RESUMO
Preeclampsia (PE) is a multisystemic syndrome specific to pregnancy. Although PE is the leading cause of death from complications associated with pregnancy, its aetiology is still unknown. In PE, lipid metabolism is altered. When lipids are damaged, both the mother and the foetus may be at risk. Lipoproteins contain apolipoproteins, triacylglycerols, free and esterified cholesterol, and phospholipids, all of which are susceptible to oxidative stress when high levels of oxygen and nitrogen free radicals are present. Lipoperoxidation can occur in three stages: mild, moderate, and severe. In severe lipid damage, highly toxic products such as malondialdehyde (MDA) can be generated; under these conditions, low-density lipoprotein (LDL) proteins can be oxidized (oxLDL). oxLDL is a biomolecule that can affect the production of nitric oxide (NO), the main vasodilator derived from the endothelium. oxLDL can interfere with the transduction of the signals responsible for triggering the activation of endothelial nitric oxide synthase (eNOS), causing reduced vasodilation and endothelial dysfunction, which are the main characteristics of preeclampsia. The objective of the review was to analyse the information the current information about exists about the impact generated by the oxidation of LDL and HDL lipoproteins in neonates of women with preeclampsia and how these alterations can predispose the neonate to develop diseases in adulthood.PE can cause foetal loss, intrauterine growth restriction, or developmental complications. Neonates of mothers with PE have a high risk of cardiovascular diseases, stroke, mental retardation, sensory deficiencies and an increased risk of developing metabolic diseases. PE not only affects the foetus, generating complications during pregnancy but also predisposes them to chronic diseases in adulthood.
Assuntos
Lipoproteínas , Pré-Eclâmpsia , Feminino , Feto/metabolismo , Humanos , Recém-Nascido , Lipoproteínas/metabolismo , Lipoproteínas HDL , Lipoproteínas LDL , Malondialdeído/metabolismo , Pré-Eclâmpsia/metabolismo , GravidezRESUMO
OBJECTIVE: To evaluate the microshear bond strength (mSBS) of 10 universal adhesive systems applied on five different CAD/CAM restorative materials, immediately and after thermal aging. METHODS AND MATERIALS: Five CAD/CAM materials were selected: 1) feldspathic glass ceramic (FeCe); 2) pre-polymerized reinforced resin composite (ReRC); 3) leucite-reinforced glass ceramic (LeGC); 4) lithium disilicate (LiDi); and 5) yttrium-stabilized zirconium dioxide (ZiDi). For each material, 15 blocks were cut into four rectangular sections (6 × 6 × 6 mm; n=60 per group) and processed as recommended by the respective manufacturer. For each indirect material, the following adhesive systems were applied according to the respective manufacturer's instructions: 1) AdheSE Universal [ADU]; 2) All-Bond Universal [ABU]; 3) Ambar Universal [AMB]; 4) Clearfil Universal Bond [CFU]; 5) Futurabond U [FBU]; 6) One Coat 7 Universal [OCU]; 7) Peak Universal Bond [PUB]; 8) Prime&Bond Elect [PBE]; 9) Scotchbond Universal Adhesive [SBU]; 10) Xeno Select [XEN, negative control]. After the application of the adhesive system, cylinder-shaped transparent matrices were filled with a dual-curing resin cement (NX3) and light cured. Specimens were tested in shear mode at 1.0 mm/min (mSBS), after 24 hours and 10,000 thermal cycles (TC). All data were submitted to statistical analysis (α=0.05). RESULTS: For FeCe, there was no significant decrease in mean mSBS for AMB, FBU, and SBU after TC when compared at 24 hours. For ReRC, AMB and SBU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LiDi, FBU and OCU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LeGC, AMB and PUB showed higher mean mSBS when compared to XEN, after 24 hours and TC. For ZiDi, OCU and SBU showed higher mean mSBS when compared to XEN, after 24 hours and TC. In addition, PBE and XEN showed the lowest mean mSBS after TC with higher percentage of bond strength reduction. CONCLUSIONS: The mean mSBS among the different universal adhesives varied widely for each CAD/CAM material used. In addition, most universal adhesives underwent a statistically significant bond strength reduction after TC.
