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INTRODUCTION: Currently there is no universally accepted standard of reference for the diagnosis of carpal tunnel syndrome so it is considered a «latent class¼ pathology, that is, it lacks any diagnostic tests that absolutely certain the presence of disease. METHODS: Prospective, observational and analytical study evaluating the three diagnostic methods used for carpal tunnel syndrome (clinical examination, ultrasound and electromyography). Normality values were set for each diagnostic method. RESULTS: 50 people (14 men and 36 women) were evaluated. The clinical examination showed a positive and significant correlation with the diameter of the affected median nerve (ecography) (R = 0.694, p = 0.032). The values of the under the curve area (UCA) for median nerve conduction speed (MNCS), cubital nerve conduction speed (CNCS), and distal latency (DL) by electromyography were 0.60, 0.519 and less than 0.50 respectively. This states that the diagnostic value of electromyography characteristics is bad. CONCLUSION: Our work establishes clinical examination as a good quality tool being the most sensitive method for diagnosing carpal tunnel syndrome. If there was a need for diagnostic confirmation, the ultrasound proved to be a highly satisfactory study generating less stress, pain and invasion to the patient, decreasing health expenditure and speeding up the process.
INTRODUCCIÓN: Actualmente, no existe un estándar de referencia aceptado universalmente para el diagnóstico del síndrome de túnel carpiano, por lo que se le considera una patología de «clase latente¼, es decir, que carece de alguna prueba diagnóstica que dé certeza absoluta de la presencia de la enfermedad. MÉTODOS: Estudio prospectivo, observacional y analítico en el cual se evaluaron los tres métodos diagnósticos utilizados para el síndrome de túnel carpiano (examen clínico, ecografía y electromiografía). En él, se establecieron valores de normalidad para cada método diagnóstico. RESULTADOS: Se evaluó un total de 50 personas (14 hombres y 36 mujeres). El examen clínico presentó correlación positiva y significativa con el diámetro del nervio mediano afectado (ecografía) (R = 0.694 y p = 0.032). Los valores del área bajo la curva (AUC, por sus siglas en inglés) para la velocidad de conducción del nervio mediano (VCNM), velocidad de conducción de nervio cubital (VCNC) y latencia distal motora (LDM) por electromiografía fueron de 0.60, 0.519 y. CONCLUSIÓN: < 0.50, respectivamente, lo cual determinó que el valor diagnóstico de las características por electromiografía es malo. Nuestro trabajo establece al examen clínico como una herramienta de buena calidad, siendo el método más sensible para el diagnóstico de síndrome de túnel carpiano. Si existiera la necesidad de realizar una confirmación diagnóstica, la ecografía mostró ser un estudio altamente satisfactorio, el cual genera menos estrés, dolor e invasión al paciente, disminuyendo, a su vez, el gasto de salud y agilizando el proceso.
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Síndrome do Túnel Carpal , Síndrome do Túnel Carpal/diagnóstico por imagem , Feminino , Humanos , Masculino , Nervo Mediano/diagnóstico por imagem , Condução Nervosa , Estudos Prospectivos , Sensibilidade e Especificidade , UltrassonografiaRESUMO
INTRODUCTION: Intraarticular distal radius fractures are a therapeutic challenge for the orthopedist surgeon there are studies that support the use of fluoroscopy, and others promote arthroscopy, with this work we try to summarize the evidence, to determine whether arthroscopic assistance provides additional benefits to avoid joint incongruities compared to results obtained under fluoroscopic assistance. MATERIAL AND METHODS: Systematic search for prospective, retrospective, cohort, follow-up, clinical trials on PubMed, MEDLINE, Scopus, Scielo, Embase, Google Scholar and other national sources, including as keywords the terms: "intra-articular distal radius fracture", "wrist arthroscopy", "arthroscopy", "fluoroscopy". The average values and standard offsets for each characteristic, obtained from the selected works, were analyzed using descriptive statistics and illustrative graphs. RESULTS: 463 patients (256 women and 207 men) were evaluated, with an average age of 48.29 years and range from 39 to 64 years. The two treatments (A and F) were homogeneous in terms of the age of the patients reporting (p = 0.5820) and the average follow-up time (p = 0.9597). Only the ulnar deviation and DASH score, for which the arthroscopy group performed best, in the remaining variables the differences were not significant. CONCLUSION: The evidence available to date is conflicting, and does not allow recommendations to be made for or against these interventions, finding other factors that could influence decision-making.
