RESUMEN
RESUMEN El objetivo principal de este estudio fue caracterizar el nivel ético en estudiantes y docentes de la carrera de medicina veterinaria de la Universidad Santo Tomás, sede de Puerto Montt, Chile. Para esto, se aplicó una encuesta dilemática a 3 grupos de estudio conformados por estudiantes de primer y quinto año, además de docentes que imparten asignaturas de formación profesional de la sede Puerto Montt. La creación de la encuesta fue por medio de la contratación de especificaciones éticas de la carrera con los diles de juicio moral en Kohlberg. De los resultados obtenidos se pudo concluir que las especificaciones de la carrera de medicina veterinaria solo contemplan el 20% de 59 artículos estudiados del Código de Ética profesional. Además, es posible decir que los estudiantes de primero y quinto año, y los docentes no conocen a cabalidad los artículos del Código de Ética según la clasificación de la teoría de Kohlberg.
ABSTRACT The main objective of this study was to characterize the ethical level in students and teachers of the veterinary medicine career of the Santo Tomás University, Puerto Montt headquarters, Chile. For this a dilemmatic survey was applied to 3 study groups, made up of students from the first and fifth years, in addition to teachers who teach professional training subjects at the Puerto Montt campus. The survey was created by contracting ethical specifications of the career with the moral judgment diles in Kohlberg. From the results obtained, it was possible to conclude that the specifications of the veterinary medicine career only contemplate 20% of the 59 articles studied of the professional code of ethics. In addition, it was possible to say that the first and fifth year students, and teachers do not fully know the articles of the code of ethics according to the classification of Kohlberg's theory.
Asunto(s)
Humanos , Estudiantes , Medicina Veterinaria , Códigos de Ética , Ética Profesional , Capacitación Profesional , Docentes , Encuestas y Cuestionarios , Principios MoralesRESUMEN
AIMS: To evaluate C-reactive protein, insulin growth factor 1 and lipid levels during the follicular and luteal phases in adolescents with Type 1 diabetes. METHODS: Adolescents with Type 1 diabetes (N = 40) and healthy controls (C; N = 43) were studied during the follicular and luteal phases of their menstrual cycles. C-Reactive protein, insulin growth factor 1 and lipid levels were measured. RESULTS: Adolescents with Type 1 diabetes exhibited higher C-reactive protein levels than the C group during the follicular (P < 0.0001) and luteal phases (P < 0.01). The elevation of C-reactive protein levels was more pronounced in overweight adolescents with Type 1 diabetes than in adolescents in the C group. More adolescents with Type 1 diabetes were classified as having an elevated risk of cardiovascular disease (C-reactive protein > 3 mg/l) in the luteal phase than in the follicular phase (37.5% and 17.5%, respectively); half of the overweight adolescents with Type 1 diabetes in the luteal phase reached this level. BMI was the only significant factor affecting follicular and luteal phase C-reactive protein levels in adolescents with Type 1 diabetes. Lower insulin growth factor 1 levels were observed during both phases of the menstrual cycle in adolescents with Type 1 diabetes compared with controls. An elevation in insulin growth factor 1 levels in the luteal phase relative to the follicular phase was observed in controls, but not in adolescents with Type 1 diabetes. Luteal insulin growth factor 1 and C-reactive protein exhibited an inverse correlation (r = -0.4, P = 0.01). CONCLUSIONS: Adolescents with Type 1 diabetes have higher C-reactive protein levels and lower insulin growth factor 1 levels relative to controls, especially during the luteal phase. Type 1 diabetes diminishes the natural elevation in insulin growth factor 1 levels observed during the luteal phase in controls. Excess weight exacerbates the subclinical inflammatory state observed during both phases of the menstrual cycle in adolescents with Type 1 diabetes.
