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1.
Saúde Soc ; 33(1): e220547pt, 2024.
Artículo en Portugués | LILACS | ID: biblio-1536859

RESUMEN

Resumo A alimentação, além de imperativo biológico para sobrevivência e saúde humana, é revestida de significados culturais que determinam suas múltiplas expressões na sociedade. Os campos da alimentação, da nutrição, da saúde e da antropologia se interseccionam na discussão sobre práticas alimentares. Este ensaio teórico do tipo reflexivo tem como objetivo refletir sobre a relevância das práticas alimentares das mulheres de camadas populares para possível superação da insegurança alimentar e nutricional, examinando as relações estabelecidas com a comida no contexto da cozinha, de seus corpos e do acesso aos alimentos. O percurso metodológico consiste no estudo reflexivo de caráter exploratório, que recorre a fontes bibliográficas e documentais para alicerçar as análises com base em uma leitura crítica da realidade. A herança patriarcal continua delegando à mulher o papel de cuidadora familiar, o que abarca a alimentação: desde a aquisição do alimento até o preparo e fornecimento das refeições. Propomos que as práticas alimentares dessas mulheres podem impulsionar potenciais mudanças, que serviriam como ferramentas para aplicação de políticas públicas. As reflexões oferecem subsídios para o planejamento de políticas que possam empoderá-las como sujeitos de ação e reflexão crítica, abrindo uma projeção de cenários possíveis para agenciar formas de superação das inseguranças alimentares.


Abstract Food, besides being a biological imperative for survival and human health, is coated with cultural meanings that determine its multiple expressions in society. The fields of food, nutrition, health, and anthropology intersect in the discussion about food practices. This theoretical and reflexive essay aims to reflect on the relevance of the food practices of low-income women for the possible overcoming of food and nutritional insecurity, examining the relationships established with food in the context of the kitchen, of their bodies, and of the access to food. The methodological path followed was the reflexive and exploratory study, which uses bibliographical and documental sources to support the analyses based on a critical reading of reality. The patriarchal heritage continues to assign women the role of family caretaker, which encompasses everything from acquiring food to its preparation and serving meals. We propose that the food practices of these women can drive potential changes, which would serve as tools for the application of public health policies. The reflections offer subsidies for planning of policies that can empower them as subjects of critical action and reflection, opening a projection of possible scenarios for the agency of ways to overcome food insecurity.


Asunto(s)
Humanos , Política Pública , Salud Pública , Conducta Alimentaria , Abastecimiento de Alimentos , Socioantropología de la Alimentación , Brasil
2.
Vaccines (Basel) ; 11(7)2023 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-37515009

RESUMEN

Cancer patients on chemotherapy have a lower immune response to SARS-CoV-2 vaccines. Therefore, through a prospective cohort study of patients with solid tumors receiving chemotherapy, we aimed to determine the immunogenicity of an mRNA vaccine booster (BNT162b2) among patients previously immunized with an inactivated (CoronaVac) or homologous (BNT162b2) SARS-CoV-2 vaccine. The primary outcome was the proportion of patients with anti-SARS-CoV-2 neutralizing antibody (NAb) seropositivity at 8-12 weeks post-booster. The secondary end points included IgG antibody (TAb) seropositivity and specific T-cell responses. A total of 109 patients were included. Eighty-four (77%) had heterologous vaccine schedules (two doses of CoronaVac followed by the BNT162b2 booster) and twenty-five had (23%) homologous vaccine schedules (three doses of BNT162b2). IgG antibody positivity for the homologous and heterologous regimen were 100% and 96% (p = 0.338), whereas NAb positivity reached 100% and 92% (p = 0.13), respectively. Absolute NAb positivity and Tab levels were associated with the homologous schedule (with a beta coefficient of 0.26 with p = 0.027 and a geometric mean ratio 1.41 with p = 0.044, respectively). Both the homologous and heterologous vaccine regimens elicited a strong humoral and cellular response after the BNT162b2 booster. The homologous regimen was associated with higher NAb positivity and Tab levels after adjusting for relevant covariates.

