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OBJECTIVE: The main study objectives were to describe the practice of mechanical ventilation over an 18-year period in Mexico, and estimate changes in mortality among critical patients subjected to invasive mechanical ventilation (IMV). DESIGN: A retrospective subanalysis of a prospective observational study conducted in 1998, 2004, 2010 and 2016 was carried out. SETTING: Intensive Care Units (ICUs) in Mexico. PARTICIPANTS: Adult patients consecutively enrolled in the ICU during one month and who underwent IMV for more than 12hours or noninvasive mechanical ventilation for more than one hour. Follow-up was performed up to a maximum of 28 days after inclusion. INTERVENTIONS: None. PRINCIPAL VARIABLES OF INTEREST: Age, sex, severity upon admission as estimated by SAPS II, parameters of daily arterial blood gases, treatment and complication variables, date and status at discharge from the ICU and from hospital. RESULTS: A total of 959 patients were included in 81 ICUs. Tidal volume (vt) decreased significantly both in patients with acute respiratory distress syndrome (ARDS) criteria (estimated 8.5ml/kg b.w. in 1998 to 6ml/kg in 2016; P<0.001) and in patients without ARDS (estimated 9ml/kg b.w. in 1998 to 6ml/kg in 2016; P<0.001). The ventilatory protective strategy (defined as vt < 6ml/kg or < 8ml/kg and a plateau pressure < 30cmH2O) was: 19% in 1998, 44% in 2004, 58% in 2010 and 75% in 2016 (P<0.001). The adjusted mortality rate in ICU over the 4 periods was: in 2004, odds ratio (OR) 1.05 (95% confidence interval, 95%CI: 0.73-1.72; P=0.764); in 2010, OR 1.68 (95%CI: 1.13-2.48; P=0.009); in 2016, OR 0.85 (95%CI: 0.60-1.20; P=0.368). CONCLUSIONS: The clinical practice of IMV in Mexican ICUs has been modified over a period of 18 years. The most significant change is the ventilatory strategy based on low vt. These changes have not been associated with significant changes in mortality.
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Electron transmission through different non-conventional (non-uniform barrier height) gated and gapped graphene superlattices (GSLs) is studied. Linear, Gaussian, Lorentzian and Pöschl-Teller superlattice potential profiles have been assessed. A relativistic description of electrons in graphene as well as the transfer matrix method have been used to obtain the transmission properties. We find that it is not possible to have perfect or nearly perfect pass bands in gated GSLs. Regardless of the potential profile and the number of barriers there are remanent oscillations in the transmission bands. On the contrary, nearly perfect pass bands are obtained for gapped GSLs. The Gaussian profile is the best option when the number of barriers is reduced, and there is practically no difference among the profiles for large number of barriers. We also find that both gated and gapped GSLs can work as omnidirectional band-pass filters. In the case of gated Gaussian GSLs the omnidirectional range goes from -50° to 50° with an energy bandwidth of 55 meV, while for gapped Gaussian GSLs the range goes from -80° to 80° with a bandwidth of 40 meV. Here, it is important that the energy range does not include remanent oscillations. On the light of these results, the hole states inside the barriers of gated GSLs are not beneficial for band-pass filtering. So, the flatness of the pass bands is determined by the superlattice potential profile and the chiral nature of the charge carriers in graphene. Moreover, the width and the number of electron pass bands can be modulated through the superlattice structural parameters. We consider that our findings can be useful to design electron filters based on non-conventional GSLs.
