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This study evaluated the effect of 2.5% sodium hypochlorite (SH) or calcium hypochlorite (CH) submitted to passive ultrasonic irrigation (PUI) or conventional irrigation (CI) on the incidence of residues and the bond strength of the cementation system to post-space dentin. Distilled water (DW) and 2.5% SH followed by 17% EDTA (SH-ED) were used as negative and positive control groups, respectively. The cervical, middle, and apical thirds of the post space were evaluated. One hundred and twenty bovine incisors were endodontically treated and post-space preparation was performed. The specimens were randomly assigned to six groups, according to the solution and irrigation method: DW-CI, SH-ED-CI-SH, SH-CI, SH-PUI, CH-CI, and CH-PUI. The incidence of residues (n=10) over the dentin was evaluated by scores using SEM images. Other specimens were irrigated as previously described and the post cementation was immediately performed using a conventional dual resin cement and a two-step etch-and-rinse adhesive system. Push-out and failure modes were performed for bonding evaluation. Kruskal-Wallis and Dunn test for incidence of residues data and one-way ANOVA and Tukey tests for bond strength data were used at a significance level of 5%. The protocols that showed a lower incidence of residues were: SH-ED-CI-SH, SH-PUI, and CH-PUI for the cervical third and SH-ED-CI-SH for the middle third (p<0.05). In the apical third, the protocols were similar to each other (p>0.05). Bond strength values were higher after irrigation with DW-CI for all thirds (p<0.05). 2.5% sodium or calcium hypochlorite negatively impacted the adhesion interface and exhibited a greater incidence of residues over the post-space radicular dentin.
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Compuestos de Calcio , Recubrimiento Dental Adhesivo , Dentina , Irrigantes del Conducto Radicular , Hipoclorito de Sodio , Irrigación Terapéutica , Bovinos , Animales , Dentina/efectos de los fármacos , Recubrimiento Dental Adhesivo/métodos , Compuestos de Calcio/química , Irrigación Terapéutica/métodos , Microscopía Electrónica de Rastreo , Técnica de Perno Muñón , Análisis del Estrés Dental , Ácido EdéticoRESUMEN
BACKGROUND: Worldwide ageing and thus, workforce ageing, is a concern for both developed and developing nations. OBJECTIVE: The aim of the current research was to determine, through a systematic literature review, the effects of age in three dimensions that are often used to define or assess productivity at work. METHODS: PICO framework was used to generate search strategies, inclusion criteria and terms. Scopus and PubMed databases were used. Peer-reviewed journal papers written in English and published (or in press) between January 2014 and December 2018 were included. RESULTS: After filtering through inclusion criteria, 74 papers were included in the review. Considering productivity, 41%of the findings showed no differences between younger and older workers, 31%report better productivity of younger workers and 28%reported that older workers had better productivity than younger workers. Performance was better in older workers (58%), presenteeism generally showed no significant differences between age groups (61%). Absenteeism was the only outcome where younger workers outperformed older workers (43%). CONCLUSION: Overall, there was no difference in productivity between older and younger workers. Older workers performed better than younger workers, but had more absenteeism, while presenteeism showed no differences. As ageing has come to workplaces, holistic approaches addressing total health are suggested to overcome the worldwide workforce ageing phenomenon.
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Eficiencia , Presentismo , Absentismo , Anciano , Envejecimiento , Humanos , Lugar de TrabajoRESUMEN
BACKGROUND: Anthropometrics is very important when ensuring a physical match between end users and product or workstations. OBJECTIVES: The purpose of this study are twofold, to provide anthropometric data for the design of products and to examine the secular changes in the adult Chilean workers in a period of more than 20 years. METHODS: Nineteen anthropometric measurements from two samples from 1995 and 2016 were compared using independent t-test (95% confidence interval), where additionally absolute and relative differences were calculated. RESULTS: The secular trend observed for Stature is characterized by an increase average of 20mm and 10.5mm per decade for females and males, respectively. There is a positive secular trend for both genders, which is observed for most of the selected body measurements. The most pronounced increases were onWeight, Shoulder breadth, Body mass index, Popliteal height; Buttock-popliteal length and Hip width. CONCLUSIONS: Segmental dimensions that experienced a positive secular trend, together with Weight and Stature, are highly correlated with seating design, addressing the need to review products targeting Chilean adult workers, such as public transport seats, office furniture or industrial workplaces.
