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Brassicaceaes are rich in glucosinolates (GSL), whose derivatives, the isothyocianates sulforaphane (SFN), iberine (IB), or indole derivatives as indole-3-carbinol (I3C), have anticancer activities. We evaluated the effects of a broccoli sprout (Brassica oleracea var italica) and red cabbage (B. oleracea L. var capitata f. rubra) extracts and their GSL derivatives on breast cancer cells. Broccoli sprout aqueous extract (BSE) and red cabbage aqueous (RCA) or ethanolic (RCE) extracts were high in SFN, IB, and/or I3C. BSE and RCA decreased proliferation at doses of 2.5-5 mg/mL but induced proliferation at lower doses. RCE decreased proliferation starting at 10 µg/mL with selectivity toward cancer cells. SFN, IB, or I3C alone or in combination did not decrease proliferation similarly, suggesting synergistic effects with other phytochemicals in the extract. RCE showed selectivity toward breast cancer cells, but the effect of the individual metabolites or their combination did not reduce proliferation to the same extent. It will be important to determine the combination responsible for this effect to characterize their use for breast cancer treatment.
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Endometriosis is a chronic proinflammatory pathology characterized by the growth of tissue similar to the endometrium outside the uterus, affecting approximately 5 to 15% of women worldwide. Suffering from endometriosis entails a complex pathophysiological process, significantly impacting the quality of life and reproductive function of affected women; therefore, it must be addressed in a personalized and comprehensive manner, as its management requires a multidisciplinary approach. This article aims to conduct a comprehensive literature review of endometriosis, not only as a pathophysiological condition but also as a significant factor impacting the social, nutritional, and mental well-being of those who experience it. Emphasis is placed on the importance of understanding and assessing the impact of the pathology to provide a better and more comprehensive approach, integrating various alternatives and strategic treatments for the factors involved in its development. The aim is to provide a complete overview of endometriosis, from its pathophysiology to its impact on the quality of life of patients, as well as a review of current treatment options, both pharmacological and alternative, in order to broaden the perspective on the pathology to improve the care of patients with this disease.
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The aim of the present study was to advance knowledge of the secular changes in the prevalence of excess weight (overweight and obesity) and body composition of children living in different localities of La Plata district (Buenos Aires province, Argentina) over the last two decades. For this purpose, anthropometric data and information on the socioeconomic and environmental context of residence of schoolchildren aged 4.0-12.9 years collected during 2005-2009 (Cohort 1, n = 1 233) and 2016-2019 (Cohort 2, n = 1 499) were analysed and compared. From a secular perspective, the current analysis showed that the socioeconomic and environmental conditions of families living in La Plata district have deteriorated in recent decades. In this context, child excess weight increased by 13% and body composition was altered, mainly as a result of an increase in fat mass, without observing changes in the muscle component.
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AIM: Gestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes. MATERIALS AND METHODS: A cohort of 369 pregnant women underwent a 75-g oral glucose tolerance test. Maternal variables, pharmacotherapy prescriptions and neonatal outcomes were analysed employing t-tests, χ2 tests, and logistic regression. A p < .05 was considered significant. RESULTS: Early GD increased the odds of neonatal hypoglycaemia [odds ratio (OR): 18.57, p = .013] and respiratory distress syndrome (OR: 4.75, p = .034). Nutritional therapy prescription by an accredited nutritionist was the most common treatment in women diagnosed after 24 weeks, but those with eGD required more frequently specialized nutritional consulting + metformin to achieve glycaemic control (p = .027). eGD was associated with a higher requirement of nutritional therapy prescription + metformin (OR: 2.26, 95% confidence interval: 1.25-4.09, p = .007) and with maternal hyperglycaemia during the post-partum period at 2 h of the oral glucose tolerance test (OR: 1.03, 95% confidence interval: 1.02-1.13, p = .024). CONCLUSION: Timely diagnosis and personalized treatment of GD are desirable because an earlier presentation is related to a higher risk of adverse neonatal and maternal outcomes.
