RESUMEN
OBJETIVO: Determinar los factores de riesgo para presentar alteraciones de la densidad mineral ósea (DMO) en mujeres posmenopáusicas atendidas en la consulta de Menopausia y Climaterio de la Maternidad "Dr. Armando Castillo Plaza", de Maracaibo, Venezuela. MÉTODOS: Investigación descriptiva, con diseño no experimental y transeccional, donde se evaluó la DMO y los factores de riesgo para presentar osteoporosis en 60 mujeres posmenopáusicas. RESULTADOS: La medición de la DMO resultó en promedio de 957,45 ± 149,95 y 905,00 ± 151,25 gramos, con índices T de -0,52 ± 1,66 y -0,55 ± 2,67 en columna vertebral y cuello femoral, respectivamente. Se estableció una prevalencia de osteoporosis del 10% y 5%, y de osteopenia del 43,3% y 50% en columna vertebral y fémur, respectivamente. La menopausia quirúrgica (OR [95% CI] = 4,75 [1,58-14,25]; p=0,004), el consumo excesivo de café (OR [95% CI] = 3,20 [1,40-7,10 1]; p=0,000) o gaseosas (OR [95% CI] = 2,50 [1,18-5,60]; p=0,002), tabaquismo (OR [95% CI] = 1,70 [1,102,80]; p=0,013) y la ausencia de suplementación de calcio más vitamina D (OR [95% CI] = 1,70 [1,00-2,80]; p=0,019) resultaron ser factores significativamente asociados al diagnóstico de osteoporosis u osteopenia (p<0,05). CONCLUSIÓN: Las mujeres posmenopáusicas evaluadas presentan una alta prevalencia de alteraciones en la DMO, principalmente osteopenia, y factores de riesgo para presentar Osteoporosis.
AIM: To determine risk factors for presenting alterations in bone mineral density (BMD) in postmenopausal women attending the consultation of Menopause and Menopause Maternity "Dr. Armando Castillo Plaza", Maracaibo, Venezuela. METHODS: A descriptive research with non-experimental and transactional design where was evaluated BMD and risk factors for developing osteoporosis in 60 postmenopausal women. RESULTS: The BMD measurement was averaged in 957.45 ± 149.95 and 905.00 ± 151.25 grams; with T indexes of -0.52 ± 1.66 and -0.55 ± 2.67 in spine and femoral neck, respectively. The prevalence of osteoporosis was 10% and 5%, while osteopenia was 43.3% and 50% in spine and femur, respectively. Surgical menopause (OR [95% CI] = 4.75 [1.58 to 14.25]; p=0.004); excessive coffee consumption (OR [95% CI] = 3.20 [1,40- 7.10 1]; p=0.000) or gaseous beverages (OR [95% CI] = 2.50 [1.18 to 5.60]; p=0.002); smoking (OR [95% CI] = 1.70 [1.10 to 2.80]; p=0.013) and the absence of supplemental calcium plus vitamin D (OR [95% CI] = 1.70 [1.00 to 2.80]; p=0.019) were be factors significantly associated with the diagnosis of osteoporosis or osteopenia (p<0.05). CONCLUSION: The evaluated postmenopausal women have a high prevalence of abnormal BMD, especially osteopenia, and risk factors for developing osteoporosis.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Enfermedades Óseas Metabólicas/epidemiología , Menopausia , Densidad Ósea , Venezuela/epidemiología , Enfermedades Óseas Metabólicas/diagnóstico , Climaterio , Osteoporosis Posmenopáusica/epidemiología , Epidemiología Descriptiva , Prevalencia , Factores de RiesgoRESUMEN
OBJETIVO: Relacionar la anemia materna con el peso al nacer (PAN) en mujeres con embarazos a término atendidas en la emergencia obstétrica de la Maternidad "Dr. Armando Castillo Plaza", Maracaibo, Venezuela. MÉTODOS: Investigación correlacional con diseño no experimental y transeccional, donde se evaluaron 200 embarazadas en fase activa del trabajo de parto, a quienes se les determinaron los valores de hemoglobina (Hb), hematocrito (Hcto) e índices hematimétricos, para luego correlacionarlas con el PAN. RESULTADOS: Los valores de Hb oscilaban entre 8,4 ± 1,0 g/dl y 11,6 ± 0,64 g/dl, mientras que los de Hcto fueron de 28,8 ± 3,3% y 38,9 ± 2,2%, anémicas y no anémicas, respectivamente. Los índices hematimétricos mostraron valores referenciales normales en ambos grupos. El PAN de los recién nacidos de madres anémicas estaba disminuido en 12,39% (-420 g) al compararse con los pesos de los neonatos de madre sin anemia (2.970 ± 0,43 g vs. 3.390 ± 0,32 g; p<0,0001). El BPN fue más frecuente en el grupo de madres anémicas, las cuales mostraron un mayor riesgo, aunque no significativo (15% vs. 10%; OR IC95% 1,558 [0,676-3,728]; p>0,05). Se demostró una relación directamente proporcional y significativa entre los valores de Hb - PAN (r=0,439; p<0,0001). CONCLUSIÓN: Existe una relación directa, proporcional y significativa entre el PAN y los valores de Hb; sin embargo, aunque las gestantes anémicas presentaron con mayor frecuencia BPN, esta diferencia no fue significativa.
