A clinical case of giant serous cystadenoma is presented in the context of a twin pregnancy complicated by severe preeclampsia. The patient was admitted to the high-risk obstetric hospitalization area and underwent surgery by emergency cesarean section. During the procedure, a large tubo-ovarian tumor was evidenced, which was removed with fertility preservation. Histopathological examination confirmed the diagnosis of ovarian serous cystadenoma. It should be noted that in none of the prenatal ultrasound controls was the presence of an adnexal tumor reported, which underscores the diagnostic difficulty in this type of scenario. Ovarian tumors are pathological structures that can be benign or malignant depending on their histological characteristics. In women of reproductive age, timely diagnosis is essential to preserve fertility and reduce complications. Ultrasound is the initial tool of choice, while magnetic resonance imaging is reserved for more complex cases. The detection of adnexal tumors during a twin pregnancy represents an additional challenge in gynecology, since the potential complications of twisting, rupture or hypovolemic shock can seriously compromise maternal and fetal health. In the present case, giant tubo-ovarian tumor was not diagnosed during prenatal care and was identified as a transsurgical finding. The removal confirmed the diagnosis of serous cystadenoma, with a favorable evolution and a good prognosis for both the mother and the newborns. This case highlights the importance of thorough ultrasound surveillance and appropriate surgical preparation in patients with high-risk pregnancies.
Malformations of the uterus are due to defective fusion of the Müller's ducts. These include the unicornuate uterus, with or without a rudimentary horn. Emergency cesarean section was performed due to alteration of the fetal heart rate diagnosed by fetal monitoring, obtaining a male newborn with a cephalic presentation of flexion with the presence of caput weighing 3360 g, height 51 cm, APGAR 7-8-9, CAPURRO 41 weeks of gestation, posterior fundic placenta, extraction was performed. Due to the percentage of infertility presented by patients with unicornuate uterus with the possibility of the use of assisted reproductive technology, women with congenital uterine anomalies should be informed about the impact on the probabilities of success, as well as on pregnancy-related complications. Women with a unicornuate uterus should undergo a prenatal checkup that includes monitoring of cervical length, growth and fetal presentation. If present, the rudimentary non-communicating horn should be removed to avoid ectopic pregnancy. Despite the pregnancy complications associated with a unicornuate uterus, there is the possibility of a successful pregnancy, as referred to in the present clinical case, however, it is important to recognize that patients who present with Mullerian malformation of the unicornuate uterus tend to infertility and to be habitual abortionists with difficulty in reaching a term and successful pregnancy. Here lies the importance and attention of the present case, the patient despite presenting the condition of unicornuate uterus reaches 41 weeks of gestation and has a successful cesarean delivery.
The study of erythrocyte characteristics is carried out through different tests, including microscopy and image analysis. The purpose of this article is to develop a functional algorithm in the ImageJ software to identify the morphological characteristics of erythrocytes and to determine the variation in osmotic fragility when they are exposed to different conditions. The images were obtained using a Leica Aristoplan microscope and captured with a Leica DMC6200 camera connected to the equipment, and subsequently processed in ImageJ. The algorithm provides an orderly description of the process, from image calibration to the acquisition of quantitative results. This process includes calibration according to the microscope magnification, correction of possible image errors, and identification of cells to obtain parameters such as area, perimeter, roundness, and Feret's diameter. The application of the algorithm in ImageJ enables image processing that facilitates the morphological quantification of erythrocytes. The algorithm presented is efficient and reproducible, and can also be adapted according to user needs. Based on the analysis, it is concluded that the algorithm can be modified depending on specific requirements. Overall, the algorithm facilitates the use of ImageJ for the morphological quantification of erythrocytes.
