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Abstract Objective: The objective of this study was to describe the clinical and imaging characteristics and the evolution of heart transplantation patients due to anthracycline-induced cardiomyopathy Methods: Patients with a diagnosis of ACM who received a heart transplantation in our institution in the period of November 2009-April 2021 were included. Clinical characteristics, pre-transplant studies, and clinical outcomes after transplantation were collected retrospectively from the electronic medical record. Results: A total of 11 patients were included in the study. The median age at the time of cancer diagnosis was 15 years (IQR 10-37 years), while the median age at the time of heart transplant was 56 years (IQR 39-62 years). Regarding post-transplant outcomes, three patients died in the post-operative period. One died 4 years after the intervention due to chronic rejection, while the other seven had a favorable evolution. No oncological relapse was observed with a median follow-up of 2.5 years (IQR 1.86-3.85 years). Conclusion: End-stage anthracycline-induced cardiomyopathy can occur many years after chemotherapy treatment, so close cardiovascular follow-up is extremely important. Heart transplantation is a treatment option after an exhaustive multidisciplinary evaluation, to minimize the risk of oncological relapse.
Resumen Objetivo: Describir las características clínicas, imagenológicas y la evolución de los pacientes trasplantados cardiacos por cardiotoxicidad inducida por antraciclinas. Métodos: Serie de casos descriptiva de pacientes consecutivos trasplantados cardiacos debido a cardiotoxicidad mediada por antraciclinas en el periodo de Noviembre de 2009 a Abril de 2021.Las características clínicas, los estudios complementarios pretrasplante y la información sobre la evolución posterior al trasplante fue recolectada de la historia clínica electrónica de forma retrospectiva. Resultados: Se incluyeron un total de 11 pacientes. La mediana de edad al diagnóstico de la patología oncológica fue de 15 años (RIC 10-37 años), mientras que la mediana de edad en la que recibieron el trasplante cardiaco fue de 56 años (RIC 39-62 años). Con respecto a la evolución posterior al trasplante, 3 pacientes murieron en el periodo del post operatorio inmediato. 1 paciente falleció a los 4 años del trasplante y los otros 7 pacientes tuvieron una evolución favorable. No se observó recaída oncológica en ningún paciente durante una mediana de seguimiento o de 2,5 años (RIC 1.86-3.85 años). Conclusión: La etapa final de la miocardiopatía inducida por antraciclinas puede ocurrir muchos años después del tratamiento con quimioterapia, por lo que es extremadamente importante un seguimiento cardiológico estricto. El trasplante cardiaco es una opción en este grupo de pacientes luego de una exhaustiva evaluación multidisciplinaria, con el fin de minimizar el riesgo de recaída oncológica.
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OBJECTIVE: The objective of this study was to describe the clinical and imaging characteristics and the evolution of heart transplantation patients due to anthracycline-induced cardiomyopathy. METHODS: Patients with a diagnosis of ACM who received a heart transplantation in our institution in the period of November 2009-April 2021 were included. Clinical characteristics, pre-transplant studies, and clinical outcomes after transplantation were collected retrospectively from the electronic medical record. RESULTS: A total of 11 patients were included in the study. The median age at the time of cancer diagnosis was 15 years (IQR 10-37 years), while the median age at the time of heart transplant was 56 years (IQR 39-62 years). Regarding post-transplant outcomes, three patients died in the post-operative period. One died 4 years after the intervention due to chronic rejection, while the other seven had a favorable evolution. No oncological relapse was observed with a median follow-up of 2.5 years (IQR 1.86-3.85 years). CONCLUSION: End-stage anthracycline-induced cardiomyopathy can occur many years after chemotherapy treatment, so close cardiovascular follow-up is extremely important. Heart transplantation is a treatment option after an exhaustive multidisciplinary evaluation, to minimize the risk of oncological relapse.
OBJETIVO: Describir las características clínicas, imagenológicas y la evolución de los pacientes trasplantados cardiacos por cardiotoxicidad inducida por antraciclinas. MÉTODOS: Serie de casos descriptiva de pacientes consecutivos trasplantados cardiacos debido a cardiotoxicidad mediada por antraciclinas en el periodo de Noviembre de 2009 a Abril de 2021.Las características clínicas, los estudios complementarios pretrasplante y la información sobre la evolución posterior al trasplante fue recolectada de la historia clínica electrónica de forma retrospectiva. RESULTADOS: Se incluyeron un total de 11 pacientes. La mediana de edad al diagnóstico de la patología oncológica fue de 15 años (RIC 10-37 años), mientras que la mediana de edad en la que recibieron el trasplante cardiaco fue de 56 años (RIC 39-62 años). Con respecto a la evolución posterior al trasplante, 3 pacientes murieron en el periodo del post operatorio inmediato. 1 paciente falleció a los 4 años del trasplante y los otros 7 pacientes tuvieron una evolución favorable. No se observó recaída oncológica en ningún paciente durante una mediana de seguimiento o de 2,5 años (RIC 1.86-3.85 años). CONCLUSIÓN: La etapa final de la miocardiopatía inducida por antraciclinas puede ocurrir muchos años después del tratamiento con quimioterapia, por lo que es extremadamente importante un seguimiento cardiológico estricto. El trasplante cardiaco es una opción en este grupo de pacientes luego de una exhaustiva evaluación multidisciplinaria, con el fin de minimizar el riesgo de recaída oncológica.
