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INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥70 years (OR = 1.85, 95% CI: 1.25-2.76), ASA III-IV (OR = 2.06, 95% CI: 1.28-3.34), total gastrectomy (OR = 1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR = 5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age ≥70 years (OR = 4.92, 95% CI:1.78-13.65), lower BMI (OR = 0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR = 0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age ≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age ≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
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Hipoalbuminemia , Neoplasias Gástricas , Anciano , Gastrectomía/efectos adversos , Humanos , Hipoalbuminemia/complicaciones , Hipoalbuminemia/epidemiología , Morbilidad , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/etiología , Neoplasias Gástricas/cirugíaRESUMEN
INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥ 70 years (OR=1.85, 95% CI: 1.25-2.76), ASA III-IV (OR=2.06, 95% CI: 1.28-3.34), total gastrectomy (OR=1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR=5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age≥70 years (OR=4.92, 95% CI:1.78-13.65), lower BMI (OR=0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR=0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
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BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.
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Laparoscopía , Neoplasias Hepáticas , Argentina , Asia , Brasil , Chile , Colombia , Europa (Continente) , Hepatectomía , Humanos , Hígado , Neoplasias Hepáticas/cirugía , PerúRESUMEN
The original version of the article unfortunately contained an error in the author group. Dr. Isabel Larré was not submitted and published in the original version.
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Studies made in the Madin-Darby canine kidney (MDCK) epithelial cell line showed that ouabain regulates cell adhesion and cell-adhesion-related biological processes, such as migration. Here, we demonstrated that 10 nM ouabain accelerates collective cell migration and heals wounds in cultured MDCK cell monolayers. Ouabain-induced acceleration of cell migration depends on activation of the cSrc-ERK1/2 signaling cascade, as it was inhibited by the kinase inhibitors PP2 and PD98059. Activation of the cSrc-ERK1/2 signaling cascade increased expression and activation of the extracellular matrix metalloproteinase-2 (MMP-2). Inhibition of MMP activity using the generic inhibitor GM6001 or the potent iMMP-2 inhibitor prevented the accelerative effect of ouabain. Likewise, Focal Adhesion Kinase (FAK) inhibition with the transfection of dominant negative peptide FRNK impaired the effect of ouabain. These results suggest that ouabain binding to the Na+,K+-ATPase accelerates collective migration of MDCK cells through activation of the cSrc-ERK1/2-FAK signaling cascade and promoting secretion and MMP activity.
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Metaloproteinasa 2 de la Matriz/metabolismo , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteína Quinasa 3 Activada por Mitógenos/metabolismo , Ouabaína/farmacología , ATPasa Intercambiadora de Sodio-Potasio/metabolismo , Animales , Adhesión Celular/efectos de los fármacos , Línea Celular , Movimiento Celular/efectos de los fármacos , Perros , Flavonoides/farmacología , Fosforilación/efectos de los fármacos , Inhibidores de Proteínas Quinasas/farmacología , Transducción de Señal/efectos de los fármacosRESUMEN
BACKGROUND: There are no data on the prevalence of non-alcoholic fatty liver disease (NAFLD) in general population samples in Guatemala or in other Central American countries. The prevalence and distribution of NAFLD and its associated risk factors were evaluated in a population-based sample of adults in Guatemala. METHODS: Cross-sectional study of 411 men and women 40 years of age or older residing in urban and rural areas of Guatemala. Metabolic outcomes included obesity, central obesity, hypercholesterolemia, diabetes, and metabolic syndrome (MetS). Liver disease outcomes included elevated liver enzymes, elevated Fatty Liver Index (FLI), and elevated FIB-4 score. RESULTS: The overall prevalence of obesity, central obesity, diabetes, and MetS were 30.9, 74.3, 21.6, and 64.2%, respectively. The fully-adjusted prevalence ratios (95% CI) for obesity, central obesity, diabetes, and MetS comparing women to men were 2.83 (1.86-4.30), 1.72 (1.46-2.02), 1.18 (1.03-1.34), and 1.87 (1.53-2.29), respectively. The overall prevalence of elevated liver enzymes (ALT or AST), elevated FLI, and elevated FIB-4 scores were 38.4, 60.1, and 4.1%, respectively. The fully-adjusted prevalence ratios (95% CI) for elevated liver enzymes (either ALT or AST) and elevated FLI score comparing women to men were 2.99 (1.84-4.86) and 1.47 (1.18-1.84), respectively. CONCLUSIONS: The prevalence of metabolic abnormalities and liver outcomes in this general population study was very high. The prevalence of metabolic and liver abnormalities was particularly high among women, an observation that could explain the atypical 1:1 male to female ratio of liver cancer in Guatemala.