3.
Glob Soc Welf ; 10(2): 181-193, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37168736

RESUMEN

Background: Violence against women is a public priority issue for epidemiological and public health sciences. Severe consequences of violence affect the quality of life of women victims. The objective of this study was to quantify the impact in the quality of life of the strengthening group in women victims of intimate partner violence who attend a reference violence center in Campinas, São Paulo, Brazil. Method: Quasi-experimental before and after the study was designed. The danger assessment and WHOQOL-BREF scales were applied at admission, after 3 and 6 months. Descriptive and statistical analysis of the variables was carried out to verify the difference between the measurements in the quality of life domains. Results: Seventy-eight victims of intimate partner violence participated in the study. The most prevalent violence was psychological (96.2%), physical (79.5%), and moral (67.7%). Three months after participating in the strengthening group, there was an improvement in the 4 domains of quality of life, significantly in the psychological (p=0.032) and physical (p=0.006) domains. More than half of the participants were classified at the extreme level of risk of femicide (51.3%). The study was stopped early because of the restrictions of the COVID-19 pandemic. Conclusion: With the available data collected, the strengthening group proved to be a strategy that positively impacts the quality of life of women victims of intimate partner violence.

4.
Transcult Psychiatry ; 59(4): 539-550, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35765241

RESUMEN

For the Miskitu of Nicaragua, Grisi Siknis is a contagious illness that predominantly affects women. It is characterized by numerous psychosomatic symptoms, including headache, fear, aggressive behavior, loss of consciousness, and periods of rapid frenzy. Although Grisi Siknis has gained academic and public attention due to its unique cultural elements and perceived sexual aspects, little is known how the contextual and gender dimensions of Grisi Siknis are played out in relation to the socio-political context in the region. Based on 16 months of ethnographic work in the Nicaraguan Miskitu Coast, including semi-structured interviews (n = 20) and participant observation, this article documents a semantic shift in the embodied and symbolic language of a cultural idiom of distress. I show how duhindu (Miskitu spirit associated with illness and misfortune) and witchcraft are symbols that share cultural resonance in the Miskitu community, while gender violence discourse is a new language incorporated into the logic of this cultural idiom of distress. I argue that this semantic shift allows the individuals in this study to communicate local experiences of complex forms of structural inequalities (migration status, unemployment, ethnic identity) and gender-based violence that tend to be normalized as a ubiquitous cultural problem while preserving the broader socio-cultural meaning the Grisi Siknis represents. The ethnographic accounts of Grisi Siknis provide empirical data to unpack the unexplored contextual processes and local discourses that transform the meaning and logic of cultural idioms of distress at the individual level of experience.


Asunto(s)
Antropología Cultural , Violencia de Género , Hechicería , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Humanos , Nicaragua , Violencia
5.
Biomédica (Bogotá) ; Biomédica (Bogotá);40(supl.2): 44-49, oct. 2020. tab
Artículo en Español | LILACS | ID: biblio-1142447

RESUMEN

Durante la pandemia por SARS CoV-2 la gran mayoría de pacientes ha presentado afectación pulmonar como síntoma cardinal. En los niños, especialmente en recién nacidos, la sintomatología debida al efecto en otros sistemas diferentes al respiratorio puede dificultar el diagnóstico. Se reportan tres casos de recién nacidos atendidos durante la fase de mitigación de la pandemia por SARS CoV-2 en el servicio de urgencias de un hospital materno-infantil en Barranquilla, Colombia, por presentar cuadros febriles que afectaban su estado general. En su evolución clínica predominó la sintomatología gastrointestinal sin que desarrollaran nunca manifestaciones respiratorias. La investigación epidemiológica no evidenció contacto con casos sospechosos o positivos para COVID-19. Sus madres no habían tenido síntomas respiratorios en los 45 días transcurridos desde la declaración de la emergencia en salud pública en el país. La ausencia de manifestaciones clínicas respiratorias en este grupo de pacientes con COVID-19 debe llamar la atención de los clínicos sobre la necesidad de sospechar la infección por SARS CoV-2 en recién nacidos con estados febriles.