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Cardiomiopatías , Trasplante de Corazón , Humanos , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Antraciclinas/efectos adversos , Estudios Retrospectivos , Cardiomiopatías/inducido químicamente , RecurrenciaRESUMEN
RESUMEN Introducción: La utilidad de la resonancia magnética cardíaca (RMC) ha crecido ampliamente en los últimos años, en los cuales se han publicado distintos registros internacionales sobre su uso e impacto clínico. Sin embargo, no contamos con este tipo de información en Argentina. Objetivo: Evaluar indicaciones, protocolos utilizados, seguridad y consecuencias terapéuticas de la RMC en la República Argentina. Material y métodos: Se diseñó un registro prospectivo a nivel nacional con recolección de datos demográficos, indicaciones de RMC, complicaciones asociadas, diagnósticos y consecuencias terapéuticas. Resultados: Participaron 34 centros de 10 provincias de Argentina (85% centros privados, 59% centros con internación). Se incluyeron 1131 pacientes (edad 54 ± 18 años, 61% varones). Las principales indicaciones para el estudio de RMC fueron la miocardiopatía hipertrófica (13,9%) y la arritmia ventricular (12,3%). El 99,7% de los estudios fueron reportados sin complicaciones. Los resultados más frecuentes de la RMC fueron: normal (31,2%), miocardiopatía no isquémica (14,7%), miocardiopatía isquémico-necrótica (11,6%) y miocardiopatía hipertrófica (8,9%). La sospecha clínica fue confirmada en el 23,6% de los casos y la RMC generó un diagnóstico nuevo no sospechado en el 48,7% de los casos. Las consecuencias terapéuticas más frecuentes fueron el alta hospitalaria (31,6%) seguida por el cambio en la medicación (28,1%). Conclusiones: La RMC es un estudio ampliamente utilizado en Argentina, principalmente en centros privados, con un número muy bajo de complicaciones. Las principales indicaciones son las miocardiopatías (hipertrófica y dilatada) y la arritmia ventricular, y provee un diagnóstico nuevo no sospechado en casi la mitad de los casos. Se requieren de otros estudios en el futuro para evaluar las implicancias clínicas y terapéuticas.
ABSTRACT Background: The usefulness of cardiac magnetic resonance imaging (MRI) has greatly increased in the last years. Different international registries have been published on its use; however, there is no data available from Argentina. Objective: The aim of this study was to evaluate different indications, protocols, safety and therapeutic consequences of cardiac MRI in Argentina. Methods: A prospective national registry was designed with collection of demographic data, indications for cardiac MRI, associated complications, diagnoses and therapeutic consequences. Results: A total of 34 centers from 10 provinces of Argentina (85% private and 59% with inpatient capacity) participated in the study, including 1131 patients (mean age 54±18 years and 61% males). The main indications for cardiac MRI were hypertrophic cardiomyopathy (13.9%), and ventricular arrhythmia (12.3%). In 99.7% of cases, no study complications were reported. The most frequent results of cardiac MRI were: normal (31.2%), non-ischemic cardiomyopathy (14.7%), ischemic-necrotic cardiomyopathy (11.6%) and hypertrophic cardiomyopathy (8.9%). Clinical suspicion was confirmed in 23.6% of cases and cardiac MRI generated an unsuspected new diagnosis in 48.7% of cases. The main therapeutic consequences were hospital discharge (31.6%) followed by change in medication (28.1%). Conclusions: Cardiac MRI is widely used in Argentina, mainly in private centers with a very low incidence of complications. Cardiomyopathies (hypertrophic and dilated) and ventricular arrhythmia are its main indication, and it provides a new unsuspected diagnosis in almost half of the cases. Further studies are required to assess its clinical and therapeutic impact.
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Glioblastoma is the most prevalent and malignant brain tumor identified in adults. Surgical resection followed by radiotherapy and chemotherapy, mainly with temozolomide (TMZ), is the chosen treatment for this type of tumor. However, the average survival of patients is around 15 months. Novel approaches to glioblastoma treatment are greatly needed. Here, we aimed to investigate the anti-glioblastoma effect of the combination of matteucinol (Mat) (dihydroxyflavanone derived from Miconia chamissois Naudin) with the chemotherapeutic TMZ in vitro using tumor (U-251MG) and normal astrocyte (NHA) cell lines and in vivo using the chick embryo chorioallantoic membrane (CAM) assay. The combination was cytotoxic and selective for tumor cells (28 µg/mL Mat and 9.71 µg/mL TMZ). Additionally, the combination did not alter cell adhesion but caused morphological changes characteristic of apoptosis in vitro. Notably, the combination was also able to reduce tumor growth in the chick embryo model (CAM assay). The docking results showed that Mat was the best ligand to the cell death membrane receptor TNFR1 and to TNFR1/TMZ complex, suggesting that these two molecules may be working together increasing their potential. In conclusion, Mat-TMZ can be a good candidate for pharmacokinetic studies in view of clinical use for the treatment of glioblastoma.