INTRODUCCIÓN: Las fracturas intraarticulares de radio distal son un desafío terapéutico para el cirujano ortopedista. Hay estudios que avalan el uso de la fluoroscopía y otros promueven la artroscopia. Con este trabajo intentamos resumir la evidencia, para determinar si la asistencia artroscópica aporta beneficios adicionales para evitar incongruencias articulares en comparación con los resultados obtenidos bajo asistencia fluoroscópica. MATERIAL Y MÉTODOS: Búsqueda sistemática de estudios prospectivos, retrospectivos, de cohortes, seguimiento, ensayos clínicos en PubMed, MEDLINE, Scopus, Scielo, Embase, Google Scholar y otras fuentes nacionales, incluyendo como palabras clave los términos. RESULTADOS: intraarticular distal radius fracture, wrist arthroscopy, arthroscopy, fluoroscopy. Los valores medios y desvíos estándar para cada característica, obtenidos de los trabajos seleccionados fueron analizados usando estadística descriptiva y gráficos ilustrativos. Fueron evaluados 463 pacientes (256 mujeres y 207 hombres), con una edad promedio de 48.29 años y rango de 39 a 64 años. Los dos tratamientos (A y F) fueron homogéneos en cuanto a la edad de los pacientes que reportan (p = 0.5820) y el tiempo de seguimiento promedio (p = 0.9597). Sólo la desviación cubital y el DASH, para las cuales el grupo de artroscopía tuvo mejor desempeño, en las variables restantes las diferencias no fueron significativas. CONCLUSIÓN: La evidencia disponible hasta la fecha es controvertida y no permite hacer recomendaciones a favor o en contra de estas intervenciones, encontrando otros factores que podrían influir en la toma de decisiones.
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Fraturas Intra-Articulares , Fraturas do Rádio , Adulto , Artroscopia , Feminino , Fluoroscopia , Fixação Interna de Fraturas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rádio (Anatomia) , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Herein, we present a 14-year-old patient with short stature (134 cm) referred from Paediatrics to our department for complementary evaluation since growth hormone (GH) treatment failed to show any improvement. He was born premature and small for gestational age. Genital examination classified the patient as Tanner I-II with small penis and testicular size for his age. Biochemical analyses revealed normal GH levels with low serum insulin-like growth factor-1 (IGF-1). Molecular diagnosis confirmed several mutations in IGF1R and IGFALS, and so he was diagnosed with Laron Syndrome or GH insensibility and treated with IGF-1 substitutive therapy. LEARNING POINTS: Evaluation of the GH/IGF-1 axis when short stature does not respond to conservative treatment must be included in the ordinary practice.Laron Syndrome real incidence should be calculated once undiagnosed cases arise, as treatment, due to lack of market, is unaffordable.Even when adulthood is reached, and no longitudinal growth can be achieved, still IGF-1 treatment in Laron Syndrome patients should be pursued as metabolic and protective derangements could arise.
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Infecciones bacterianas en pacientes con Pie Diabético. Hospital Regional de Ciudad del Este, Paraguay. Año 2015 RESUMEN La Organización Mundial de la Salud define el pié diabético como una "situación de infección, ulceración o también destrucción de los tejidos profundos de los pies, asociada a anormalidades neurológicas y varios grados de enfermedad vascular periférica en los miembros inferiores de pacientes con Diabetes Mellitus. El objetivo del trabajo fue identificar la prevalencia de microorganismos que causaron infecciones en pacientes diagnosticados con pie diabético atendidos en el Hospital Regional de Ciudad del Este, Paraguay, durante el año 2015. Estudio descriptivo, transversal y retrospectivo. El muestreo fue no probabilístico, por conveniencia, y se incluyeron 115 muestras correspondientes a 94 pacientes. Fue utilizada la base de datos del Laboratorio de Bacteriología del Hospital Regional de Ciudad del Este. De los 94 pacientes con pie diabético, 52% fueron hombres. El 25% de las infecciones se produjeron en pacientes con edades comprendidas entre 51 a 60 años. Fueron aislados 21 microorganismos diferentes en las 115 muestras. El 80% (75) fueron monomicrobianos, y 20% (40) polimicrobianos. Entre los Gram positivos, el microorganismo más frecuentemente aislado fue el Staphylococcus aureus 19% (22) y el Enterococcus spp. 6% (6) y entre los Gram negativos fueron la Klebsiella pneumoniae13% (16) y Acinetobacter spp. 12% (14). Los resultados de las pruebas de sensibilidad antimicrobiana demostraron que el 100% de las cepas de S. aureus fueron resistentes a la Oxacilina y alta resistencia de las cepas de K. pneumoniae a las Cefalosporinas. Las cepas de Acinetobacter spp. fueron 100% resistentes a las cefalosporinas y Piperacilina. Los microorganismos aislados y el perfil de resistencia antimicrobiana que los mismos presentan, coinciden con la bibliografía, y es muy importante implementar programas de prevención a esta patología a fin de evitar amputaciones en este tipo de pacientes. Palabras claves: bacterias; pie; diabético; hospital; Paraguay.