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Síndrome Metabólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Adulto , Pruebas Enzimáticas Clínicas , Estudios Transversales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Femenino , Guatemala/epidemiología , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiología , Pruebas de Función Hepática , Masculino , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Obesidad Abdominal/diagnóstico , Obesidad Abdominal/epidemiología , Prevalencia , Factores de Riesgo , Salud Rural , Salud UrbanaRESUMEN
Introducción: La reparación de la pared abdominal, presenta escenarios complejos, como los abdómenes abiertos con ostomías o fístulas intestinales, que para su tratamiento el cirujano debe buscar la táctica quirúrgica y el manejo ideal para cada caso. Objetivo: Describir los resultados en la reparación de defectos complejos de la pared abdominal y restitución de tránsito intestinal en un solo tiempo. Pacientes y método: Estudio observacional, descriptivo, prospectivo y longitudinal, de una serie de casos de 30 pacientes, ambos sexos, mayores a 18 años, portadores de defectos complejos de la pared abdominal (abdomen abierto cicatrizado por segunda intención y hernias paraestomales) y ostomías que ingresaron para cirugía electiva en la II Cátedra de Clínica Quirúrgica del Hospital de Clínicas de marzo del 2011 a diciembre del 2015. Todos los pacientes fueron evaluados con tomografía axial computarizada, según el caso sometidos a preparación con neumoperitoneo progresivo pre operatorio y manejados por equipo multidisciplinario...
Introduction: Abdominal wall repair, presents complex scenarios, as the bellies open with ostomy or intestinal fistulas, that treatment the surgeon should seek surgical tactics and ideal management for each case. Objective: To describe the results in repair of complex defects of the abdominal wall and return of intestinal transit in a single time. Patients and methods: observational, descriptive, prospective and longitudinal study, a series of 30 patients, both sexes, over 18 years, carriers of complex defects of the abdominal wall (open abdomen healed by second intention and paraestomales herniations) and ostomy admitted for elective surgery at the surgical clinic of the Hospital de Clínicas of March 2011 to2015 December II. All patients were evaluated with axial computed tomography, according to the case subject to progressive pneumoperitoneumprogressive pre operative and managed by a multidisciplinary team...
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Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Pared Abdominal/cirugía , Intestinos/cirugíaRESUMEN
Diazo dye Congo Red (CR) solutions at 100mg/L, were degraded using different supporting electrolytes in an electrochemical advanced oxidation process (EAOPs), like the anodic oxidation (AOx/BDD). All experiments were carried out in a 3L flow reactor with a Boron-doped diamond (BDD) anode and stainless steel cathode (AISI 304), at 7.5, 15, 30 and 50mA/cm(2) current densities (j). Furthermore, each experiment was carried out under a flow rate of 7L/min. Additionally, HClO4, NaCl, Na2SO4, and H2SO4 were tested as supporting electrolytes at a 50mM concentration. The degradation process was at all times considerably faster in NaCl medium. Solutions containing SO4(2-) or ClO4(-) ions were less prompted to degradation due to the low oxidation power of these species into the bulk. Dissolved organic carbon (DOC) analysis, was carried out to evaluate the mineralization of CR. The degradation of CR, was evaluated with the HPLC analysis of the treated solutions.
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Diarrhoea remains a common cause of illness in Guatemala, with children suffering most frequently from the disease. This study directly compared the frequency, enterotoxin, and colonization factor (CF) profiles of enterotoxigenic Escherichia coli (ETEC) strains isolated from children living in a rural community in Guatemala and from Western visitors to the same location during the same seasons, using similar detection methodologies. We found that ETEC accounted for 26% of severe cases of diarrhoea in children requiring hospitalization, 15% of diarrhoea in the community, and 29% of travellers' diarrhoea in visitors staying ⩾2 weeks. The toxin and CF patterns of the ETEC strains isolated from both groups differed significantly (P < 0·0005) as determined by χ 2 = 60·39 for CFs and χ 2 = 35 for toxins, while ETEC phenotypes found in Guatemalan children were comparable to those found in children from other areas of the world.