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Glioblastoma , Receptores Tipo I de Factores de Necrosis Tumoral , Animales , Apoptosis , Línea Celular Tumoral , Proliferación Celular , Embrión de Pollo , Cromonas , Biología Computacional , Glioblastoma/tratamiento farmacológico , Humanos , Temozolomida/farmacología , Temozolomida/uso terapéuticoRESUMEN
OBJECTIVE: The traditional method of recording electrically evoked compound action potentials (ECAPs), as implemented in the MAESTRO clinical software (standard ART), requires manual adjustments during threshold determination through a specialist. The "FineGrain" research tool (FineGrain RT) uses a continuous stimulation paradigm combined with automatic ECAP threshold determination. The aim of this study was to compare the FineGrain RT with standard ART. DESIGN: ECAPs were recorded with standard ART and the FineGrain RT in paediatric cochlear implant recipients. Different stimulation rates were used for FineGrain ECAP recordings (40, 60, and 76 Hz). STUDY SAMPLE: Thirteen children (6 - 19 years) participated in this study - nine were bilaterally and four unilaterally implanted, resulting in a total of twenty-two implanted ears. RESULTS: ECAP threshold determination success rates were similar between the two approaches (92% and 89%) and ECAP thresholds correlated well (r: 0.94, p < 2.2e-16) with average ART thresholds being lower than FineGrain RT thresholds. FineGrain stimulation with different stimulation rates did not have a significant effect on ECAP thresholds but ECAP thresholds at medial and apical contacts were lower compared to basal contacts. CONCLUSIONS: TheFineGrain research approach is a reliable replacement for standard ART in clinical practice.
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Implantación Coclear , Implantes Cocleares , Potenciales de Acción/fisiología , Umbral Auditivo/fisiología , Niño , Implantación Coclear/métodos , Nervio Coclear , Estimulación Eléctrica , Potenciales Evocados Auditivos/fisiología , Humanos , Programas InformáticosRESUMEN
Glioblastoma is the most prevalent and malignant brain tumor identified in adults. Surgical resection followed by radiotherapy and chemotherapy, mainly with temozolomide (TMZ), is the chosen treatment for this type of tumor. However, the average survival of patients is around 15 months. Novel approaches to glioblastoma treatment are greatly needed. Here, we aimed to investigate the anti-glioblastoma effect of the combination of matteucinol (Mat) (dihydroxyflavanone derived from Miconia chamissois Naudin) with the chemotherapeutic TMZ in vitro using tumor (U-251MG) and normal astrocyte (NHA) cell lines and in vivo using the chick embryo chorioallantoic membrane (CAM) assay. The combination was cytotoxic and selective for tumor cells (28 μg/mL Mat and 9.71 μg/mL TMZ). Additionally, the combination did not alter cell adhesion but caused morphological changes characteristic of apoptosis in vitro. Notably, the combination was also able to reduce tumor growth in the chick embryo model (CAM assay). The docking results showed that Mat was the best ligand to the cell death membrane receptor TNFR1 and to TNFR1/TMZ complex, suggesting that these two molecules may be working together increasing their potential. In conclusion, Mat-TMZ can be a good candidate for pharmacokinetic studies in view of clinical use for the treatment of glioblastoma.
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Evaluate the mid-term success rate of these stems in periprosthetic femur fractures and to analyze the complications observed with the use of these stems. METHODS: Thirty five patients that underwent hip revision surgery secondary to Vancouver type B2 and B3 periprosthetic femur fracture were evaluated. In all cases, modular fluted tapered stems were used. RESULTS: Average follow-up was 42 months. Average Postoperative Harris Hip Score (HHS) was 78.11. Fracture healing was obtained in a 100% of the patients. Average implant survival was 50 months. CONCLUSION: Modular fluted tapered stems demonstrated a high rate implant stability, proximal femoral bone reconstitution, and fracture healing.