Asunto(s)
Proteína C-Reactiva/análisis , Diabetes Mellitus Tipo 1/sangre , Fase Folicular/sangre , Hiperlipidemias/complicaciones , Factor I del Crecimiento Similar a la Insulina/análisis , Fase Luteínica/sangre , Sobrepeso/complicaciones , Adolescente , Biomarcadores/sangre , Índice de Masa Corporal , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Chile/epidemiología , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/inmunología , Angiopatías Diabéticas/epidemiología , Cardiomiopatías Diabéticas/epidemiología , Regulación hacia Abajo , Femenino , Hospitales Públicos , Hospitales Urbanos , Humanos , Hiperlipidemias/epidemiología , Lípidos/sangre , Riesgo , Regulación hacia ArribaRESUMEN
We measured circulating endothelial precursor cells (EPCs), activated circulating endothelial cells (aCECs), and mature circulating endothelial cells (mCECs) using four-color multiparametric flow cytometry in the peripheral blood of 84 chronic myeloid leukemia (CML) patients and 65 healthy controls; and vascular endothelial growth factor (VEGF) by quantitative real-time PCR in 50 CML patients and 32 healthy controls. Because of an increase in mCECs, the median percentage of CECs in CML blast crisis (0.0146%) was significantly higher than in healthy subjects (0.0059%, P<0.01) and in the accelerated phase (0.0059%, P=0.01). There were no significant differences in the percentages of CECs in chronic- or active-phase patients and healthy subjects (P>0.05). In addition, VEGF gene expression was significantly higher in all phases of CML: 0.245 in blast crisis, 0.320 in the active phase, and 0.330 in chronic phase patients than it was in healthy subjects (0.145). In conclusion, CML in blast crisis had increased levels of CECs and VEGF gene expression, which may serve as markers of disease progression and may become targets for the management of CML.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Crisis Blástica/patología , Células Endoteliales/patología , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Células Neoplásicas Circulantes/patología , Factor A de Crecimiento Endotelial Vascular/genética , Biomarcadores de Tumor/análisis , Crisis Blástica/sangre , Crisis Blástica/genética , Estudios de Casos y Controles , Recuento de Células , Citometría de Flujo/métodos , Expresión Génica/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/sangre , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Neovascularización Patológica/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Valores de Referencia , Estadísticas no Paramétricas , Factor A de Crecimiento Endotelial Vascular/análisisRESUMEN
With the increasing interest in natural formulations for drug administration and functional foods, it is desirable a good knowledge of the phase behavior of lecithin/fatty acid formulations. Phase structure and properties of ternary lecithin/fatty acids/water systems are studied at 37°C, making emphasis in regions with relatively low water and fatty acid content. The effect of fatty acid saturation degree on the phase microstructure is studied by comparing a fully saturated (palmitic acid, C16:0), monounsaturated (oleic acid, C18:1), and diunsaturated (linoleic acid, C18:2) fatty acids. Phase determinations are based on a combination of polarized light microscopy and small-angle X-ray scattering measurements. Interestingly, unsaturated (oleic acid and linoleic acid) fatty acid destabilizes the lamellar bilayer. Slight differences are observed between the phase diagrams produced by the unsaturated ones: small lamellar, medium cubic and large hexagonal regions. A narrow isotropic fluid region also appears on the lecithin-fatty acid axis, up to 8wt% water. In contrast, a marked difference in phase microsctructure was observed between unsaturated and saturated systems in which the cubic and isotropic fluid phases are not formed. These differences are, probably, a consequence of the high Krafft point of the C16 saturated chains that imply rather rigid chains. However, unsaturated fatty acids result in more flexible tails. The frequent presence of, at least, one unsaturated chain in phospholipids makes it very likely a better mixing situation than in the case of more rigid chains. This swelling potential favors the formation of reverse hexagonal, cubic, and micellar phases. Both unsaturated fatty acid systems evolve by aging, with a reduction of the extension of reverse hexagonal phase and migration of the cubic phase to lower fatty acid and water contents. The kinetic stability of the systems seems to be controlled by the unsaturation of fatty acids.