The World Health Organization defines the diabetic foot as a "situation of infection, ulceration or destruction of the deep tissues of the feet. It is associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limbs of patients with Diabetes Mellitus". The objective of the research was to identify the prevalence of microorganisms which caused infections in patients diagnosed with diabetic foot treated at the Regional Hospital of Ciudad del Este, Paraguay, during the year 2015. It is a descriptive, crosssectional and retrospective study. The sampling was nonprobabilistic, for convenience, and 115 samples were included corresponding to 94 patients. The database of the Department of Bacteriology of the Regional Hospital of Ciudad del Este was used. Of the 94 patients with diagnosed diabetic foot, 52% were men. 25% of the infections occurred in patients with ages ranging from 51 to 60 years. 21 microorganisms were isolated in the 115 different samples. 80% (75) were monomicrobial, and 20% (40) polymicrobial. The most isolated bacterium in this group of bacteria was the Staphylococcus aureus (19%). Among the Gram positive bacilli, the most frequently isolated microorganism was Staphylococcus aureus, 19% (22) and Enterococcus spp. 6% (6) and among Gram negatives: Klebsiella pneumoniae 13% (16) and Acinetobacter spp. 12% (14). The results of the sensitivity tests demonstrated that 100% of the strains of S. aureus were resistant to Oxacillin and 100% of the strains of K. pneumoniae showed resistance to cefhems. 100% of the strains of Acinetobacter spp were resistant to Cefotaxime and Piperacillin. The isolated microorganisms and the antimicrobial resistance profile they present coincide with the literature, and it is of most importance to implement prevention programs regarding this pathology in order to avoid amputations in this type of patients. Key words: bacteria; foot; diabetic; h Palabras claves: bacterias; pie; diabético; hospital; Paraguay.
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Even though the liver synthesizes most of circulating IGF-1, it lacks its receptor under physiological conditions. However, according to previous studies, a damaged liver expresses the receptor. For this reason, herein, we examine hepatic histology and expression of genes encoding proteins of the cytoskeleton, extracellular matrix, and cell-cell molecules and inflammation-related proteins. A partial IGF-1 deficiency murine model was used to investigate IGF-1's effects on liver by comparing wild-type controls, heterozygous igf1+/-, and heterozygous mice treated with IGF-1 for 10 days. Histology, microarray for mRNA gene expression, RT-qPCR, and lipid peroxidation were assessed. Microarray analyses revealed significant underexpression of igf1 in heterozygous mice compared to control mice, restoring normal liver expression after treatment, which then normalized its circulating levels. IGF-1 receptor mRNA was overexpressed in Hz mice liver, while treated mice displayed a similar expression to that of the controls. Heterozygous mice showed overexpression of several genes encoding proteins related to inflammatory and acute-phase proteins and underexpression or overexpression of genes which coded for extracellular matrix, cytoskeleton, and cell junction components. Histology revealed an altered hepatic architecture. In addition, liver oxidative damage was found increased in the heterozygous group. The mere IGF-1 partial deficiency is associated with relevant alterations of the hepatic architecture and expression of genes involved in cytoskeleton, hepatocyte polarity, cell junctions, and extracellular matrix proteins. Moreover, it induces hepatic expression of the IGF-1 receptor and elevated acute-phase and inflammation mediators, which all resulted in liver oxidative damage.