AIM: To link maternal anemia and birth weight (BW) in women with term pregnancies present to emergency obstetric at the Maternity "Dr. Armando Castillo Plaza", in Maracaibo, Venezuela. METHODS: A correlational research, with non-experimental and transactional design, where valued a sample of 200 pregnant women in active phase of labor, who are determined hemoglobin (Hb), hematocrit (Hct), and hematimetric indexes values. RESULTS: The values of Hb and Hct in anemic ranged from 8.4 ± 1 g/dl and 11.6 ± 0.64 g/dl, whereas the Hct was 28.8 ± 3.3% and 38.9 ± 2.2%, in patients with and without anemia, respectively. The hematimetric indexes showed normal reference values in both groups. The BW in newborn of anemic mothers was decreased by 12.39% (-420 g) when compared to the weights of infants of mother without anemia (2.970 ± 0.43 g vs. 3.390 ± 0.32 g; p<0.0001). LBW was more common in the group of anemic mothers, who showed an increased risk, although not significant (15% vs. 10%; OR 95%CI 1.588 [0,676-3,728]; p>0.05). Was demonstrated a directly proportional and significant relationship between Hb values and BW(r=0.439; p<0.0001). CONCLUSION: Exist a direct proportional and significant relationship between the PAN and the Hb; however, while anemic pregnant women presented more frequently LBW, this difference was not significant.
Asunto(s)
Humanos , Femenino , Embarazo , Recién Nacido , Adulto , Adulto Joven , Peso al Nacer , Nacimiento a Término , Anemia , Factores SocioeconómicosRESUMEN
In this paper a 3D morphological composition of transformations for brain extraction on brain Magnetic Resonance Images T1 (MRI T1) is presented. The proposal makes use of two morphological connected transformations, the lower leveling and a family of the viscous alternating sequential filters (VASFs). The properties of these operators -which consist in the control of the reconstruction process of a marker into the original image-, are exploited to segment the brain in 20 volumes of MRI T1. The segmented brains are compared with respect to: i) the segmentations obtained from BET which is popular among the scientific community for segmenting the brain; and ii) manual segmentations. The computed indices indicate that the proposed transformation produces good results during its performance. The consumed time for the algorithm during the execution is acceptable and it can be implemented in Matlab.
En este artículo se presenta una composición de transformaciones morfológicas para la extracción del cerebro en imágenes de resonancia magnética T1 (MRI T1) en 3D. La propuesta hace uso de dos transformaciones morfológicas conexas, la nivelación inferior y una familia de filtros viscosos alternados secuenciales (VASFs). Las propiedades de estos operadores- las cuales consisten en el control del proceso de reconstrucción de un marcador dentro de la imagen original-, se explotan para segmentar el cerebro de 20 volúmenes de MRI T1. Los cerebros segmentados se comparan respecto a: i) segmentaciones obtenidas a partir del algoritmo BET, el cual es popular en la comunidad científica para la segmentación del cerebro; y ii) segmentaciones manuales. Los índices calculados indican que la transformación propuesta produce buenos resultados en su desempeño. El tiempo empleado por el operador durante su ejecución es aceptable además de que la propuesta puede ser implementada en Matlab.