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Diseño Interior y Mobiliario , Instituciones Académicas , Adulto , Antropometría , Estatura , Chile , Diseño de Equipo , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: With the aging of the population, the number of older drivers is on the rise. This poses significant challenges for public health initiatives, as older drivers have a relatively higher risk for collisions. While many studies focus on developing screening tools to identify medically at-risk drivers, little research has been done to develop training programs or interventions to promote, maintain or enhance driving-related abilities among healthy individuals. The purpose of this systematic review is to synopsize the current literature on interventions that are tailored to improve driving in older healthy individuals by working on components of safe driving such as: self-awareness, knowledge, behaviour, skills and/or reducing crash/collision rates in healthy older drivers. METHODS: Relevant databases such as Scopus and PubMed databases were selected and searched for primary articles published in between January 2007 and December 2017. Articles were identified using MeSH search terms: ("safety" OR "education" OR "training" OR "driving" OR "simulator" OR "program" OR "countermeasures") AND ("older drivers" OR "senior drivers" OR "aged drivers" OR "elderly drivers"). All retrieved abstracts were reviewed, and full texts printed if deemed relevant. RESULTS: Twenty-five (25) articles were classified according to: 1) Classroom settings; 2) Computer-based training for cognitive or visual processing; 3) Physical training; 4) In-simulator training; 5) On-road training; and 6) Mixed interventions. Results show that different types of approaches have been successful in improving specific driving skills and/or behaviours. However, there are clear discrepancies on how driving performance/behaviours are evaluated between studies, both in terms of methods or dependent variables, it is therefore difficult to make direct comparisons between these studies. CONCLUSIONS: This review identified strong study projects, effective at improving older drivers' performance and thus allowed to highlight potential interventions that can be used to maintain or improve older drivers' safety behind the wheel. There is a need to further test these interventions by combining them and determining their effectiveness at improving driving performance.
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Prevención de Accidentes/métodos , Accidentes de Tránsito/prevención & control , Envejecimiento/fisiología , Conducción de Automóvil/educación , Cognición/fisiología , Promoción de la Salud/métodos , Anciano , Animales , Femenino , Humanos , Conocimiento , Masculino , RatonesRESUMEN
RESUMEN Introductión El síndrome de apneas e hipopneas obstructivas del sueño (SAHOS) afecta al 2%-4% de las personas adultas. El CPAP es la principal terapia en casos moderados y severos, pero sólo es tolerado en el 50%-70% de los pacientes. La terapia miofuncional orofaríngea (TMO) ayuda a reducir el colapso de la via aérea superior mediante ejercicios de fortalecimiento de la musculatura orofaríngea. En la última década ha demostrado una buena eficacia en grupos variados de pacientes con SAHOS. Objetivo Estudiar efectividad de la TMO en pacientes con SAHOS. Material y método Revisamos retrospectivamente 12 pacientes con SAHOS leve y moderado tratados con TMO. Los datos demográficos y polisomnográficos se analizaron antes y después de la terapia. Resultados Edad media: 65 ±9,0 años, el 58,3% eran mujeres, el 33,3% eran obesos. Observamos una disminución significativa del IAH (13,64 ±1,99 vs 10,13 ±2,09, p =0,008); una mejoría en la eficiencia del sueño, los porcentajes de etapas N3-REM y del índice de microdespertares. También observamos una reducción clínicamente significativa en las puntuaciones de la escala de somnolencia de Epworth, del Mallampatti y el perímetro cervical. Conclusión La TMO fue eficaz en la mayoría de los pacientes con SAHOS leve y moderado. Cada unidad de sueño en centros de salud públicos en Chile debe considerar este tratamiento.
ABSTRACT Introduction The obstructive sleep apnea syndrome (OSA) affects about 2%-4% of adults. CPAP is the first indication to treat moderate and severe cases, however the treatment is tolerated in only 50%-70% of patients. Therapy with myofunctional oropharyngeal (TMO) exercises helps to reduce upper airway collapsibility by strengthening the oropharyngeal musculature, and in the last decades had demonstrated good efficacy in variated groups of OSA patients. Aim: To study TMO effectivity in OSA patients. Material and method: We reviewed retrospectively the clinical records of 12 (7 female) mild and moderate unselected OSA patients. Clinical and polysomnographic data were analyzed before and after TMO. Results: The mean age of patients was 65.0 ±9.0 years and median BMI was 26.7 kg/m2. TMO was associated to a significant reduction in median of Epworth somnolence scale (11.0 vs. 7.0), median apnea hypopnea index (13.4 vs 9.0 events/h), and decrease in cervical circumference. There was a tendency to improve quality of NREM sleep with increases in N3 stage and decrease in arousal index. Conclusion: In a real clinical context, TMO reduced the severity of OSA in 41.6% in the studied patients. Because of its safety and low cost, TMO should be introduced as a therapeutic option in public sleep units in Chile.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Terapia Miofuncional , Apnea Obstructiva del Sueño/terapia , Ronquido , Chile , Polisomnografía , SomnolenciaRESUMEN
RESUMEN La estenosis del conducto auditivo interno con aplasia/hipoplasia del nervio cocleovestibular es una patología muy infrecuente. Suele ser unilateral y puede acompañarse de aplasia/hipoplasia del nervio facial y otras malformaciones del oído interno. Se presentan aquí dos casos clínicos de pacientes pediátricos con estenosis del conducto auditivo interno unilateral con compromiso del séptimo y octavo par craneal ipsilateral. Se describen las historias y evaluaciones clínicas, hallazgos audiovestibulares, hallazgos imagenológicos, tratamientos indicados y sus resultados.