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Diabetes Gestacional , Diagnóstico Precoz , Prueba de Tolerancia a la Glucosa , Hipoglucemiantes , Metformina , Humanos , Femenino , Embarazo , Diabetes Gestacional/tratamiento farmacológico , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/sangre , Recién Nacido , Adulto , Hipoglucemiantes/uso terapéutico , Metformina/uso terapéutico , Hipoglucemia/inducido químicamente , Hipoglucemia/prevención & control , Hipoglucemia/epidemiología , Resultado del Embarazo/epidemiología , Estudios de Cohortes , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & control , Síndrome de Dificultad Respiratoria del Recién Nacido/epidemiología , Glucemia/metabolismo , Glucemia/análisisRESUMEN
BACKGROUND: The sphenoid bone is an irregular, unpaired, symmetrical bone located in the middle of the anterior skull and is involved in craniofacial growth and development. Since the morphology of Sella turcica (ST) is associated with different craniofacial patterns, this study aimed to investigate if there is a correlation between ST morphology on the one hand and sagittal craniofacial patterns on the other hand. METHODS: This study was conducted with a convenience sample that included Brazilian individuals undergoing orthodontic treatment. Lateral cephalograms were used to evaluate the calcification pattern and morphology of ST, as well as skeletal class by analyzing the ANB angle. Pearson's chi-square test with Bonferroni post-hoc test was performed to evaluate the association between ST calcification pattern and morphology, and anteroposterior skeletal malocclusion. The established significance level was 0.05. RESULTS: The study collective was comprised of 305 orthodontic patients (178 (58.4 %) female, 127 (41.6 %) male), who had a mean age of 23.2 (±10.6) years. 131 participants (42.9 %) presented skeletal class I, 142 (46.6%) skeletal Class II, and 32 (10.5%) had a skeletal class III. The degree of prognathism of the mandible showed a homogenous distribution within the study collective (91 (29.9 %) orthognathic, 100 (32.9 %) retrognathic, 113 (37.2 %) prognathic mandible). Concerning the maxilla, 92 (30.2%) individuals presented an orthognathic upper jaw, whereas 60 (19.7%) showed maxillary retrognathism and 153 (50.2%) maxillary prognathism. Compared to patients with skeletal class I, skeletal class III individuals presented significantly more hypertrophic posterior clinoid process (p<0.007) and pyramidal shape of the dorsum of the ST (p<0.038). CONCLUSIONS: Our results suggest that the hypertrophic posterior clinoid process and pyramidal shape of the ST dorsum are more prevalent in individuals with skeletal class III malocclusion.
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Cefalometría , Maloclusión , Silla Turca , Humanos , Femenino , Masculino , Silla Turca/patología , Silla Turca/diagnóstico por imagen , Estudios Transversales , Maloclusión/patología , Adolescente , Adulto Joven , Adulto , Brasil/epidemiología , Calcinosis/patología , Calcificación FisiológicaRESUMEN
OBJECTIVE: To provide information on the secular trend in age at menarche (AgM) in Argentinean girls in relation to excess weight (EW) and body adiposity. METHODS: Two cohorts (C) (C1, 2005-2007 and C2, 2015-2019) of children aged 8-14 years from La Plata district were studied using identical methodological criteria. Each participating child was asked about menarche (M) status: M presence (MP) or absence (MA). The AgM was estimated using the status quo method and logistic regression analysis. Body weight, height, and tricipital and subscapular skinfolds were collected to estimate EW (overweight + obesity) according to WHO criteria, and body adiposity (sum of skinfolds, SSK = [tricipital + subscapular]). The prevalence of EW by C was estimated and compared using the Chi-square test. The MP probability in relation to age, C, and EW was analyzed by applying logistic regression. Parents completed a questionnaire to assess family socioeconomic conditions. Data were compared using the Chi-square test. RESULTS: Differences in MP prevalence between C were significant (C1: 21.1% vs. C2: 28.7%). Median AgM was 12.81 years in C1 and 12.22 in C2. The prevalence of EW was higher in C2 (35.3%) than in C1 (24.6%). The probability of MP was higher in C2 than in C1 and children with EW. Both BMI and SSK showed inter-cohort increases. Socioeconomic conditions were substantially deteriorated between C. CONCLUSION: In an obesogenic context marked by the significant increase in body adiposity and EW, M prevalence exhibited a positive secular trend and AgM reduced by nearly seven months between the cohorts studied.
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Menarquia , Humanos , Argentina/epidemiología , Niño , Adolescente , Femenino , Factores de Edad , Sobrepeso/epidemiología , Pubertad , Adiposidad , Estudios de Cohortes , PrevalenciaRESUMEN
ABSTRACT BACKGROUND AND OBJECTIVES: With the necessity to assess musculoskeletal complaints caused by computer use, The Maastricht Upper Extremity Questionnaire (MUEQ) was created, which aims to assess musculoskeletal complaints of the upper limbs, shoulder complex and cervical spine in computer users. However, there is currently no comprehensive summary in the scientific literature on the psychometric properties of the MUEQ. The objective of this study was to conduct a synthesis of all available scientific evidence that has analyzed the psychometric properties of the MUEQ. CONTENTS: This study followed the PRISMA recommendations. The bibliographic search was carried out in the following databases: MEDLINE (via VHL), Embase, LILACS (via VHL), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus and SPORTDiscus. Studies that addressed the psychometric properties of the MUEQ were included, as long as they were original articles of research carried out with human beings and indexed in the databases used. The studies were selected in two phases, with two independent reviewers. A total of 6 articles were included in the analysis. The evidence based on internal structure showed acceptable results. The reliability indexes ranged from α=0.52 to α=0.84, and ICC/composite reliability > 0.70 in the analyzed studies, classified as "good" and "excellent," respectively. CONCLUSION: In general, this research found a lack of detail on the process of content validity and evidence related to external variables and the description of the sample. These problems extended to the evidence based on the internal structure and reliability of the MUEQ, which did not reach levels considered acceptable to ensure its adequacy and accuracy.