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Toxinas Bacterianas/metabolismo , Diarrea/epidemiología , Escherichia coli Enterotoxigénica/genética , Enterotoxinas/metabolismo , Infecciones por Escherichia coli/epidemiología , Proteínas de Escherichia coli/metabolismo , Viaje , Factores de Virulencia/metabolismo , Adulto , Preescolar , Diarrea/microbiología , Escherichia coli Enterotoxigénica/metabolismo , Infecciones por Escherichia coli/microbiología , Guatemala , Humanos , Lactante , Grupos de Población , Población RuralRESUMEN
The prevalence of genetic polymorphisms identified as predictors of therapeutic-induced hepatitis C virus (HCV) clearance differs among ethnic groups. However, there is a paucity of information about their prevalence in South American populations, whose genetic background is highly admixed. Hence, single-nucleotide polymorphisms rs12979860, rs1127354 and rs7270101 were characterized in 1350 healthy individuals, and ethnicity was assessed in 259 randomly selected samples. The frequency of rs12979860CC, associated to HCV treatment response, and rs1127354nonCC, related to protection against hemolytic anemia, were significantly higher among individuals with maternal and paternal Non-native American haplogroups (64.5% and 24.2%), intermediate among admixed samples (44.1% and 20.4%) and the lowest for individuals with Native American ancestry (30.4% and 6.5%). This is the first systematic study focused on analyzing HCV predictors of antiviral response and ethnicity in South American populations. The characterization of these variants is critical to evaluate the risk-benefit of antiviral treatment according to the patient ancestry in admixed populations.
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Antivirales/farmacología , Antivirales/uso terapéutico , Hepacivirus/efectos de los fármacos , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/genética , Polimorfismo de Nucleótido Simple/genética , Etnicidad/genética , Genotipo , Hepatitis C Crónica/virología , Humanos , Medición de Riesgo , América del SurRESUMEN
AIM: To determine the association of functional single nucleotide polymorphisms in genes of the pro-inflammatory cytokines tumour necrosis factor-α, interleukin-1ß, interleukin-8 and interleukin-12B with the development of two clinical forms of apical periodontitis (AP): acute suppurative and chronic nonsuppurative. METHODOLOGY: The study included 120 patients from Bucaramanga City, Colombia, 63 diagnosed with acute suppurative AP (ASAP) and 57 diagnosed with chronic nonsuppurative AP (CNAP). Genotyping for IL1B +3954 (rs1143634), IL8 / CXCL8 -251 (rs4073), IL12B +1188 (rs3212227) and TNFA -308 (rs1800629) was performed by the PCR-restriction fragment length polymorphisms method. The statistical analysis was performed using STATA 10.0 and PLINK V1.07 software. RESULTS: Significant differences in the distribution of IL8 / CXCL8 -251 A allele (P adjusted = 0.041; OR adjusted = 0.41, CI adjusted = 0.31-0.97) and IL8 / CXCL -251 TT genotype (P adjusted = 0.04; OR adjusted = 2.24, CI adjusted = 1.04-4.84) were observed comparing patients diagnosed with ASAP and CNAP. No association was observed in genotype and allele distribution for other genetic polymorphisms analysed. CONCLUSION: This study provides molecular epidemiological evidence that suggests in the present cohort that IL8 / CXCL8 -251 T allele, which is associated with higher production of IL8/CXCL8, is also associated with a higher risk of developing acute suppurative form of AP, whereas IL8 / CXCL8 -251 A allele, which is associated with lower production of IL8/CXCL8, is associated with chronic nonsuppurative form of AP. This suggests a pivotal role for IL-8/CXCL8 in periapical disease because of its ability to induce chemotaxis and modulating the directed migration of neutrophils to the site of inflammation in response to microbial infection of pulp.