ABSTRACT Congenital internal auditory canal stenosis associated with aplasia/hypoplasia of the cochleovestibular nerve is a very infrequent pathology. It is usually unilateral and may be accompanied by aplasia/hypoplasia of the facial nerve and other malformations of the inner ear. We hereby present two clinical cases of pediatric patients with congenital internal auditory canal stenosis, with involvement of the seventh and eighth ipsilateral cranial nerve. The medical histories and clinical evaluations, audiovestibular findings, imaging findings, treatments and their results are described.
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Humanos , Masculino , Femenino , Niño , Pérdida Auditiva Sensorineural/etiología , Oído Interno/anomalías , Audiometría , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Constricción Patológica/diagnóstico por imagen , Parálisis Facial/etiología , Pérdida Auditiva Sensorineural/diagnóstico por imagenRESUMEN
Objetivo: Analizar las manifestaciones clínicas y evolución de los casos sospechosos o confirmados de Difteria en Venezuela. Materiales y Métodos: Se realizó un estudio prospectivo, observacional, descriptivo, longitudinal y multicentrico en los estados Anzoátegui, Bolívar, Carabobo, Distrito Capital, Lara, Mérida, Miranda y Zulia, se siguieron 48 pacientes sospechosos o confirmados para difteria y se describieron sus características clínicas. Resultados: 54,2 % fueron de sexo femenino, 2 de ellas embarazadas, 1 de ellas falleció. La localización más frecuente de lesiones fue la faríngea, sin embargo se observaron otras como la tonsilar, laringotraqueal, nasal y cutánea. Todos los pacientes recibieron antibióticos pero solo 32 toxina antidiftérica. Solo 11 pacientes tenían esquema vacunal completo y 18 presentaron complicaciones. El 18,8 % de la muestra falleció y el resto egresó sin secuelas. Conclusiones: El brote de difteria en Venezuela sigue activo, las cifras de pacientes afectados invitan a implementar estrategias de control a través de la inmunización de susceptibles, erradicación de portadores asintomáticos, diagnóstico temprano, reporte obligatorio, atención y manejo adecuado de los infectados.
Objective: To analize the clinical manifestations and evolution of suspected or confirmed cases of Diphtheria in Venezuela. Methods: A prospective, observational, descriptive, longitudinal and multicentric study was conducted in the Venezuelan's states of Anzoategui, Bolivar, Carabobo, Capital District, Lara, Merida, Miranda and Zulia. The time 1 of the investigation was at the hospital admission and the final time was at discharge. During the hospitalization, the follow-up was performed. Results: 48 patients were followed and all of them had suspected or confirmed Diphtheria. 45,5 % were men and 54.2 % were female, 2 of them were pregnant, and 1 of them died. The most frequent location of lesions was the pharyngeal, however other location were observed such as tonsillar, laryngotracheal, nasal and cutaneous. All patients received antibiotics but only 32 diphtheria antitoxin. Only 11 patients had a complete vaccination scheme and 18 (36 %) had complications. 18.8 % of the sample died and the rest withdrew without sequelae. Conclusions: The diphtheria outbreak in Venezuela is still active, the number of affected patients invite to implement strategies of control through the immunization of susceptibles, eradication of asymptomatic carriers, early diagnosis, mandatory reporting, care and adequate management of the infected.
RESUMEN
Difteria es una enfermedad infecciosa bacteriana producida por Corynebacterium diphtheriae, es altamente contagiosa, prevenible por vacunas, con importantes complicaciones agudas y alta mortalidad. Objetivo: Describir las características clínicoepidemiológicas y el manejo médico de los pacientes con diagnóstico de Difteria ingresados en el Servicio de Enfermedades Infecciosas del Adulto del Hospital Universitario de Caracas (HUC) en los años 2017 y 2018. Metodología: Estudio de casos, analítico, retrospectivo, de revisión de historias clínicas. Resultados: Ingresaron 27 pacientes de los cuales se encontraron 22 historias clínicas y se excluyeron 2. De los 20 pacientes 13 (65 %) ingresaron en el año 2017 y 7 (35 %) hasta mayo del 2018. Predominó el género masculino 11 (55 %). La mayoría eran procedentes del Distrito Capital 9 (45 %), seguido del estado Miranda 8 (40 %). El promedio de edad fue de 26 años. La mayoría 8 (40 %) no tenían reportes de datos epidemiológicos en la historia clínica, 7 (35 %) negaron viajes recientes, 3 (15 %) estaban vacunados. La mayoría de los pacientes consultaron por fiebre, odinia y odinofagia 13 (65 %), seguido de fiebre y odinia 6 (30 %), el 100 % tuvo membrana blanco grisácea como clínica primaria, seguido de edema de cuello 10 (50 %). La ubicación de las membranas fue más frecuente en amígdalas palatinas 15 (75 %), con 9 casos (45 %) de formas extensivas a úvula, paladar blando y paredes de orofaringe. Las complicaciones al ingreso fueron respiratorias 9 (45 %) y neurológicas 1 (5 %). El tratamiento fue penicilina cristalina en 12 casos (60 %) y antitoxina diftérica (ATD) en el 100 %, la mayoría administrada en las primeras 24 hrs 9 (45 %). Un paciente presentó polineuropatía y 1 falleció por insuficiencia respiratoria. Conclusiones: El HUC es un centro de referencia y es pertinente determinar las características clínico-epidemiológicas y el manejo médico de los pacientes hospitalizados con diagnóstico de difteria, en el contexto de la actual epidemia.