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Introducción: Las enfermedades degenerativas de la cadera y la columna vertebral son causas comunes de discapacidad y dolor y los síntomas suelen superponerse. Cuando algún parámetro se altera, otro debe modificarse para evitar el choque femoroacetabular y una posible luxación. Se piensa que la fijación lumbar afectaría la adaptación de la unidad espino-pélvica en las diferentes posturas. El objetivo de este estudio fue analizar el comportamiento espino-pélvico en pacientes con artroplastia total de cadera y artrodesis lumbar. Materiales y Métodos: Se realizó un estudio no aleatorizado, retrospectivo, de casos y controles en pacientes con artroplastia total de cadera evaluados con radiografía lumbopélvica de frente y de perfil en posición erecta y en sedestación, divididos en dos grupos: con artrodesis lumbar o sin ella. Se midieron parámetros espino-pélvicos y femoroacetabulares. Resultados: La muestra tenía 50 pacientes: 25 en cada grupo. Quince tenían artroplastia total de cadera bilateral y el nivel de fijación lumbar más frecuente era L5-S1. No hubo diferencia estadísticamente significativa en la edad y el sexo entre ambos grupos. Los pacientes con artrodesis lumbar necesitaron más flexión de cadera para sentarse, sin un aumento significativo asociado en la tasa de luxación. Conclusiones: La composición ideal de los componentes aún es difícil de alcanzar. La reconsideración de las "zonas seguras" de los componentes ha comenzado a alejarse de los valores del plano coronal de Lewinnek. Se ha propuesto un nuevo enfoque en las zonas seguras del plano sagital más apropiadas y precisas en pacientes seleccionados con enfermedad espino-pélvica grave. Nivel de Evidencia: III
Introduction: Degenerative diseases of the hip and spine are common causes of disability and pain, and the symptoms usually overlap. When a parameter is altered, another one should be modified to avoid femoroacetabular impingement and a potential dislocation. It is believed that lumbar fixation would affect the adaptation of the spinopelvic unit in different postures. This article aims to analyze the spinopelvic behavior in patients with Total Hip Arthroplasty (THA) and lumbar arthrodesis. Materials and Methods: A non-randomized retrospective study of cases and controls was carried out in patients with THA, who were assessed using anterior and lateral X-ray views in functional sitting and standing postures, divided into two groups depending on the presence or absence of lumbar arthrodesis. Spinopelvic parameters as well as femoroacetabular parameters were measured. Results: A sample of 50 patients was selected, 25 in each group. In total, 15 patients had bilateral THA, and the most common level of lumbar fixation was L5-S1. There was no statistically significant difference in gender and age between both groups. Lumbar arthrodesis patients required more hip flexion to sit, without being associated with a significant increase in the rate of dislocation. Conclusion: The ideal composition of the components is still difficult to achieve. The review of the "safe zones" of the components has started to depart from the values of the body plane proposed by Lewinnek. A new approach has been proposed to the safe zones of the sagittal plane, which are more appropriate and accurate in selected patients with severe spinopelvic pathology. Level of Evidence: IIII
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Anciano , Pelvis , Fusión Vertebral , Rango del Movimiento Articular , Artroplastia de Reemplazo de Cadera , Luxaciones ArticularesRESUMEN
Introducción: Debido al crecimiento exponencial del número de artroplastias de cadera, se espera una mayor cantidad de re-visiones en las próximas décadas. Los vástagos cónicos estriados modulares se han vuelto populares en la última década por sus resultados favorables. El objetivo de este estudio es evaluar los resultados, las complicaciones y la tasa de supervivencia de estos vástagos en las revisiones de cadera, con un seguimiento a mediano plazo. materiales y métodos: Estudio multicéntrico, retrospectivo. Se incluyeron 182 pacientes a quienes se les realizó una cirugía de revisión de cadera entre 2007 y 2017. Se colo-caron 185 vástagos cónicos estriados de fijación distal. El déficit de stock óseo femoral se clasificó según Paprosky y Burnett; y las facturas periprotésicas, según la clasificación de Vancouver. Se evaluó a los pacientes clínicamente con el Harris Hip Score (HHS) y con radiografías a los 3 meses y anualmente para evaluar la estabilidad del vástago, la subsidencia y el aflojamiento, así como la consolidación de la osteotomía. Resultados: Seguimiento medio 55.18 meses. El HHS posoperatorio tuvo una media de 80,28 (DE = 12,8, IC95% 78,5-82,97). No hubo complicaciones posoperatorias en el 75,4% de los pacientes. Las complicaciones más frecuentes fueron inestabilidad (7,6%) y subsidencia del implante (11,5%). Al final del seguimiento, el 95,05% de los pacientes tenía un implante estable. Conclusiones: Los vástagos cónicos estriados modulares de fijación distal proporcionan una solución confiable, reproducible y duradera para el manejo de revisiones de componentes femorales a medio plazo. Nivel de Evidencia: IV