During the SARS COV-2 pandemic, the vast majority of infected patients are showing symptoms related to lung damage. At pediatric ages, especially newborns, symptoms from other organ systems without respiratory illness could make COVID-19 hard to diagnose. We are reporting three cases of newborns who were attended in the course of the mitigation phase in the emergency service of a maternal hospital in Barranquilla, Colombia, for high temperature and general compromised condition. During their clinical course, they developed gastrointestinal symptoms without showing any respiratory manifestations. They were not epidemiologically linked to a contact suspected to be a COVID-19 case and their mothers had had no respiratory symptoms since the public health emergency in our country was declared 45 days before. The absence of clinical respiratory manifestations in this group of patients with COVID-19 should draw clinicians' attention to the need to suspect SARS CoV-2 infection in febrile newborns.


Asunto(s)
Infecciones por Coronavirus , Sepsis Neonatal , Recién Nacido , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo
6.
Environ Technol ; 41(11): 1358-1365, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30301410

RESUMEN

Organic micropollutants (OMP) in the household and industrial wastewater are not efficiently removed by conventional treatment processes and a significant fraction ends in sludge. Proper valorization technologies become fundamental to attain sustainable sewage sludge management, with anaerobic digestion (AD) as one of the preferred strategies. However, it exhibits some limitations that can be overcome with pre-treatment processes. In this study, the influence of different pre-treatment configurations over OMP concentration and removal during AD was assessed. The incorporation of a sequential US - TT-PT resulted in decreased concentrations of 7 of the 9 detected compounds in biosolids compared to conventional AD digestate, with bisphenol-A and ter-octylphenol showing the opposite effect. The results suggest that the assessed PT could improve the removal of sequestered or highly hydrophobic compounds through their solubilization and increased bioavailability.


Asunto(s)
Aguas del Alcantarillado , Eliminación de Residuos Líquidos , Anaerobiosis , Hidrólisis , Aguas Residuales
7.
Int J Lab Hematol ; 41(4): 536-541, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31066993

RESUMEN

INTRODUCTION: Flow cytometry (FC) is a helpful tool for the diagnosis of myelodysplastic syndrome (MDS). Different FC score systems have been developed. The "Ogata score" is a simple diagnostic score that has been validated having a sensitivity of 69% and a specificity of 92% in low-risk MDS. We aimed to study the feasibility and the utility of the "Ogata score" for the diagnosis of MDS among Latin America (LA) Laboratories. METHODS: This is a case and control study conducted in LA institutions members of Grupo Latinoamericano de Mielodisplasia (GLAM). A total of 146 MDS patients and 57 control patients were included. "Ogata score" was calculated. RESULTS: The sensitivity of "Ogata score" was 75.6% (95% CI, 66.8-81.3), specificity was 91.2% (95% CI, 79.7-96.7), PPV was 95.6% (95% CI, 88.5-98.3), and NPV was 65.4% (95% CI, 49.1-71.9). In low/intermediate-1 IPSS patients group, the sensitivity was 70.1% (95% CI, 60.2-78.2), specificity was 91.2% (CI-95%, 79.7-96.7), PPV was 94.2% (95% CI, 86.4-97.8), and NPV was 62.1% (95% CI, 53.0-78.7). In the group of patients "without MDS specific markers" (patients without ring sideroblasts, blast excess, or chromosomal abnormalities), the sensitivity was 66.7% (CI-95%, 55.8-76.0), specificity was 91.2% (95% CI, 79.7-96.7), PPV was 92.3% (95% CI, 82.2-97.1), and NPV was 63.5% (95% CI, 51.9-73.5). CONCLUSIONS: The diagnostic power found in this study was similar to the reported by Della-Porta et al. Also in LA, the analysis was made in modern equipment with acquisition of at least 100 000 events which permits a good reproducibility of the results.