Diphtheria is a bacterial infectious disease caused by Corynebacterium diphtheriae, it is highly contagious, preventable by vaccines, with important acute complications and high mortality. Objective: To describe the clinical-epidemiological characteristics and medical management of patients diagnosed with Diphtheria admitted to the Adult Infectious Diseases Service of the Hospital Universitario de Caracas (HUC) in the years 2017 and 2018. Methodology: Case study, analytical , retrospective, review of medical records. Results: 27 patients were admitted, of which 22 clinical records were found and 2 were excluded. Of the 20 patients, 13 (65%) entered in 2017 and 7 (35%) up to May 2018. The male gender predominated 11 (55 %). Most were from Distrito Capital 9 (45%), followed by Miranda 8 (40%). The average age was 26 years. The majority 8 (40%) had no reports of epidemiological data in the clinical history, 7 (35%) denied recent trips, 3 (15%) were vaccinated. The majority of patients consulted for fever, odinia and odynophagia 13 (65%), followed by fever and odinia 6 (30%), 100% had grayish white membrane as primary clinic, followed by neck edema 10 (50%) . The location of the membranes was more frequent in palatine tonsils 15 (75%), with 9 cases (45%) of extensive forms to the uvula, soft palate and walls of the oropharynx. Complications at admission were respiratory 9 (45%) and neurological 1 (5%). The treatment was crystalline penicillin in 12 cases (60%) and diphtheria antitoxin (DAT) in 100%, the majority administered in the first 24 h 9 (45%). One patient presented polyneuropathy and 1 died due to respiratory failure. Conclusions: The HUC is a reference center and it is pertinent to determine the clinical-epidemiological characteristics and medical management of hospitalized patients diagnosed with diphtheria, in the context of the current epidemic.
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INTRODUCCIÓN Las infecciones de transmisión sexual, incluida el VIH, son un importante problema de salud pública. Cada día más de un millón de personas contraen una infección de transmisión sexual. Los sistemas de salud están buscando soluciones para mejorar la educación y lograr cambios en el comportamiento de las personas para prevenir infecciones de transmisión sexual. Las intervenciones digitales basadas en tecnologías móviles en salud (M-health), en especial las basadas en teléfonos móviles, podrían ser una importante herramienta en salud pública para la prevención de infecciones de transmisión sexual/VIH. Esta revisión sistemática resume la evidencia sobre la efectividad de las intervenciones basadas en teléfonos móviles para la prevención de infecciones de transmisión sexual/VIH. MÉTODOS Y ANÁLISIS El protocolo fue diseñado y será reportado en concordancia con la directriz "Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P)". Se incluirán ensayos controlados aleatorizados que evalúen el efecto de las intervenciones basadas en teléfonos móviles para la prevención de infecciones de transmisión sexual/VIH. Las intervenciones de interés serán aquellas dirigidas a usuarios de teléfonos móviles, basada en cualquier función o aplicación que pueda usarse o enviarse y que hayan sido diseñadas para educar, promocionar o modificar conductas para reducir comportamiento sexual de riesgo y prevención de infecciones de transmisión sexual incluyendo VIH. La búsqueda electrónica para identificar los estudios se realizará en el Registro Cochrane Central de ensayos controlados (CENTRAL), en EMBASE y MEDLINE/PubMed. Se evaluará el riesgo de sesgo utilizando la herramienta recomendada por la colaboración Cochrane. Se realizará metanálisis y se presentarán los datos mediante el método GRADE.