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Proteínas de Fase Aguda/metabolismo , Regulação da Expressão Gênica , Hepatite/metabolismo , Mediadores da Inflamação/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Fígado/metabolismo , Receptores de Somatomedina/metabolismo , Proteínas de Fase Aguda/genética , Animais , Caderinas/genética , Caderinas/metabolismo , Cruzamentos Genéticos , Proteínas do Citoesqueleto/genética , Proteínas do Citoesqueleto/metabolismo , Desmossomos/imunologia , Desmossomos/metabolismo , Desmossomos/patologia , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/metabolismo , Perfilação da Expressão Gênica , Hepatite/imunologia , Hepatite/patologia , Hepatite/prevenção & controle , Injeções Subcutâneas , Fator de Crescimento Insulin-Like I/administração & dosagem , Fator de Crescimento Insulin-Like I/genética , Fator de Crescimento Insulin-Like I/uso terapêutico , Peroxidação de Lipídeos , Fígado/imunologia , Fígado/patologia , Masculino , Camundongos , Camundongos Transgênicos , Estresse Oxidativo , Receptores de Somatomedina/genética , Proteínas de Junções Íntimas/genética , Proteínas de Junções Íntimas/metabolismoRESUMO
Consistent evidence associates IGF-1 deficiency and metabolic syndrome. In this review, we will focus on the metabolic effects of IGF-1, the concept of metabolic syndrome and its clinical manifestations (impaired lipid profile, insulin resistance, increased glucose levels, obesity, and cardiovascular disease), discussing whether IGF-1 replacement therapy could be a beneficial strategy for these patients. The search plan was made in Medline for Pubmed with the following mesh terms: IGF-1 and "metabolism, carbohydrate, lipids, proteins, amino acids, metabolic syndrome, cardiovascular disease, diabetes" between the years 1963-2015. The search includes animal and human protocols. In this review we discuss the relevant actions of IGF-1 on metabolism and the implication of IGF-1 deficiency in the establishment of metabolic syndrome. Multiple studies (in vitro and in vivo) demonstrate the association between IGF-1 deficit and deregulated lipid metabolism, cardiovascular disease, diabetes, and an altered metabolic profile of diabetic patients. Based on the available data we propose IGF-1 as a key hormone in the pathophysiology of metabolic syndrome; due to its implications in the metabolism of carbohydrates and lipids. Previous data demonstrates how IGF-1 can be an effective option in the treatment of this worldwide increasing condition. It has to distinguished that the replacement therapy should be only undertaken to restore the physiological levels, never to exceed physiological ranges.
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Fator de Crescimento Insulin-Like I/metabolismo , Síndrome Metabólica/metabolismo , Animais , Metabolismo dos Carboidratos , Humanos , Resistência à Insulina , Metabolismo dos Lipídeos , Modelos BiológicosRESUMO
Alzheimer׳s disease (AD) is characterized by a number of alterations including those in cognition and olfaction. An early symptom of AD is decreased olfactory ability, which may affect odor-guided behaviors. To test this possibility we evaluated alterations in sexual incentive motivation, sexual olfactory preference, sexual olfactory discrimination, nursing-relevant olfactory preference and olfactory discrimination in female mice. We tested 3xTg-AD (a triple transgenic model, which is a "knock in" of PS1M146V, APPSwe, and tauP300L) and wild type (WT) female mice when receptive (estrous) and non-receptive (anestrous). Subjects were divided into three groups of different ages: (1) 4-5 months, (2) 10-11 months, and (3) 16-18 months. In the sexual incentive motivation task, the receptive 3xTg-AD females showed no preference for a sexually active male at any age studied, in contrast to the WT females. In the sexual olfactory preference test, the receptive WT females were able to identify sexually active male secretions at all ages, but the oldest (16-18 months old) 3xTg-AD females could not. In addition, the oldest 3xTg-AD females showed no preference for nursing-relevant odors in dam secretions and were unable to discriminate between cinnamon and strawberry odors, indicating olfactory alterations. Thus, the present study suggests that the olfactory deficits in this mouse model are associated with changes in sexual incentive motivation and discrimination of food-related odors.
