RESUMEN
Alpine grassland vegetation supports globally important biodiversity and ecosystems that are increasingly threatened by climate warming and other environmental changes. Trait-based approaches can support understanding of vegetation responses to global change drivers and consequences for ecosystem functioning. In six sites along a 1314 m elevational gradient in Puna grasslands in the Peruvian Andes, we collected datasets on vascular plant composition, plant functional traits, biomass, ecosystem fluxes, and climate data over three years. The data were collected in the wet and dry season and from plots with different fire histories. We selected traits associated with plant resource use, growth, and life history strategies (leaf area, leaf dry/wet mass, leaf thickness, specific leaf area, leaf dry matter content, leaf C, N, P content, C and N isotopes). The trait dataset contains 3,665 plant records from 145 taxa, 54,036 trait measurements (increasing the trait data coverage of the regional flora by 420%) covering 14 traits and 121 plant taxa (ca. 40% of which have no previous publicly available trait data) across 33 families.
Asunto(s)
Ecosistema , Pradera , Plantas , Biodiversidad , Perú , Clima , Altitud , IncendiosRESUMEN
BACKGROUND: Ovarian endometriosis is present in 17%-44% of women with endometriosis. The main treatment is surgery, but ultrasonography-guided aspiration is a less invasive alternative. OBJECTIVES: To evaluate the effectiveness of this alternative treatment in recurrent ovarian endometrioma. SEARCH STRATEGY: Multiple databases were searched for articles published between 1994 and 2014 using the keywords "ultrasound-guided aspiration," "ovarian," and "endometriosis." SELECTION CRITERIA: Randomized controlled trials and observational studies published in English, Portuguese, or Spanish were included. DATA COLLECTION AND ANALYSIS: Two researchers independently extracted and reviewed the data. The main outcome of interest was the recurrence rate. MAIN RESULTS: Eight studies were eligible. Ovarian endometriosis is associated with high recurrence rates after one ultrasonography-guided aspiration (28.9%-91.5%), but involves less ovarian manipulation. The results of aspiration followed by sclerotherapy are not uniform, but overall the addition of a sclerosing agent does not seem to significantly reduce the likelihood of recurrence (13.3%-75.0%). Repeated aspiration of the cysts can reduce the recurrence rate to 5.4% by the sixth aspiration. CONCLUSIONS: Repeated ultrasonography-guided aspiration of ovarian endometriomas can be performed for the treatment of recurrent ovarian endometriosis. Further studies comparing the efficacy of this procedure and ovarian surgery are needed.
Asunto(s)
Endometriosis/terapia , Quistes Ováricos/terapia , Escleroterapia , Ultrasonografía Intervencional , Etanol/uso terapéutico , Femenino , Humanos , Metotrexato/uso terapéutico , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Tetraciclina/uso terapéuticoRESUMEN
INTRODUCTION: Endometriosis is occasionally found in the appendix, particularly in severe forms of deep infiltrating disease. Carcinoid tumor is the most common neoplasm of the appendix and may be overlooked or misdiagnosed when there are multiple endometriosis lesions in the pelvis. CASE DESCRIPTION: We describe two cases of carcinoid tumor diagnosed in patients who underwent surgery to treat endometriosis, in whom the diagnosis of appendiceal endometriosis was presumed. DISCUSSION: In the context of endometriosis, surgery is indicated when the appendix is affected. Despite the more likely diagnosis of appendiceal endometriosis, carcinoid tumors cannot be ruled out by imaging examinations.
Asunto(s)
Neoplasias del Apéndice/diagnóstico , Apéndice/patología , Tumor Carcinoide/diagnóstico , Diagnóstico por Imagen/métodos , Endometriosis/diagnóstico , Adulto , Femenino , Humanos , MasculinoRESUMEN
As national health systems seek to apply breast cancer screening recommendations to an entire population of women (within target age ranges for which there is evidence that screening reduces mortality), the volume of screening tests and resulting diagnostic investigations arising from abnormal test results-and the cost associated with them-will grow dramatically. Population-based early detection (screening) programs will need information systems and management tools to help these programs. This report describes Brazil's highly decentralized health care system and then describes in greater detail how the development and implementation of an information system for Brazil's nationwide breast cancer early detection program was carried out with input from various stakeholders. Challenges encountered in the implementation are shared. Preliminary findings from the first 1.5 million mammograms are presented to demonstrate the kind of provocative management information such a system can yield in a relatively short period of time. The potential of such information systems for improving efficiency, efficacy and cost-effectiveness of early detection programs is emphasized.
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Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer/métodos , Sistemas de Información , Adulto , Anciano , Brasil , Femenino , Implementación de Plan de Salud , Humanos , Mamografía , Persona de Mediana Edad , Programas Nacionales de Salud , Diseño de SoftwareRESUMEN
This study tests for the presence of education-frailty correlations among 1,176 Mexican Americans, 522 Cuban Americans, and 560 Puerto Ricans, 50 years and older, in the Hispanic Health and Nutrition Examination Survey. Hispanics with the least schooling (less than 7 years) were found to have the highest frailty rates, and those with the most (more than 12 years of schooling) were found to have the lowest frailty rates. Similar, but somewhat weaker, correlations were discovered after a measure of self-efficacy was accounted for.
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Personas con Discapacidad/estadística & datos numéricos , Escolaridad , Encuestas Epidemiológicas , Hispánicos o Latinos/educación , Encuestas Nutricionales , Actividades Cotidianas/clasificación , Adolescente , Adulto , Anciano , Niño , Cuba/etnología , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Americanos Mexicanos/educación , Americanos Mexicanos/estadística & datos numéricos , Persona de Mediana Edad , Puerto Rico/etnología , Autoeficacia , Estados Unidos/epidemiologíaRESUMEN
We tested the hypothesis that Part B of the Trail Making Test (TMT) is a measure of cognitive set-shifting ability in 55 normal subjects with the conventional (written) TMT and a verbal adaptation, the "verbal TMT" (vTMT). The finding of a significant association between Parts B of TMT and vTMT (r = 0,59, p < 0,001), after correcting for age and education, supports the view that Part B of TMT is a valid measure of the ability to alternate between cognitive categories
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Cognición , Prueba de Secuencia Alfanumérica , Conducta Verbal , Factores de Edad , EscolaridadRESUMEN
Magnetic resonance (MR) is a technique that permits the noninvasive evaluation of morphologic features and function based on the distribution of protons and other selected elements. We present a basic description of MR and illustrate both 31P-MR spectroscopy and proton imaging applications in pediatric patients. The applications of these techniques are diverse, and are presented concisely in an attempt to give pediatricians an overview of this new technology and its potential role in patient management.