Assuntos
Colagem Dentária , Cerâmica/uso terapêutico , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Cimentos Dentários/uso terapêutico , Materiais Dentários , Teste de Materiais , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Resistência ao Cisalhamento , Propriedades de SuperfícieRESUMO
Objetivo: la responsabilidad ética del investigador obliga al monitoreo de la seguridad de los participantes a través del estudio y, por ende, se requiere de un comité de monitoreo de datos, cuya tarea principal es el análisis interino que se refiere a la supervisión de variables como beneficios dramáticos, efectos adversos, mortalidad y futilidad, que lleven a la terminación temprana del estudio. El objetivo de esta investigación es determinar los métodos estadísticos más utilizados en el análisis interino en los ensayos clínicos aleatorizados y publicados en 2016 en una revista médica general de alto factor de impacto. Metodología: se realizó un estudio meta-epidemiológico descriptivo, constituido por ensayos clínicos aleatorizados publicados en el The New England Journal of Medicine, desde el 7 de enero hasta el 10 de noviembre de 2016. Resultados: se analizaron 104 artículos con una muestra promedio de 5 531 ± 762 pacientes y un tiempo de seguimiento promedio de 31 ± 45 meses. De los estudios evaluados se encontró que 88 (84.61%) realizaron análisis interino y 16 (15.38%) no lo realizaron. Los métodos estadísticos utilizados en los artículos fueron O'Brien-Fleming en 30 (34.09%), Haybittle-Peto en 13 (14.77%); otros métodos en dos (2.27%) y no especificado en 43 (48.86%) de ellos. Conclusiones: la mayoría de los ensayos clínicos aleatorizados realizó análisis interino y lo describen en su protocolo. Aproximadamente la mitad de los estudios no especificó el método estadístico; sin embargo, el método descrito más utilizado fue O'Brien-Fleming y, en segundo lugar, Haybittle-Peto y en ningún estudio se especificó el método de Pocock.
Objective: The ethical responsibility of the researcher requires that the safety of participants be monitored throughout the study. Thus, a data monitoring committee is required, whose main function is the interim analysis, which monitors variables such as dramatic benefits, adverse effects, mortality and futility that lead to the early termination of a study. The objective of this study is to determine the most frequently used statistical methods in interim analysis in randomized clinical trials published during 2016 in a high impact factor medical journal. Methodology: Meta-epidemiological descriptive study, consisting of randomized clinical trials published in The New England Journal of Medicine from January 7 to November 10 of 2016. Results: 104 articles were analyzed, where the mean sample was 5,531 ± 762 patients and and average follow-up time was 31 ± 45 months. Of the studies evaluated, 88 (84.61%) performed interim analysis, while 16 (15.38%) did not. Regarding statistical methods used, O'Brien-Fleming was used in 30 (34.09%) studies, Haybittle-Peto in 13 (14.77%), other methods in two (2.27%), and the method was not specified in 43 (48.86%). Conclusions: most of the randomized clinical trials reviewed had interim analysis and described it in their protocol. Approximately half of the studies did not specify the statistical method; however, the most commonly described method was O'Brien-Fleming, followed by Haybittle-Peto; no study used the Pocock method.
Objetivo: a responsabilidade ética do investigador obriga à monitoração da segurança dos participantes através do estudo e, por consequência, se requere de um comitê de monitoração de dados, cuja a tarefa principal é a análise interino que se refere à supervisão de variáveis como benefícios dramáticos, efeitos adversos, mortalidade e futilidade, que levem à terminação precoce do estudo. O objetivo desta investigação é determinar os métodos estatísticos mais utilizados na análise interino nos ensaios clínicos aleatorizados e publicados em 2016 em uma revista médica geral de alto fator de impacto. Metodologia: se realizou um estudo meta-epidemiológico descritivo, constituído por ensaios clínicos aleatorizados publicados no The New England Journal of Medicine, desde o dia 7 de Janeiro até o dia 10 de novembro de 2016. Resultados: se analisaram 104 artigos com uma amostra média de 5 531 ± 762 pacientes e um tempo de seguimento médio de 31 ± 45 meses. Dos estudos avaliados se encontrou que 88 (84.61%) realizaram análise interino e 16 (15.38%) não o realizaram. Os métodos estatísticos utilizados nos artigos foram O'Brien-Fleming em 30 (34.09%), Haybittle-Peto em 13 (14.77%); outros métodos em dois (2.27%) e não especificado em 43 (48.86%) deles. Conclusões: a maioria dos ensaios clínicos aleatorizados realizou análise interino e o descrevem no seu protocolo. Aproximadamente a metade dos estudos não especificou o método estatístico; mas, o método descrito mais utilizado foi O'Brien-Fleming e, em segundo lugar, Haybittle-Peto e em nenhum estudo se especificou o método de Pocock.