INTRODUCTION Sexually transmitted infections, including HIV, are an important public health problem. Every day, over one million persons become infected with a sexually transmitted infection (STI). Health systems are searching for solutions to improve sex education and change the sexual behavior of people in order to prevent them. In public health, digital interventions based on mobile health technologies (M-health), especially those based on mobile phones, might be a crucial tool for the prevention of STIs and HIV. This systematic will review and summarize the evidence on the effectiveness of mobile phone-based interventions for the prevention of STIs and HIV. METHODS AND ANALYSIS The protocol was designed and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The protocol will include randomized controlled trials that assess the effect of interventions based on mobile phones for the prevention of STIs/HIV. The interventions of interest will be those targeting mobile phone users and should consist of providing information by mobile phone through any function or application that can be used or sent to, and that has been designed to educate, promote or modify sexual behaviors and prevent STIs, including HIV. The data sources to identify these studies will be the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and MEDLINE. The risk of bias will be assessed using the tool recommended by Cochrane. Finally, a meta-analysis will be done and data will be presented following the GRADE method.
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Humanos , Educación Sexual/métodos , Enfermedades de Transmisión Sexual/prevención & control , Teléfono Celular , Revisiones Sistemáticas como Asunto , Infecciones por VIH/prevención & control , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: Despite offering many benefits, direct manual anthropometric measurement method can be problematic due to their vulnerability to measurement errors. OBJECTIVE: The purpose of this literature review was to determine, whether or not the currently published anthropometric studies of school children, related to ergonomics, mentioned or evaluated the variables precision, reliability or accuracy in the direct manual measurement method. METHODS: Two bibliographic databases, and the bibliographic references of all the selected papers were used for finding relevant published papers in the fields considered in this study. RESULTS: Forty-six (46) studies met the criteria previously defined for this literature review. However, only ten (10) studies mentioned at least one of the analyzed variables, and none has evaluated all of them. Only reliability was assessed by three papers. Moreover, in what regards the factors that affect precision, reliability and accuracy, the reviewed papers presented large differences. This was particularly clear in the instruments used for the measurements, which were not consistent throughout the studies. Additionally, it was also clear that there was a lack of information regarding the evaluators' training and procedures for anthropometric data collection, which are assumed to be the most important issues that affect precision, reliability and accuracy. CONCLUSIONS: Based on the review of the literature, it was possible to conclude that the considered anthropometric studies had not focused their attention to the analysis of precision, reliability and accuracy of the manual measurement methods. Hence, and with the aim of avoiding measurement errors and misleading data, anthropometric studies should put more efforts and care on testing measurement error and defining the procedures used to collect anthropometric data.
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Antropometría/métodos , Ergonomía/métodos , Estudiantes/estadística & datos numéricos , Universidades/normas , Exactitud de los Datos , Humanos , Reproducibilidad de los Resultados , Universidades/organización & administración , Universidades/estadística & datos numéricosRESUMEN
BACKGROUND: Hypoestrogenic (HE) women are one of the most vulnerable groups for the development of obesity and its complications. Capsaicin and exercise have demonstrated to reduce body weight and to improve insulin sensitivity in different animal models, but it is unknown whether their combination could be useful in HE obese females. METHODS: We investigated whether topical capsaicin, exercise or their combination had better therapeutic effects in an obesity-hypoestrogenism model. Ovariectomized Wistar rats were given a 30% sucrose solution (HE-Obese (HEOb)) or purified water (HE) during 28 weeks ad libitum; four experimental groups per each condition. After shaving the abdominal skin, cold cream vehicle was applied to the Sedentary groups (Sed) and capsaicin cream 0.075% (0.6 mg kg-1 per day) to the Capsaicin groups (Cap). Exercise (Ex) groups ran on a treadmill every day for 20 min at speeds from 9 to 18 m per min increased every 10 days; combination groups (Cap+Ex) were given topical capsaicin 90 min before exercise. The treatments were performed for 6 weeks, and caloric intake and body weight were monitored. At the end of the experimental protocol, glucose tolerance tests were performed, the animals were killed by decapitation; blood and organs were obtained to perform oxidative profile, histology, biochemical analyses and Western blot. RESULTS: In HEOb rats, the combined therapy reduced caloric intake, body weight and abdominal fat in a higher proportion than the individual treatments; it also decreased insulin resistance (IR), oxidative stress and pancreatic islet size. It was the only treatment that significantly increased p-AMPK levels in the soleus muscle. In HE rats, topical capsaicin was the only treatment that reduced glucose intolerance and improved the oxidative profile in a higher proportion than the combined therapy or Ex alone. CONCLUSIONS: Capsaicin per se or its combination with moderate exercise could be a useful therapy against complications linked to obesity-IR in HE females.
