RESUMEN
Abstract: Focal fibrous hyperplasia (FFH) is an oral mucosal localized non-neoplastic enlargement representing a reaction to chronic local irritations or injuries. The purpose of this report is to describe the management of an asymptomatic fibrotic lesion located in the tongue, in a preschooler boy. A 7-year-6-month old boy attended our clinic for the evaluation of an exophytic pedunculated tumor-like round mass located in the dorsal surface of the tongue. Based on the initial examination and the natural history of the lesion, the presumptive clinical diagnosis determined an irritation FFH. The lesion was surgically excised with a diode laser device, and the postoperative period evolution occurred without any complication. The appropriate treatment of FFH in children initially consists of the removal of local irritant factors. Excellent oral hygiene maintenance and close follow-up care are strongly suggested. Surgical excision is the most frequent modality for persistent lesions. Early diagnosis and proper management of FFH can reduce the risk of future recurrences or complications.
Resumen: La hiperplasia fibrosa focal (HFF) es un agrandamiento no neoplásico localizado en la mucosa oral que representa una reacción a irritaciones o lesiones locales crónicas. El propósito de este informe es describir el tratamiento de una lesión fibrótica asintomática ubicada en la lengua, en un niño en edad preescolar. Un niño de 7 años y 6 meses de edad asistió a nuestra clínica para la evaluación de una masa redonda exofítica y pedunculada con forma de tumor ubicada en la superficie dorsal de la lengua. Basado en el examen inicial y la historia natural de la lesión, el diagnóstico clínico presuntivo determinó una irritación HFF. La lesión se extirpó quirúrgicamente con un láser de diodo, y la evolución en el período postoperatorio se produjo sin ninguna complicación. El tratamiento apropiado de HFF en niños inicialmente consiste en la eliminación de factores irritantes locales. Se recomienda un excelente mantenimiento de la higiene bucal y una estrecha atención de seguimiento. La escisión quirúrgica es la modalidad más frecuente para lesiones persistentes. El diagnóstico temprano y el manejo adecuado de la HFF pueden reducir el riesgo de futuras recurrencias o complicaciones.
Asunto(s)
Humanos , Masculino , Niño , Fibrosis de la Submucosa Bucal/cirugía , Lengua/cirugíaRESUMEN
The objective of this study was to evaluate the effects of the energy restriction of gestation of adult ewes from day 45 to day 115 on lamb live performance parameters, carcass and meat traits. In experiment I, dietary energy was restricted at 70% of the metabolizable energy (ME) requirements, after which ewes were re-fed ad libitum until lambing. In experiment II, dietary energy was restricted at 60% of the ME requirements, and ewes were re-fed to ME requirements until lambing. All ewes grazed together from the end of the restriction periods to weaning. Lambs were weaned and lot fed until slaughter. Feed intake, weight gain and feed efficiency were recorded, and body fat thickness and ribeye area (REA) were measured in the longissimus thoracis muscle. After slaughter, carcass weight and yield, fat depth, carcass and leg length, and frenched rack and leg weights and yields were determined. Muscle fiber type composition, Warner-Bratzler shear force, pH and color were determined in the longissimus lumborum muscle. In experiment I, energy restriction followed by ad libitum feeding affected lamb birth weight (P0.05) were observed on later BW, REA, BF or carcass traits. Lambs born to non-restricted-fed ewes had higher (P<0.05) weight and yield of the frenched rack cut and their meat tended (P=0.11) to be tender compared with that of lambs from restricted ewes. The percentage of oxidative muscle fibers was lower for lambs born to non-restricted ewes (P<0.05); however, no effects of ewe treatment were observed on other muscle fiber types. For experiment II, energy restriction followed by ME requirements feeding, affected (P<0.01) pre-weaning live weight gain, weaning and final weights. Lambs from restricted ewes had higher (P<0.05) feed intake as % of leg weight and a trend to be less efficient (P=0.16) than lambs from unrestricted dams. Ribeye area and BF were not influenced by treatment. Treatment significantly affected slaughter weight, but had no effects on carcass yield and traits or on meat traits. The results obtained in both experiments indicate submitting ewes to energy restriction during gestation affects the performance of their progeny but the final outcome would depend on the ewe's re-feeding level during late gestation and the capacity of the offspring to compensate the in utero restriction after birth.