Asunto(s)
Ácidos Grasos/química , Glycine max/química , Lecitinas/química , Membrana Dobles de Lípidos/química , Ácidos Grasos Insaturados/química , Cinética , Microscopía de Polarización , Dispersión del Ángulo Pequeño , Agua/química , Difracción de Rayos XRESUMEN
We measured circulating endothelial precursor cells (EPCs), activated circulating endothelial cells (aCECs), and mature circulating endothelial cells (mCECs) using four-color multiparametric flow cytometry in the peripheral blood of 84 chronic myeloid leukemia (CML) patients and 65 healthy controls; and vascular endothelial growth factor (VEGF) by quantitative real-time PCR in 50 CML patients and 32 healthy controls. Because of an increase in mCECs, the median percentage of CECs in CML blast crisis (0.0146%) was significantly higher than in healthy subjects (0.0059%, P<0.01) and in the accelerated phase (0.0059%, P=0.01). There were no significant differences in the percentages of CECs in chronic- or active-phase patients and healthy subjects (P>0.05). In addition, VEGF gene expression was significantly higher in all phases of CML: 0.245 in blast crisis, 0.320 in the active phase, and 0.330 in chronic phase patients than it was in healthy subjects (0.145). In conclusion, CML in blast crisis had increased levels of CECs and VEGF gene expression, which may serve as markers of disease progression and may become targets for the management of CML.
Asunto(s)
Crisis Blástica/patología , Células Endoteliales/patología , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Células Neoplásicas Circulantes/patología , Factor A de Crecimiento Endotelial Vascular/genética , Adulto , Anciano , Biomarcadores de Tumor/análisis , Crisis Blástica/sangre , Crisis Blástica/genética , Estudios de Casos y Controles , Recuento de Células , Femenino , Citometría de Flujo/métodos , Expresión Génica/genética , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/sangre , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Masculino , Persona de Mediana Edad , Neovascularización Patológica/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Valores de Referencia , Estadísticas no Paramétricas , Factor A de Crecimiento Endotelial Vascular/análisis , Adulto JovenRESUMEN
The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. In addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode.
Asunto(s)
Bacteriófago lambda/fisiología , Escherichia coli/virología , Proteínas Virales/metabolismo , Secuencia de Aminoácidos , Membrana Celular/metabolismo , Regulación Viral de la Expresión Génica/fisiología , Datos de Secuencia Molecular , Proteínas Virales/genética , Liberación del Virus/fisiologíaRESUMEN
The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. In addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode.
Asunto(s)
Electrocardiografía , Epilepsia/complicaciones , Infarto del Miocardio/etiología , Daño por Reperfusión Miocárdica/complicaciones , Animales , Modelos Animales de Enfermedad , Conductividad Eléctrica , Corazón/inervación , Frecuencia Cardíaca , Masculino , Infarto del Miocardio/fisiopatología , Daño por Reperfusión Miocárdica/fisiopatología , Pilocarpina/administración & dosificación , Ratas Wistar , Factores de TiempoRESUMEN
Objective: To determinate dietary habits and physical condition of physical activity students from the Autonomous University of Chile, Temuco, relating these to their fitness level. Methods: An observational cross-sectional study was conducted among 239 students (76.5 % males). Assessment included a food questionnaire, anthropometric measurements and physical condition. Results: In a sample of 239 students, 35.6% of them were overweight or obese as well as having unhealthy dietary habits independent of the academic year at university. Only 4.7 % of the students used the national recommendations for fruit intake and only 30% ate breakfast daily. In men weight, waist circumference and BMI were negatively associated with the Nvette Course test (R = -0.203, R= -0.249 and R= -0.196, p<0.01 respectively). Conclusion: Physical activity education students have poor dietary habits throughout the university academic years while their fitness decreases irregularly as studies progress. This is a major concern since they will become healthy life style role models for their future students.
Objetivo: Determinar los hábitos alimentarios y condición física de los estudiantes de pedagogía en educación física de la Universidad Autónoma de Chile, sede Temuco y relacionarlos con el nivel de condición física. Sujetos y métodos: Estudio transversal observacional, se evaluaron 239 estudiantes de educación física, de los cuales 76,5% eran hombres, aplicándoles una encuesta alimentaria, antropometría y evaluación de la condición física. Resultados: El 35,6% de los estudiantes presentaba sobrepeso/obesidad, además tenían malos hábitos alimentarios independientes del año de ingreso. Sólo 4,7% consumía las recomendaciones de frutas y 30% tomaba desayuno todos los días. En hombres el peso, la circunferencia de la cintura e IMC correlacionan negativamente con la prueba de Course navette (R=-0,203; R=-0,249; R=-0,196, p<0,01 respectivamente). Conclusión: Los estudiantes universitarios presentan malos hábitos alimentarios durante toda la carrera universitaria, mientras que su condición física disminuye de manera irregular a medida que avanzan los estudios, situación preocupante ya que ellos se transformaran en modelos de estilos de vida saludable especialmente a nivel escolar.