Assuntos
Humanos , Ensaio Clínico , Interpretação Estatística de Dados , Comitês de Monitoramento de Dados de Ensaios Clínicos , Metodologia como AssuntoRESUMO
INTRODUCTION: Subclinical thyroid dysfunction is a possible risk factor for cognitive impairment in old age, but results are inconsistent. Aim of the present study was to evaluate the prevalence of thyroid dysfunction among older community-dwelling adults and to see whether thyroid function impacts the cognitive status of the elderly. METHODS: We included 1750 participants from the Study on Aging and Dementia in Mexico (SADEM). All subjects were evaluated clinically via specific interviews. TSH levels were analyzed by chemiluminescent immunometry assay. We classified participants into five thyroid state groups: (1) normal TSH levels (0.40-4.0 IU/L) were considered euthyroid; (2) Overt hyperthyroidism: TSH <0.3 IU/l and FT4 >23 pmol/l; (3) Overt hypothyroidism: TSH >4.8 IU/l, FT4 <13 pmol/l; (4) Subclinical hyperthyroidism: TSH <0.3 IU/l, FT4: 13-23 pmol/l; (5) Subclinical hypothyroidism: TSH >4.8 IU/l, FT4: 13-23 pmol/l. RESULTS: The overall estimated prevalence of thyroid dysfunction in Mexican population was 23.7% (95% CI, 22.66-26.77). Of these, 15.4% older adults were classified as subclinical hypothyroidism, 7.2% overt hypothyroidism, 0.5% subclinical hyperthyroidism, and 0.6% overt hyperthyroidism. The association of thyroid dysfunction with cognitive impairment was most evident in overt hypothyroidism OR = 1.261 (1.185-1.343). CONCLUSIONS: The present study demonstrated a high prevalence of thyroid dysfunction in Mexican elderly people living in the community. A relationship between cognitive impairment and the presence of hypothyroidism was also shown, and to a lesser degree in hyperthyroidism.
Assuntos
Envelhecimento/psicologia , Cognição/fisiologia , Demência/epidemiologia , Demência/psicologia , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/psicologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/sangue , Escalas de Graduação Psiquiátrica Breve , Transtornos Cognitivos/sangue , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Demência/sangue , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Doenças da Glândula Tireoide/sangue , Glândula Tireoide/metabolismoRESUMO
BACKGROUND: Postmenopausal women present weight gain and intensification of obesity, especially visceral adipose tissue (VAT) increases in postmenopausal women. But it is still not clear whether abdominal fat increases during this stage independently of body weight. OBJECTIVE: compare the VAT and lipid profile between postmenopausal and premenopausal Mexican women. METHODS: A case control study in postmenopausal women matched for BMI with premenopausal women. Anthropometric and laboratory measurements as well as body composition analysis were performed. RESULTS: VAT was increased in postmenopausal women in contrast with premenopausal women (114.8 ± 39.5 vs 97.3 ± 29.0, p<0.05). Compared with premenopausal women, postmenopausal women showed higher total cholesterol (231 .6 ± 56.1 vs 206.8 ± 29.5 p <0.05), and LDL-cholesterol levels (145.9 ± 48.3 vs 121.7 ± 34.1, p < 0.05), whereas H DL-cholesterol remained unchanged. CONCLUSION: The results of the present study have demonstrated that Mexican postmenopausal women had a significant increment in visceral adipose tissue and in other metabolic risk factors, independent of the body mass index.
Assuntos
Gordura Intra-Abdominal , Lipídeos/sangue , Pós-Menopausa/sangue , Pré-Menopausa/sangue , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
La vaginitis es el proceso patológico que con mayor frecuencia afecta a mujeres en edad reproductiva y puede ser responsable, en algunos casos, de complicaciones y secuelas serias para la salud de la mujer. En Guatemala, no se tiene conocimiento preciso de la frecuencia de estos procesos, ni tampoco de los agentes que lo causan, razón por la cual se llevó a cabo esta investigación. Se realizó un estudio prospectivo en 594 pacientes que asistieron a la clínica de Papanicolaou de la Asociación Pro-bienestar de la familia (APROFAM) en la ciudad de Guatemala, las cuales fueron evaluadas clínicamente y mediante pruebas de laboratorio para determinar la presencia de microorganismos patógenos. Utilizando una metodología de laboratorio sencilla y estrictas definiciones de caso, se determinó que 305 pacientes (51.3%) padecían de vaginitis...