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Ingestión de Alimentos , Ingestión de Energía , Carne Roja/normas , Ovinos/fisiología , Alimentación Animal , Animales , Animales Recién Nacidos/crecimiento & desarrollo , Peso al Nacer , Dieta/veterinaria , Femenino , Fibras Musculares Esqueléticas/fisiología , Fenotipo , Embarazo , Ovinos/crecimiento & desarrollo , Destete , Aumento de PesoRESUMEN
To compare the reproductive performance after TAI in ewes synchronized with mid (12 or 13) or long (14-16 d) interval prostaglandin (PG) or progesterone plus eCG (P4-eCG) based protocols, 440 multiparous Corriedale ewes were synchronized with two PG injections administered 12-16 d apart (PG12, PG13, PG14, PG15 and PG16 respectively), or P4-eCG (MAP sponges 14 d and eCG). Cervical TAI (Day 0) was performed with fresh semen. It was evaluated the ovulated ewes (OE, %) and the ovulation rate (OR) on Day 8 by trans-rectal ultrasonography, the rate of non-return to service between Days 13 and 21 by painted rams, and the pregnancy rate, prolificacy and fecundity on Day 60 by trans-abdominal ultrasonography. No significant differences were found in OE among groups (P>0.05), but P4-eCG achieved higher OR (P<0.05) compared to PG protocols, without differences among them (P>0.05). Similar NRR-21, pregnancy and fecundity were observed among PG15 (64.3, 62.9 and 84.3), PG16 (59.7, 59.7 and 77.8) and P4-eCG (70.3, 66.2 and 95.9), but higher compared to PG12 (42.5, 39.7 and 52.1) and PG13 group (44.0, 40.0 and 48.0, respectively; P<0.05). PG14 achieved intermediate results compared to other groups. No differences were found in prolificacy among groups (P>0.05), except PG13 that was lower compared to P4-eCG (P<0.05). In conclusion, long interval between PG injections (15 or 16 d) determined better reproductive outcome that mid interval (12 or 13 d), equating the P4-eCG based protocol after cervical TAI with fresh semen during the breeding season in sheep.
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Dinoprost/análogos & derivados , Inseminación Artificial/veterinaria , Prostaglandinas F Sintéticas/farmacología , Ovinos/fisiología , Administración Intravaginal , Animales , Gonadotropina Coriónica , Dinoprost/administración & dosificación , Dinoprost/farmacología , Esquema de Medicación , Femenino , Acetato de Medroxiprogesterona/administración & dosificación , Acetato de Medroxiprogesterona/farmacología , Embarazo , Progesterona/farmacología , Prostaglandinas F Sintéticas/administración & dosificaciónRESUMEN
The objective of this experiment was to study the reproductive performance obtained after a short-interval prostaglandin (PG) F2α-based protocol for timed artificial insemination (TAI) in sheep (Synchrovine®: two injections of PG 7 d apart), including a GnRH analogue at 24 or 36h after the second PG injection. The experiment involved 296 Corriedale ewes (206 multiparous and 90 nulliparous) grazing natural pastures during the breeding season (March-April; UTU "La Carolina", Flores Uruguay, 33° S-57° W). Ewes were assigned to three treatment groups: a) Synchrovine® (Control, n=101): two injections of D-Cloprostenol 75µg, 7 d apart, b) Synchrovine®+GnRH24 (n=98): Synchrovine® plus GnRH (busereline acetate 8.4µg) 24h after the second PG injection, and c) Synchrovine®+GnRH36 (n=97): Synchrovine® plus GnRH 36h after the second PG injection. All ewes were subjected to cervical TAI (Day 0), 44 to 47h after second PG injection, with fresh extended semen pool from six rams. Reproductive performance of ewes having ovulations and ovulation rate on Day 10, estrous cycle length in ewes that returned to estrus and non-return rate to estrus up to Day 22, fertility, prolificacy and fecundity on Day 70 were analyzed. Ewes having ovulations, ovulation rate, estrous cycle length and prolificacy did not differ between groups (P>0.05). However, non-return to estrus, fertility and fecundity was decreased in Synchrovine®+GnRH24 (P<0.05) and similar between Synchrovine® and Synchrovine®+GnRH36 (P>0.05). It was concluded that the reproductive performance obtained by Synchovine® TAI protocol was impaired by GnRH at 24h and not improved by GnRH administered at 36h after the second PG injection.