Background: The number of arthroplasties performed every year is increasing; therefore, a greater number of revisions is expected in the coming decades. Modular fluted tapered stems have become the gold standard for their results in different series of patients. The objective of this article is to evaluate the results, complications and the survival rate of these stems in hip revisions with a medium-term follow-up. Materials and Methods: Retrospective, multicenter analysis. One hundred eighty-two patients who had undergone hip revision surgery between 2007 and 2017 were included. One hundred eighty-five modular fluted tapered stems were placed. Femoral bone stock defects were classified according to Paprosky and Burnett; and periprosthetic femur fractures according to Vancouver classification. Patients were evaluated clinically with Harris Hip Score (HHS) and radiographically 3 months after surgery and every year to assess stem stability, subsidence and loosening, as well as osteotomy healing. Results: Average follow-up was 55.18 months. Postoperative HHS had an average of 80.28 (SD = 12.8, 95% CI = [78.5, 82.97]). There were no postoperative complications in 75.4% of the patients. The most frequent complications were instability in 7.6% and implant subsidence in 11.5%. At the end of the follow-up, 95.05% of the patients had a stable implant. Conclusion: Modular fluted tapered stems provide a reliable, reproducible solution for the management of femoral component revisions at medium-term. Level of Evidence: IV
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Persona de Mediana Edad , Anciano , Complicaciones Posoperatorias , Reoperación , Falla de Prótesis , Resultado del Tratamiento , Artroplastia de Reemplazo de Cadera , Articulación de la Cadera/cirugíaRESUMEN
La investigación inicial del proyecto mirar fue la observación del proceso social y legislativo que tuvo lugar en diciembre de 2020: se estudiaron los debates en torno al proyecto de ley de IVE dentro del Congreso y los mensajes difundidos y comunicados tanto en las redes sociales como en los diarios impresos. Esta publicación reúne aquellos tres primeros estudios. El primer estudio, "Mensajes en disputa. El debate legislativo del proyecto de Ley de Interrupción Voluntaria del Embarazo" (Argentina, 2020), a cargo de Paloma Dulbecco, Santiago L. Cunial y Daniel E. Jones, se abocó a describir y analizar cuantitativa y cualitativamente el debate de la Ley de IVE en las dos Cámaras del Congreso de la Nación. El segundo estudio, "Análisis de la cobertura periodística del debate legislativo sobre la Ley de Interrupción Voluntaria del Embarazo" (Argentina, 2020),a cargo de Sara Pérez, Ana Aymá, Florencia Moragas y Emilse Kejner, analiza el discurso de la prensa gráfica digital durante el debate desarrollado en el Congreso sobre el proyecto de Ley de IVE, incluyendo medios de alcance nacional, regional y provincial. El tercer estudio, "#ESLEY | Aprobación de la IVE y activación de narrativas en redes sociales" (Argentina, 2020), de Ernesto Calvo, Natalia Aruguete, Paola Ingrassia y Celeste Gómez Wagner, se concentró en medir y analizar la propagación de noticias y mensajes relativos a la consideración y aprobación de la Ley en las redes sociales.
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Humanos , Femenino , Aborto Legal , Jurisprudencia , Medios de Comunicación de Masas , ArgentinaRESUMEN
Since the Alma Ata World Health Organization Conference in 1978, countries around the world have adopted institutions that promote the participation of citizens in their public health systems. The main objectives of this article are two-fold. First, we describe the origins and implementation of a national-level civic participatory program that was in place in Argentina in the mid-2000s: the Local Participatory Projects (Proyectos Locales Participativos). Second, we analyze the 201 local participatory projects that were carried out in Argentina between 2007 and 2008. We study health and environmental problems that prompt people's participation in the program and the social dynamics through which such participation is executed.
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Participación de la Comunidad , Planificación en Salud/métodos , Política de Salud , Atención Primaria de Salud/organización & administración , Argentina , Participación de la Comunidad/historia , Femenino , Planificación en Salud/historia , Política de Salud/historia , Historia del Siglo XX , Humanos , Gobierno Local , Masculino , Atención Primaria de Salud/historia , Evaluación de Programas y Proyectos de Salud , Participación SocialRESUMEN
Objetivou-se com o presente trabalho caracterizar o processo de compostagem de fluxo contínuo e aeração passiva de resíduos da produção e abate da caprino-ovinocultura e de seu composto orgânico gerado. O processo de compostagem utilizou resíduos sólidos provenientes da produção e do abate de caprinos e ovinos e foi realizado em galpão de alvenaria. Os resíduos agropecuários utilizados incluíram sobras de capim-elefante triturado seco, poda de árvores, esterco e carcaça de caprinos e ovinos. Os tratamentos empregados foram três níveis de umidade aplicados nas leiras de compostagem (30, 50 e 70% com base no peso da carcaça dos animais) e épocas do ano de montagem (período seco, transição e úmido) com base na precipitação, com três repetições. As variáveis avaliadas foram atributos químicos, físicos, microbiológicos e parasitológicos do composto e sua comparação com a legislação vigente. O composto orgânico gerado atende as especificações das legislações utilizadas para comparação. Independentemente da época do ano ou da umidade aplicada, o processo de compostagem foi eficiente em reduzir passivos ambientais, como carcaças. A compostagem promoveu a eliminação dos patógenos avaliados, indicando que o composto não oferece risco de transmissão e pode ser utilizado de forma segura.(AU)
The objective of this study to characterize the process of continuous flow of composting and passive aeration of waste production and slaughter the goat and sheep industry and its generated organic compound. The composting process, performed in a brick barn, used solid residues (manure and carcass parts) from the slaughter of goats and sheep along with chopped dry elephant grass and tree trimmings. The treatments employed three moisture levels in the piles and four collections of samples from the piles at timed intervals (0, 30, 60 and 120 days), with three repetitions. The variables evaluated were the chemical and physical attributes of the compost generated. The treatments were three moisture levels applied in compost piles (30, 50 and 70% based on the housing of animals) and assembly times of the year (dry, transitional and humid) based on rainfall, with three replications. The variables were chemical, physical, microbiological and parasitological of the compound and its comparison with current legislation. The generated organic compound meets the specifications of the laws used for comparison. Regardless of the time of year or moisture applied, the composting process was effective in reducing environmental liabilities as carcasses. Composting promoted elimination of this pathogen, indicating that the compound can be used safely.(AU)