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Doença de Alzheimer/genética , Percepção Olfatória/genética , Comportamento Sexual Animal/fisiologia , Animais , Discriminação Psicológica/fisiologia , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Camundongos Transgênicos , Motivação/genética , OdorantesRESUMO
Objetivo. Determinar la respuesta antioxidante [actividad de superóxido dismutasa (SOD) y catalasa (CAT)] así como la cuenta total de hemocitos (CTH) y el contenido de proteínas (CP) en camarones (Litopenaeus vannamei) expuestos a diferentes dosis y cepas de la levadura Debaryomyces hansenii (DH5, DH6, LL1), y un inmunoestimulante comercial (LAM). Materiales y métodos. Las levaduras fueron cultivadas y suministradas diariamente en concentraciones diferentes (104 106 UFC/mL) directamente a los tanques de cultivo de los camarones (8 ± 0.2 g) mientras que LAM fue aplicado una vez a la semana (0.5 mg/L). Los organismos fueron mantenidos bajo condiciones de laboratorio (28°C, 35%, 80% de recambio diario de agua, dieta comercial para camarón ad libitum). Los tratamientos fueron distribuidos por duplicado y los resultados evaluados a los 15 días con un análisis de varianza y una prueba de Tukey. Resultados. Se registró un CTH significativo (p<0.05) en los tratamientos con DH6 y LL1 (106 UFC/mL) comparada con el control, mientras que las cepas DH5 y DH6 revelaron un incremento significativo (p<0.05) de CP con la dosis de 104 UFC/mL. Los camarones tratados con LAM incrementaron significativamente (p<0.05) los valores de SOD y CAT. Conclusiones. Los resultados obtenidos demuestran que D. hansenii incrementa la respuesta antioxidante y CTH en camarones.
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Animais , Antioxidantes , ImunizaçãoRESUMO
Brazil must comply with international quality standards and animal welfare requirements in order to maintain its position as world's largest exporter of poultry meat. With the scenario of global climate change there is the forecast of occurrence of extreme events with characteristics of both excess cold and heat for several regions of the country. This study aimed to evaluate the effectiveness of using images of infrared thermography to evaluate the loss of sensible heat in young broilers fed different dietary energy levels. Twenty birds were reared in a house with appropriate brooding using infrared lamps. Birds were distributed in a completely randomized experimental into two treatments: T1 (control diet with 2950 kcal ME/kg-1), and T2 (high-energy diet with 3950 kcal ME/kg-1). Infrared thermographic images of the birds were recorded for four consecutive days. One bird was randomly chosen per treatment, and had special images taken and analyzed. Average surface temperature of the body area was calculated using the surface temperature recorded at 100 spots (50 at the front and 50 at the lateral side of the bird's body). Mean surface temperature of the flock was calculated recording 100 spots on the group of birds. Total radiant heat loss was calculated based on the average data of surface temperature. The results indicated that the young broilers fed the high-energy diet presented a metabolic energy loss equivalent to 0.64 kcal h-1, while the birds fed with the control diet lost 2.18 kcal h-1. This finding confirms that oil supplementation to the diet reduces bird heat loss. The infrared camera was able to record young broilers' surface temperature variation when birds were fed diets with different energy contents(AU)
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Animais , Galinhas/classificação , Dieta , Energia Térmica , Termografia , Metabolismo/fisiologia , Regulação da Temperatura CorporalRESUMO
Brazil must comply with international quality standards and animal welfare requirements in order to maintain its position as world's largest exporter of poultry meat. With the scenario of global climate change there is the forecast of occurrence of extreme events with characteristics of both excess cold and heat for several regions of the country. This study aimed to evaluate the effectiveness of using images of infrared thermography to evaluate the loss of sensible heat in young broilers fed different dietary energy levels. Twenty birds were reared in a house with appropriate brooding using infrared lamps. Birds were distributed in a completely randomized experimental into two treatments: T1 (control diet with 2950 kcal ME/kg-1), and T2 (high-energy diet with 3950 kcal ME/kg-1). Infrared thermographic images of the birds were recorded for four consecutive days. One bird was randomly chosen per treatment, and had special images taken and analyzed. Average surface temperature of the body area was calculated using the surface temperature recorded at 100 spots (50 at the front and 50 at the lateral side of the bird's body). Mean surface temperature of the flock was calculated recording 100 spots on the group of birds. Total radiant heat loss was calculated based on the average data of surface temperature. The results indicated that the young broilers fed the high-energy diet presented a metabolic energy loss equivalent to 0.64 kcal h-1, while the birds fed with the control diet lost 2.18 kcal h-1. This finding confirms that oil supplementation to the diet reduces bird heat loss. The infrared camera was able to record young broilers' surface temperature variation when birds were fed diets with different energy contents
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Animais , Dieta , Energia Térmica , Galinhas/classificação , Metabolismo/fisiologia , Regulação da Temperatura Corporal , TermografiaRESUMO
El propósito del escrito consiste en explorar la metáfora levinasiana del no-lugar, precisar sus sentidos y evaluar críticamente su pertinencia en el ámbito de las reflexiones contemporáneas. Para ello, contextualizaremos la propuesta levinasiana en torno al no-lugar, especialmente bajo los conceptos de sensibilidad, proximidad e infinito; reconstruiremos algunas de las críticas de Levinas a lo que denominamos: "filosofías del regreso a casa"; y, finalmente, sugeriremos algunos aspectos en los cuales las tesis del filósofo judío podrían hacerse pertinentes. Este último propósito lo acompañaremos con una investigación social adelantada al respecto.