Assuntos
Candida , Guatemala , Incidência , Neoplasias Uterinas , Esfregaço Vaginal , VaginiteRESUMO
Production of periplasmic human interferon-gamma (hINF-gamma) and human interleukin-2 (hIL-2) by the Tat translocation pathway in Escherichia coli BL21-SI was evaluated. The expression was obtained using the pEMR vector which contains the Tat-dependent modified penicillin acylase signal peptide (mSPpac) driven by the T7 promoter. The mSPpac-hINF-gamma was processed and the protein was transported to periplasm. Up to 30.1% of hINF-gamma was found in the periplasmic soluble fraction, whereas only 15% of the mSPpac-hIL-2 was processed, but hIL-2 was not found in the periplasmic soluble fraction.
Assuntos
Escherichia coli/fisiologia , Interferon gama/metabolismo , Interleucina-2/metabolismo , Engenharia de Proteínas/métodos , Humanos , Interferon gama/química , Interferon gama/genética , Interleucina-2/química , Interleucina-2/genética , Periplasma/química , Proteínas Recombinantes/metabolismo , SolubilidadeRESUMO
ANTECEDENTES: El predominio de la diabetes gestacional está aumentando en nuestra población y sus efectos en el metabolismo celular y estatus oxidativo están siendo estudiados. OBJETIVO: Determinar si existe una relación entre la actividad de la glutatión reductasa eritrocitaria, evaluada a través del test CAGRE y la diabetes gestacional. MÉTODO: Estudio transversal de casos y controles, incluyó a 30 embarazadas con diagnóstico de diabetes gestacional y 30 sin patologías asociadas, pertenecientes a la Maternidad del Hospital Barros Luco-Trudeau, Santiago de Chile. La actividad de la glutatión reductasa de eritrocitos fue determinada espectrofotométricamente a través del test CAGRE, la que fue relacionada con variables maternas como: edad, hematocrito, presencia de antecedentes de enfermedades familiares, estado nutricional materno e índice de masa corporal. Para comparar las variables entre ambos grupos, se realizaron medidas de disparidad, posición y análisis de la correlación. RESULTADOS: El grupo de madres diabéticas presentó edad materna, índice de masa de corporal y antecedentes de diabetes gestacional mayores que el grupo control, aunque sin diferencia estadísticamente significativa. El predominio de anemia y la respuesta al suplemento del cofactor FAD en la actividad de la glutatión reductasa eritrocitaria fue similar entre los grupos. La mayor incidencia de diabetes familiar en el grupo control fue estadísticamente significativa. La distribución de los valores de CAGRE, utilizado también como un indicador de los niveles de riboflavina, mostró en el grupo de casos riesgo medio a alto de malnutrición, mientras que en el grupo control la tendencia fue normal o de riesgo bajo. CONCLUSIÓN: Las embarazadas diabéticas gestacionales, presentaron mal nutrición y un estrés oxidativo mayor que el grupo control, evidenciado por el test de CAGRE.
BACKGROUND: The prevalence of the gestational diabetes is increasing in our population and its effects in the cellular metabolism and oxidative status had been studied. OBJECTIVE: Determine if exists a relationship between the erythrocyte glutathione reductase activity evaluated by EGRAC test and the gestational diabetes. METHODS: This traversal study of cases and controls, included at 30 pregnant with diagnostic of gestational diabetes and 30 without associate pathologies, belonging to the Maternity of the Hospital Barros Luco-Trudeau, Santiago-Chile. The activity of the glutathione reductase was determined by spectrophotometric assay through the EGRAC test, and their values were related with maternal variables as: age, hematocrite, presence of antecedents of family illnesses, maternal nutritional status and the body mass index. To compare the variables between both groups, they were carried out measures of disparity, position and analysis of the correlation. RESULTS: We determine that the group of diabetic mothers was older, with higher body mass index and a bigger frequency of antecedents of gestational diabetes that the control group, although without significant difference. The prevalence of anemia and the answer to the supplement with FAD in the activity of the glutathione reductase was similar among the groups. On the other hand, the incidence of familiar diabetes in the group control was bigger. The distribution of the values of EGRAC, also used as an indicator of the riboflavin levels, showed in the group of cases half risk to high of malnutrition, while in the group control the tendency was normal or low risk. CONCLUSION: We can conclude that the gestational diabetics pregnant presented malnutrition and higher oxidative stress that the control group, evidenced by means of the EGRAC test.
Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Diabetes Gestacional/enzimologia , Glutationa Redutase/metabolismo , Índice de Massa Corporal , Estudos de Casos e Controles , Estado Nutricional , Estudos Transversais , Estresse Oxidativo , Ensaios Enzimáticos Clínicos/métodos , Eritrócitos/enzimologiaAssuntos
Adulto , Humanos , Masculino , Calcinose , Soropositividade para HIV , Pancreatite , Doença Crônica , Tomógrafos ComputadorizadosRESUMO
No reports testing the efficacy of the use of the QT/RR ratio <1/2 for detecting a normal QTc interval were found in the literature. The objective of the present study was to determine if a QT/RR ratio <=1/2 can be considered to be equal to the normal QTc and to compare the QT and QTc measured and calculated clinically and by a computerized electrocardiograph. Ratios (140 QT/RR) of 28 successive electrocardiograms obtained from 28 consecutive patients in a tertiary level teaching hospital were analyzed clinically by 5 independent observers and by a computerized electrocardiograph. The QT/RR ratio provided 56 percent sensitivity and 78 percent specificity, with an area under the receiver operator characteristic curve of 75.8 percent (95 percentCI: 0.68 to 0.84). The divergence in QT and QTc interval measurements between clinical and computerized evaluation were 0.01 ± 0.03 s (95 percentCI: 0.04-0.02) and 0.01 ± 0.04 s (95 percentCI: -0.05-0.03), respectively. The QT and QTc values measured clinically and by a computerized electrocardiograph were similar. The QT/RR ratio <=1/2 was not a satisfactory index for QTc evaluation because it could not predict a normal QTc value.
Assuntos
Humanos , Masculino , Feminino , Arritmias Cardíacas , Eletrocardiografia , Frequência Cardíaca , Processamento de Sinais Assistido por Computador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Curva ROC , Sensibilidade e EspecificidadeRESUMO
No reports testing the efficacy of the use of the QT/RR ratio <1/2 for detecting a normal QTc interval were found in the literature. The objective of the present study was to determine if a QT/RR ratio < or =1/2 can be considered to be equal to the normal QTc and to compare the QT and QTc measured and calculated clinically and by a computerized electrocardiograph. Ratios (140 QT/RR) of 28 successive electrocardiograms obtained from 28 consecutive patients in a tertiary level teaching hospital were analyzed clinically by 5 independent observers and by a computerized electrocardiograph. The QT/RR ratio provided 56% sensitivity and 78% specificity, with an area under the receiver operator characteristic curve of 75.8% (95%CI: 0.68 to 0.84). The divergence in QT and QTc interval measurements between clinical and computerized evaluation were 0.01 +/- 0.03 s (95%CI: 0.04-0.02) and 0.01 +/- 0.04 s (95%CI: -0.05-0.03), respectively. The QT and QTc values measured clinically and by a computerized electrocardiograph were similar. The QT/RR ratio < or =1/2 was not a satisfactory index for QTc evaluation because it could not predict a normal QTc value.
Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia/métodos , Frequência Cardíaca , Processamento de Sinais Assistido por Computador , Feminino , Humanos , Masculino , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Fast food sold on the streets are good vehicle to transmit gastrointestinal diseases to consumers because they are highly manipulated. The vegetables are a good media for pathogens growth. Raw vegetables salads for hot dog sold in Maracay were studied. Total and fecal Coliforms and Staphylococcus sp. were quantified by the Most Probable Number Technique, Coliforms and Staphylococcus isolated were partially identified. Also the mould population was quantified and identified. Microbial growth was correlated with pH and acidity measurements. MPN/g of Total Coliforms was 1.44 x 10(5) and 4.57 x 10(4) for fecal Coliforms. E. coli was no detected. 87 isolated from the Coliforms were partially identified as Citrobacter freundii variety 1 (45.09% of the isolated), C. freundii variety II (21.57%), Enterobacter aerogenes variety I (17.65%) and E. aerogenes variety II (15.69%); Staphylococcus sp. 3.93 x 10(6) MPN/g and all of its isolated (52) were coagulase negative. The mould population was 4.5 x 10(4) ufc/g, Penicillium sp., Aspergillus, sp., Fusarium sp. were partially identified. The salads presented a pH of 5.92 and an acidity of 0.78 ml of NaOH.