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Dinoprost/administración & dosificación , Hormona Liberadora de Gonadotropina/administración & dosificación , Inseminación Artificial/métodos , Reproducción/efectos de los fármacos , Oveja Doméstica , Animales , Esquema de Medicación , Sincronización del Estro/métodos , Femenino , Fármacos para la Fertilidad Femenina/administración & dosificación , Inseminación Artificial/veterinaria , Masculino , Inducción de la Ovulación/métodos , Inducción de la Ovulación/veterinaria , Reproducción/fisiología , Oveja Doméstica/fisiología , Resultado del TratamientoRESUMEN
The objective was to improve the reproductive performance of a prostaglandin (PG) F(2α)-based protocol for timed artificial insemination (TAI) in sheep (Synchrovine®: two doses of 160 µg of delprostenate 7 d apart, with TAI 42 h after second dose). Three experiments were performed: Experiment 1) two doses of a PGF(2α) analogue (delprostenate 80 or 160 µg) given 7 d apart; Experiment 2) two PGF(2α) treatment intervals (7 or 8 d apart) and two times of TAI (42 or 48 h); and Experiment 3) insemination 12 h after estrus detection or TAI with concurrent GnRH. Experiments involved 1131 ewes that received cervical insemination with fresh semen during the breeding season (32/34 °S-58 °W). Estrous behaviour, conception rate, prolificacy, and fecundity (ultrasonography 30-40 d), were assessed. In Experiment 1, ewes showing estrus between 25 and 48 h or at 72 h after the second PGF(2α) did not differ between 80 and 160 µg of delprostenate (73 vs 86%, P = 0.07; and 92 vs 95%, P = NS, respectively). Conception rate and fecundity were lower (P < 0.05) using 80 vs 160 µg (0.24 vs 0.42, and 0.27 vs 0.47, respectively). In Experiment 2, giving PGF(2α) 7 d apart resulted in higher (P < 0.05) rates of conception (0.45 and 0.51) and fecundity (0.49 and 0.53) than treatments 8 d apart (conception: 0.33 and 0.29; fecundity: 0.33 and 0.34) for TAI at 42 and 48 h, respectively. In Experiment 3, rates of conception, prolificacy and fecundity were similar (NS) between Synchrovine® with TAI at 42 h (0.50, 1.13, and 0.56) and AI 12 h after estrus detection (0.47, 1.18, and 0.55), and Synchrovine® plus GnRH at TAI (0.38, 1.28, and 0.49). However, all TAI treatments had lower (P < 0.05) prolificacy and fecundity compared to AI following detection of spontaneous estrus (1.39 and 0.83, respectively). In conclusion, the Synchrovine® protocol was: a) more successful using 160 vs 80 µg delprostenate; b) more successful with a 7 d than 8 d PGF(2α) interval; c) similarly effective for TAI versus AI 12 h after estrus detection; and d) not improved by giving GnRH at TAI.