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Peso Corporal/efectos de los fármacos , Capsaicina/administración & dosificación , Capsaicina/farmacología , Estrógenos/deficiencia , Resistencia a la Insulina/fisiología , Obesidad/metabolismo , Estrés Oxidativo/efectos de los fármacos , Condicionamiento Físico Animal/fisiología , Administración Tópica , Animales , Modelos Animales de Enfermedad , Estrógenos/metabolismo , Femenino , Ovariectomía , Ratas , Ratas WistarRESUMEN
En el presente escrito abordaremos la experiencia del parto vivenciada por una importante cantidad de mujeres que optaron, en un determinado momento del estado de gravidez o ya iniciado el trabajo de parto, dar a luz en el Hospital Materno-Infantil San Agustín de Valparaíso, dejando atrás la ayuda prestada por la empírica partera; portadora de un acervo sociocultural aceptado y respaldado aún por las autoridades e instituciones del período. Más que ahondar en detalles relativos al contexto epocal, nos centraremos en mostrar los resultados alcanzados a partir del análisis de la información suministrada por las fuentes estudiadas (Boletines Clínicos y Estadísticos de la Maternidad). Resultados que nos hablarán del estado físico presentado por los recién nacidos, La cantidad de embarazos y partos experimentados por las gestantes antes de la actual atención, las ciudades de procedencia de las parturientas, entre otras consideraciones de índole descriptiva. Es así como las fi chas clínicas nos remitirán a la asistencia médica de más de 5.000 mujeres que decidieron aceptar un tipo de ayuda profesional que solo se encontraba cuando se recurría a una sala de maternidad como la construida en el San Agustín al fi nalizar la década de 1880, en los inicios de la medicalización del parto.
In this paper we will address the experience of childbirth experienced by a signifi cant number of women who chose to, at one point of the pregnancy state or already started the labor, give birth at the San Agustín maternal and child Hospital of Valparaíso, leaving behind support provided by the empirical midwife; bearer of a socio-cultural heritage accepted and still endorsed by the authorities and institutions of the period. Rather than delve into details of the epochal context, we will focus on showing the results obtained from the analysis of information provided by the studied sources (Clinical and Statistical Bulletins of Motherhood). Results that will show us the physical condition presented by the newborn, number of pregnancies and births experienced by pregnant women before the current attention, precedence of the parturients, among others descriptive considerations. That is how the medical records will send us to the medical care of over 5000 women that accepted, one kind of professional help, found only when it involved a maternity ward as the built in San Agustín at the end of 1880, at the beginning of the medicalization of childbirth.
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Historia del Siglo XIX , Hospitales/historia , Parto Obstétrico/estadística & datos numéricos , Parto Obstétrico/historia , Servicios de Salud Materno-Infantil , ChileRESUMEN
El sistema de Pelvic Organ Prolapse Quantification (POPQ) ha demostrado ser útil, fácil de aprender, rápido de realizar y con una buena confiabilidad intra e interobservador. Quisimos comenzar a aplicar este tipo de clasificación y compararla con la clasificación clásica de Baden y Walker descrita en la ficha clínica. Para esto se realizó un estudio observacional de 41 pacientes en que se comparó el sistema tradicional consignado en la ficha, con la medición de nueve puntos que utiliza el sistema POPQ. En 17 por ciento de los casos ambos sistemas coincidieron en el diagnóstico del descenso de todos los elementos del prolapso: pared anterior, posterior y cuello uterino. El sistema POPQ permite un diagnóstico acabado del estado y magnitud del descenso de los órganos pelvianos.
The Pelvic Organ Prolapse Quantification (POPQ) System has proved to be a good method for describing and quantifying pelvic organ prolapse. The objective of this observational study was to compare the classification consigned in the clinical records (Baden and Walker classification) with the new POPQ system. In the first 41 cases we proceed to evaluate our patients by mean of the POPQ system. In only 17 percent of the cases the two systems agreed in the diagnosis of the anterior, posterior and cervix descents. POPQ system allows an acute diagnosis of the state and magnitude of the descent of pelvic organs.
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Examen Físico/métodos , Prolapso Uterino/clasificación , Antropometría , Chile/epidemiología , Prolapso Uterino/diagnóstico , Diafragma Pélvico/anatomía & histología , Diafragma Pélvico/patologíaRESUMEN
Gabriel Cano de Aponte was Governor of Chile since 1717 and until his death in 1733, being 68 years old. As a soldier, he was an experienced horse rider. The sequence of events that caused his death three months after an equestrian accident is unclear. A systematic clinical analysis of the latter is the main objective of this review. Historians have documented Cano de Aponte's "inclination for unbridled fun and equestrian exercises". During a holiday Cano de Aponte suffered a horse fall and subsequent crushing by the latter. It has been stated that a spinal lesion caused by the accident kept him bedridden for a period of three months, clear in reason and with intense pain, before his death. However, there is no evidence on historic data that conveys any typical sign associated with spinal injury following the accident. Therefore we suggest that Cano de Aponte suffered a complex pelvic ring fracture. The fact that he was prostrated, lucid, but suffered an intense pain best sustains the hypothesis of a pelvic fracture. After the initial period, one of the most common causes of death resulting from a pelvic fracture is deep venous thrombosis with secondary pulmonary thromboembolism. This must have been the sequence of events that most probably caused Cano de Aponte's death.