We determined the role of measuring 25-hydroxy vitamin D to predict clinical activity and severity of pulmonary involvement in sarcoidosis. 61 consecutive patients with sarcoidosis were assessed. The serum level of 25 hydroxyvitamin D was measured using the chemiluminescent immunoassay. Sarcoid clinical activity classification (SCAC) was used to assess the clinical condition of the disease. The patients were also followed for 6 months. 14.8 % suffered severe 25-hydroxy vitamin D deficiency and 26.2 % had mild to moderate 25-hydroxy vitamin D deficiency. Serum phosphorus level was negatively associated with SCAC. There was also significant relationship between SCAC and pulmonary stages. The serum level of 25-hydroxy vitamin D was not associated with clinical activity. Within a 6month follow-up time, clinical improvement of disease was overall achieved in 32 out of 61 patients leading success rate 52.5 %. Advanced age and stage 3-4 of pulmonary defects were main predictors for lack of 6-month clinical improvement in sarcoidosis patients. There is no relation between serum level of 25-hydroxy vitamin D and two indices of clinical activity of sarcoidosis and the severity of pulmonary involvement. The assessment of serum phosphorus and serum creatinine can be assessed to determine disease severity.
Acute kidney injury secondary to myocardial ischemia-reperfusion is a serious complication driven by oxidative stress and inflammation. Although reperfusion restores oxygenation, it also increases reactive oxygen species generation, worsening renal injury. S-allyl cysteine, a garlic-derived organosulfur compound, exerts antioxidative effects by enhancing endogenous antioxidant defenses. Hence, this study investigates the effects of S-allyl cysteine in ovariectomized rats subjected to myocardial ischemia-reperfusion injury. Thirty-two female Wistar rats underwent either ovariectomy (n=24) or sham surgery (n=8). After a 3-week recovery, myocardial ischemia-reperfusion injury was induced by 30 min of left anterior descending coronary artery ligation followed by 2 h of reperfusion. S-allyl cysteine or propargylglycine was administered via the right carotid artery at reperfusion onset. Kidney tissues were analyzed biochemically and histologically. S-allyl cysteine significantly reduced malondialdehyde levels and insignificantly increased both glutathione level and catalase activity in renal tissues. However, no changes were observed in superoxide dismutase activity and hydrogen sulfide levels. Renal histology revealed that S-allyl cysteine preserved renal morphology in ovariectomized rats, likely via reactive oxygen species scavenging and Nrf2 pathway activation. This study concludes that S-allyl cysteine attenuates myocardial ischemia-reperfusion-induced kidney injury in estrogen-deficient rats by reducing oxidative stress and enhancing antioxidant defenses, suggesting potential as a therapeutic supplement to reduce risk of acute kidney injury in menopausal women.
Well instability is one of the main problems in the drilling aspect. This can be managed by determining a window for the drilling mud considering the mechanical properties of the formation. Pore pressure and orientation of the main stresses in situ are essential parameters for determining the safe sludge weight window. This article aimed to determine a safe mud weight window for vertical and deviated wells under underbalanced drilling conditions. A carbonate formation was chosen for numerical modeling of the well using FLAC software. Several oil wells in Iran were selected as representative carbonate formations for research purposes. A numerical model of the well was constructed using well log data and calibrated with laboratory results and drill reports. To verify the numerical results, the Mohr-Coulomb failure criterion was used. Therefore, an elastic porous model and finite difference codes were generated to determine the mud weight window for the designated wells. Also, choosing a numerical analysis method is crucial and should be considered. The numerical model used in this study can be used to simply and reliably determine the safe mud weight window and the required pit path.
Breast cancer is the most common type in the female population, and ranks first in mortality with 10.9 % and an incidence of 38.2 % of all causes of cancer in women. The objective of this study was to determine the immunohistochemical characteristics of breast cancer and its histopathology correlation. An observational, retrospective, and correlational study was carried out that involved from 2019 to 2021 with information obtained from the pathology department of the Luis Vernaza hospital in Guayaquil, Ecuador. In this research, the results were that the most frequent breast tumor, according to pathology, was invasive ductal carcinoma in 78 %. All patients with ductal carcinoma in situ were estrogen, progesterone, and Ki67 receptors < 10 % in the vast majority (83 %). Patients with invasive lobular carcinoma had the vast majority of estrogen receptors, progesterone positive, and Ki67 > 10 %. In patients diagnosed with invasive ductal carcinoma, the overexpressed intrinsic molecular subtype HER2/neu predominated. Molecular markers obtained by immunohistochemistry are important for the classification of breast cancer subtypes, treatment selection, and prediction of prognosis. In this study, great variability and heterogeneity were noted in the different tumors, which gives them a different prognosis and therapeutic approach.