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La encefalopatía traumática crónica (ETC) es una enfermedad neurodegenerativa que se produce como consecuencia traumatismos cerebrales repetitivos; concusiones, que son un síndrome clínico que se caracteriza por una alteración de la función cerebral. Una concusión, bajo su estricta definición, no debiese causar cambios estructurales en el cerebro por lo que no sería visible a través de imágenes, sí existen cambios a nivel microscópicos, bioquímicos y biomecánicos. La mayoría de los pacientes tienen completa resolución de sus síntomas dentro de 10 días (90 por ciento), pero existe un pequeño porcentaje que persiste con estos, pudiendo presentarse como un síndrome postconcusional, síndrome de segundo impacto o una encefalopatía traumática crónica. La ETC se caracteriza por la acumulación de prot-tau hiperfosforilada en neuronas y astrocitos. Estas se van a presentar en forma de ovillos o hilos neurofibrilares. En etapas iniciales las encontraremos de forma focalizada en la corteza frontal y en las formas más severas su distribución será más generalizada, distribuyéndose en la mayoría de las regiones del cerebro. Su diagnóstico se realiza a través de histopatología, por lo que hasta el momento sólo se ha logrado post-mortem. Se está trabajando en nuevas tecnologías asociadas a biomarcadores y PET para lograr una diagnostico premortem. El mayor énfasis en el manejo de esta taupatía es la prevención y adecuado manejo de las concusiones.
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease which is produced as a consequence of repeated brain trauma: concussions, which are a clinical syndrome characterized by an alteration in brain functions. A concussion, understrict definition, should not cause structural changes to the brain. Therefore, it would not be possible to see through images if there were changes at a microscopic, biochemical level. Most patients see their symptoms completely resolved within 10 days (90 percent), but there is a small percentage which persists, and these might cause a post-concussional syndrome, second impact syndrome of chronic traumatic encephalopathy. CTE is characterized by the accumulation of hyper-phosphorylated Tau protein in neurons and astrocytes. These appear in the form of neurofibrillary tangles. During the initial stages they are focalized in the frontal cortex and, in more severe cases, their distribution is more generalized, spreading through the majority of the regions in the brain. It is diagnosis is done through histopathology. Thus, it has only been possible to do post mortem. New technologies associated with bio-markers and PET are being worked on to achieve a pre-mortem diagnosis. The greatest emphasis in the handling of this tauopathy lies in the prevention and the adequate handling of concussions.
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Humanos , Concussão Encefálica/complicações , Encefalopatia Traumática Crônica/diagnóstico , Encefalopatia Traumática Crônica/etiologia , Encefalopatia Traumática Crônica/prevenção & controle , Proteínas tau , Tauopatias , Dano Encefálico Crônico , Cadáver , Dano Encefálico Crônico/complicações , Doenças NeurodegenerativasRESUMO
Resumen ANTECEDENTES: 50% de las crisis asmáticas son desencadenadas por infecciones virales, su relación con parámetros clínicos no se ha descrito en los adultos. OBJETIVO: determinar la prevalencia de crisis asmáticas de acuerdo con el espectro viral y su asociación con características clínicas y mecánica respiratoria. MATERIAL Y MÉTODO: estudio clínico, prospectivo y observacional en el que se incluyeron pacientes con crisis asmática grave del 1 de diciembre de 2010 al 31 de diciembre de 2011. Se excluyeron los pacientes con sospecha de infección bacteriana. Se aplicó cuestionario de síntomas, se determinó panel viral por hisopado nasal, espirometría y estudios de laboratorio. Se obtuvo el consentimiento informado de los participantes. RESULTADOS: se incluyeron en el estudio 100 pacientes. La edad promedio fue de 39±14 años, IMC 27±4 kg/m2, escala de Borg 6.2±1.2, escala mMRC 2.6±0.6, tiempo de los síntomas 7±7 días, FEV1 de 42±14%, oximetría de pulso 88±3% y estancia de 4.5±1.7 días. El 47% de los pacientes tenía rinitis alérgica. Se aisló virus en 36% (rinovirus 15% y coronavirus 6%). Al comparar la causa viral vs no viral, se observó que los pacientes eran menores en el primer grupo (36±13 vs 43±17 años, p=0.014); no hubo diferencia entre grado de obstrucción y síntomas. A mayor severidad del asma hubo más aislamientos de virus. CONCLUSIÓN: las crisis asmáticas asociadas con virus respiratorios tienen comportamiento clínico similar al de las no asociadas. En los pacientes con menor edad y con comportamiento más grave se aíslan virus con más frecuencia.