Asunto(s)
Traumatismos en Atletas/historia , Traumatismos de la Médula Espinal/historia , Chile , Historia del Siglo XVIIIRESUMEN
Gabriel Cano de Aponte was Governor of Chile since 1717 and util his death in 1733, being 68 years old. As a soldier, he was an experimented horse rider. The sequence ofevents that caused his death three months after an equestrian accident are unclear. A systematic clinical analysis of the later is the main objective of this review. Historians have documented Cano de Aponte's "inclination for unbridled fun and equestrian exercises". During a holiday Cano de Aponte suffered a horse fall and subsequent crushing by the latter. It has been stated that a spinal lesion caused by the accident kept him bedridden for a period of three months, clear in reason and with intense pain, before his death. However, there is no evidence on historie data that conveys any typical sign associated to spinal injury following the accident. Therefore we suggest that Cano de Aponte suffered a complex pelvic ring fracture. The fact that he was prostrated, lucid, but suffered and intense pain best sustains the hypothesis of a pelvic fracture. After the initial period, one ofthe most common causes of death resulting from a pelvic fracture is deep venous thrombosis with secondary pulmonary thromboembolism. This must have been the sequence ofevents that most probably caused Cano de Aponte's death).
Asunto(s)
Historia del Siglo XVIII , Traumatismos en Atletas/historia , Traumatismos de la Médula Espinal/historia , ChileRESUMEN
BACKGROUND/AIMS: It was the aim of this study to evaluate the relationships between sweetened beverage (SB) consumption and the following indicators of overweight/fatness among Mexican adolescents: body mass index, body composition and body fat distribution. METHODS: We performed a cross-sectional analysis of data from adolescents participating in the baseline assessment of the Health Workers Cohort Study. Information on sociodemographic conditions, sexual maturation, dietary patterns and physical activity was collected via self-administered questionnaires. SB consumption was evaluated through a validated semiquantitative food frequency questionnaire. Anthropometric measures were assessed with standardized procedures. The associations of interest were evaluated by means of multivariate regression and logistic regression models. RESULTS: A total of 1,055 adolescents, 10-19 years old (mean age 14.5+/-2.5 years), were evaluated. The overweight/obesity prevalence was 31.6% among girls and 31.9% among boys. We found that for each additional SB serving consumed daily, the subject's body mass index increased by on average 0.33 (p<0.001). Subjects consuming 3 daily servings of SB face a 2.1 times greater risk of proportionally excess body fat than those who consume less than 1 SB a day. CONCLUSIONS: Our data support the hypothesis that the consumption of SB increases the risk of overweight and/or obesity and encourages excess body fat and central obesity in Mexican adolescents.
Asunto(s)
Tejido Adiposo/metabolismo , Bebidas , Composición Corporal/fisiología , Sacarosa en la Dieta/administración & dosificación , Obesidad/epidemiología , Sobrepeso/epidemiología , Adolescente , Análisis de Varianza , Índice de Masa Corporal , Niño , Estudios de Cohortes , Estudios Transversales , Sacarosa en la Dieta/efectos adversos , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Modelos Logísticos , Masculino , México/epidemiología , Obesidad/etiología , Sobrepeso/etiología , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Introducción: Los síntomas y trastornos depresivos y ansiosos en adolescentes son un problema de salud relevante, con implicaciones tanto inmediatas como en el desarrollo posterior de los jóvenes. Objetivo: Estimar la prevalencia de síntomas y síndromes depresivos y ansiosos en una muestra representativa de adolescentes. Muestra y Método: Se evaluó una muestra de 700 adolescentes de la comuna de Concepción, representativos de los cuatros niveles de la enseñanza media, utilizando la versión actualizada del Inventario de Depresión de Beck (BDI-II) y el Inventario de Ansiedad de Beck (BAI). Resultados: Se obtuvo una cifra de prevalencia de síndrome depresivo de 32,6 por ciento y de síndrome ansioso de 42,3 por ciento. Conclusiones: Las tasas obtenidas son concordantes con otros estudios realizados en Chile, y claramente más altas que las encontradas en estudios realizados en muestras semejantes en otros países. Es necesario entender mejor las causas e implicaciones de estos altos niveles de malestar emocional en nuestros adolescentes. Desde un punto de vista más aplicado, es clara la importancia de fortalecer estrategias destinadas a mejorar el nivel de bienestar emocional de éstos.