In 1954 Abalos described the species Tityus proseni with specimens found in Cochabamba-Bolivia, however, since then the data of the species have not been updated. New specimens were recently captured from the departments of Beni and Santa Cruz - Bolivia. In order to carry out a detailed redescription and expansion of the distribution data of the species in Bolivia, these were reviewed according to: its external morphology, pigmentation patterns and mor-phometric data. The data resulting from the analysis provide new characters for the species, not contemplated in the original description, new ranges in morphometric variables previously analyzed, new data on pigmentation patterns. On the other hand, the differential morphological and morphometric data of T. proseni with those of T. argentinus and T. sorataensis are presented, since they are apparently similar species within the country.
The presence of a giant ovarian tumor in pregnancy is very rare, these masses are usually asymptomatic and are detected incidentally on the ultrasound examination of the first trimester or until they reach a large size, whose removal can be performed during cesarean section. We present a clinical case of a 34-year-old female patient, 36 weeks pregnant, who presented a giant ovarian tumor evidenced during the emergency cesarean section, a live newborn was obtained and a giant tumor of the left ovary was present that measured 22 x 17 cm in diameter. An elective cesarean section can be chosen along with salpingo oophorectomy in case of a giant ovarian cyst that complicates a full-term pregnancy as in the case presented. Ultrasound continues to be the most important tool in the study of adnexal masses due to its safety, availability and accuracy; however, the definitive diagnosis is granted by histopathology. The use of magnetic resonance imaging can also be used, to help distinguish benign tumors from malignant ones more accurately during pregnancy. It is important to carry out prenatal control and strict monitoring of the tumor, to decide the time of surgical treatment, in order to avoid maternal or fetal complications.
The impossibility of procreating has always been a cause of anguish and pain since ancient times, regardless of its social connotations; However, achieving pregnancy is not something that always occurs in a simple and predictable way, as there are unexpected and unwanted events that force us to reformulate expectations in relation to fertility and all that this implies. The recognition of infertility as a global health problem is increasing every day. Although the scientific and technological progress made in the biology of reproduction is remarkable, the number of couples seeking counselling and treatment for infertility is increasing considerably. Becoming parents and creating a family is the goal of most couples, however, not all will be able to achieve it without some medical intervention, which is why infertility has been declared a Public Health problem by the World Health Organization (WHO)
The human papillomavirus is a common sexually transmitted infection, widely spread worldwide, it is considered the main agent for the development of cervical cancer. With the aim of improving information on human papillomavirus infection in women over 20 years of age, a quasi-experimental educational intervention study was carried out in office 3 of the Previsora Polyclinic between January 2023 and April 2024. The universe was made up of 310 women, a sample of 115 was selected, who met the inclusion criteria. The variables that were analyzed were, age, school level, knowledge about the human papillomavirus, risk factors, manifestations and prevention. The survey was used before and after the intervention. The study was carried out in 3 phases: diagnostic, interventional and an evaluative phase. To evaluate the effectiveness of the educational intervention, the McNemar test was used. It was observed that 44.3% of the participants were between 20-29 years old and more than half of them had a pre-university school level. Before the educational intervention, an inadequate level of information on aspects of human papillomavirus infection predominated, and in general a low cognitive level, then with the intervention it was possible to raise the level of information. The intervention was effective in modifying knowledge through participatory didactic resources that could be applied in daily medical practice.
Breast cancer is the most common type in the female population, and ranks first in mortality with 10.9 % and an incidence of 38.2 % of all causes of cancer in women. The objective of this study was to determine the immunohistochemical characteristics of breast cancer and its histopathology correlation. An observational, retrospective, and correlational study was carried out that involved from 2019 to 2021 with information obtained from the pathology department of the Luis Vernaza hospital in Guayaquil, Ecuador. In this research, the results were that the most frequent breast tumor, according to pathology, was invasive ductal carcinoma in 78 %. All patients with ductal carcinoma in situ were estrogen, progesterone, and Ki67 receptors < 10 % in the vast majority (83 %). Patients with invasive lobular carcinoma had the vast majority of estrogen receptors, progesterone positive, and Ki67 > 10 %. In patients diagnosed with invasive ductal carcinoma, the overexpressed intrinsic molecular subtype HER2/neu predominated. Molecular markers obtained by immunohistochemistry are important for the classification of breast cancer subtypes, treatment selection, and prediction of prognosis. In this study, great variability and heterogeneity were noted in the different tumors, which gives them a different prognosis and therapeutic approach.