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Antecedentes: La asociación entre cáncer y embarazo es infrecuente, con una incidencia entre 0,02-0,1 por ciento ocupando el cáncer de ovario (CAO) el tercer lugar entre las neoplasias ginecológicas más frecuentemente asociada a la gestación, con tasas entre 1/10.000 a 1/100.000 embarazos. Objetivo: Divulgar un caso clínico de interés para la comunidad médica. Caso clínico: Gestante de 22 años que consulta por presentar dolor abdominal, vómitos, disnea y aumento de circunferencia abdominal. Presenta tumoración parauterina que alcanzaba a hipocondrio derecho, e ingresa con diagnostico de embarazo interrumpido de 12 semanas, tumoración de ovario; síndrome de pseudo Meigs y anemia. Mediante ecografía transabdominal se confirma lesión en fosa ilíaca y flanco derecho multilobulada de 17,3 x 9,9 x 13,7 cm, concordante con imágenes de RMN donde se aprecia como una tumoración ovárica sólido-quística. Se práctica laparotomía y la biopsia por congelación diagnosticó tumor ovario de células germinales (disgerminoma). Se procede a practicar histerectomía total con feto obitado in útero, más salpingo-ooforectomía bilateral. Egresando en buenas condiciones y actualmente en quimioterapia. Conclusión: La coincidencia de CAO durante el embarazo es rara, siendo los digerminomas los tumores malignos más frecuentemente diagnosticados.
Background: The association between cancer and pregnancy is infrequent, with an incidence of 0.02 to 0.1 percent; occupying ovarian cancer (OCA) in third place among the most common gynaecological malignancies associated with pregnancy, with rates between 1/10,000 to 1/100,000 pregnancies. Aim: To disseminate clinical case of interest to the medical community. Case report: A 22 years old pregnant who consulted for abdominal pain, vomiting, dyspnoea and increased abdominal girth. Who has an anexial tumour reaching right upper quadrant, which was admitted with diagnosis of interrupted pregnancy of 12 weeks, ovary's tumour, pseudo Meigs' syndrome and anaemia. Transabdominal ultrasound confirmed space occupying lesion in the right lower quadrant and flank multilobed of 17.3 x 9.9 x 13.7 cm, with concordance in MRI which is seen as a mixed ovarian tumour. Laparotomy was practice and the frozen biopsy was diagnosed as ovarian germ cell tumour (dysgerminoma). It proceeds to total hysterectomy with death fetus in uterus, with bilateral salpingo oophorectomy. Withdrawal in good condition and currently under chemotherapy regimen. Conclusion: The coincidence of OCA during pregnancy is rare, the dysgerminoma are the most frequently diagnosed malignancy.
Asunto(s)
Humanos , Adulto , Femenino , Embarazo , Adulto Joven , Complicaciones Neoplásicas del Embarazo , Disgerminoma/cirugía , Disgerminoma/diagnóstico , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/diagnóstico , Histerectomía , Síndrome de MeigsRESUMEN
En este trabajo se presenta un método para medir la variación del calcio intracelular en células foliculares. Esta propuesta consiste en dos etapas: (i) La detección de los núcleos de las células; y (ii) el análisis de las variaciones de fluorescencia. La primera etapa se realiza a través de la transformada modificada de líneas divisoras de agua controlada por marcadores (en inglés: Modified-Watershed Transformation) controlando el proceso de etiquetado de células por el establecimiento de criterios particulares. El proceso de detección homogeniza las condiciones de luminosidad a través de un filtro morfológico y utiliza como descriptores a los bordes de las células. En la segunda etapa, se asocia la variación de la fluorescencia con los cambios de Ca2+ intracelular donde la variación se modela como una función exponencial decreciente. Luego, se presenta un nuevo proceso morfológico, denominado proceso de reconstrucción medio, que permite suavizar los datos para el proceso de modelado. Este proceso utiliza la información del sub modelado y sobre modelado de la señal, mediante las propiedades de los operadores de reconstrucción, conservando la estructura interna de la señal original. Finalmente, en un proceso experimental utilizando células de anfibios, se muestran los resultados obtenidos después de aplicar la propuesta a un grupo de células.