Asunto(s)
Masculino , Femenino , Adolescente , Adulto , Humanos , Inventario de Personalidad , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Chile , Prevalencia , Psicometría , Distribución por Sexo , Factores Socioeconómicos , Estudiantes , Encuestas y CuestionariosRESUMEN
Antecedentes. El trauma es la causa número uno de muertes en jóvenes y el traumatismo torácico es responsable del 25 por ciento. Objetivo. Analizar clínica, trauma score revisado de triage (TSRt), injurry severity score (ISS), morbimortalidad y terapéutica en un hospital regional polivalente. Lugar de aplicación. Servicio de Cirugía. Hospital General polivalente. Diseño. Retrospectivo. Población. Se analizaron 126 pacientes tratados quirúrgicamente en el período 01/12/1998-28/02/2005 con herida cardiotorácica penetrante. Materiales y métodos. Se analizaron edad, sexo, etiología, modalidad traumática, región torácica afectada, signos y síntomas, diagnóstico, tratamiento quirúrgico, lesiones asociadas, estadía hospitalaria, categorización, morbilidad y mortalidad. Resultados. Edad promedio 28 años. Masculino 91,2 por ciento. Arma blanca 71,4 por ciento. Hemoneumotórax 51 por ciento, hemotórax 32,5 por ciento, neumotórax 16,6 por ciento. El avenamiento pleural como tratamiento definitivo 82,4 por ciento, el 11 por ciento requirió toracotomía amplia. Estadía hospitalaria 7 días. Herida cardíaca 6,3 por ciento (n=8). Lesiones asociadas 38,8 por ciento. TSRt 11 puntos. ISS 13 puntos. Morbilidad 18,2 por ciento. Mortalidad 1,5 por ciento. Conclusiones. En el área correspondiente al área geográfica analizada, las personas más afectadas fueron jóvenes varones. La etiología más frecuente fue herida única de arma blanca. No hubieron diferencias significativas entre las incidencias correspondientes a las regiones torácicas y toraco-abdominal. El drenaje pleural por toracotomía mínima fue el tratamiento de elección y definitivo en la mayoría de nuestros pacientes. Los resultados del algoritmo diagnóstico terapéutico utilizado son comparables a los de otras publicaciones. Las heridas cardíacas representaron el 6,3 por ciento. La morbimortalidad fue la esperada acorde a la categorización de los pacientes. Los scores en trauma utilizados fueron útiles para predecir la probabilidad de supervivencia (AU)
Asunto(s)
Masculino , Adulto , Humanos , Femenino , Niño , Adolescente , Persona de Mediana Edad , Anciano , Heridas Penetrantes/cirugía , Traumatismos Torácicos/cirugía , Lesiones Cardíacas/cirugía , Algoritmos , Estudios Retrospectivos , Procedimientos Quirúrgicos Torácicos , Taponamiento Cardíaco/cirugía , Taponamiento Cardíaco/diagnóstico por imagenRESUMEN
Antecedentes. El trauma es la causa número uno de muertes en jóvenes y el traumatismo torácico es responsable del 25 por ciento. Objetivo. Analizar clínica, trauma score revisado de triage (TSRt), injurry severity score (ISS), morbimortalidad y terapéutica en un hospital regional polivalente. Lugar de aplicación. Servicio de Cirugía. Hospital General polivalente. Diseño. Retrospectivo. Población. Se analizaron 126 pacientes tratados quirúrgicamente en el período 01/12/1998-28/02/2005 con herida cardiotorácica penetrante. Materiales y métodos. Se analizaron edad, sexo, etiología, modalidad traumática, región torácica afectada, signos y síntomas, diagnóstico, tratamiento quirúrgico, lesiones asociadas, estadía hospitalaria, categorización, morbilidad y mortalidad. Resultados. Edad promedio 28 años. Masculino 91,2 por ciento. Arma blanca 71,4 por ciento. Hemoneumotórax 51 por ciento, hemotórax 32,5 por ciento, neumotórax 16,6 por ciento. El avenamiento pleural como tratamiento definitivo 82,4 por ciento, el 11 por ciento requirió toracotomía amplia. Estadía hospitalaria 7 días. Herida cardíaca 6,3 por ciento (n=8). Lesiones asociadas 38,8 por ciento. TSRt 11 puntos. ISS 13 puntos. Morbilidad 18,2 por ciento. Mortalidad 1,5 por ciento. Conclusiones. En el área correspondiente al área geográfica analizada, las personas más afectadas fueron jóvenes varones. La etiología más frecuente fue herida única de arma blanca. No hubieron diferencias significativas entre las incidencias correspondientes a las regiones torácicas y toraco-abdominal. El drenaje pleural por toracotomía mínima fue el tratamiento de elección y definitivo en la mayoría de nuestros pacientes. Los resultados del algoritmo diagnóstico terapéutico utilizado son comparables a los de otras publicaciones. Las heridas cardíacas representaron el 6,3 por ciento. La morbimortalidad fue la esperada acorde a la categorización de los pacientes. Los scores en trauma utilizados fueron útiles para predecir la probabilidad de supervivencia