RESUMO JUSTIFICATIVA E OBJETIVOS: Com a necessidade de avaliar as queixas musculoesqueléticas ocasionadas pelo uso de computadores, foi criado o The Maastricht Upper Extremity Questionnaire (MUEQ), cujo objetivo foi avaliar as queixas musculoesqueléticas relativas aos membros superiores, ao complexo do ombro e à cervical em usuários de computadores. No entanto, atualmente não existe uma sumarização abrangente, na literatura científica, sobre as propriedades psicométricas do MUEQ. O objetivo deste estudo foi realizar uma síntese de evidências científicas disponíveis que analisaram as propriedades psicométricas do MUEQ. CONTEÚDO: Este estudo seguiu as recomendações do PRISMA. A busca bibliográfica foi realizada nas bases de dados Medline (via BVS), Embase, LILACS (via BVS), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus e SPORTDiscus. Foram incluídos estudos que abordaram as propriedades psicométricas do MUEQ, desde que fossem artigos originais de pesquisas desenvolvidas com seres humanos e indexados nas bases utilizadas. A seleção dos estudos ocorreu em duas fases, com dois revisores independentes. Foram incluídos 6 artigos/publicações na análise. A evidência baseada na estrutura interna apresentou resultados aceitáveis. Os índices de fidedignidade variaram de α=0,52 a α=0,84 e ICC/confiabilidade composta foram maiores que 0,70 nos estudos selecionados, classificados como "bom" e "excelente", respectivamente. CONCLUSÃO: De um modo geral, esta pesquisa constatou a falta de detalhamento sobre o processo de validade de conteúdo e de evidências relacionados a variáveis externas e à descrição da amostra. Esses problemas se estenderam à evidência baseada na estrutura interna e à confiabilidade do MUEQ, que não alcançaram níveis considerados aceitáveis para garantir sua adequação e precisão.
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INTRODUCTION: The frame index (FI), based on measurements of elbow breadth and height, is the body frame size parameter most frequently used in child and adolescent populations to assess skeletal robustness. In 2018, the first FI reference percentiles were elaborated with data of boys and girls aged 0-18 years from different European populations. In Argentina, the FI reference values were published in 2022. OBJECTIVE: The present study aims to compare the Argentine (AR) and European (EU) FI reference percentiles to evaluate possible variation in bone robustness between populations. METHODS: The values of the 3rd, 50th and 97th percentiles of the AR and EU FI references for boys and girls aged 4-14 years were compared using the Wilcoxon test (p < .05). Percentage differences between means (PDM) were calculated to analyze the magnitude of the differences between both references. The R 3.2.0 program was used to plot the percentile curves. RESULTS: The FI reference values were lower in AR than in EU in both the 3rd and the 50th percentiles, regardless of sex and age. Conversely, the AR reference values of the 97th percentile were higher than the EU values at most ages. CONCLUSIONS: The comparison of the AR and EU FI references showed similar age and sex growth patterns. However, differences in percentile values between populations were observed, highlighting the importance of having local references for the evaluation of skeletal robustness.
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Estatura , Masculino , Niño , Femenino , Adolescente , Humanos , Valores de Referencia , Argentina , Índice de Masa CorporalRESUMEN
Three-dimensional (3D) printing is a new method for creating human and veterinary anatomical models, which makes the education of students and professionals in the health area more complete, in addition to helping the patients themselves understand. In the area of cardiology, this technique can efficiently help the assessment of cardiac alterations for the patient during medical consultations, tying a feeling of involvement with the medical team. Likewise, it is possible to use 3D printing to understand the echocardiographic technique, where conceptual knowledge of the anatomy of the heart and the ability to translate a two-dimensional ultrasound image into a 3D idea is required. This research aimed to develop printable 3D cardiac models, to demonstrate cardiac sections used in echocardiography and use them to teach dog owners, evaluating their suitability as a tool for a better understanding of the echocardiographic exam. The 3D cardiac models were validated by dog owners through an evaluation questionnaire prepared on a Likert scale, after monitoring the echocardiographic examination with an explanation by the echocardiographer using the printed models. A total of 30 dog owners participated in the study. In all seven questions of the questionnaire, the vast majority of positive responses were observed, with partial or total agreement by the participants. These results showed that the use of 3D printed models is effective in improving the understanding of the echocardiographic examination and is feasible in the daily workflow.(AU)
A manufatura aditiva ou impressão 3D é um novo método para a criação de modelos anatômicos humanos e veterinários, que torna a educação de alunos e profissionais da área da saúde mais completa, além de auxiliar o entendimento dos próprios pacientes. Na área da cardiologia, esta técnica pode auxiliar de maneira eficiente a avaliação das alterações cardíacas para o paciente durante as consultas médicas, atrelando um sentimento de envolvimento com a equipe médica. Da mesma maneira, é possível utilizar a impressão 3D para o entendimento da técnica ecocardiográfica, onde é necessário conhecimento conceitual da anatomia do coração e a capacidade de traduzir uma imagem de ultrassonografia bidimensional em uma ideia tridimensional. Este artigo teve como objetivo desenvolver modelos cardíacos 3D imprimíveis, com o intuito de demonstrar cortes cardíacos utilizados na ecocardiografia e utilizá-los para ensinar os tutores de cães, avaliando sua adequação como ferramenta para melhor compreensão do exame ecocardiográfico. Imagens em DICOM de um exame de tomografia computadorizada de uma cadela foi adquirida para criação, edição e impressão dos diferentes modelos em 3D, que representam os cortes ecocardiográficos. Os modelos cardíacos em 3D foram validados por tutores de cães por meio de um questionário de avaliação elaborado em uma escala Likert, após acompanhamento do exame ecocardiográfico com uma explicação pelo ecocardiografista utilizando os modelos impressos. Um total de 30 tutores de cães participaram do estudo. Em todas as sete perguntas do questionário, foram observadas em sua grande maioria respostas positivas, sendo elas com concordância parcial ou total dos participantes. Até o momento não foram encontrados na literatura estudos com modelos de coração desenvolvidos para a educação clínica dos tutores de cães. Os resultados revelam que o uso dos modelos impressos em 3D é eficaz para melhorar a compreensão do exame ecocardiográfico e é viável no fluxo de trabalho diário.(AU)