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Citocinas/genética , Mediadores de Inflamación/inmunología , Absceso Periapical/inmunología , Granuloma Periapical/inmunología , Polimorfismo de Nucleótido Simple/genética , Adenina , Adolescente , Adulto , Alelos , Quimiotaxis de Leucocito/genética , Estudios de Cohortes , Colombia , Femenino , Genotipo , Humanos , Subunidad p40 de la Interleucina-12/genética , Interleucina-1beta/genética , Interleucina-8/genética , Masculino , Persona de Mediana Edad , Infiltración Neutrófila/genética , Polimorfismo de Longitud del Fragmento de Restricción/genética , Timina , Factor de Necrosis Tumoral alfa/genética , Adulto JovenRESUMEN
The aim of this investigation was to evaluate the prognostic factors in patients with differentiated thyroid carcinoma treated and followed for a long period of time. Patients and Method: The following prognostic variables: gender, age at diagnosis, goiter characteristics, histology, differentiation grades, tumor anatomical extension, lymph node and distant initial metastasis and post treatment evolution were studied in a historical cohort of thyroid carcinoma. Surgical treatment was subtotal and total thyroidectomy plus lymphatic cervical selective neck dissection. Radioiodine was employed en 59.2 percent and thyroid hormone replacement was used indefinitely. Kaplan Meyer analisis was employed to plot survival curves, log Rank test was used to establish the significance of each variable and square chi to determine differences among groups. Cox model was used to identify prognostic variables. Results: A group of 477 patients with differentiated thyroid carcinoma treated at the Hospital San Juan de Dios, from 1948 to 1992, were studied. Median survival rate was 87 percent at the end of observation period. Univariate analysis showed significant differences for age, tumor anatomical extension and histological grade on survival, for the entire serie. According to Cox model method, initial distant metastasis, age > 40 years, anatomical extension, tumor size > 10 mm, were determinant for unfavorable prognosis for the papillary cancer; distant metastasis, anatomical extension and age at the time of diagnosis were determinant for unfavorable prognosis for the follicular cancer. Conclusion: Overall survival was 87 percent. Distant metastasis at the time of diagnosis: age older than 40 years, anatomical extension and the size of the tumor were determinant of survival prognosis.
El objetivo de esta investigación fue estudiar la supervivencia y los factores del pronóstico del cáncer diferenciado del tiroides tratado y seguido por un período de observación prolongado. Pacientes y Método: En una cohorte histórica prospectiva de cáncer de tiroides diagnosticada por biopsia quirúrgica, se analizó las variables: género, edad en el momento del diagnóstico, semiología del bocio, histología, grado de diferenciación, extensión anatómica del tumor, la presencia de metástasis linfáticas y a distancia iniciales y la evolución post tratamiento como factores pronosticadores de la sobrevida de los pacientes. La cirugía practicada consistió en tiroidectomía sub total y total más disección linfática cervical selectiva. El método de Kaplan y Meier se usó para diseñar curvas de supervivencia, log Rank test para la significación de cada variable y chi cuadrado para definir la diferencias entre los grupos. El método de Cox se utilizó para identificar las variables del pronóstico. Resultados: 477 pacientes con cáncer diferenciado del tiroides tratados en el Hospital San Juan de Dios desde 1948 hasta 1992. El 59,2 por ciento recibió yodo 131, todos con tratamiento hormonal de frenación indefinidamente. La supervivencia media fue de 87 por ciento al final del período de observación. El análisis univariable demostró diferencias significativas para la edad, extensión anatómica y grado histológico. Determinan un pronóstico desfavorable para el cáncer papilar: las metástasis a distancia iniciales (p < 0,0001), la edad > de 40 años (p < 0,0018) y la extensión anatómica; en el cáncer folicular fueron las metástasis a distancia, extensión anatómica y la edad en el momento del diagnóstico. Conclusión: La supervivencia fue de 87 por ciento. Las variables metástasis a distancia en el momento del diagnóstico, edad mayor de 40 años, extensión anatómica y el tamaño del tumor fueron determinantes del pronóstico en la supervivencia de los pacientes.