Asunto(s)
Citometría de Flujo , Síndromes Mielodisplásicos/sangre , Síndromes Mielodisplásicos/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , América Latina , Masculino , Persona de Mediana Edad
10.
Agora USB ; 16(1): 277-286, ene.-jun. 2016.
Artículo en Español | LILACS | ID: lil-790133

RESUMEN

Este artículo, comparte el abordaje metodológico desarrollado por el programa “Experiencias Pedagógicas Itinerantes Museo del Agua EPM” apoyado por Colciencias y desarrollado por la Fundación Empresas Públicas de Medellín (EPM) y la Universidad EAFIT en Colombia, el cual implementó una estrategia de participación comunitaria centrada en procesos de co-creación, para llevar a comunidades alejadas del territorio antioqueño, opciones paradesarrollar procesos de conocimiento, comprensión y relacionamiento con el recurso agua, basados en información científica y experiencias del Museo del Agua EPM en Colombia.


This article shares the methodological approach developed by the program “Experiences Teaching Travelling Public Enterprises of Medellin Water Museum” supported by Colciencias and developed by the Public Enterprises of Medellin (EPM) Foundation and EAFIT University in Colombia, which implemented a strategy of focusing on processes of cocreation community participation, in order to take distant communities from the Antioquia territory, options to develop processes of knowledge, understanding, and relationship withwater resource, based on scientific information and experiences of the Public Enterprises of Medellin Water Museum in Colombia.


Asunto(s)
Humanos , Conservación de los Recursos Energéticos , Conservación de los Recursos Naturales , Ciencia , Tecnología , Creación de Capacidad , Planificación Ambiental
11.
Rev. chil. pediatr ; 87(2): 110-115, abr. 2016. ilus
Artículo en Español | LILACS | ID: lil-783492

RESUMEN

INTRODUCCIÓN Las enfermedades crónicas durante la adolescencia son un gran desafío para el paciente, su familia y los proveedores de salud. La transición desde los servicios de salud pediátricos a adultos involucra el proceso de traspaso programado y planificado, de adolescentes portadores de enfermedades crónicas, para mantener una buena calidad de vida y desarrollo biopsicosocial. No existe, actualmente, un modelo único de transición. El objetivo del estudio es comprender el proceso de transición desde la perspectiva de adolescentes hospitalizados, para colaborar al diseño de un modelo acorde a las necesidades estudiadas. PACIENTES Y MÉTODO Incluye entrevistas semiestructuradas a 13 adolescentes portadores de enfermedades crónicas, hospitalizados en 2 centros asistenciales de Santiago de Chile, en un estudio analítico-relacional, sostenido por una metodología de carácter cualitativo. RESULTADOS En el análisis destacan 5 temas principales: experiencia de la vivencia de la enfermedad, importancia de la relación médico-paciente, concepto de autonomía limitado a lo farmacológico, ausencia de un proceso de transición propiamente dicho y la identificación de barreras y necesidades para una transición adecuada. CONCLUSIONES Este estudio es pionero en Chile en explorar el fenómeno de la transición en adolescentes con enfermedades crónicas. Enfatiza la necesidad de reforzar el concepto de autocuidado y autonomía desde etapas tempranas del cuidado y la importancia de la planificación temprana de un proceso de transición saludable, de acuerdo a las necesidades detectadas por los propios adolescentes.