Asunto(s)
Dinoprost/análogos & derivados , Dinoprost/farmacología , Sincronización del Estro/métodos , Fármacos para la Fertilidad Femenina/farmacología , Inseminación Artificial/veterinaria , Prostaglandinas F Sintéticas/farmacología , Ovinos/fisiología , Animales , Dinoprost/administración & dosificación , Femenino , Fármacos para la Fertilidad Femenina/administración & dosificación , Inseminación Artificial/métodos , Embarazo , Índice de Embarazo , Prostaglandinas F Sintéticas/administración & dosificación , Factores de TiempoRESUMEN
Two experiments were conducted to determine the effects of prostaglandin administration on ovarian follicular dynamics, conception, prolificacy, and fecundity in sheep. During the breeding season, multiparous Corriedale ewes were randomly allocated to two groups: 1) PG group (n = 15 and n = 135 in Experiments I and II, respectively): synchronized with two injections of DL-Cloprostenol (125 µg) given 7 d apart, and inseminated at a fixed time (Day 0), 48 h after the second injection; and 2) Control group (n = 15 and n = 73 in Experiments I and II): ewes in spontaneous estrus inseminated at detected estrus. Ewes received 100 × 10(6) sperm by intrauterine AI. Ultrasonography was used to evaluate growth of the ovulatory follicle, ovulation rate (OR), conception rate, and prolificacy on Days 30 and 60. Ewes from the group PG had a larger (4.8 ± 0.5 mm, mean ± SEM; P < 0.05) ovulatory follicle that grew faster (1.2 ± 0.3 mm/d, P = 0.08), and a lower OR (1.37 ± 0.1, P < 0.05), compared to ewes from the Control group (3.9 ± 0.2 mm, 0.7 ± 0.2 mm/d, and 1.61 ± 0.1 respectively). Plasma progesterone concentrations from Days -6 to 1 were lower in the PG group (P < 0.05), but plasma estradiol concentrations were similar between groups (P > 0.05). Progesterone concentrations were similar between groups during the early luteal phase and on Days 12 and 17 (P > 0.05). The embryo recovery rate (Day 7) tended to be lower in the PG group (39 vs 64%, P = 0.08), but embryo quality did not differ between groups. Conception, prolificacy and fecundity, were lower in the PG than in the Control group (P < 0.05). Cumulative reproductive losses were similar between groups, but more twins were lost in the PG group (P < 0.05). We concluded that in ewes synchronized with PGF(2α) given twice, 7 d apart, lower reproductive performance was associated with an environment dominated by lower progesterone concentrations that stimulated the preovulatory follicle to grow faster and become larger; this was associated with lower rates of ovulation, conception, prolificacy, and fecundity.
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Cloprostenol/farmacología , Luteolíticos/farmacología , Folículo Ovárico/efectos de los fármacos , Folículo Ovárico/fisiología , Ovinos/fisiología , Animales , Estradiol/sangre , Femenino , Fertilidad/efectos de los fármacos , Fertilidad/fisiología , Inseminación Artificial/veterinaria , Masculino , Folículo Ovárico/diagnóstico por imagen , Embarazo , Progesterona/sangre , Distribución Aleatoria , UltrasonografíaRESUMEN
The objective was to compare the reproductive performance of a new PGF(2α)-based timed artificial insemination (TAI) protocol in sheep (Synchrovine®: two doses of PGF(2α), 7 d apart) to a traditional progesterone-eCG (P4-eCG) protocol, considering the effects of seminal state, AI-times, and AI-pathway. Three experiments involving 1297 multiparous Australian Merino ewes were done during the physiologic breeding season (location 32 °S-57 °W). Reproductive performance was assessed as non-return rate to service 21 d after AI (NRR21d), based on detection with androgenized wethers, as well as Fertility (pregnant/inseminated ewes), Prolificacy (fetuses/pregnant ewe), and Fecundity (fetuses/inseminated ewe), which were based on transabdominal ultrasonography 50 d after TAI. In Experiment 1, Synchrovine® treated ewes TAI cervically with fresh semen at 42, 48, or 54 h had similar NRR21d (0.51, 0.46, 0.57), Fertility (0.27, 0.31, 0.26), and Fecundity (0.29, 0.32, 0.27), all of which were lower (P < 0.05) than in a control P4-eCG group inseminated at 54 h (0.61, 0.48, 0.52, NRR21d, Fertility and Fecundity respectively). In Experiment 2, using chilled semen and cervical TAI, Synchrovine® treated ewes inseminated at 42 h yielded lower (P < 0.05) NRR21d, Fertility and Fecundity (0.28, 0.06, 0.06) compared to 48 (0.43, 0.24, 0.24) and 54 h (0.44, 0.22, 0.23). In Experiment 3 with chilled semen, Synchrovine® treated ewes TAI into the cervix at 51 or 57 h were similar in NRR21d (0.16 vs 0.20), Fertility (0.12 vs 0.14), and Fecundity (0.12 vs 0.15), respectively; but lower (P < 0.05) than P4-eCG treated ewes TAI at 54 h (0.34, 0.28, and 0.33 for NRR21d, Fertility and Fecundity respectively). Synchrovine® treated ewes intrauterine TAI at 51 or 57 h yielded similar NRR21d (0.51 vs 0.58), Fertility (0.43 vs 0.51), and Fecundity (0.45 vs 0.56) respectively, but lower (P < 0.05) results compared to P4-eCG treated ewes (0.75, 0.71, and 0.88 for NRR21d, Fertility and Fecundity respectively). In conclusion, AI-time in Synchrovine® treated ewes with fresh semen might be extended (42 to 54 h after the second PGF(2α)), but should be delayed to 48-54 h with chilled semen and cervical AI. Independent of the seminal state, AI-time or AI-pathway, Synchrovine® yielded lower reproductive results than a conventional P4-eCG protocol.
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Dinoprost/administración & dosificación , Sincronización del Estro/métodos , Inseminación Artificial/veterinaria , Progesterona/administración & dosificación , Ovinos , Animales , Esquema de Medicación , Femenino , Fertilidad/efectos de los fármacos , Fertilidad/fisiología , Fármacos para la Fertilidad Femenina/administración & dosificación , Inseminación Artificial/métodos , Masculino , Embarazo , Índice de Embarazo , Ovinos/fisiología , Factores de TiempoRESUMEN
This study aimed at comparing in vitro, ultra-heat-treated (UHT) skim milk and INRA-96(®) -based extenders supplemented or not with 5% egg yolk and/or 2% glycerol on sperm quality parameters along 72 h of preservation at 5 °C, using a factorial design. Semen from six healthy mature Merino rams was pooled and extended in each medium using a split sample procedure (six replicates) and chilled. Subjective motility (SM) (%), membrane integrity (MI) (%) and uncapacitated spermatozoa (US) (× 10(6) spermatozoa/AI dose) were used to assess the semen quality at 0, 12, 24, 48 and 72 h of preservation. UHT-based extenders yielded better (p<0.05) SM and MI than INRA-96(®) -based extenders (59.7% vs 57.9%; 60.2% vs 55.8%, respectively) but similar numbers of US (64.2% vs 62.3 × 10(6) sperm/AI dose, respectively) along the preservation time. Egg yolk-glycerol or just egg yolk as additives improved (p<0.05) the results compared with the base extenders without additives or just with glycerol. The sperm parameters assessed decline slowly from 0 to 48 h, with a sharp decline (p<0.05) at 72 h of preservation. In conclusion, UHT and INRA-96(®) were similar as base extenders, and the addition of 5% egg yolk plus 2% glycerol or just 5% egg yolk improved the quality of ram semen preserved at 5 °C, at least for 48 h. The combination of egg yolk-glycerol might provide extra protection in case of fluctuation of temperatures below 5 °C, commonly seen under field conditions.