The purpose of this writing is to explore the Levinasian no-place metaphor, in order to clarify its meanings as well as to critically evaluate its pertinence under the light of contemporary reflections. In order to do this, we will contextualize the Levinasian proposal around the no-place, especially under the concepts of sensitivity, proximity, and infinite; we will reconstruct some Levinas's critiques which we will call "philosophies of the coming back home", and finally we will suggest some aspects in which the Jew philosopher theses might be pertinent. This last purpose will be accompanied by a social research carried out about this issue.
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Humanos , Metáfora , Filosofia , Pesquisa , Sensibilidade e EspecificidadeRESUMO
Furoxan derivatives with in vitro cytotoxic activity were investigated as antitumoral agents in vivo. The compounds were tested in murine models of both CCRFS-180 II sarcoma and mammary adenocarcinoma. Two of the furoxan derivatives considered here, 3-formyl-4-phenyl-1,2,5-oxadiazole N2-oxide and 3-carbonitrile-4-phenyl-1,2,5-oxadiazole N2-oxide, present in vivo antitumoral activity. They were able to produce more than 90% of tumoral necrosis under the experimental protocol of administration and posology employed. NO-releasing capacity of furoxans may explain the anti-neoplastic activity of these compounds.
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Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Oxidiazóis/síntese química , Oxidiazóis/farmacologia , Animais , Antineoplásicos/toxicidade , Linhagem Celular Tumoral , Fenômenos Químicos , Química Farmacêutica , Físico-Química , Feminino , Neoplasias Mamárias Experimentais/tratamento farmacológico , Neoplasias Mamárias Experimentais/patologia , Camundongos , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Oxidiazóis/toxicidade , Quinoxalinas/farmacologia , Sarcoma Experimental/tratamento farmacológico , Sarcoma Experimental/patologiaRESUMO
PURPOSE: To evaluate the safety and feasibility of perfluorocarbon-perfused vitrectomy (PCPV) as a technique during vitrectomy for proliferative diabetic retinopathy (PDR) and rhegmatogenous retinal detachment (RRD). METHODS: In an experimental, prospective, noncomparative and interventional study, 28 eyes of 28 patients were submitted to vitrectomy with the PCPV technique, 18 eyes with PDR and 10 with RRD. In this technique we replaced the traditional balanced saline solution (BSS) in the infusion line (conventional vitrectomy) by perfluorocarbon liquids (PCL). Some patients with PDR were treated with oxygenated PCL. Clinical evaluation, electroretinography (ERG), and endothelial cell count (ECC) were used to assess the safety of this procedure. An arbitrary grading system (grades 0-5) was used to classify the surgery and maneuvers to assess feasibility. RESULTS: No eyes had a significant decrease in ECC, and the patients in whom we could obtain ERG postoperatively showed no significant differences from preoperative ERG. In the PDR group (using oxygenated and nonoxygenated PCL), 77.8% were graded 5/5; in the RRD group 90% were 5/5. PCPV allowed better visualization of vitreous and intraocular structures, rapid retinal reattachment, less blood in the vitreous cavity, subretinal fluid resolution, blood confinement, retinal stabilization, and easier dissection of epiretinal membranes. In all cases at least one surgical step was eliminated. CONCLUSIONS: PCPV in humans is a safe and feasible technique. Probably in selected cases the use of PCL offers several advantages over BSS, because of their properties (gravitational forces, immiscibility with bodily fluids, and ability to transport oxygen). Prospective and comparative studies are necessary to establish formal indications and possible contraindications.