INTRODUCTION Chronic illnesses during adolescence are a big challenge for the patient, his or her family, and health care providers. The transition from paediatric health services to adult health services involves a programmed and planned transfer process of adolescent sufferers of chronic illnesses, in order to maintain a high quality of life and bio-psycho-social development. There is currently no transition model. The objective of the study is to understand the transition process from the perspective of hospitalised adolescents to collaborate towards the design of a model that meets the needs studied. PATIENTS AND METHOD Semi-structured interviews with 13 adolescent sufferers of chronic illnesses, hospitalised in two healthcare centres in Santiago, Chile, in one analytical-relational study, supported by qualitative methodology. RESULTS In the analysis, 5 major themes stand out: experience of living with the illness, the importance of the doctor-patient relationship, the concept of limited autonomy to the pharmacology, the absence of the transition process as such, and the identification of barriers and needs for an adequate transition. CONCLUSIONS This study is new in Chile in that it explores the phenomenom of the transition of adolescents with chronic illnesses. It emphasises the need to reinforce the concept of self-care and autonomy from early stages of care, and the importance of early planning of a healthy transition process, in accordance to the detected needs of the adolescents themselves.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Calidad de Vida , Enfermedad Crónica/terapia , Transición a la Atención de Adultos/organización & administración , Hospitalización , Relaciones Médico-Paciente , Autocuidado , Chile , Entrevistas como Asunto , Adolescente Hospitalizado , Autonomía Personal
12.
Rev Chil Pediatr ; 87(2): 110-5, 2016.
Artículo en Español | MEDLINE | ID: mdl-26900102

RESUMEN

INTRODUCTION: Chronic illnesses during adolescence are a big challenge for the patient, his or her family, and health care providers. The transition from paediatric health services to adult health services involves a programmed and planned transfer process of adolescent sufferers of chronic illnesses, in order to maintain a high quality of life and bio-psycho-social development. There is currently no transition model. The objective of the study is to understand the transition process from the perspective of hospitalised adolescents to collaborate towards the design of a model that meets the needs studied. PATIENTS AND METHOD: Semi-structured interviews with 13 adolescent sufferers of chronic illnesses, hospitalised in two healthcare centres in Santiago, Chile, in one analytical-relational study, supported by qualitative methodology. RESULTS: In the analysis, 5 major themes stand out: experience of living with the illness, the importance of the doctor-patient relationship, the concept of limited autonomy to the pharmacology, the absence of the transition process as such, and the identification of barriers and needs for an adequate transition. CONCLUSIONS: This study is new in Chile in that it explores the phenomenom of the transition of adolescents with chronic illnesses. It emphasises the need to reinforce the concept of self-care and autonomy from early stages of care, and the importance of early planning of a healthy transition process, in accordance to the detected needs of the adolescents themselves.


Asunto(s)
Enfermedad Crónica/terapia , Hospitalización , Calidad de Vida , Transición a la Atención de Adultos/organización & administración , Adolescente , Adolescente Hospitalizado , Chile , Femenino , Humanos , Entrevistas como Asunto , Masculino , Autonomía Personal , Relaciones Médico-Paciente , Autocuidado/métodos
13.
Rev. colomb. radiol ; 25(2): 3961-3964, 2014. graf
Artículo en Español | LILACS, COLNAL | ID: biblio-995204

RESUMEN

El linfoma no Hodgkin de tipo folicular en la edad pediátrica es una patología muy rara, por lo que es difícil encontrar estadísticas epidemiológicas veraces acerca de su presentación. Los linfomas no Hodgkin en general constituyen el 8 % de los casos en niños con patologías neoplásicas, pero su variedad folicular en infantes se encuentra escasamente referenciada por su baja frecuencia. Es relevante el reconocimiento de su abordaje diagnóstico, en el que se destacan la histopatología y el manejo en el servicio de oncohematología pediátrica. Se puede afirmar que el diagnóstico adecuado constituye un reto para el equipo tratante, pues su escasa presentación en esta población específica no aporta herramientas a la sospecha clínica. Este artículo presenta un caso de linfoma folicular en una adolescente de 17 años de edad. Inicialmente se realiza una ecografía hepatobiliar y luego una TAC contrastada. Se encuentra una lesión de centro hipodenso localizada en el hipocondrio derecho; se plantea una neoplasia de contenido necrótico, que se confirma el linfoma folicular con la histopatología e inmunohistoquímica de la muestra de un tumor retroperitoneal obtenida en la intervención quirúrgica.


