). Within the behavioural and medical health fields, both psychologists and physicians as well as a number of other disciplines are moving towards more integrative solutions which include the mind-body-spirit dimensions of the individual. Drossman, Whitehead and Camilleri (1997) have begun to consider the individualized expression of the illness in the patient and to situate him among his wider systems, as well as incorporating a referral team approach to the treatment of IBS. Salt (1997) extends the use of the biopsychosocial model to include the spiritual dimension in his treatment of IBS patients. Broom (1997) weaves the various internal systems of the person into the story of the client’s illness that integrates the mind and body. The psychologically based holistic intervention of this study was developed in response to the calls for more integrative approaches to treatment which incorporate whole-person care. The specific aim of this study is to compare a group of IBS participants who receive the holistic individualized psychotherapy and synergistic stress management intervention with a group of IBS participants who do not receive the treatment. The sample consisted of two groups, an experimental (N = 20) group and a control (N = 20) group. The IBS Client Questionnaire also known as the Functional Bowel Disorder Severity Index (FBDSI) (Drossman, Zhiming, Toner, Diamant, Creed, Thompson, Read, Babbs, Barreiro, Bank, Whitehead, Schuster & Guthrie 1995) was used to verify a diagnosis of IBS as well as a measure of the severity of symptoms. This index is based on the current international diagnostic criteria for IBS. The Occupational Stress Inventory was used as a measure of vocational stress and was developed to provide an integrated theoretical model linking sources of stress in the work environment, psychological strains experienced by individuals as a result of work stressors and the coping resources available to counterbalance the effect of stressors and alleviate strain. It consists of three scales, namely Occupational Roles, Personal Strain and Personal Resources scales respectively. Wilks’ Lambda was used for the between-groups comparisons between the intervention and non-intervention groups and Paired Samples t-test was used for the within-groups analysis. The comparisons were made in terms of improvement in symptoms, determined by the Functional Bowel Disorder Severity Index (FBDSI) and lowering of occupational stress, determined by two of the scales of the Occupational Stress Inventory, namely the Occupational Roles and Personal Strain scales and an increase in coping responses determined by the Personal Resources scale. Both of these were administered as pre- and post-test measures before and three months after the intervention was completed. The results of the study indicate that the experimental group of IBS participants who received the intervention improved in symptom severity, their occupational stress was lowered and they began utilizing more coping resources than the group of IBS participants who did not receive the intervention. Thus it is concluded that an individualized holistic approach for the treatment of IBS is indicated and that individuals with refractory IBS can be helped to manage their illness and their lives. In particular, this psychologically based study confirms a very definite and specific place for psychologists in the treatment of clients with IBS and stress. An invitation was extended to the control group to use the facilities for therapeutic intervention offered by the RAU Psychogastroenterology project once the post-tests had been completed, thus addressing any ethical questions that could have arisen. This was an initial investigation using an ecologically based meta-theoretical framework as well as specific stress techniques for the holistic treatment of clients. A number of recommendations arose from this particular intervention and are included for future studies.

El presente trabajo tiene la intención de dar a conocer, la casuistica y las técnicas quirúrgicas realizados en los pacientes que han ingresado por el servicio de emergencia del Hospital Alberto Hurtado Abadia, con el diagnóstico de vólvulo, en el lapso de 10 años, de enero de 1991 a Diciembre del 2001, por tal motivo se han revisado un total de 208 Historias clínicas que corresponden a un total de pacientes que han ingresado con diagnóstico de obstrucción intestinal, se seleccionaron los casos de vólvulo de colon