Abstract BACKGROUND: 50% of asthma attacks are triggered by viral in fections; its relationship with clinical parameters has not been described in adults. OBJECTIVE: To determine the prevalence of asthma attacks according to viral spectrum and its association with clinical features and respiratory mechanics. MATERIAL AND METHOD: A clinical, prospective and observational study with patients with severe asthma attended from December 1st 2010 to December 31st 2011. We excluded patients with suspected bacterial infection. Symptom questionnaire was applied, it was determined by nasal swab viral panel, spirometry and laboratory studies. Informed consent was obtained. RESULTS: One hundred patients were included. Mean age was 39±14 years, BMI 27±4 kg/m2, Borg 6.2±1.2, mMRC 2.6±0.6, length of symptoms 7±7 days and FEV1 of 42±14%, pulse oximetry 88±3% and stay 4.5±1.7 days; 47% of patients had allergic rhinitis. Virus was isolated in 36% (15% rhinovirus and 6% coronavirus). Comparing the non-viral vs viral etiology, patients were younger (36±13 vs 43±17 years, p=0.014) there was no difference between the degree of obstruction and symptoms. A greater severity of asthma was related to more isolation. CONCLUSION: Asthma attacks associated with respiratory viruses have similar clinical behavior to not associated ones. In younger patients with more severe behavior virus are isolated more frequently.
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BACKGROUND: The optimal regimen of preoperative chemoradiotherapy for resectable esophageal cancer has not been established. We evaluated accelerated hyperfractionated radiotherapy (RT) concurrent to low-dose weekly cisplatin and continuous infusion fluorouracil (LDCI-FU) followed by esophagectomy in patients with locally advanced squamous cell carcinoma (SCC) of the esophagus. METHODS: Patients with clinical stage II or III SCC of the esophagus received cisplatin 30 mg/m2/week (days 1, 8, 15), LDCI-FU 300 mg/m2/day (days 1-21), and concomitant RT to a dose of 45 Gy (150 cGy/fraction, 2 fractions/day) on tumor and affected lymph nodes, followed by radical esophagectomy. RESULTS: From 1997 to 2012, 64 patients were treated with this regimen. Twenty-four patients (37 %) had grade 3 esophagitis, 18 (28 %) of whom required hospitalization. The risk of hospitalization was reduced by placement of a jejunostomy tube before starting induction chemoradiotherapy. Six patients (9 %) had grade 3-4 neutropenia. Fifty-three patients (83 %) underwent esophageal resection and complete resection was achieved in 45 (70 %). The overall median survival was 28 months (95 % CI: 20.4-35.6) and 5-year survival was 38 %. In the 18 patients attaining a pathological complete response, median survival was 132 months and 5-year survival was 72 %. Positron emission tomography standardized uptake values (PET SUVmax) post-chemoradiotherapy were associated with pathological response (p = 0.03) and survival (p = 0.04). CONCLUSIONS: Intensive preoperative hyperfractionated RT concomitant to low-dose cisplatin and LDCI-FU is effective in patients with locally advanced SCC of the esophagus, with good pathological response and survival and manageable toxicities. Post-chemoradiotherapy PET SUVmax shows promise as a potential prognostic factor.