This paper presents a method for the measurement of the variation of intracellular calcium in follicular cells. This proposal consists in two stages: (i) The detection of the cell's nuclei, and (ii) the analysis of the fluorescence variations. The first stage is performed with the modified-watershed transformation, where the marker process is controlled by establishing own criterion. The detection process homogenizes the luminance conditions through a morphological filter and uses as descriptors the edges of the cells. In the second stage, the variations of fluorescence are associated with changes in intracellular Ca2+, which are modeled as an exponential decay function. Then, we present a new morphological process called medium reconstruction process, that smoothes the data in the process of model creation. This process uses the information of under and over model of the signal, through the properties of reconstruction operators, keeping the internal structure of the original signal. Finally, using amphibian cells in an experimental process, the results obtained are showed after applying the proposal to a group of cells.
RESUMEN
BACKGROUND: Urinalysis is one of the most common studies performed on the diabetic patient at every visit. The presence of leukocyturia is relatively common but it is not clear what the attitude of the physician toward this particular finding should be. The main objective of the present study was to investigate the clinical significance of leukocyturia in diabetic women. METHODS: Ninety-eight diabetic women (84.7% type 2) aged 57 +/- 13 years who were being seen at the diabetic out-patient clinic were randomly selected. All patients underwent a clinical and gynecologic examination and a urinalysis. A Papanicolaou smear and a urine culture were also obtained. RESULTS: The overall prevalence of leukocyturia (>5 cells/high power field (hpf)) was 46.5%. Patients with urinary tract infections (UTI) were 7.5 times more likely to have leukocyturia, while a leukocyte count <5cells/hpf predicted the absence of UTI in 96% of the women. In the comparison of patients with and without leukocyturia, we found that proteinuria (p = 0.06) and bacteriuria (p <0.002) were more common in the women with leukocyturia. A significant association with leukorrhea was not demonstrated. The empirical use of antibiotics was 12 times more frequent in the patients with leukocyturia. CONCLUSIONS: A urinary culture should be requested in all diabetic patients with leukocyturia. The possibility of a UTI is remote when leukocyturia is absent.
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Diabetes Mellitus/orina , Recuento de Leucocitos , Orina/citología , Adulto , Anciano , Antibacterianos/uso terapéutico , Actitud del Personal de Salud , Bacteriuria/etiología , Bacteriuria/orina , Comorbilidad , Complicaciones de la Diabetes , Susceptibilidad a Enfermedades , Utilización de Medicamentos/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Pautas de la Práctica en Medicina , Prevalencia , Infecciones Urinarias/complicaciones , Infecciones Urinarias/epidemiología , Infecciones Urinarias/orina , Cervicitis Uterina/epidemiología , Cervicitis Uterina/orinaRESUMEN
Any effort to control dengue hemorrhagic fever (DHF) faces a number of challenges. Among these are the great environmental heterogeneity of homes and neighborhoods in urban centers where the primary dengue vector, Aedes aegypti, breeds, as well as shortages of resources and of personnel trained in mosquito control. Adequate epidemiological surveillance could serve as a basis to begin to stratify urban communities and identify the areas in them where control efforts should be focused. In this study we stratified Maracay, Venezuela, a city with hyperendemic dengue hemorrhagic fever, using a geographic information system and analyzing the persistence, incidence, and prevalence of dengue, by means of clinical diagnoses reported from 1993 through 1998. Maracay has around one million inhabitants living in some 349 neighborhoods in the six communities that make up the greater Maracay metropolitan area. During that 1993-1998 period the Maracay area reported 10,576 cases of dengue, 2,593 cases of DHF, and 8 deaths. The incidence of DHF was related to the incidence of dengue, the number of inhabitants in an area, and population density. The spatial pattern of dengue incidence was stable over the years that were studied, and significant, positive relationships were found between pairs of years and the incidence of dengue by neighborhood. The persistence of dengue was related directly to monthly incidence by neighborhood. These spatial patterns helped to divide the city into three strata: 68 neighborhoods without apparent dengue, 226 neighborhoods with low persistence and prevalence, and 55 neighborhoods with high persistence and prevalence. We recommend giving the highest priority for control efforts to these 55 neighborhoods, which make up just 35% of the Maracay urban area but had 70% of all the reported dengue cases.