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Ecocardiografía/veterinaria , Perros , Educación en Veterinaria , Impresión Tridimensional , Modelos CardiovascularesRESUMEN
Sella turcica development involves molecular factors and genes responsible for ossification. It is possible that single nucleotide polymorphisms (SNPs) in key genes are involved in morphological variation of sella turcica. Genes belonging to the WNT signaling pathway are involved in the ossification process and are candidates of sella turcica morphology. This study aimed to evaluate if SNPs in WNT6 (rs6754599) and WNT10A (rs10177996 and rs3806557) genes are associated with the calcification and patterns of the sella turcica. Nonsyndromic individuals were included in the research. Cephalometric radiographs were examined and the sella calcification was evaluated and classified according to the calcification of the interclinoid ligament (no calcification, partial calcification, and incomplete calcification) and sella turcica pattern (normal sella turcica, bridge type A-ribbon-like fusion, bridge type B-extension of the clinoid processes, incomplete bridge, hypertrophic posterior clinoid process, hypotrophic posterior clinoid process, irregularity in the posterior part, pyramidal shape of the dorsum, double contour of the floor, oblique anterior wall, and oblique contour of the floor). DNA samples were used to evaluate SNPs in the WNT genes (rs6754599, rs10177996, and rs3806557) using real-time PCR. Chi-square test or Fisher's exact test were used to compare the allele and genotype distributions according to sella turcica phenotypes. The alpha was set as 5% for all comparisons. A total of 169 individuals were included, 133 (78.7%) present sella turcica partially or completely calcified. Sella turcica anomalies were found in 131 individuals (77.5%). Sella turcica bridge type A (27.8%), posterior hypertrophic clinoid process (17.1%), and sella turcica bridge type B (11.2%) were the most prevalent morphological patterns observed. Individuals carrying the TT genotype in rs10177996 (TT vs. CT + CC) had higher chance to present a partially calcified sella turcica (p = 0.047; Odds ratio = 2.27, Confidence Interval 95% 1.01-5.13). In conclusion, the SNP in WNT10A is associated with the calcification phenotype of the sella turcica, the pleiotropic effect of this gene should be taken into consideration in future studies.
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Polimorfismo de Nucleótido Simple , Silla Turca , Silla Turca/anomalías , Vía de Señalización Wnt/genética , Radiografía , Calcificación Fisiológica , CefalometríaRESUMEN
Resumen ANTECEDENTES: El síndrome de Klippel Trenaunay es una enfermedad congénita rara, caracterizada por malformaciones capilares y venosas, sobrecrecimiento de miembros y en algunos casos malformaciones linfáticas. Quienes lo padecen tienen un riesgo incrementado de hemorragia y tromboembolismo. CASOS CLÍNICOS: Tres pacientes primigestas con diagnóstico de síndrome de Klippel Trenaunay con complicaciones del embarazo que finalizaron mediante cesárea con el nacimiento de sus hijos sanos, de término, en todos los casos. CONCLUSIONES: Las embarazadas y con síndrome de Klippel-Trenaunay tienen un riesgo significativo de que sus síntomas se agraven, de tener hemorragia durante el nacimiento y de eventos tromboembólicos, incluso después del nacimiento. La atención individualizada y multidisciplinaria ayudará a mitigar las complicaciones asociadas y a conseguir desenlaces óptimos.
Abstract BACKGROUND: Klippel Trenaunay syndrome is a rare congenital disease characterized by capillary and venous malformations, limb overgrowth and in some cases lymphatic malformations. Sufferers have an increased risk of hemorrhage and thromboembolism. CLINICAL CASES: Three primigravid patients diagnosed with Klippel Trenaunay syndrome with pregnancy complications that were terminated by cesarean section with the birth of their healthy, full-term children in all cases. CONCLUSIONS: Women with Klippel-Trenaunay syndrome and pregnancy are at significant risk for aggravation of their symptoms, hemorrhage during birth, and thromboembolic events, even after birth. Individualized, multidisciplinary care will help mitigate associated complications and achieve optimal outcomes.
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Resumen INTRODUCCIÓN: La epidermólisis bulosa engloba a un grupo de enfermedades caracterizadas por una fragilidad extrema de la piel y membranas mucosas, consecuencia de la formación de ampollas posterior a un traumatismo mínimo. Hay tres tipos principales de epidermólisis. Se comunica el caso para hacer notar las implicaciones del cuidado al momento del nacimiento, y las consideraciones anestésicas. CASO CLÍNICO: Paciente de 25 años en su segundo embarazo con epidermólisis bulosa distrófica recesiva. El nacimiento fue electivo mediante cesárea, con anestesia regional. CONCLUSIONES: Debe tenerse especial cuidado durante las intervenciones terapéuticas a fin de evitar la formación de bulas o exacerbar las existentes. Las fuerzas de fricción son más dañinas que las de compresión. La planeación multidisciplinaria es necesaria para un desenlace sin complicaciones.
