BackgroundSerum levels of CA125 measured before any treatment have been evaluated in epithelial ovarian cancer (EOC) as a predictor of patient survival; however, results in survival index are controversial, as CA125 levels are influenced by several variables. Taking this into consideration, the present study evaluated the association of pretreatment levels of CA125 serum with the clinical stage, histology and differentiation grade of the tumor and the survival rate in a group of patients from an oncology referral center in Mexico, all of them diagnosed with ovarian carcinoma.This retrospective study consisted of 1009 patients with EOC, diagnosed between 2006 and 2013 at the National Cancerology Institute (Instituto Nacional de Cancerología-INCan), considering only those with CA125 measurements before any chemotherapy or surgical cytoreduction. Patients with three years of medical follow-up having pretreatment CA125 value and simultaneous diagnoses of histological subtype, clinical stage and differentiation grade of the tumor (n = 656) were studied in order to determine their survival rate.ResultsThe abnormal level (>35 U/mL) of CA125 was observed in 99 % of serous carcinoma cases rated I to IV in the FIGO stages. Abnormal CA125 proportions were 89 % in endometrioid subtype and 69 % in mucinous tumors, with the highest absolute value of CA125 observed in serous carcinoma surpassing any other histological subtype. Clinical stages III and IV displayed increased CA125 values compared to stages I and II. Undifferentiated carcinomas show the highest level of this indicator compared with those of low and moderate differentiated grade. Survival evaluation by Kaplan-Meier analysis including only high grade serous carcinoma at FIGO stage III (n = 57) demonstrated 57.1 % chances of survival in patients with CA125 pretreatment levels higher than 500 U/mL. Survival was 26.7 % in patients with CA125 lower than 500 U/mL and the hazard ratio for CA125 ≤ 500 U/mL was 2.28, 95 % CI 1.08–4.84, P = 0.032.ConclusionsClinical stage associated with pretreatment absolute values of CA125 should be considered as prognostic factor in EOC patients. Values of CA125 higher than 500 U/mL in high grade serous carcinoma with FIGO stage III resulted in an enhanced survival rate of the patients.
Femoroacetabular impingement (FAI) syndrome is a frequent cause of pain and in recent years considered to be a precursor of premature hip osteoarthritis. The structural abnormalities which characterize FAI syndrome, such as the cam-type deformity, are associated with morphological alterations that may lead to hip osteoarthritis. The aim of this study was to determine the prevalence and topographic and morphometric features of the cam deformity in a series of 326 femur specimens obtained from a Mexican population, as well as changes in prevalence in relation to age and gender. The specimens were subdivided into groups according to gender and age. A standardized photograph of the proximal femur of each specimen was taken, and the photograph was used to determine the alpha angle using a computer program; the location of the lesion was determined by quadrant and the morphometric characteristics were determined by direct observation. The overall prevalence of cam deformities in the femur specimens was 29.8 % (97/326), with a prevalence by gender of 35.2 % (64/182) in men and 22.9 % (33/144) in women. The mean alpha angle was 54.6° ± 8.5° in all of the osteological specimens and 65.6° ± 7.5° in those specimens exhibiting a cam deformity. Cam deformities were found topographically in the anterior-superior quadrant of the femoral head-neck junction in 86.6 % (84/97) of the femurs. Deformities were found in 28.2 % of the right femurs and 31.3 % of the left femurs. The prevalence of cam deformity was higher in the femur specimens of young men and in those of middle-aged and older women. There were no significant differences in this deformity in relation to the alpha angle according to age and gender.
diseño, composición tipográfica y proceso fotomecánico por Elsevier México. Todos los derechos reservados.
Retention of knowledge acquired in the first two years of Medical School. Does it persist when tested it in the fourth year students? Introduction. Students generally go deep into the knowledge according to the type of questions they are evaluated with, if they only will support mechanical and repetitive learning that remains just a short time in the memory, if they understand and apply their learning then these supports significant learning. Materials and methods. Analytical observational study by the method of judges there were selected 88 questions of the three levels of knowledge from tests of Anatomy, Psychology, Physiology and Surgery. The same test was randomized and applied to 13 groups of second and fourth grade. The evaluation and the analysis were performed with an electronic system. The U of Mann-Whitney was applied to identify differences and percentiles with inter-quartiles rank for the dispersion. Results. 310 students of second grade and 247 of fourth grade were answered and analyses. The reliability of the test was of 0.9009 and 0.9102, respectively. Significant differences were identified (p = 0.000) in the global examination and the answers of Surgery and Psychology, considering right answers and level of knowledge and Psychology. Considering right answers and level of knowledge (memory and understanding). There were no differences in Anatomy (p = 0.527) and Physiology (p = 0.203). There median of right answers was 39 and 43, respectively. The dispersion of items in the global analysis and by subject maintained an inter-quartiles rank between 3 and 4. Conclusions. It is important to include as many items of high cognitive levels in assessments to facilitate meaningful learning.
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