A total of 34 cases and 34 healthy individuals were included in this study. The patient group had a history of COVID-19 infection and hospitalization. They underwent full optometric examinations on their right eye, which included, autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, and examinations with specular microscope and Pentacam devices. The average corneal endothelial cell density was 2503.78 +/- 311.76 in the patient group and 2831.72 +/- 276.65 in the healthy group, which indicated a significant decrease in the patient group, compared to the healthy group. There was a significant difference in the endothelial cell density between the two groups (P<0.001). Moreover, the coefficient of variation of cells was 36.63 in the healthy group and 37.00 in the patient group, which was raised. No significant differences were observed in the other anterior segment parameters, such as the central corneal thickness, anterior chamber angle, keratometry, corneal horizontal diameter, and pupil diameter (P>0.05). Individuals who have previously overcome COVID-19 experienced a reduction in the corneal endothelial cell density and an increase in cell coefficient of variation, as revealed by tests using a specular microscope and Pentacam devices. These findings could contribute to our comprehension of the systemic impacts of COVID-19 on the body.
This study aims to compare the effects of early breastfeeding and formula feeding on the growth and developmental outcomes of preterm infants over 24 months. A comparative longitudinal study was conducted involving 100 preterm infants divided into two groups: breastfeeding and formula feeding. Growth parameters (weight, length, head circumference) were monitored at regular intervals, and developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development. Statistical analyses, including repeated measures ANOVA and regression models, were applied. Both groups exhibited similar growth trajectories, with formula-fed infants demonstrating slightly higher weight, length, and head circumference values, though these differences were not statistically significant (p > 0.05). Developmental assessments showed comparable results across cognitive, motor, and social-emotional domains, with breastfed infants scoring marginally higher in cognitive and social-emotional development at 24 months. Breastfeeding and formula feeding both support the growth and development of preterm infants effectively. 2025. Journal of the Selva Andina Research Society (R). Bolivia. All rights reserved.
In 1954 Abalos described the species Tityus proseni with specimens found in Cochabamba-Bolivia, however, since then the data of the species have not been updated. New specimens were recently captured from the departments of Beni and Santa Cruz-Bolivia. In order to carry out a detailed redescription and expansion of the distribution data of the species in Bolivia, these were reviewed according to: its external morphology, pigmentation patterns and morphometric data. The data resulting from the analysis provide new characters for the species, not contemplated in the original description, new ranges in morphometric variables previously analyzed, new data on pigmentation patterns. On the other hand, the differential morphological and morphometric data of T. proseni with those of T. argentinus and T. sorataensis are presented, since they are apparently similar species within the country.
Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. This study aimed to evaluate the effect of quadriceps neuromuscular electrical stimulation (NMES) on pain scores, functional tests, and quality of life in military personnel with partial ACL ruptures. A total of 60 male military patients with knee pain were divided into two groups: an intervention group receiving NMES and a control group without NMES. Both groups underwent standard treatments, including infrared therapy, ultrasound, and quadriceps strengthening exercises. Evaluations were performed before and after treatment for pain reduction (VAS scale), quality of life (QOL ACL questionnaire), and a 10-meter walk test. Data were analyzed using SPSS software. The mean VAS score in the NMES group decreased from 3.57 +/- 1.25 to 1.07 +/- 0.9, while in the control group it decreased from 3.6 +/- 1.07 to 2.64 +/- 1.66 (P < 0.001). The QOL scores improved from 32.08 +/- 10.5 to 59.83 +/- 6.9 in the NMES group and from 31.03 +/- 9.8 to 41.6 +/- 7.1 in the control group (P < 0.001). No statistically significant difference was observed in the 10-meter walking test between the groups. Quadriceps NMES appears to be a promising intervention for reducing pain, improving muscle function, and enhancing the quality of life in patients with partial ACL ruptures.