Abstract BACKGROUND: Epidermolysis bullosa encompasses a group of diseases characterized by extreme fragility of the skin and mucous membranes, resulting in the formation of blisters after minimal trauma; There are three main types of epidermolysis. The case is presented to highlight the implications of care both at the time of birth, as well as anesthetic considerations. CLINICAL CASE: A 25-year-old patient in her second pregnancy with recessive dystrophic epidermolysis bullosa. The birth was elective by caesarean section under regional anesthesia. CONCLUSIONS: Special care must be taken during therapeutic interventions to avoid the formation of bullae or exacerbate those already present. Friction forces are more damaging than compression forces. Multidisciplinary planning is necessary for a smooth outcome.
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Resumen ANTECEDENTES: El síndrome de Andersen Tawil es una canalopatía multisistémica genética, muy rara, sin alteración cardiaca estructural, heredada de manera autosómica dominante y causada por mutación en el gen KCNJ2. Este síndrome se caracteriza por una triada de parálisis muscular periódica, cambios en el electrocardiograma y estructurales corporales. El rasgo distintivo es la taquicardia ventricular bidireccional, las contracciones ventriculares prematuras y raramente taquicardia polimórfica tipo torsade de pointes. En la actualidad se carece de guías para el peri y postparto y para la prevención de arritmias. CASO CLÍNICO: Paciente de 21 años, embarazada, con síndrome de Andersen Tawil diagnosticado a esta edad, con base en los antecedentes de síncope de repetición y debilidad en las extremidades desde los 11 años. Recibía tratamiento con un beta-bloqueador y un desfibrilador automático implantable. La ecocardiografía fetal a las 23 y 33 semanas de gestación reportó una comunicación interventricular apical de 1.6 mm. A las 39 semanas de embarazo se practicó una cesárea electiva, con evolución posoperatoria satisfactoria. El estudio molecular dirigido al recién nacido descartó el síndrome de Andersen Tawil congénito. CONCLUSIÓN: En pacientes con síndromes de arritmia congénita, el embarazo puede ser seguro siempre y cuando un grupo de especialistas esté pendiente para tomar decisiones de atención y tratamiento durante todo el proceso del embarazo y puerperio.
Abstract BACKGROUND: Andersen Tawil syndrome is a very rare genetic multisystemic channelopathy without structural cardiac alteration, inherited in an autosomal dominant manner and caused by mutation in the KCNJ2 gene. This syndrome is characterised by a triad of periodic muscle paralysis, electrocardiogram and body structural changes. The hallmark is bidirectional ventricular tachycardia, premature ventricular contractions and rarely polymorphic torsade de pointes tachycardia. Currently there is a lack of guidelines for peri- and postpartum and arrhythmia prevention. CLINICAL CASE: 21-year-old pregnant patient with Andersen-Tawil syndrome diagnosed at this age, based on a history of repeated syncope and weakness in the extremities since the age of 11. She was being treated with a beta-blocker and an implantable cardioverter defibrillator. Fetal echocardiography at 23 and 33 weeks gestation reported an apical ventricular septal defect of 1.6 mm. Elective caesarean section was performed at 39 weeks of pregnancy, with satisfactory postoperative evolution. Molecular study of the newborn ruled out congenital Andersen-Tawil syndrome. CONCLUSION: In patients with congenital arrhythmia syndromes, pregnancy can be safe as long as it is managed by a group of experts to make decisions and optimise care throughout the pregnancy and postpartum period.
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Resumen ANTECEDENTES: La ruptura uterina es la separación de las tres capas del útero que se asocia con una cicatriz. La mayoría de los casos se relacionan con intento de trabajo de parto, después de una cesárea. La ruptura es una complicación grave, que pone en riesgo a la madre y al feto. De forma excepcional puede haber ruptura uterina sin síntomas, y el hallazgo se advierte durante la cesárea de repetición. CASO CLÍNICO: Paciente de 27 años, programada para cesárea de repetición por disfunción de una prótesis valvular. A la apertura de la cavidad abdominal no se encontró hemoperitoneo y se visualizó un defecto transverso en el segmento uterino inferior de las tres capas uterinas, con saco amniótico íntegro, coincidente con ruptura uterina. Se obtuvo un recién nacido sano, de 2610 g y Apgar de 9-9. La herida uterina se suturó en dos planos y se practicó la oclusión tubaria bilateral. La evolución durante el puerperio fue satisfactoria. CONCLUSIONES: La ruptura uterina puede pasar inadvertida por algún descuido en la historia clínica y ausculatación, de ahí la necesidad de ser más minuciosos para poder indicar el tratamiento adecuado.