Asunto(s)
Adulto , Estudiantes , Aptitud Física , Universidades , Adulto Joven , Conducta Alimentaria , Pesos y Medidas Corporales , Encuestas NutricionalesRESUMEN
Introducción: El cáncer papilar del tiroides (CPT) es la neoplasia endocrina más frecuente, siendo el 80% de los casos de la variedad papilar; sólo el 10 por ciento se manifiesta antes de los 21 años y tiene una incidencia estimada en este grupo de 0,54:100.000. Su comportamiento en la edad pediátrica se caracteriza por el diagnóstico en una etapa más avanzada de la enfermedad pero con buena respuesta terapéutica y muy baja mortalidad. Objetivo: Presentar 4 casos familiares de CPT, discutir las características particulares y la importancia del diagnóstico precoz en pacientes. Casos clínicos: Se presentan 4 familias con sujetos portadores de un carcinoma papilar familiar de Tiroides, en todas ellas el caso pediátrico se presentó con posterioridad a un caso de un adulto familiar directo, por lo que su búsqueda fue más precoz, y a pesar de un tratamiento oportuno ya tenían enfermedad avanzada al diagnóstico. Los casos pediátricos corresponden a 3 mujeres y 1 varón de edades promedio de 12 años 6 meses al momento del diagnóstico. Discusión: La variedad familiar del carcinoma papilar de tiroides (2 o más familiares de primer grado afectados), representa el 5 por ciento de los cánceres papilares. Se transmite a través de herencia autosómica dominante con penetrancia incompleta y expresividad variable. Se manifiesta a menor edad que el esporádico, es más agresivo con mayor invasión local (32 por ciento), recurrencia (20-50 por ciento) y metástasis linfática (57 por ciento), y se asocia a enfermedades tiroídeas benignas. Con frecuencia es multifocal. Conclusión: El cáncer familiar papilar de tiroides es una patología con peor pronóstico que la variedad esporádica por lo que se requiere una alto índice de sospecha en las familias afectadas para un diagnóstico y tratamiento precoz.
Introduction: Papillary thyroid cancer (PTC) is the most common endocrine malignancy, representing 80 percent of all thyroid cancers; only 10 percent of cases are manifested before age 21 and have an estimated incidence of 0.54 cases per 100,000 people. In children it is diagnosed at a more advanced stage of the disease but with good therapeutic response and very low mortality. Objective: To present four family cases with PTC, discuss the particular characteristics and the importance of early diagnosis. Case reports: 4 families with members affected by family papillary thyroid carcinoma are presented, all pediatric cases were manifested after a direct member adult case was diagnosed, therefore pediatric patients were early detected, but despite a timely treatment, the disease was advanced at the time of diagnosis. The pediatric cases are 3 females and 1 male with an average age of 12 ½ years old at diagnosis. Discussion: The family variety of papillary thyroid carcinoma (2 or more direct members affected), represents 5 percent of papillary cancers. It is transmitted through autosomal dominant inheritance with incomplete penetrance and variable expressivity. It occurs at a younger age than the sporadic type, and it is more aggressive with greater local invasion (32 percent), recurrence (20-50 percent) and lymphatic metastases (57 percent), and it is associated with benign thyroid diseases and often, it is multifocal. Conclusion: The family papillary thyroid cancer is a disease with worse prognosis than the sporadic variety; therefore, a high index of suspicion is required in affected families for early diagnosis and treatment.