Follicular type non-Hodgkin's lymphoma is a very rare pathology at a pediatric age. For this reason, it is very difficult to find truthful epidemiological statistics regarding its appearance. Generally speaking, non-Hodgkin's lymphoma constitute 8% of cases in children with neoplastic pathologies. However, its follicular variety in children is scarcely found because of its low frequency. The recognition of its diagnosis is relevant. This diagnosis includes the histopathology and the handling of pediapediatric oncohematology. One can say that making a suitable diagnosis is a challenge for the treating team, given that its scarce presentation in this specific population does not provide tools for the clinic suspicion. This article shows a case of follicular lymphoma in a 17 year old teenager. Initially, a hepatic-biliar sonogram, and then a contrastive CT scan were performed. A located lesion of a dense core is found in the right hypochondriac. A neoplasia of necrotic content is set out, in which a follicular lymphoma is confirmed with the histopathology and immunohistochemistry of a retro peritoneum tumor sample obtained through surgical intervention.


Asunto(s)
Humanos , Linfoma Folicular , Radiología , Adolescente
14.
J Clin Anesth ; 20(6): 415-20, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18929280

RESUMEN

STUDY OBJECTIVE: To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy. DESIGN: Prospective, randomized, controlled study. SETTING: Postoperative recovery area at a university-affiliated medical center. PATIENTS: 50 ASA physical status I and II adult outpatients undergoing arthroscopic knee surgery. INTERVENTIONS: Study subjects were equally divided (n = 25 each) into spinal and sciatic-femoral groups. Spinal group patients received spinal anesthesia with 7.5 mg of 0.5% hyperbaric bupivacaine. Sciatic-femoral group patients received combined sciatic-femoral nerve blocks using a mixture of 20 mL of lidocaine 2% plus 20 mL of bupivacaine 0.5%. MEASUREMENTS: Times including that from arrival in the operating room to readiness for surgery, duration of surgery, recovery time, and patient satisfaction were recorded. Analgesia and occurrence of adverse events also were recorded. MAIN RESULTS: No significant differences between the two groups were found for any of the study measurements of recovery. After discharge, postoperative pain differed significantly between groups only at 6 hours (P < 0.002). Patient satisfaction was high with both techniques. CONCLUSIONS: Combined sciatic-femoral nerve block for outpatient arthroscopic knee surgery offers satisfactory anesthesia, with a clinical profile similar to that of low-dose spinal anesthesia. Sciatic-femoral nerve blocks are associated with significantly lower pain scores during the first 6 postoperative hours.


Asunto(s)
Anestesia Raquidea , Artroscopía , Nervio Femoral , Articulación de la Rodilla/cirugía , Bloqueo Nervioso/métodos , Nervio Ciático , Procedimientos Quirúrgicos Ambulatorios , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/prevención & control , Estudios Prospectivos , Factores de Tiempo , Resultado del Tratamiento
15.
Rev. colomb. anestesiol ; 35(1): 45-52, ene.-mar. 2007. ilus
Artículo en Español | LILACS | ID: lil-490993

RESUMEN

Se ha sugerido que la anestesia regional posee efectos benéficos en cirugía ambulatoria resultando en mejor analgesia, superior satisfacción del paciente y disminución de la utilización de recursos. El objetivo del presente estudio fue comparar dos técnicas anestésicas regionales en relación con la preparación para cirugía y la recuperación de los pacientes, en una población ambulatoria estandarizada. Métodos: Se estudiaron 50 pacientes adultos, ASA I-II, sometidos a cirugía artroscópica de rodilla. Los sujetos se dividieron aleatoriamente en grupo espinal (n = 25) y grupo ciático-femoral (n=25). Pacientes del grupo espinal recibieron anestesia subaracnoidea con 7.5 mg de bupivacaina hiperbárica. Pacientes del grupo ciáticofemoral recibieron bloqueo nervioso ciático-femoral utilizando una mezcla de 20 mL de lidocaina al 2 por cien más 20 mL de bupivacaina al 0.5 por cien. Se registraron los tiempos desde el ingreso a salas de cirugía hasta el comienzo de la misma, duración del procedimiento quirúrgico, tiempos de recuperación, satisfacción del paciente, calidad de la analgesia y ocurrencia de efectos adversos. Resultados: No se encontraron diferencias significativas en las medidas de recuperación entre los dos grupos. Luego de la salida del hospital el dolor difirió significativamente a las 6 horas post-operatorias (P = 0.002). La satisfacción fue alta con ambas técnicas. Conclusiones: En pacientes sometidos ambulatoriamente a cirugía artroscópica de rodilla la utilización de bloqueo nervioso ciático-femoral ofrece anestesia satisfactoria con un perfil clínico similar al obtenido con anestesia espinal a bajas dosis. Sin embargo, el bloqueo ciático-femoral se asocia significativamente con menos dolor durante las primeras 6 horas post-operatorias.