Abstract BACKGROUND: Uterine rupture is a separation of the three layers of the uterus and is associated with a uterine scar. Most cases are related to an attempted labor after a cesarean section. Uterine rupture is a serious complication that puts both mother and fetus at risk. Exceptionally uterine rupture can occur without symptoms, being a finding during a repeat cesarean section. CLINICAL CASE: A 27-year-old patient scheduled for repeat cesarean section due to dysfunction of a prosthetic valve. Upon opening the abdominal cavity, no hemoperitoneum was found and a transverse defect was visualized in the lower uterine segment of the three uterine layers, with an intact amniotic sac, coinciding with uterine rupture. A healthy newborn was obtained, weighing 2610 g and Apgar 9-9. The uterine wound was sutured in two planes and bilateral tubal occlusion was performed. The evolution during the puerperium was satisfactory. CONCLUSIONS: Uterine rupture may go unnoticed due to an oversight in the clinical history and auscultation, hence the need to be more thorough in order to indicate appropriate treatment.
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Describir los hallazgos ecográficos de las pacientes que acudieron por sangrado uterino anormal al servicio de Ginecología y Obstetricia del Hospital Dr. Domingo Luciani durante el período enero 2021 a enero 2022. Métodos: Estudio observacional-descriptivo, de tipo retrospectivo. Muestra no probabilística e intencional, integrada por 99 pacientes. Variables involucradas: edad, raza, paridad, antecedentes personales, ciclo menstrual, duración del período menstrual, fecha última de menstruación, uso de algún medicamento, método anticonceptivo y hallazgos ecográficos. Resultados: Los hallazgos ecográficos evidenciaron diferentes causas que explican el sangrado uterino anormal de las pacientes que integraron la muestra de estudio; las tres más frecuentes fueron: miomatosis uterina, sangrado uterino anormal por leiomioma o por endometrio, sangrado uterino anormal tipo L y tipo E(AU)
Objective: To describe the ultrasound findings ofpatients who came for abnormal uterine bleeding to theGynecology and Obstetrics service of the Dr. Domingo LucianiHospital during the period January 2021 to January 2022.Methods: This was an observational-descriptive, retrospectivestudy. The sample was non-probabilistic and intentional,consisting of 99 patients. The data were collected in an Excelsheet for analysis to determine their percentage frequencyaccording to the variables involved: age, ethnicity, parity,personal history, menstrual cycle, duration of menstrual period,last date of menstruation, use of some medication, contraceptivemethod and ultrasound findings. Results: The ultrasoundfindings showed different causes to explain the abnormal uterinebleeding of the patients who made up the study sample; however,the three most frequent were: uterine myomatosis, sangradouterino anormal tipo L y tipo E(AU)
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Hemorragia Uterina , Ultrasonografía , Anticonceptivos , Ginecología , Hemorragia , Mioma , ObstetriciaRESUMEN
El índice de masa corporal (IMC) es una eficaz herramienta para detectar la sobrecarga ponderal en niños y adolescentes, asociado a la adiposidad corporal. Objetivo. Analizar la concordancia, sensibilidad y especificidad de tres referencias internacionales de IMC/edad (OMS, IOTF y CDC) para diagnosticar el exceso ponderal y conocer su precisión diagnóstica para identificar el exceso de adiposidad con relación al área grasa braquial (AGB) en población infanto juvenil de Argentina. Materiales y métodos. Se realizó un estudio multicéntrico, descriptivo-comparativo y transversal entre 2003 y 2008, en 22.658 niños y adolescentes argentinos de 4 a 13 años de edad. A partir del peso, talla, circunferencia del brazo y pliegue tricipital, se calcularon IMC y AGB. Se analizó la concordancia, sensibilidad y especificidad de referencias de IMC/edad (OMS, CDC, IOTF) y la precisión diagnóstica (curvas ROC) para identificar exceso de adiposidad, a partir del AGB, así como el punto de corte óptimo (PCO). Resultados. Las tres referencias tuvieron buena concordancia. La mayor sensibilidad correspondió a OMS y la mayor especificidad a IOTF. El área bajo la curva (ABC) fue mayor en Z-IMC/IOTF en varones y en Z-IMC/OMS en mujeres. Los PCO mostraron discrepancias, siendo mayores con OMS. Conclusión. Las tres referencias muestran similar precisión diagnóstica para detectar alta reserva calórica, con puntos de corte óptimo para las puntuaciones Z-IMC menores a 2 Z scores. Esto resulta relevante para la identificación de exceso de adiposidad en poblaciones, en relación con la implementación de políticas públicas de prevención de enfermedades crónicas no transmisibles(AU)
The body mass index (BMI) is an effective tool to detect weight overload in children and adolescents, associated with body adiposity. Objective. To analyze the concordance, sensitivity and specificity of three international BMI/age references (WHO, IOTF and CDC) to diagnose excess weight and to know their diagnostic accuracy to identify excess adiposity in relation to the brachial fat area (BFA) in Argentine child-youth population. Materials and methods. A multicenter, descriptive- comparative and cross-sectional study was carried out between 2003 and 2008 in 22.658 Argentine children and adolescents between aged 4 to 13 years. From the weight, height, arm circumference and tricipital fold, BMI and BFA were calculated. The concordance, sensitivity, and specificity of BMI / age references (WHO, IOTF, CDC,) were analyzed and the diagnostic precision (ROC curves) to identify excess adiposity, from the BFA, as well as the optimal cut-off point (OCP). Results. The three references had good agreement, the highest sensitivity corresponded to WHO and the highest specificity to IOTF. The area under the curve (AUC) was greater in Z-BMI/IOTF in men and in Z-BMI/WHO in women. The OCPs showed discrepancies, being higher with WHO. Conclusion. The three references show similar diagnostic accuracy to detect high caloric reserve, but with cut-off points for Z-BMI scores less than 2 Z scores. This is relevant for the identification of excess adiposity in populations in relation to the implementation of public policies for the prevention of chronic non-communicable diseases(AU)