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Frío , Yema de Huevo , Glicerol , Leche , Preservación de Semen/veterinaria , Ovinos , Animales , Crioprotectores , Inseminación Artificial/veterinaria , Masculino , Preservación de Semen/métodos , Motilidad Espermática , Espermatozoides/fisiologíaRESUMEN
This study aimed at comparing the effect of ram semen preserved at 5 °C on two milk-based extenders (UHT skim milk or INRA-96(®) , 5% egg yolk) supplemented with 2% glycerol, and the preservation time (24 and 48 h) on conception rates after cervical AI of ewes. In two field trials, 1198 Merino ewes were cervical AI in spontaneous oestrus. In Experiment 1, pooled semen (6 rams) was extended in UHT-base (fresh, control) or chilled for 24 h in UHT5Y (UHT-base 5% egg yolk), INRA5Y (INRA-96(®) 5% egg yolk), UHT5Y2G (UHT5Y 2% glycerol) or INRA5Y2G (INRA5Y 2% glycerol). In Experiment 2, AI was performed with pooled semen (7 rams) used fresh (extended in UHT-base or UHT5Y2G, control groups) or chilled (extended in UHT5Y2G) for 24 or 48 h. Conception rate was determined by ultrasound 40 days after AI. INRA-96(®) - had similar conception as UHT-preserved semen (56.7 vs 55.4%, p>0.05). Addition of 2% glycerol did not modify the results (56.8 vs 55.2%, p>0.05). Fresh semen extended in UHT-base, and UHT5Y2G yielded similar conception rates (60 vs 64%, p>0.05). Preservation for 24 or 48 h in UHT5Y2G gave similar results (49 vs 47%; p>0.05). In conclusion, ram semen chilled for 24 h in UHT- or INRA-96(®) -based extenders yielded similar results, and glycerol addition did not have a detrimental effect. UHT5Y2G might be used to extend ram semen for fresh AI, or to preserve it for 24 or 48 h with acceptable results.
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Fertilización , Glicerol , Inseminación Artificial/veterinaria , Preservación de Semen/veterinaria , Semen/fisiología , Animales , Frío , Crioprotectores , Yema de Huevo , Femenino , Inseminación Artificial/métodos , Masculino , Leche , Embarazo , Preservación de Semen/métodos , Ovinos , Factores de TiempoRESUMEN
PURPOSE: Lymph node involvement is the most important prognostic factor when staging patients with colorectal cancer. The probability of detecting metastasis grows with the number of nodes examined. However, the number of nodes found in surgical specimens varies substantially. We have therefore determined the number and distribution of lymph nodes in the mesorectum by cadaveric dissection. METHODS: Twenty formalin-fixed cadaveric pelvises were dissected (13 males). The search for lymph nodes was performed in a systematic way, from the division of the superior rectal artery following the smallest visible branches to the level of the anorectal ring. RESULTS: A total of 168 lymph nodes were found in 20 mesorectal blocks, with a mean (standard deviation) number per specimen of 8.4 (4.45). Lymph node size ranged from 2 to 10 mm. Distribution of lymph nodes in mesorectum was as follows: 120 nodes (71.4 percent) were found around the branches of the superior rectal artery proximal to the peritoneal reflection, and 48 nodes (28.6 percent) were found distal to the peritoneal reflection. Fourteen specimens (70 percent) had lymph nodes at the division of the superior rectal artery. CONCLUSIONS: The mean number of lymph nodes found in the mesorectum distal to the superior rectal artery division was 8.4. Most of these lymph nodes were proximal to the peritoneal reflection. The range found in the number of lymph nodes per case should be considered for use in the formulation of guidelines in anatomicopathologic studies of surgical specimens obtained after mesorectal excision.