Asunto(s)
Humanos , Anestesia Epidural , Artroscopía/métodos , Artroscopía/tendencias , Nervio Ciático/cirugía
16.
Pediatrics ; 117(4): 1077-83, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16585301

RESUMEN

BACKGROUND: Persistent pulmonary hypertension (PPHN) occurs in as many as 6.8 of 1000 live births. Mortality is approximately 10% to 20% with high-frequency ventilation, surfactant, inhaled nitric oxide, and extracorporeal membrane oxygenation but is much higher when these therapies are not available. Sildenafil is a phosphodiesterase inhibitor type 5 that selectively reduces pulmonary vascular resistance. OBJECTIVE: Our goal was to evaluate the feasibility of using oral sildenafil and its effect on oxygenation in PPHN. DESIGN: This study was a proof-of-concept, randomized, masked study in infants >35.5 weeks' gestation and <3 days old with severe PPHN and oxygenation index (OI) >25 admitted to the NICU (Hospital Niño Jesús, Barranquilla, Colombia). The sildenafil solution was prepared from a 50-mg tablet. The first dose (1 mg/kg) or placebo was given by orogastric tube <30 minutes after randomization and every 6 hours. Preductal saturation and blood pressure were monitored continuously. OI was calculated every 6 hours. The main outcome variable was the effect of oral sildenafil on oxygenation. Sildenafil or placebo was discontinued when OI was <20 or if there was no significant change in OI after 36 hours. RESULTS: Six infants with an OI of >25 received placebo, and 7 received oral sildenafil at a median age of 25 hours. All infants were severely ill, on fraction of inspired oxygen 1.0, and with similar ventilatory parameters. Intragastric sildenafil and placebo were well tolerated. In the treatment group, OI improved in all infants within 6 to 30 hours, all showed a steady improvement in pulse oxygen saturation over time, and none had noticeable effect on blood pressure; 6 of 7 survived. In the placebo group, 1 of 6 infants survived. CONCLUSIONS: Oral sildenafil was administered easily and tolerated as well as placebo and improved OI in infants with severe PPHN, which suggests that oral sildenafil may be effective in the treatment of PPHN and underscores the need for a large, controlled trial.


Asunto(s)
Síndrome de Circulación Fetal Persistente/tratamiento farmacológico , Inhibidores de Fosfodiesterasa/administración & dosificación , Piperazinas/administración & dosificación , Vasodilatadores/administración & dosificación , Administración Oral , Presión Sanguínea/efectos de los fármacos , Método Doble Ciego , Femenino , Humanos , Recién Nacido , Masculino , Oxígeno/sangre , Síndrome de Circulación Fetal Persistente/sangre , Síndrome de Circulación Fetal Persistente/mortalidad , Proyectos Piloto , Purinas , Citrato de Sildenafil , Sulfonas , Tasa de Supervivencia
17.
Alergia inmunol. pediátr ; 6(5): 168-72, sept.-oct. 1997. ilus
Artículo en Español | LILACS | ID: lil-217454

RESUMEN

En este artículo revisamos los avances en el entendimiento de la fisopatología del asma, especialmente el papel de la inflamación y su asociación con lo leucotrienos. Revisamos los medicamentos antagonistas del receptor e inhibidores de la síntesis, utilizados en asma asociado a ejercicio, alergenos y reto con aspirina. Estudios clínicos con antagonistas de los leucotrienos han confirmado el papel central de los leucotrienos en la fisiopatología de el asma; sugiriendo la importancia de estos agentes en el tratamiento del asma