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Compostaje/métodos , Técnicas Microbiológicas/métodos , Fenómenos Físicos , Administración de ResiduosRESUMEN
Objetivou-se com o presente trabalho caracterizar o processo de compostagem de fluxo contínuo e aeração passiva de resíduos da produção e abate da caprino-ovinocultura e de seu composto orgânico gerado. O processo de compostagem utilizou resíduos sólidos provenientes da produção e do abate de caprinos e ovinos e foi realizado em galpão de alvenaria. Os resíduos agropecuários utilizados incluíram sobras de capim-elefante triturado seco, poda de árvores, esterco e carcaça de caprinos e ovinos. Os tratamentos empregados foram três níveis de umidade aplicados nas leiras de compostagem (30, 50 e 70% com base no peso da carcaça dos animais) e épocas do ano de montagem (período seco, transição e úmido) com base na precipitação, com três repetições. As variáveis avaliadas foram atributos químicos, físicos, microbiológicos e parasitológicos do composto e sua comparação com a legislação vigente. O composto orgânico gerado atende as especificações das legislações utilizadas para comparação. Independentemente da época do ano ou da umidade aplicada, o processo de compostagem foi eficiente em reduzir passivos ambientais, como carcaças. A compostagem promoveu a eliminação dos patógenos avaliados, indicando que o composto não oferece risco de transmissão e pode ser utilizado de forma segura.(AU)
The objective of this study to characterize the process of continuous flow of composting and passive aeration of waste production and slaughter the goat and sheep industry and its generated organic compound. The composting process, performed in a brick barn, used solid residues (manure and carcass parts) from the slaughter of goats and sheep along with chopped dry elephant grass and tree trimmings. The treatments employed three moisture levels in the piles and four collections of samples from the piles at timed intervals (0, 30, 60 and 120 days), with three repetitions. The variables evaluated were the chemical and physical attributes of the compost generated. The treatments were three moisture levels applied in compost piles (30, 50 and 70% based on the housing of animals) and assembly times of the year (dry, transitional and humid) based on rainfall, with three replications. The variables were chemical, physical, microbiological and parasitological of the compound and its comparison with current legislation. The generated organic compound meets the specifications of the laws used for comparison. Regardless of the time of year or moisture applied, the composting process was effective in reducing environmental liabilities as carcasses. Composting promoted elimination of this pathogen, indicating that the compound can be used safely.(AU)
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Compostaje/métodos , Técnicas Microbiológicas/métodos , Fenómenos Físicos , Administración de ResiduosRESUMEN
Abstract: Since the Alma Ata World Health Organization Conference in 1978, countries around the world have adopted institutions that promote the participation of citizens in their public health systems. The main objectives of this article are two-fold. First, we describe the origins and implementation of a national-level civic participatory program that was in place in Argentina in the mid-2000s: the Local Participatory Projects (Proyectos Locales Participativos). Second, we analyze the 201 local participatory projects that were carried out in Argentina between 2007 and 2008. We study health and environmental problems that prompt people's participation in the program and the social dynamics through which such participation is executed.
Resumo: Desde a Conferência de Alma Ata da Organização Mundial da Saúde em 1978, países do mundo inteiro adotaram instituições que promovem a participação dos cidadãos nos sistemas de saúde pública. O artigo teve dois objetivos principais. Primeiro, descrevemos as origens e a implementação de um programa participativo em nível nacional que foi implementado na Argentina em meados da primeira década deste século: os chamados Projetos Locais Participativos (Proyectos Locales Participativos). Segundo, analisamos os 201 projetos de participação local que foram implementados na Argentina entre 2007 e 2008. Estudamos os problemas sanitários e ambientais que motivaram a participação popular no programa e a dinâmica social através da qual essa participação é efetivada.
Resumen: Desde la Conferencia de la Organización Mundial de la Salud de Alma Ata en 1978, varios países alrededor del mundo han creado instituciones que promueven la participación de la ciudadanía en sus sistemas públicos de salud. En este artículo, en primer lugar, describimos los orígenes e implementación de un programa cívico participativo en el territorio nacional, que se realizó en Argentina a mediados de la década de los años 2000, denominado Proyectos Locales Participativos; en segundo lugar, analizamos 201 proyectos locales participativos que se llevaron a cabo en el país entre 2007 y 2008. Estudiamos los problemas de salud y medioambientales que motivaron la participación de la gente en el programa, así como la dinámica social a través de la cual se canalizaba esta participación.