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Circunferencia del Brazo , Índice de Masa Corporal , Estado Nutricional , Distribución de la Grasa Corporal , Estudiantes , Peso por Estatura , Desnutrición , Obesidad InfantilRESUMEN
The genus Fusarium can be utilized to produce a great variety of secondary metabolites under specific culture conditions, including pigments of increasing biotechnological interest, such as bikaverin. Such pigments are important due to the biological properties they possess, including antitumor and antibiotic activities, among others. In Fusarium fujikuroi, bik1-bik6 have been identified as the genes that are responsible for the synthesis of bikaverin. Therefore, in this study, we screened for the presence of bik genes and examined changes in mRNA levels of the bik genes under the influence of NH4NO3 (0.024, 0.048, 0.50, 1.0, and 4.60 g L-1) and NH4Cl (0.50 and 1.0 g L-1) as nitrogen sources for the phytopathogen Fusarium oxysporum f. sp. lycopersici. Our results indicated the presence of at least six bik (bik1-bik6) genes and showed increased mRNA levels for bik4, bik5, and bik6 in conditions where NH4NO3 was used at pH 3.0. The characteristic coloration of bikaverin was obtained in 10 out of 16 culture conditions, except when the fungus was grown with higher concentrations of NH4NO3 (1.0 and 4.60 g L-1). The pigment was chloroform-extracted from the culture conditions of NH4NO3 (0.024, 0.048, and 0.50 g L-1) and NH4Cl (0.50 and 1.0 g L-1) with 3 and 9 days of incubation. Analysis via visible spectroscopy and matrix-assisted laser desorption ionization-time of flight mass spectrometry were used for the identification of bikaverin.
Asunto(s)
Fusarium , Xantonas , Fusarium/genética , NitrógenoRESUMEN
Resumen ANTECEDENTES: El embarazo cornual es un reto diagnóstico debido a que la capacidad de estiramiento del miometrio hace que la manifestación sea tardía y con alta mortalidad debido al riesgo de choque hemorrágico que llega a suceder, incluso, hasta en un tercio de las pacientes. OBJETIVO: Hacer hincapié en la importancia del adecuado control prenatal para el diagnóstico oportuno de embarazo ectópico y la consecuente disminución de complicaciones asociadas. CASO CLÍNICO: Paciente primigesta, de 20 años de edad, originaria y residente de Guadalupe, Nuevo León. Sin antecedentes heredofamiliares o personales médicos o quirúrgicos relevantes. Ingresó a la sala de urgencias de Obstetricia con un cuadro de choque hipovolémico y 31 semanas de embarazo. En la revisión la cavidad abdominal se encontró con un embarazo cornual izquierdo, con ruptura uterina y acretismo placentario. Por lo anterior, se procedió a la histerectomía obstétrica, salpingectomía bilateral y ooforectomía izquierda, con reporte de 1000 mL de hemoperitoneo. La evolución posquirúrgica fue satisfactoria. CONCLUSIONES: El embarazo cornual debe sospecharse en toda mujer con amenorrea, dolor abdominal y sangrado transvaginal, con búsqueda intencionada de los hallazgos ultrasonográficos de cavidad uterina vacía, saco coriónico separado por lo menos 1 cm desde el borde lateral de la cavidad uterina, capa del miometrio delgada (menos de 5 mm) que rodea el saco gestacional y signo de la línea intersticial (visualización de una línea ecogénica que se extiende desde la cavidad endometrial hasta la región cornual, contigua al saco gestacional). El diagnóstico temprano de estos embarazos evita complicaciones y afectaciones al futuro obstétrico.
Abstract BACKGROUND: Cornual pregnancy is a diagnostic challenge because the stretching capacity of the myometrium makes the manifestation late and with high mortality due to the risk of hemorrhagic shock that occurs in up to one third of patients. OBJECTIVE: To emphasize the importance of adequate prenatal care for the timely diagnosis of ectopic pregnancy and the consequent reduction of associated complications. CLINICAL CASE: Primigestation patient, 20 years old, native, and resident of Guadalupe, Nuevo Leon. No relevant heredofamilial or personal medical or surgical history. She was admitted to the obstetrics emergency room with hypovolemic shock and 31 weeks of pregnancy. On examination the abdominal cavity was found to have a left cornual pregnancy, with uterine rupture and placental accretism. Therefore, obstetric hysterectomy, bilateral salpingectomy and left oophorectomy were performed, with a report of 1000 mL of hemoperitoneum. The postoperative evolution was satisfactory. CONCLUSIONS: Cornual pregnancy should be suspected in any woman with amenorrhea, abdominal pain and transvaginal bleeding, with purposeful search for ultrasonographic findings of empty uterine cavity, chorionic sac separated at least 1 cm from the lateral border of the uterine cavity, thin myometrial layer (less than 5 mm) surrounding the gestational sac, and interstitial line sign (the visualization of an echogenic line extending from the endometrial cavity to the cornual region, contiguous with the gestational sac). The early diagnosis of these pregnancies avoids complications and affects the future obstetrician.