Asunto(s)
Asma/fisiopatología , Leucotrieno C4 , Leucotrienos/efectos adversos , Leucotrienos/antagonistas & inhibidores , Leucotrienos/inmunología , Leucotrienos/fisiología , Receptores de Leucotrienos/antagonistas & inhibidores
18.
Alergia inmunol. pediátr ; 6(2): 58-65, mar.-abr. 1997. tab
Artículo en Español | LILACS | ID: lil-214245

RESUMEN

La rinitis alérgica es el proceso inflamatorio que afecta a la cubierta externa de la nariz, se caracteriza por la presencia de los siguientes síntomas: congestión nasal, rinorrea, estornudos, prurito nasal y/o ocular y en ocasiones descarga retronasal y tos. Afecta tanto a niños como a adultos siendo más frecuente durante la infancia. Es considerada una de las enfermedades alérgicas más frecuentes, se estima su prevalancia en 5-22 por ciento y su incidencia en 10-20 por ciento en población general y de 5-9 por ciento en población pediátrica. Resulta de la interacción entre un alergeno específico (ácaros del polvo, hongos y epitelio de animales), irritantes o contaminantes ambientales y la mucosa nasal, que llevan al desarrollo de una respuesta inflamatoria alérgica temprana y tardía ya sea local o sistémica


Asunto(s)
Humanos , Alérgenos , Causalidad , Rinitis Alérgica Perenne/etiología , Rinitis Alérgica Perenne/fisiopatología , Rinitis Alérgica Perenne/tratamiento farmacológico , Rinitis Alérgica Perenne/terapia , Rinitis Alérgica Perenne/epidemiología
19.
Rev. chil. obstet. ginecol ; 50(2): 127-39, 1985. tab
Artículo en Español | LILACS | ID: lil-33401

RESUMEN

Se presentan los resultados obtenidos durante el primer año de aplicación de un programa de atención personalizada, gratuito y multidisciplinario a embarazadas de 16 años o menos de edad. El programa incluye no sólo atención obstétrica especializada, sino también educación con respecto al embarazo, parto, atención del recién nacido y planificación familiar, con asistencia social, seguimiento pediátrico del recién nacido y ginecológico de la adolescente. Durante este período se atendieron 315 gestantes precoces y 192 resolvieron su embarazo antes de los 16 años. Se comparan los resultados obtenidos con un grupo control de 60 embarazadas que tenían 17 años o más de edad y que tuvieron en el Servicio de Obstetricia y Ginecología del Hospital del Salvador. Se establece que la mayoría de las adolescentes eran solteras al momento de embarazarse (85,9%), disminuyendo este porcentaje apreciablemente después del parto. La gestación fue resultado de uniones con otros adolescentes en el 56.8%. Llama la atención que la actividad sexual, generalmente voluntaria (96.4%), se inició en el 62% de ellas antes de cumplirse dos años de su menarquia. Sin embargo, sólo el 36% tenía algún grado de información sexual. Todas las adolescentes que estudiaban suspendieron su educación a raíz del embarazo. Destaca el alto porcentage de hipertensión arterial inducida por el embarazo (22.4%), de anemia hipocrómica (21.3%), de edad gestacional dudosa (30.2%) y de desnutrición materna (38%), comparadas con el grupo control. Cabe mencionar también en alto porcentaje de parto por cesarea (34.9%). En relación al peso Apgar y patología del recién nacido no hubo diferencias significativas con el grupo control. La tasa de mortalidad perinatal fue de 10.7%. A los 6 meses post parto, el 51.9% de las jóvenes daban pecho, el 60.4% utilizaba algún método anticonceptivo y el 7.8% de los lactantes estaba desnutrido


Asunto(s)
Embarazo , Niño , Adolescente , Humanos , Femenino , Servicios de Salud Materna , Embarazo en Adolescencia , Servicio de Ginecología y Obstetricia en Hospital
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