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Retinopatia Diabética/cirurgia , Fluorocarbonos/administração & dosagem , Retina/patologia , Descolamento Retiniano/cirurgia , Vitrectomia/métodos , Adulto , Idoso , Retinopatia Diabética/patologia , Retinopatia Diabética/fisiopatologia , Eletrorretinografia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Bombas de Infusão , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Estudos Prospectivos , Retina/fisiopatologia , Descolamento Retiniano/patologia , Descolamento Retiniano/fisiopatologia , Resultado do Tratamento , Acuidade Visual , Vitrectomia/normas , Adulto JovemRESUMO
Extensive chromosome variation involving Robertsonian and non-Robertsonian changes were proposed to explain chromosomal evolution within killifishes of the aplocheiloid group belonging to the order Cyprinodontiforms. In the present work we describe the karyotypes of four Cynolebias species and analyze chromosome changes by means of mitochondrial phylogenetic studies, including 10 taxa of this genus. Diploid numbers varied from 48 to 44 and the number of chromosome arms from 50 to 54. Molecular phylogenetic analyses allow us to corroborate previous hypothesis about chromosome evolution in aplocheiloid fishes. The tree topology based on a combined dataset of mitochondrial cytochrome b and 12S genes shows that recent cladogenetic events within the genus Cynolebias could have occurred by allopatric or 'in-situ' differentiation involving chromosomal rearrangements. Our analyses of approximately 10% of mitochondrial genome can be helpful in determining these recent cladogenetic events but it showed limited phylogenetic resolution at intermediate levels of divergence. This can be explained in part by the high levels of DNA sequence divergence (ranging from 0.015 to 0.245) detected at intrageneric level. Different methodological approaches suggest that chromosomal changes in Cynolebias have occurred during their differentiation, supporting the hypothesis that the unresolved basal polytomy could be the result of rapid speciation events, like a true 'star polytomy'.
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Cromossomos/genética , Peixes Listrados/genética , Mitocôndrias/genética , Animais , Bandeamento Cromossômico , Grupo dos Citocromos b/genética , DNA Mitocondrial/análise , Evolução Molecular , Cariotipagem , Peixes Listrados/classificação , Filogenia , RNA Ribossômico/genéticaRESUMO
During the XVII Central American and Caribbean Sports Games held in Ponce in 1993 the health services offered to the Puerto Rico Delegation included medical, dental and psychological assistance, physical therapy and services on the playing field. Information about the use of these services was obtained from the encounter sheets. The Puerto Rican delegation of 750 members had 1,800 encounters with the health team; 612 (34.0%) individual consults; 896 (54.8%) physical therapy sessions; 166 (9.2%) encounters in the sports venues; and 36 (20%) group therapies. The most common diagnoses were athletic injuries (304; 58.2%) and diseases of the respiratory system (76; 14.5%). The most frequent athletic injuries were first degree strains (75; 24.7%) and tendinitis (73, 24.0%). This pattern is similar to that observed in other sports games and delegations with mild conditions prevailing. An interdisciplinary work and biopsychosocial approach will be important for the better health and performance of our athletes.