The human papillomavirus is a common sexually transmitted infection, widely spread worldwide, it is considered the main agent for the development of cervical cancer. With the aim of improving information on human papillomavirus infection in women over 20 years of age, a quasi-experimental educational intervention study was carried out in office 3 of the Previsora Polyclinic between January 2023 and April 2024. The universe was made up of 310 women, a sample of 115 was selected, who met the inclusion criteria. The variables that were analyzed were, age, school level, knowledge about the human papillomavirus, risk factors, manifestations and prevention. The survey was used before and after the intervention. The study was carried out in 3 phases: diagnostic, interventional and an evaluative phase. To evaluate the effectiveness of the educational intervention, the McNemar test was used. It was observed that 44.3% of the participants were between 20-29 years old and more than half of them had a pre-university school level. Before the educational intervention, an inadequate level of information on aspects of human papillomavirus infection predominated, and in general a low cognitive level, then with the intervention it was possible to raise the level of information. The intervention was effective in modifying knowledge through participatory didactic resources that could be applied in daily medical practice. 2025. Journal of the Selva Andina Research Society (R). Bolivia. All rights reserved.
The presence of a giant ovarian tumor in pregnancy is very rare, these masses are usually asymptomatic and are detected incidentally on the ultrasound examination of the first trimester or until they reach a large size, whose removal can be performed during cesarean section. We present a clinical case of a 34-year-old female patient, 36 weeks pregnant, who presented a giant ovarian tumor evidenced during the emergency cesarean section, a live newborn was obtained and a giant tumor of the left ovary was present that measured 22 x 17 cm in diameter. An elective cesarean section can be chosen along with salpingo oophorectomy in case of a giant ovarian cyst that complicates a full-term pregnancy as in the case presented. Ultrasound continues to be the most important tool in the study of adnexal masses due to its safety, availability and accuracy; however, the definitive diagnosis is granted by histopathology. The use of magnetic resonance imaging can also be used, to help distinguish benign tumors from malignant ones more accurately during pregnancy. It is important to carry out prenatal control and strict monitoring of the tumor, to decide the time of surgical treatment, in order to avoid maternal or fetal complications.
This study aimed to develop a model for contracting with the indirect treatment paraclinical units of the social security organization. Using a mixed exploratory design, the research was conducted in two consecutive stages: qualitative and quantitative. Data were collected through questionnaires developed by the researchers based on the conceptual model and analyzed using AMOS software. Thematic analysis of the interviews identified 176 primary codes, which were refined into 78 initial codes, grouped into 26 main themes and 10 factors. These factors included demographics, economic considerations, acculturation, specialization, physical conditions, staff literacy and experience, performance management, marketing, customer satisfaction, and external influences. The 10 factors significantly influenced the contracting criteria of the indirect treatment paraclinical units of the social security organization. The results of the Friedman test indicated that demographic factors had the greatest impact, followed by external factors, economic factors, customer satisfaction, marketing, staff literacy and experience, cultural background, specialization, physical factors, and performance management. The proposed model proved to be an effective tool for contracting indirect treatment paraclinical units within the social security organization, offering a structured approach to improving the efficiency and effectiveness of service delivery.
Green mold, caused by Penicillium digitatum, is the most destructive postharvest disease in citrus, leading to major economic losses globally. This study aimed to assess the epidemiological traits, pathogenicity, and aggressiveness of P. digitatum isolates from citrus fruits in Northern Iran. A total of 150 citrus samples were collected from orchards and warehouses across three regions. Isolates were purified using the single-spore method and examined microscopically. Pathogenicity tests involved inoculating oranges with spore suspensions, recording infection frequency (IF), lesion area (LA), sporulation capacity (SC), incubation period (IP), and latent period (LP). Data analysis included ANOVA, Pearson correlation, regression, and cluster analysis. All 88 isolates showed 100 % pathogenicity. LA ranged from 40-80 %, and SC from 7.25x10(7) to 2.37x10(8) spores. The average IP and LP were 2.3 and 5.4 days, respectively. A strong correlation (r = 0.8) was found between SC and the composite aggressiveness index (CAI), while IP and LP were inversely correlated with CAI. Cluster analysis grouped isolates into four categories based on aggressiveness, indicating genetic diversity without geographic clustering. These findings demonstrate the high aggressiveness of P. digitatum isolates in Northern Iran and underline the urgent need for targeted postharvest management strategies. This research contributes to understanding the pathogen's behavior and supports future development of region-specific control measures.