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Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Quimiorradioterapia Adjuvante/métodos , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Terapia Neoadjuvante/métodos , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Quimiorradioterapia Adjuvante/efeitos adversos , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Intervalo Livre de Doença , Fracionamento da Dose de Radiação , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago , Esofagectomia , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/efeitos adversos , Tomografia por Emissão de PósitronsRESUMO
The potential protective effect of the dietary antioxidant curcumin (120 mg/Kg/day for 6 days) against the renal injury induced by maleate was evaluated. Tubular proteinuria and oxidative stress were induced by a single injection of maleate (400 mg/kg) in rats. Maleate-induced renal injury included increase in renal vascular resistance and in the urinary excretion of total protein, glucose, sodium, neutrophil gelatinase-associated lipocalin (NGAL) and N-acetyl ß-D-glucosaminidase (NAG), upregulation of kidney injury molecule (KIM)-1, decrease in renal blood flow and claudin-2 expression besides of necrosis and apoptosis of tubular cells on 24 h. Oxidative stress was determined by measuring the oxidation of lipids and proteins and diminution in renal Nrf2 levels. Studies were also conducted in renal epithelial LLC-PK1 cells and in mitochondria isolated from kidneys of all the experimental groups. Maleate induced cell damage and reactive oxygen species (ROS) production in LLC-PK1 cells in culture. In addition, maleate treatment reduced oxygen consumption in ADP-stimulated mitochondria and diminished respiratory control index when using malate/glutamate as substrate. The activities of both complex I and aconitase were also diminished. All the above-described alterations were prevented by curcumin. It is concluded that curcumin is able to attenuate in vivo maleate-induced nephropathy and in vitro cell damage. The in vivo protection was associated to the prevention of oxidative stress and preservation of mitochondrial oxygen consumption and activity of respiratory complex I, and the in vitro protection was associated to the prevention of ROS production.
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Curcumina/farmacologia , Complexo I de Transporte de Elétrons/metabolismo , Hemodinâmica/efeitos dos fármacos , Nefropatias/prevenção & controle , Mitocôndrias/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Consumo de Oxigênio/efeitos dos fármacos , Aldeído Redutase/antagonistas & inibidores , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Apoptose/efeitos dos fármacos , Biomarcadores/análise , Western Blotting , Complexo I de Transporte de Elétrons/efeitos dos fármacos , Inibidores Enzimáticos/toxicidade , Nefropatias/induzido quimicamente , Células LLC-PK1 , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Maleatos/toxicidade , Mitocôndrias/metabolismo , Oxirredução , Ratos , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , SuínosRESUMO
Se propuso identificar los estilos de vida en adolescentes de una comunidad semiurbana, buscando respuesta a la pregunta: ¿Cuáles son los factores que se identifican en el instrumento Fantastic, en los estudiantes de la comunidad de Ixtlahuaca? Se trabajó con la variable de estilos de vida, ocupando el instrumento FANTASTIC. La muestra la conforman 1088 estudiantes, 603 hombres y 485 mujeres. La religión de mayor prevalencia es la católica con 844. Del instrumento se obtuvo una fiabilidad de .79, con 6 factores identificados: sentimientos negativos y estrés, satisfacción y pensamiento positivo, alimentación dañina, relajación y sueño, alcohol y tabaco, cafeína. Se concluye que se requiere manejo de hábitos saludables, prevención de adicciones y alimentación.
The proposal was to identify lifestyles among adolescents in a semi-urban community, seeking answers to the question: What are the factors that are identified in the Fantastic instrument in students Ixtlahuaca community? We worked with the lifestyle variable, holding the instrument FANTASTIC. The sample is formed by 1088 students, 603 men and 485 women. The most prevalent religion is Catholic with 844. The instrument yielded a reliability of .79, with 6 factors identified: negative feelings and stress, satisfaction and positive thinking, harmful food, relaxation and sleep, alcohol and snuff, caffeine. It is concluded that it is required management of healthy habits, addictions and alimentation prevention.
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Urinary tract infections (UTIs) affect both healthy and immunocompromised people, and they are treated with antibiotics. However, the high recurrence of UTIs obliges the use of natural mechanisms to regulate the normal microbiota through the use of e.g. lactic acid bacteria. In order to induce a UTI, 20 µl of the Escherichia coli (Ec-01) strain, in doses of 2.7×10(7) cfu/ml, was inoculated by way of the urethra in female Balb/c mice, all of them immunosuppressed with dexamethasone (10 mg/kg). Lactobacillus plantarum LPLM-O1 was used as a treatment, in daily doses of 1×10(7) cfu/ml, which were orally administered for seven days before the infection (preventive) or alongside the infection for seven days (curative). The oral administration of LPLM-O1 did not cause any adverse effects when used in an immunosuppressed animal model. It was observed that, when used as a preventive measure, LPLM-O1 induces a decrease in the infection, in the concentration of urinary leukocytes, and in the bacterial load. This study proposes the use of this lactic bacterium as a probiotic.