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Humanos , Masculino , Adolescente , Adulto , Femenino , Preescolar , Niño , Persona de Mediana Edad , Anciano de 80 o más Años , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/mortalidad , Factores de Edad , Estudios de Seguimiento , Escisión del Ganglio Linfático , Metástasis Linfática , Neoplasias de la Tiroides/patología , Pronóstico , Estudios Prospectivos , Análisis de Supervivencia , TiroidectomíaRESUMEN
Objetivo: identificar el nivel de conocimientos básicos sobre el diagnóstico enfermero en estudiantes de enfermería del ciclo avanzado. Métodos: se realizó estudio descriptivo transversal con muestra probabilística empleando como variables de estratificación, semestre y grupo, para un tamaño de 68 estudiantes. El instrumento fue elaborado ex profeso, al cual se aplicó prueba piloto en población semejante. Constó de dos apartados, uno para variables sociodemográficas y el otro sobre conocimientos básicos (concepto, estructura, prioridad) con un total de 11 preguntas y 18 puntos; la aplicación fue realizada en el mes de enero previo consentimiento informado. El procesamiento y análisis fue realizado en SPSS mediante estadística descriptiva. Resultados: la media de edad fue 23,5 años con desviación estándar de 1,4, siendo el 79% mujeres y el 23,5% empleados. Respecto a los conocimientos básicos en su mayoría fueron correctos; la identificación de prioridad obtuvo menor porcentaje de respuestas correctas. Las dificultades señaladas por los estudiantes para aplicar el diagnóstico enfermero fueron debidas a fallas en la forma de enseñanza y de uso en la práctica entre otras. El nivel de conocimientos predominante fue malo en 72%. Conclusión: el nivel de conocimientos básicos se calificó como malo, a pesar que la mayoría de los estudiantes expresa no tener dificultades en la aplicación del diagnóstico y señala que su uso tiene demasiada importancia para ellos.
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Atención de Enfermería , Conocimientos, Actitudes y Práctica en Salud , Diagnóstico de Enfermería , Epidemiología Descriptiva , Estudiantes de EnfermeríaRESUMEN
An HIV incidence estimation was performed among men who have sex with men (MSM), drug users (DUs), sex workers (SWs), and pregnant women (PW) from Argentina. Volunteers older than 18 years old without a previous HIV-positive diagnosis were included. HIV-positive samples were analyzed by the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) to estimate incidence. By partial RT-PCR and sequencing of the HIV pol gene, an HIV subtype and resistance profile were determined. A total of 12,192 volunteers were recruited from October 2006 to September 2008. A higher HIV prevalence was detected among trans SWs (33.9%, 38/112), male SWs (10.8%, 12/111), and MSM 10.4% (161/1549). HIV incidence estimates by STARHS was also higher on trans SWs (11.31 per 100 person-years), male SWs (6.06 per 100 person-years), and MSM (6.36 per 100 person-years). Antiretroviral primary resistant mutations were detected in 8.4% of the study group, with a higher frequency in female DUs (33.3%). Phylogenetic analysis showed that 124 (57.9%) samples were subtype B, 84 (39.3%) intersubtype BF recombinants, 5 (2.3%) subtype C, and 1 (0.5%) subtype F in the pol region. Subtype B was most commonly found in MSM and male SWs whereas the intersubtype BF recombinant was more prevalent in female DUs, female SWs, and PW. Given the high HIV prevalence and incidence found in most of these groups, monitoring the continuing spread of the HIV epidemic is essential for determining public health priorities, assessing the impact of interventions, and estimating current and future health care needs.
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Antirretrovirales/farmacología , Farmacorresistencia Viral , Infecciones por VIH/epidemiología , VIH-1/clasificación , VIH-1/efectos de los fármacos , Adulto , Argentina/epidemiología , Análisis por Conglomerados , Femenino , Genotipo , Infecciones por VIH/diagnóstico , Infecciones por VIH/virología , VIH-1/genética , VIH-1/aislamiento & purificación , Homosexualidad Masculina , Humanos , Incidencia , Masculino , Filogenia , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , ARN Viral/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ADN , Trabajo Sexual , Trastornos Relacionados con Sustancias/complicaciones , Productos del Gen pol del Virus de la Inmunodeficiencia Humana/genéticaRESUMEN
Objetivo: presentar el proceso y los resultados de una inves-tigación-acción en el ámbito de la educación, en el programa de crecimiento y desarrollo de una institución prestadora de servicios de salud de la ciudad de Medellín. Metodología: si¬guiendo los planteamientos de Stenhouse sobre un educador-investigador, se llevó a cabo un proceso reflexivo donde los miembros de los equipos del programa, investigaron sus prác¬ticas pedagógicas y las analizaron a la luz de su propia expe¬riencia y de la teoría proveniente de investigaciones realizadas en su institución, y de la literatura científica. Resultados: me¬diante la reflexión y la investigación de su práctica pedagó¬gica los educadores lograron concebir el programa desde una perspectiva más amplia: la crianza. Así mismo consiguieron situarse de manera diferente hacia la educación y el educando y generar propuestas alternativas. Discusión: la experiencia investigativa muestra la dificultad para realizar cambios en las perspectivas pedagógicas en el ámbito de de la educación para salud, generalmente sustentadas en modelos tradicionales o conductistas. Teniendo en cuenta los resultados obtenidos, se presenta esta propuesta investigativa como una vía para avan¬zar en el fortalecimiento de la dimensión educativa en el ámbi¬to de salud desde una perspectiva alternativa.