Asunto(s)
Humanos , Masculino , Adolescente , Femenino , Niño , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/genética , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/genética , Carcinoma Papilar/terapia , Predisposición Genética a la Enfermedad , Neoplasias de la Tiroides/terapiaRESUMEN
INTRODUCTION: Papillary thyroid cancer (PTC) is the most common endocrine malignancy, representing 80% of all thyroid cancers; only 10% of cases are manifested before age 21 and have an estimated incidence of 0.54 cases per 100,000 people. In children it is diagnosed at a more advanced stage of the disease but with good therapeutic response and very low mortality. OBJECTIVE: To present four family cases with PTC, discuss the particular characteristics and the importance of early diagnosis. CASE REPORTS: 4 families with members affected by family papillary thyroid carcinoma are presented, all pediatric cases were manifested after a direct member adult case was diagnosed, therefore pediatric patients were early detected, but despite a timely treatment, the disease was advanced at the time of diagnosis. The pediatric cases are 3 females and 1 male with an average age of 12 ½ years old at diagnosis. DISCUSSION: The family variety of papillary thyroid carcinoma (2 or more direct members affected), represents 5% of papillary cancers. It is transmitted through autosomal dominant inheritance with incomplete penetrance and variable expressivity. It occurs at a younger age than the sporadic type, and it is more aggressive with greater local invasion (32%), recurrence (20-50%) and lymphatic metastases (57 %), and it is associated with benign thyroid diseases and often, it is multifocal. CONCLUSION: The family papillary thyroid cancer is a disease with worse prognosis than the sporadic variety; therefore, a high index of suspicion is required in affected families for early diagnosis and treatment.
Asunto(s)
Carcinoma/genética , Predisposición Genética a la Enfermedad , Neoplasias de la Tiroides/genética , Adolescente , Carcinoma/diagnóstico , Carcinoma/patología , Carcinoma Papilar , Niño , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Estadificación de Neoplasias , Pronóstico , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patologíaRESUMEN
Cistos renais podem formar-se em qualquer parte do néfron e dos ductos coletores. Alguns são hereditários, originando-se durante a organogênese, e outros se desenvolvem no tecido renal normal, depois que os rins estão completamente formados. No presente relato, descreve-se a ressecção de cisto e abscesso renais, por cirurgia laparoscópica em um cão. Para o acesso, foram utilizados três portais, dois de 10mm de diâmetro e um de 5mm, dispostos na parede abdominal lateral direita e, num segundo momento, na parede abdominal lateral esquerda. Conclui-se, portanto, que a técnica laparoscópica com três portais permite a realização de ressecção de cisto e abscesso renais em cães, sem a ocorrência de recidivas em curto prazo.
Renal cysts can be formed anywhere in the nephron and collecting duct system. Some are hereditary, originated during organogenesis, and others could have origin in the normal kidney tissue, after the kidney's development. This report describes the resection of renal cysts and abscesses by laparoscopic surgery in a dog. In order to access the cavity, three portals were used; two with 10mm and another with 5mm diameter, in the right lateral abdominal wall, and in another moment, in the left lateral abdominal wall. It is concluded that the laparoscopic technique with three portals allows the resection of renal cysts and abscesses in dogs, without the occurrence of relapses in the short postoperative time.
Asunto(s)
Animales , Perros , Absceso/patología , Cirugía General , Laparoscopía , Riñón/anatomía & histología , Perros/clasificaciónRESUMEN
Cistos renais podem formar-se em qualquer parte do néfron e dos ductos coletores. Alguns são hereditários, originando-se durante a organogênese, e outros se desenvolvem no tecido renal normal, depois que os rins estão completamente formados. No presente relato, descreve-se a ressecção de cisto e abscesso renais, por cirurgia laparoscópica em um cão. Para o acesso, foram utilizados três portais, dois de 10mm de diâmetro e um de 5mm, dispostos na parede abdominal lateral direita e, num segundo momento, na parede abdominal lateral esquerda. Conclui-se, portanto, que a técnica laparoscópica com três portais permite a realização de ressecção de cisto e abscesso renais em cães, sem a ocorrência de recidivas em curto prazo.(AU)
Renal cysts can be formed anywhere in the nephron and collecting duct system. Some are hereditary, originated during organogenesis, and others could have origin in the normal kidney tissue, after the kidney's development. This report describes the resection of renal cysts and abscesses by laparoscopic surgery in a dog. In order to access the cavity, three portals were used; two with 10mm and another with 5mm diameter, in the right lateral abdominal wall, and in another moment, in the left lateral abdominal wall. It is concluded that the laparoscopic technique with three portals allows the resection of renal cysts and abscesses in dogs, without the occurrence of relapses in the short postoperative time.(AU)
Asunto(s)
Animales , Perros , Absceso/patología , Laparoscopía , Cirugía General , Riñón/anatomía & histología , Perros/clasificaciónRESUMEN
El interés por los biotipos periodontales se ha acrecentado en el último tiempo, por lo cual en los años recientes el estudio de las dimensiones de los diferentes tejidos periodontales se ha desarrollado desde un punto de vista epidemiológico, estético y terapéutico en varias áreas de la odontología, especialmente en periodoncia. Esta revisión bibliográfica tiene por objetivo mostrar las últimas evidencias relacionadas con esta temática.