Assuntos
Enterobacter/isolamento & purificação , Microbiologia de Alimentos , Fungos/isolamento & purificação , Produtos da Carne/microbiologia , Staphylococcus/isolamento & purificação , Verduras/microbiologia , Análise de Variância , Contagem de Colônia Microbiana , Comércio , Escherichia coli/isolamento & purificação , Manipulação de Alimentos/normas , Concentração de Íons de Hidrogênio , Estatísticas não Paramétricas , VenezuelaRESUMO
Bioactivity-directed fractionation of a CHCl(3)-MeOH (1:1) extract prepared from the seeds of Rollinia mucosa led to the isolation of a mixture of eight novel tryptamine amides. Extensive HPLC allowed the isolation of the major component of the mixture, which was characterized as N-lignoceroyltryptamine (6) using a combination of spectroscopic and chemical methods. The minor amides were identified by GC-MS analysis as N-palmitoyltryptamine (1), N-stearoyltryptamine (2), N-arachidoyltryptamine (3), N-behenoyltryptamine (4), N-tricosanoyltryptamine (5), N-pentacosanoyltryptamine (7), and N-cerotoyltryptamine (8). Two lignans (pinoresinol dimethyl ether and magnolin) and six acetogenins [membranacin (9), desacetyluvaricin (10), rolliniastatin 1, bullatacin, squamocin, and motrilin] were also isolated. The cytotoxicity of membranacin (9) and desacetyluvaricin (10) against six human solid tumor cell lines was determined. The absolute configuration of the former is reported.
Assuntos
Antineoplásicos Fitogênicos/isolamento & purificação , Furanos/isolamento & purificação , Lactonas/isolamento & purificação , Plantas Medicinais/química , Triptaminas/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Furanos/farmacologia , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Hidrólise , Lactonas/farmacologia , México , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Sementes/química , Espectrometria de Massas de Bombardeamento Rápido de Átomos , Espectrofotometria Ultravioleta , Triptaminas/farmacologia , Células Tumorais CultivadasRESUMO
The aim of this work was to study the usefulness of CSF adenosine deaminase determination in the diagnosis of tuberculous meningitis and determine if the proposed cutoff value of 7.1 i.u./ml had the better sensitivity and specificity. We retrospectively studied 148 patients, 12 with tuberculous meningitis and 136 with other central nervous system diseases. Adenosine deaminase values ranged from 3.6 to 31.2 i.u./ml in patients with tuberculous meningitis and from 0.1 to 312 i.u./ml in controls. The best sensitivity/specificity ratio (83.3 and 85.3% respectively) was obtained using a cutoff value of 6.5 i.u./ml. It is concluded that CSF adenosine deaminase values are useful in the diagnosis of tuberculous meningitis and that the cutoff value should be lowered to 6.5 i.u./ml to improve its diagnostic yield.
Assuntos
Adenosina Desaminase/líquido cefalorraquidiano , Tuberculose Meníngea/líquido cefalorraquidiano , Adolescente , Adulto , Pré-Escolar , Estudos de Avaliação como Assunto , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Tuberculose Meníngea/diagnósticoRESUMO
PURPOSE: To determine the type of cardiac disease causing left bundle branch block (LBBB) in Porto Alegre, Brazil, and to assess the role of associated left axis deviation (-30 degrees or more in the frontal plane) in order to identify a specific etiology of LBBB. METHODS: Through reports from the assistant physicians or through examination of the patients, the underlying heart disease in 264 cases of LBBB was assessed. The chi-square test was used to determine a possible association between left anterior hemiblock LBBB and one or more specific type of underlying heart disease. RESULTS: Systemic arterial hypertension (30.7%), ischemic heart disease (30.3%), valvar heart disease (8.7%), cardiomyopathies (7.5%), idiopathic degenerative disease of the conduction system (1.6%) and miscellaneous heart diseases (1.2%) were the underlying heart diseases. The presence of LBBB did not indicate any specific type of cardiac disease. CONCLUSION: The causes of LBBB in Porto Alegre are the same as reported in the international medical literature. Upward and leftward deviation (> or = -30 degrees) of QRS axis in the frontal plane did not show statistical significant association with any type of underlying cardiac disease.