Objective: to present the process and results of an action research in the educational dimension, the growth and development program of a health institution in Medellin. Methodology: following Stenhouses ideas about a teacher-researcher, it was developed a reflective process where the programs teams, researched their pedagogical practices, and analyzed them taking in consideration their own experience as well as theory coming from past research done in their institution, and the scientific literature. Results: through a reflective process and by investigating their pedagogical process, educators were able to design the program from a wider perspective: child rearing. Also they were able to locate themselves in a different way with respect to education and to parents generating alternative proposal for education Discussion: research experience shows the difficulty of making changes in pedagogical perspectives in health education, usually based on traditional or behavioral models. According to the results, this research proposal is presented as a way to forward in the strengthening of a educational dimension in health field from an alternative perspective.
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Educación en Salud , Educadores en Salud , InvestigaciónRESUMEN
Styrylquinolines isolated from Galipea longiflora have shown leishmanicidal, trypanocidal, nematocidal and antimalarial activity. Here, we propose to use analogs of these styrylquinolines to enhance the activity against Trypanosoma cruzi. Three compounds in a reduced and oxidized state were synthesized, and the activity against epimastigotes and trypomastigotes was evaluated. in addition, the cytotoxic activity and genotoxic effect were also determined. The results indicated that epimastigotes from different T. cruzi I stocks were highly sensitive to the three compounds. The PQM4 compound presented promising activity against trypomastigotes and low cytotoxic and genotoxic effects. Finally, we observed that the doublebond reduction of the lateral chain of the three carbons made on these compounds improved the activity and substantially diminished the toxicity of the compounds.
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Proliferación Celular/efectos de los fármacos , Daño del ADN , ADN Protozoario/efectos de los fármacos , Quinolinas/farmacología , Tripanocidas/farmacología , Trypanosoma cruzi/efectos de los fármacos , Enfermedad de Chagas/genética , Enfermedad de Chagas/parasitología , Humanos , Pruebas de Sensibilidad Parasitaria , Quinolinas/síntesis química , Tripanocidas/síntesis química , Trypanosoma cruzi/genética , Células U937RESUMEN
The aim of this study was to investigate the role of the IL-6-174G/C gene polymorphism in susceptibility/resistance to Trypanosoma cruzi infection in two independent cohorts from Colombia and Peru. We determined the IL-6-174G/C genotypes in a sample of 399 seronegative individuals and 317 serologically positive patients from Colombia and Peru. All individuals are from regions where T. cruzi infection is endemic. No statistically significant differences in the frequency of IL-6-174G/C gene polymorphism between chagasic patients and controls or between asymptomatic and individuals with cardiomyopathy were observed. Our results do not support an evidence for a major role contribution of this IL-6 gene polymorphism in the susceptibility to or clinical manifestations of Chagas disease in these studied cohorts.
Asunto(s)
Enfermedad de Chagas/genética , Enfermedad de Chagas/inmunología , Interleucina-6/genética , Polimorfismo de Nucleótido Simple , Adulto , Anciano , Alelos , Estudios de Casos y Controles , Cardiomiopatía Chagásica/genética , Cardiomiopatía Chagásica/inmunología , Estudios de Cohortes , Colombia , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Perú , Adulto JovenRESUMEN
Tumorlets are pulmonary neuroendocrine tumours smaller than 0.5 cm. They are benign and their diagnosis is histologic as incidental fndings. We report a case of pulmonary tumorlet discussing the polemical points.
Denominamos tumorlet a los tumores neuroendocrinos pulmonares cuyo tamaño no alcanza los 0,5 cm. Se trata de tumores de comportamiento benigno que son diagnosticados histológicamente en el transcurso de estudios justifcados por otras causas. Presentamos un caso de tumorlet y analizamos la polémica en torno al mismo.