Asunto(s)
Humanos , Estética Dental , Encía/anatomía & histología , Papila Dental/anatomía & histología , Somatotipos , Coronas , Implantes Dentales , Rehabilitación Bucal , Valores de Referencia , Cirugía BucalRESUMEN
El interés por los biotipos periodontales se ha acrecentado en el último tiempo, por lo cual en los años recientes el estudio de las dimensiones de los diferentes tejidos periodontales se ha desarrollado desde un punto de vista epidemiológico, estético y terapéutico en varias áreas de la odontología, especialmente en periodoncia. Esta revisión bibliográfica tiene por objetivo mostrar las últimas evidencias relacionadas con esta temática.(AU)
Asunto(s)
Humanos , Somatotipos , Encía/anatomía & histología , Papila Dental/anatomía & histología , Estética Dental , Implantes Dentales , Coronas , Rehabilitación Bucal , Valores de Referencia , Cirugía BucalRESUMEN
Postoperative delirium or acute confusional state is a common complication among older subjects. Many factors influence its appearance, such as preexistent problems of the patient, medication use, pain, the perioperative anesthetic management and the intensity of the inflammatory reaction to surgical trauma. Its consequences are a longer hospital stay, higher risk of complications and a long term derangement of functional status and cognitive performance. The management of delirium is multifactorial, including the avoidance of precipitating factors, the maintenance of an adequate environment and the conscious use of neuroleptics. The prevention of delirium should be a priority that will improve health care standards.
El delirium postoperatorio constituye una complicación frecuente y relevante de los pacientes quirúrgicos, en particular en los adultos mayores Su génesis es multifactorial participando características preexistentes del paciente, y gatillantes como medicamentos, dolor, el enfrentamiento anestésico peri operatorio y la intensidad de la respuesta inflamatoria asociada al trauma quirúrgico, entre otros. La aparición de delirium postoperatorio se asocia a desenlaces adversos, como una mayor estadía hospitalaria, mayor riesgo de complicaciones, y a una reducción en la funcionalidad y el estado cognitivo en la evolución alejada. Estrategias de prevención no farmacológicas multimodales, han documentado una reducción significativa en la incidencia de delirium. La terapia del delirium, debe enfocarse en la búsqueda y manejo de factores precipitantes, en favorecer un adecuado entorno no farmacológico, y en el uso apropiado de neurolépticos. El adecuado reconocimiento de esta entidad, y la implementación de estrategias de prevención no farmacológicas constituyen actualmente un estándar que promueve una atención de calidad y segura a los pacientes quirúrgicos.
Asunto(s)
Humanos , Delirio/diagnóstico , Delirio/terapia , Procedimientos Quirúrgicos Operativos/efectos adversos , Factores de Edad , Envejecimiento , Confusión , Cuidados Críticos , Delirio/epidemiología , Delirio/etiología , Delirio/prevención & control , Complicaciones Posoperatorias , Factores de RiesgoRESUMEN
Background: The public health reform in Chile resulted in changes in working conditions and organization of health centers. Aim: To examine the presence of psychophysiological symptoms in professionals of public hospitals in the Metropolitan Region and their association with current working conditions. Material and Methods: A questionnaire of quality of working life was applied to a sample of 80 physicians and 110 nurses. The questionnaire considers scales and open questions. Results: Nurses had a higher level of discomfort than physicians (p < 0.01) and had significantly higher scores for emotional distress, physical fatigue, digestive disorders, headache, insomnia, back pain and muscle tension (p < 0.01). There were statistically significant negative correlations between psychophysiological distress and working conditions (r = -0.418), social climate (r = -0.395), satisfaction with the organization (r = -0.337) and psychosocial well-being (r = -0.267). A regression model showed that 21 percent of the variance in psychophysiological distress was explained by working conditions, psychosocial well-being and adaptation to the organization. Conclusions: There is a relationship between the high prevalence of psychophysiological symptoms and bad working conditions of public health professionals.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuerpo Médico de Hospitales/psicología , Personal de Enfermería en Hospital/psicología , Salud Laboral/normas , Trastornos Psicofisiológicos/epidemiología , Calidad de Vida/psicología , Estrés Psicológico/epidemiología , Chile/epidemiología , Métodos Epidemiológicos , Hospitales Públicos , Cuerpo Médico de Hospitales/estadística & datos numéricos , Trastornos Psicofisiológicos/psicología , Estrés Psicológico/psicologíaRESUMEN