Assuntos
Traumatismos em Atletas/terapia , Serviços de Saúde/estatística & dados numéricos , Infecções Respiratórias/terapia , Adolescente , Adulto , Região do Caribe , América Central , Feminino , Humanos , Masculino , México , Porto RicoRESUMO
Se presenta el análisis de 30 casos de cáncer de mama consecutivos atendidos en un hospital de segundo nivel en el estado de Veracruz, México. La edad promedio de los pacientes fue de 53 años (intervalo de 28-80 años). El tiempo de evolución antes de acudir al hospital tuvo una mediana de nueve meses. Las etapas tempranas correspondieron únicamente al 16 por ciento de los casos y las avanzadas al 83 por ciento. El tipo histopatológico predominante fue el carcinoma canicular en 73 por ciento de los casos. Se intentó tratamiento curativo en 63 por ciento de las pacientes. El tratamiento fue quirúrgico en 73 por ciento, quimioterapia en 63 por ciento, radioterapia en 30 por ciento y hormonoterapia 43 por ciento. La supervivencia real fue de 46.6 por ciento de pacientes vivas sin enfermedad después de un mínimo de tres años de seguimiento ser llevado a cabo en hospitales de segundo nivel si se cuenta con un mínimo recursos. La detección temprana sigue siendo una meta por alcanzar en nuestro medio. Se hacen comentarios acerca del manejo del cáncer de mama localmente avanzados en nuestro medio
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/fisiopatologia , Neoplasias da Mama/terapia , Diagnóstico Diferencial , Secretárias de Consultório Médico/classificação , Biópsia/estatística & dados numéricos , Níveis de Atenção à Saúde , Mastectomia/estatística & dados numéricosRESUMO
The pattern of sports injuries appears to be population-specific. The purpose of the present study is to describe 1750 injuries evaluated between April 1988 and April 1994 in our Olympic Training Center Interdisciplinary Sports Injury Clinic. Our patient population included elite and recreational athletes of both sexes between the ages of 7 and 71 years. Males comprised 73% of the patient population and approximately 80% of the injuries corresponded to the 10 to 29 age range. The most frequent sports in males were baseball (21.9%) and basketball (15.9%) and in females were track and field (17.1%) and gymnastics (15.1%). Most injuries (52%) were traumatic in nature, chronic (71.6%), and occurred during training sessions (57.4%). The most commonly affected anatomical areas were the knee (31.2%) and shoulder (15.5%). The most common diagnoses were tendinitis (25.4%), and first degree strains (11.8%) and sprains (9.3%). Finally, treatment strategies included medications (61.0%), physical therapy (48.9%), relative rest (35.7%), and home exercise programs (35.2%). The variety of musculoskeletal disorders seen in combination with the frequent use of conservative treatment confirms the importance of an interdisciplinary approach to sports injuries.
Assuntos
Traumatismos em Atletas/epidemiologia , Adolescente , Adulto , Criança , Feminino , Hospitais Especializados , Humanos , MasculinoRESUMO
Using data from Mexico's Demographic and Health Survey, the authors examine the effects of breast-feeding and the pace of childbearing on early childhood mortality in a sample of 2,665 children born between 1982 and 1986. From a family planning perspective, they seek to assess the impact that changes in childbearing patterns and associated changes in breast-feeding patterns may have on infant and childhood mortality. This is done by integrating breast-feeding models with variables influencing the pace of childbearing. The analysis indicates that the effects of breast-feeding on infant mortality were strong, consistently negative, and statistically significant until at least the sixth month of life, after which they were considerably diluted. Among the other variables analyzed, the effects of a following conception on mortality were found to be very strong among infants 3-5 months old; and maternal age at delivery appeared to have some importance among infants 1-2 months old and among children in the second year of life. To examine likely interactions between family planning, breast-feeding, and mortality, an integrated model was applied that simultaneously considered these and a range of other variables. The results suggest that the effects of improved birth spacing and maternal age at delivery associated with family planning are powerful enough to cause 20-40% reductions in infant mortality. However, the effects of reduced breast-feeding associated with family planning are great enough to offset more than 60% of these benefits. Limitations of the model make it necessary to emphasize that all of these conclusions need to be accepted with caution.
Assuntos
Intervalo entre Nascimentos , Aleitamento Materno , Mortalidade , Adolescente , Adulto , Pré-Escolar , Serviços de Planejamento Familiar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Idade Materna , México/epidemiologia , Pessoa de Meia-IdadeRESUMO
The health services offered to the Puerto Rican Delegation during the XVI Central American and Caribbean Sports Games in México in 1990 included: medical, dental and psychological assistance, physical therapy and services on the playing field. From the consultation sheets completed during the Games we obtained information about the use of these services. The 336 members of the Puerto Rico Delegation in the village at México City had 1,838 encounters with the health team. Of these, 991 were medical consults, 55 group therapies, 466 physical therapy sessions and 326 encounters in the sports venues. Among the encounters for medical evaluation the most frequent problems were athletic injuries (318; 32.1%), respiratory problems (240; 24.2%), gastrointestinal conditions (126; 12.7%) and dental services (119; 12.0%). The most frequent athletic injuries were first degree strains (83; 26.1%), tendinitis (56; 17.6%), contusions (42; 13.2%), myositis (40; 12.6%) and first degree sprains (28; 8.8%). The health problems found were diversed and in the majority of cases mild in character, which can be attend by adequately trained on sports health primary health professionals.