RESUMEN
OBJECTIVES: The aim of this study was investigate the cranium dimensions of adult female rats, who suffered estrogen deficiency during the prepubertal stage, to assess the impact of estrogen deficiency on craniofacial morphology. MATERIAL AND METHODS: Twenty-two female Wistar rats were divided into ovariectomy (OVX) (n = 11) and sham-operated control (n = 11) groups. Bilateral ovariectomy were performed in both groups at 21 days old (prepubertal stage), and rats were euthanized at an age of 63 days (post-pubertal stage). Micro-CT scans were performed with rat skulls, and the cranium morphometric landmark measurements were taken in the dorsal, lateral, and ventral view positions. Differences in measurements between the OVX and sham control groups were assessed using t test with an established alpha error of 5%. RESULTS: The measures of the rats' skull showed that the inter-zygomatic arch width and anterior cranial base length were significantly larger in OVX group (p = 0.020 and p = 0.050, respectively), whereas the length of parietal bone was significantly higher in the sham group (p = 0.026). For the remaining measurements no significant differences between groups were detected (p > 0.05). CONCLUSION: This study provides evidence that ovariectomized rats had alterations in cranial bone dimensions, demonstrating that estrogens during puberty are important for skull morphology. CLINICAL RELEVANCE: To understand the role of estrogen on the postnatal cranium development will impact the clinical diagnose and therapy during childhood and adolescence.
Asunto(s)
Estrógenos , Cráneo , Animales , Densidad Ósea , Niño , Femenino , Humanos , Ovariectomía , Ratas , Ratas Wistar , Cráneo/diagnóstico por imagen , Microtomografía por Rayos XRESUMEN
The aim of this study was to evaluate body composition in relation to nutritional status and socio-environmental conditions of residence in schoolchildren living in the urban periphery of La Plata, Argentina. Weight, height, arm circumference and tricipital and subscapular skinfolds were measured in 3,284 schoolchildren aged 4-12 years in the period 2014-2017. The National Health and Nutrition Examination Survey (NHANES) III reference was used to assess nutritional status, identifying the following categories: normal, underweight, stunting, wasting, overweight and obesity. Body composition was evaluated based on upper arm muscle area (UMA) and upper arm fat area (UFA). Deficit and excess UMA and UFA were also calculated. Central fat distribution was determined with the subscapular-tricipital index. Socio-environmental characteristics were surveyed using a structured questionnaire. The prevalence of nutritional status and body composition indicators were compared by sex using Chi square test. Socio-environmental data were analyzed using categorical Principal Component Analysis, discriminating into more favorable and unfavorable conditions. Nutritional status results were as follows: normal, 64.5%; stunting, 3.4%; underweight, 0.0%; wasting, 0.1%; overweight, 15.6% and obesity 16.4%. The nutritional status of children worsened as the socio-environmental condition of their families became more precarious. Long-term socio-environmental stress manifested as decreased muscle tissue in normal, stunted, overweight and obese children. The current results evidence the strong impact of poverty on child growth and development and at the same time enforce the need for continuous monitoring of children with hidden malnutrition(AU)
El objetivo del trabajo fue analizar la composición corporal en relación al estado nutricional y las condiciones socio-ambientales de niños residentes en la periferia urbana de La Plata, Argentina. Sobre 3284 escolares de 4 a 12 años se evaluaron peso, talla, perímetro braquial y pliegues tricipital y subescapular, durante los años 2014-2017. Se determinaron, utilizando la referencia NHANES III, las categorías de estado nutricional Normal; Bajo Peso/Edad; Baja Talla/Edad; Bajo IMC/Edad; Sobrepeso y Obesidad, y para composición corporal, se calcularon las áreas muscular y grasa (UMA y UFA) y se estimaron los déficits y excesos de tejido muscular y graso. La adiposidad centralizada fue estimada con el índice subescapular-tricipital. Las características socio-ambientales se evaluaron mediante encuesta estructurada. Las prevalencias del estado nutricional y de los indicadores de composición corporal fueron estimados y comparados por sexos, mediante pruebas de Chi2. Los datos socio-ambientales se analizaron empleando Análisis de Componentes Principales categóricos y se discriminaron dos grupos: con condiciones más favorables y con condiciones desfavorables. Los resultados indicaron: 64.5% Normal, 3.4% Baja Talla/Edad, 0.0% Bajo Peso/Edad; 0.1% Bajo IMC/Edad; 15.6% Sobrepeso; 16.4% Obesidad. El estado nutricional de los niños empeoró cuando la calidad socio-ambiental de sus familias se hizo más precaria. Debido al estrés socio-ambiental continuo, los niños tuvieron disminución del tejido muscular, incluyendo aquellos con estado nutricional Normal, Baja Talla/Edad, Sobrepeso y Obesidad. Los resultados alcanzados evidencian la impronta que deja la pobreza e impone urgentemente el monitoreo continuo de niños "con desnutrición oculta"(AU)