Asunto(s)
Humanos , Masculino , Femenino , Historia del Siglo XX , Atención Primaria de Salud/organización & administración , Participación de la Comunidad/historia , Planificación en Salud/métodos , Política de Salud/historia , Argentina , Atención Primaria de Salud/historia , Evaluación de Programas y Proyectos de Salud , Participación Social , Planificación en Salud/historia , Gobierno LocalRESUMEN
PURPOSE: To analyze time to return to sport, functional outcomes, and recurrences of the modified Latarjet procedure without capsulolabral repair in athletes with recurrent anterior shoulder instability after a failed previous operative stabilization. METHODS: We included athletes with recurrent anterior shoulder instability with a previous failed operative stabilization treated with the modified Latarjet procedure without capsulolabral repair with a minimum of 2-year follow-up. Return to sports, range of motion, the Rowe score, a visual analog scale for pain in sport activity, and the Athletic Shoulder Outcome Scoring System were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. RESULTS: Between June 2008 and June 2015, 68 athletes were treated with the modified Latarjet procedure without capsulolabral reconstruction for recurrent shoulder instability after a previous failed stabilization surgery. The mean follow-up was 44 months (range, 24-108 months), and the mean age at the time of operation was 26.8 years (range, 17-35 years). All the patients returned to sports, and 95% returned to the same sport they practiced before the surgery, all to the same level. No significant difference in shoulder range of motion was found between preoperative and postoperative results. The Rowe score, visual analog scale, and Athletic Shoulder Outcome Scoring System showed statistical improvement after operation (P < .001). There was no recurrence of shoulder dislocation or subluxation. The bone block healed in 92% of patients. There were 8 complications (12.3%) and 2 reoperations (3%). CONCLUSIONS: In athletes with previous failed operative stabilization procedures, the modified Latarjet without capsulolabral repair produced excellent functional outcomes with most athletes returning to sport at the same level they had before the surgery without recurrences. LEVEL OF EVIDENCE: Level IV, therapeutic, case series study.
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Artroplastia , Inestabilidad de la Articulación/cirugía , Luxación del Hombro/cirugía , Articulación del Hombro/cirugía , Adolescente , Adulto , Artroplastia/efectos adversos , Femenino , Humanos , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/fisiopatología , Masculino , Complicaciones Posoperatorias , Rango del Movimiento Articular , Recurrencia , Reoperación , Estudios Retrospectivos , Volver al Deporte , Luxación del Hombro/diagnóstico por imagen , Luxación del Hombro/fisiopatología , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/fisiología , Tomografía Computarizada por Rayos X , Insuficiencia del Tratamiento , Adulto JovenRESUMEN
Background and Aims: Amazonia is a major world centre of plant domestication, but little is known about how the crops were dispersed across the region. Manioc (Manihot esculenta) was domesticated in the south-western Amazon basin, and is the most important staple food crop that originated in Amazonia. Current contrasting distributions may reflect distinct histories of dispersal of bitter and sweet manioc landraces. To produce new insights into the evolutionary history of the crop, we investigated the contemporary genetic diversity and structure of bitter and sweet manioc along major Amazonian rivers. Methods: The patterns of genetic structure and diversity of wild and cultivated sweet and bitter manioc with four chloroplast and 14 nuclear microsatellite markers were evaluated. Results were interpreted in terms of the crop's dispersal. Key results: No phylogeographic patterns among rivers were detected, and genetic structure among rivers was confounded by the bitter-sweet divergence. However, differences in the distribution of nuclear diversity and somewhat distinctive patterns of genetic structure across rivers were observed within bitter and sweet manioc. Conclusions: Various pre-Columbian and post-European conquest events in the history of Amazonian occupation may explain the absence of clearer patterns of genetic structure. However, the wide distribution of the most common chloroplast haplotype agrees with an early dispersal of manioc across Brazilian Amazonia. Furthermore, differences in genetic structure and in the spatial distribution of genetic diversity suggest that bitter and sweet manioc had distinct dispersal histories. Knowledge about how prehistoric and contemporary Amazonian peoples manage their crops is valuable for the maintenance and conservation of the impressive diversity of their native crops.
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Cloroplastos/genética , Manihot/genética , Brasil , ADN de Plantas/genética , Domesticación , Variación Genética/genética , Haplotipos/genética , Manihot/anatomía & histología , Repeticiones de Microsatélite/genética , Filogenia , Fitomejoramiento , RíosRESUMEN
BACKGROUND: The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss in high-demand collision athletes remains a challenge. PURPOSE: To analyze the time to return to sport, clinical outcomes, and recurrences following a modified Latarjet procedure without capsulolabral repair in rugby players with recurrent anterior shoulder instability and significant glenoid bone loss. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between June 2008 and June 2015, 50 competitive rugby players (practice >2 times per week and competition during weekends) with recurrent anterior shoulder instability underwent operation with the modified congruent arc Latarjet procedure without capsulolabral repair in our institution. Cases included 18 primary repairs and 32 revisions. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale for pain in sport activity (VAS), and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. The final analysis included 49 shoulders in 48 patients (31 revision cases). RESULTS: The mean follow-up was 48 months (range, 24-108 months) and the mean age at the time of operation was 22.8 years (range, 17-35 years). Forty-five patients (93.7%) returned to playing rugby, all at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistically significant improvement after operation ( P < .001). The Rowe score increased from a mean of 39.5 points preoperatively to 94 points postoperatively ( P < .01). The VAS score decreased from 3.6 points preoperatively to 1.2 points postoperatively ( P < .01). The ASOSS score improved significantly from a mean of 44 points preoperatively to 89.5 points postoperatively ( P < .01). No recurrence of shoulder dislocation or subluxation was noted. The bone block healed in 43 shoulders (88%). CONCLUSION: In rugby players with recurrent anterior shoulder instability and significant glenoid bone loss, the modified Latarjet procedure without capsulolabral repair produced excellent functional outcomes, with most athletes returning to rugby at their preinjury level of play without recurrences.