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Ganglios Linfáticos/anatomía & histología , Recto/patología , Anciano , Anciano de 80 o más Años , Cadáver , Neoplasias Colorrectales/patología , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Peritoneo/anatomía & histología , Recto/cirugíaRESUMEN
Background: Home care of tracheostomized children is considered a safe and low-cost alternative. Aim: To report the experience with tracheostomized children at the Pediatric Respiratory Unit of the Catholic University Hospital. Patients and methods: The records of 16 children (9 male) with tracheostomy (TQ) in home care between 1992 and 1998 were reviewed. Results: The average age at the moment of TQ was 9 months (range 1-30 months) and the postoperative hospital management period was 5 months (range 1-11 months). The average age at discharge was 13 months (range 3 to 30 months). Surgical indication were upper airway obstruction (congenital or acquired subglotic stenosis in three, upper airway malformations in one, vocal cord palsy in one and tracheobronchomalacia in one) and chronic assisted ventilation (severe tracheobronchomalacia in four, pulmonary hypoplasia in two, myopathy in one, central nervous injury in one and bronchopulmonary displasia in one). Overall rate complications were 2 per 100 tracheostomy months during home care and 8 per 100 tracheostomy months during hospital care. No tracheostomy-related deaths were observed. A parenteral education program to teach about tracheostomy management and cardiopulmonary resuscitation was carried out. Conclusions: Tracheostomized children can be safely managed at home
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Tratamiento Domiciliario , Traqueostomía , Cuidados Posoperatorios , Complicaciones Posoperatorias , Traqueostomía/efectos adversosRESUMEN
BACKGROUND: Home care of tracheostomized children is considered a safe and low-cost alternative. AIM: To report the experience with tracheostomized children at the Pediatric Respiratory Unit of the Catholic University Hospital. PATIENTS AND METHODS: The records of 16 children (9 male) with tracheostomy (TQ) in home care between 1992 and 1998 were reviewed. RESULTS: The average age at the moment of TQ was 9 months (range 1-30 months) and the postoperative hospital management period was 5 months (range 1-11 months). The average age at discharge was 13 months (range 3 to 30 months). Surgical indication were upper airway obstruction (congenital or acquired subglottic stenosis in three, upper airway malformations in one, vocal cord palsy in one and tracheobronchomalacia in one) and chronic assisted ventilation (severe tracheobronchomalacia in four, pulmonary hypoplasia in two, myopathy in one, central nervous injury in one and bronchopulmonary dysplasia in one). Overall rate complications were 2 per 100 tracheostomy months during home care and 8 per 100 tracheostomy months during hospital care. No tracheostomy-related deaths were observed. A parenteral education program to teach about tracheostomy management and cardiopulmonary resuscitation was carried out. CONCLUSIONS: Tracheostomized children can be safely managed at home.
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Servicios de Atención a Domicilio Provisto por Hospital , Atención Domiciliaria de Salud , Traqueostomía/enfermería , Servicios de Salud del Niño , Preescolar , Femenino , Educación en Salud , Humanos , Lactante , Masculino , Estudios Retrospectivos , Traqueostomía/efectos adversosRESUMEN
Patterns of production of specific cytokines are accepted as standards for T-lymphocyte subsets in diseases caused by intracellular parasites. These lymphocyte subsets (Th1 and Th2) have been associated with the different poles of the leprosy spectrum. Lepromatous leprosy (LL) onset correlates with cytokines produced by Th2 cells on the grounds of the patient's poor cellular immune response, i.e., interleukin 2 (IL-2) and gamma interferon (IFN-gamma) deficiency. On the other hand, tuberculoid leprosy (TL) has been associated with a Th1 response. Moreover, pro-inflammatory cytokines like IL-1 beta and tumor necrosis factor-alpha (TNF-alpha) play a major role in chronic inflammatory pathologies being IL-1ra and TNF-alpha soluble receptors, natural counterbalancing inhibitors. In light of this background, we decided to measure serum levels of IL-1 beta, IL-1ra, TNF-alpha and IL-6 in LL and TL patients, and we also studied the production in vitro of Th1 (IFN-gamma, IL-2), Th2 (IL-4, IL-10) and TNF-alpha cytokines. Our data showed that IL-1ra is highly elevated in sera from LL patients; there were no differences in Th2 cytokine levels and there were diminished levels in Th1 cytokines.