Meconium aspiration syndrome causes respiratory failure after birth and in vivo monitoring of pulmonary edema is difficult. The objective of the present study was to assess hemodynamic changes and edema measured by transcardiopulmonary thermodilution in low weight newborn piglets. Additionally, the effect of early administration of sildenafil (2 mg/kg vo, 30 min after meconium aspiration) on this critical parameter was determined in the meconium aspiration syndrome model. Thirty-eight mechanically ventilated anesthetized male piglets (Sus scrofa domestica) aged 12 to 72 h (1660 ± 192 g) received diluted fresh human meconium in the airway in order to evoke pulmonary hypertension (PHT). Extravascular lung water was measured in vivo with a PiCCO monitor and ex vivo by the gravimetric method, resulting in an overestimate of 3.5 ± 2.3 mL compared to the first measurement. A significant PHT of 15 Torr above basal pressure was observed, similar to that of severely affected humans, leading to an increase in ventilatory support. The vascular permeability index increased 57 percent, suggesting altered alveolocapillary membrane permeability. Histology revealed tissue vessel congestion and nonspecific chemical pneumonitis. A group of animals received sildenafil, which prevented the development of PHT and lung edema, as evaluated by in vivo monitoring. In summary, the transcardiopulmonary thermodilution method is a reliable tool for monitoring critical newborn changes, offering the opportunity to experimentally explore putative therapeutics in vivo. Sildenafil could be employed to prevent PHT and edema if used in the first stages of development of the disease.
Asunto(s)
Animales , Humanos , Recién Nacido , Masculino , Agua Pulmonar Extravascular/efectos de los fármacos , Hipertensión Pulmonar/prevención & control , Síndrome de Aspiración de Meconio/tratamiento farmacológico , Piperazinas/administración & dosificación , Sulfonas/administración & dosificación , Vasodilatadores/uso terapéutico , Animales Recién Nacidos , Modelos Animales de Enfermedad , Pulmón/efectos de los fármacos , Pulmón/patología , Síndrome de Aspiración de Meconio/patología , Purinas/administración & dosificación , Sus scrofa , Factores de Tiempo , Termodilución/métodosRESUMEN
Meconium aspiration syndrome causes respiratory failure after birth and in vivo monitoring of pulmonary edema is difficult. The objective of the present study was to assess hemodynamic changes and edema measured by transcardiopulmonary thermodilution in low weight newborn piglets. Additionally, the effect of early administration of sildenafil (2 mg/kg vo, 30 min after meconium aspiration) on this critical parameter was determined in the meconium aspiration syndrome model. Thirty-eight mechanically ventilated anesthetized male piglets (Sus scrofa domestica) aged 12 to 72 h (1660 ± 192 g) received diluted fresh human meconium in the airway in order to evoke pulmonary hypertension (PHT). Extravascular lung water was measured in vivo with a PiCCO monitor and ex vivo by the gravimetric method, resulting in an overestimate of 3.5 ± 2.3 mL compared to the first measurement. A significant PHT of 15 Torr above basal pressure was observed, similar to that of severely affected humans, leading to an increase in ventilatory support. The vascular permeability index increased 57%, suggesting altered alveolocapillary membrane permeability. Histology revealed tissue vessel congestion and nonspecific chemical pneumonitis. A group of animals received sildenafil, which prevented the development of PHT and lung edema, as evaluated by in vivo monitoring. In summary, the transcardiopulmonary thermodilution method is a reliable tool for monitoring critical newborn changes, offering the opportunity to experimentally explore putative therapeutics in vivo. Sildenafil could be employed to prevent PHT and edema if used in the first stages of development of the disease.