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Fútbol Americano , Inestabilidad de la Articulación/cirugía , Luxación del Hombro/cirugía , Articulación del Hombro/cirugía , Adolescente , Adulto , Femenino , Humanos , Masculino , Dimensión del Dolor , Periodo Posoperatorio , Rango del Movimiento Articular , Recurrencia , Estudios Retrospectivos , Escápula/cirugía , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: The literature lacks evidence comparing outcomes between the Latarjet procedure performed as a primary procedure versus a revision procedure in competitive athletes. PURPOSE: To compare return to sport, functional outcomes, and complications of the modified Latarjet performed as a primary or revision procedure in competitive athletes. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Between June 2008 and June 2015, a total of 100 competitive athletes with recurrent anterior shoulder instability underwent surgery with the congruent arc Latarjet procedure without capsulolabral repair. There were 46 patients with primary repairs and 54 with revisions. Return to sport, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sport activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed by computed tomography. RESULTS: The mean follow-up period was 58 months (range, 24-108 months). A total of 96 patients (96%) returned to competitive sports; 91% returned to their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistically significant improvements after surgery (P < .001). The Rowe score increased from a preoperative mean of 43.8 to a postoperative mean of 96.1 (P < .01). Subjective pain during sports improved from a preoperative VAS score of 3.3 to a postoperative score of 1.2 (P < .01). The ASOSS score improved significantly from a preoperative mean of 46.3 to a postoperative mean of 88.1 (P < .001). No significant differences in shoulder ROM and functional scores were found between patients who underwent a primary versus a revision procedure. No recurrence of shoulder dislocation or subluxation was noted. The bone block healed in 91 patients (91%). CONCLUSION: In competitive athletes with recurrent anterior glenohumeral instability, the modified Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before surgery and without recurrence, regardless of whether the surgery was performed as a primary or a revision procedure.
RESUMEN
Introducción: El objetivo de este estudio experimental fue evaluar el resultado radiológico e histológico del empleo de alendronato colocado localmente en el foco de fracturas de fémur en conejos. Materiales y Métodos: Se utilizaron 30 conejos a los cuales se les fracturó el fémur derecho y se los dividió en tres grupos de 10 animales cada uno. A los conejos del grupo 1 se les colocó una solución con alendronato en el foco de fractura; los del grupo 2 fueron sometidos al mismo procedimiento a los siete días de la fractura y el grupo 3 era de control. Se realizó la evaluación radiográfica en el momento de la fractura y a los 42 días del procedimiento. Se evaluaron las características del callo óseo mediante anatomía patológica, radiología y tomografía computarizada. Resultados: Se evaluaron 24 conejos (2 conejos del grupo 2 y 4 del grupo 3 murieron). El análisis histológico reveló moderada formación ósea en los tres grupos, sin diferencias estadísticamente significativas (p = 0,8336). Según los resultados de los estudios por imágenes, no existieron diferencias estadísticamente significativas en el tamaño del callo óseo entre los grupos para los dos estudios (radiografía: p = 0,777 y tomografía: p = 0,349). Conclusión: El alendronato colocado localmente en el foco de fractura, en la etapa aguda y luego de una semana, no alteró, de manera estadísticamente significativa, el proceso normal de consolidación, determinado por anatomía patológica y radiología, a las seis semanas de la fractura de fémur en conejos. Nivel de Evidencia: II
Introduction: The aim of this experimental study was to evaluate the radiologic and histological results of the use of alendronate administered locally at the fractures site in rabbits. Methods: The fractured right femur of 30 rabbits was used for evaluation. The animals were distributed in three groups of 10 rabbits each. A solution with alendronate was placed at the fracture site in group 1; the same procedure was performed 7 days after the fracture in group 2, and group 3 functioned as control. Radiographic evaluation was performed at the time of the fracture and at day 42. Radiological, PA and CT-scan evaluations of bone callus characteristics in each rabbit were performed. Results: Twenty-four rabbits were evaluated (2 rabbits in group 2 and 4 in group 3 died). Histological evaluation evidenced moderate bone formation in the three groups without statistically significant differences (p=0.8336). Concerning imaging studies, there were no statistically significant differences in the size of bone callus among groups for both studies (X-rays: p=0.777 and CT: p=0.349). Conclusion: The use of alendronate administered locally at the fracture site, in the acute period and after one week, did not alter the normal consolidation process determined by PA and radiology, six weeks after femur fracture in rabbits. Level of Evidence: II