Assuntos
Bloqueio de Ramo/etiologia , Cardiopatias/complicações , Brasil , Bloqueio de Ramo/diagnóstico , Distribuição de Qui-Quadrado , Cardiopatias/diagnóstico , HumanosRESUMO
Isradipine, a new antihypertensive dihydropyridine calcium antagonist, was evaluated for its efficacy, tolerability, and safety in 91 ambulatory patients who had mild-to-moderate hypertension. The design of the present study included a two-week wash-out period after confirmation of disease, followed by 12 weeks of active treatment with 2.5 mg isradipine twice daily. Patients were switched from other antihypertensive drugs, mainly diuretics and beta-blockers. The dose of isradipine remained virtually unchanged throughout the study and resulted in a mean decrease of 22 mm Hg in systolic blood pressure (SBP) (P less than .00001) and 19 mm Hg in diastolic blood pressure (DBP) (P less than .00001). Heart rate was unchanged (difference of -1 beats/min), as was the mean body weight of the study patients. Isradipine was generally well tolerated. Side effects were few and, when present, tended to diminish and eventually disappear during the treatment period. All of the clinical laboratory parameters tested and electrocardiograph intervals remained unchanged. In conclusion, these results indicate that isradipine is a novel drug which is highly effective and well tolerated in the treatment of mild to moderate hypertension in this group of patients.
Assuntos
Anti-Hipertensivos/normas , Hipertensão/tratamento farmacológico , Piridinas/normas , Adulto , Idoso , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Estudos de Coortes , Colômbia/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Isradipino , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/efeitos dos fármacos , Piridinas/efeitos adversos , Piridinas/uso terapêuticoRESUMO
The Department of Family Medicine of the University of Puerto Rico Medicine School performed a census of the inhabitants 60 years and older in the community of Gurabo. A total of 1,890 elderly were interviewed 51% were female and 49% male. Sixty percent were married and twenty-five percent were widowed. Eighty two percent still lived within a family setting and only seventeen percent lived alone 86% owned their own home despite ninety percent reporting incomes below $400.00 per month. Ninety five percent have access to medical services but 63% receive services in multiples sites. Eighteen percent were functionally impaired, fourteen percent intellectually impaired and five percent had impairment in both areas. Preliminary data show that the latter group had an annual mortality rate of 15% compared to only 3.6% and 1.3% respectively in the other two group. We concluded that: 1) functional and mental impairment are indicators of increased mortality. 2) although access to health care is not a problem this health care is episodic and interrupted being provided in multiple different sites.
Assuntos
Envelhecimento , Serviços de Saúde para Idosos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Feminino , Acessibilidade aos Serviços de Saúde , Serviços de Saúde para Idosos/provisão & distribuição , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Mortalidade , Porto Rico/epidemiologia , População Rural , Fatores SocioeconômicosAssuntos
Cateterismo/métodos , Estenose da Valva Mitral/terapia , Adulto , Pressão Sanguínea , Eletrocardiografia , Feminino , Humanos , MasculinoRESUMO
Para determinar los valores normales de PaO2, PaCO2 y pH en Bogota (altura = 2640 m, PB = 560 mmHg) se estudiaron 25 sujetos jovenes, sanos y no fumadores. Con el sujeto sentado, en reposo se analizo el aire espirado para determinar el cuociente respiratorio y descartar sujetos con hiperventilacion alveolar aguda. La muestra de sangre arterial se obtuvo por puncion directa de la arteria humeral. Resultados: PaCO2: 30 mmHg; pH: 7.38; HCO3: 17 mEq/L; PaO2: 67 mmHg; SaO2%: 93. Estos datos nos indican que a la altura de Bogota hay una moderada hiperventilacion alveolar cronica gracias a la cual se tiene una PaO2 que permite una saturacion normal de la oxihemoglobina. Como consecuencia de la hiperventilacaion cronica la PaCO2 y el HCO3 son inferiores a los encontrados a nivel del mar, pero similares a los encontrados en alturas semejantes