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Infecções por Escherichia coli/terapia , Lactobacillus plantarum/crescimento & desenvolvimento , Probióticos/administração & dosagem , Infecções Urinárias/terapia , Administração Oral , Animais , Carga Bacteriana , Citocinas/sangue , Dexametasona/efeitos adversos , Escherichia coli/patogenicidade , Infecções por Escherichia coli/microbiologia , Feminino , Hospedeiro Imunocomprometido , Intestinos/microbiologia , Lactobacillus plantarum/metabolismo , Leucócitos/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Modelos Animais , Infecções Urinárias/microbiologia , Urina/microbiologiaRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Tecoma stans aqueous extract (TAE) is widely used as a traditional antidiabetic remedy in Mexico; its rational use is controversial. We provide evidence of its main antidiabetic activities. AIM OF THE STUDY: To evaluate in vivo and in vitro intestinal alpha-glucosidases inhibition as the possible mode of action of TAE on type 2 diabetes mellitus (DM2) animal models, and to test the effects of its sub-chronic administration on lipids and glucose blood levels. MATERIALS AND METHODS: In healthy and streptozotocin (STZ)-induced diabetic male Sprague-Dawley rats, glucose or cornstarch was administered after an oral dose of TAE, acarbose, tolbutamide or vehicle, in order to build starch and glucose tolerance curves (STC and GTC). An intestinal brush border preparation was used to evaluate the TAE alpha-glucosidases inhibitory activity. Moreover, in STZ-induced diabetic rats TAE, tolbutamide or vehicle was administered for 21 days for evaluate their effects on fasting glucose cholesterol and triglycerides. Also, TAE total phenolic compounds were quantified. RESULTS: In STC, TAE decreased hyperglycemic peak values in both healthy and STZ-treated rats, in a magnitude similar to that of acarbose. The in vitro preparation showed a dose-dependent inhibition of glucose release from starch. Sub-chronic administration of TAE significantly reduced cholesterol and triglycerides levels. Moreover, we confirmed that acute and sub-chronic administration of TAE (500mg/kg) in both rat models did not diminish fasting glucose and did not modify the GTC. CONCLUSIONS: The study present evidence that the main antidiabetic effect of TAE is due to intestinal alpha-glucosidase inhibition by decreasing the postprandial hyper-glycaemia peak; in addition, TAE sub-chronic administration reduces triglycerides and cholesterol, without modifying fasting glucose.
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Bignoniaceae , Colesterol/sangue , Diabetes Mellitus Experimental/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Fitoterapia , Extratos Vegetais/uso terapêutico , Triglicerídeos/sangue , Acarbose/farmacologia , Animais , Bignoniaceae/química , Glicemia/metabolismo , Diabetes Mellitus Experimental/metabolismo , Feminino , Teste de Tolerância a Glucose , Inibidores de Glicosídeo Hidrolases , Hipoglicemiantes/farmacologia , Mucosa Intestinal/metabolismo , Intestinos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Fenóis/análise , Extratos Vegetais/farmacologia , Ratos , Ratos Sprague-Dawley , Amido , Tolbutamida/farmacologiaRESUMO
INTRODUCTION: 'Biopsy-only' high-grade glioma (HGG) patients get limited benefit from post-operative treatments, and as a group, negatively impact median survival outcomes. MATERIAL AND METHODS: We retrospectively evaluated clinical characteristics, treatment and overall survival of HGG patients with a 'biopsy- only' surgical approach diagnosed between 1997 and 2005 at a University Hospital in Spain. RESULTS: In 31% of 294 suspected gliomas, only a diagnostic biopsy was undertaken. Reasons for 'biopsy-only' for all patients were either location in eloquent areas: (motor area 18.7%, language area 25,3%, basal ganglia 7.7%, visual area 4.4%) or extension of the disease (corpus callosum invasion 14.3% and multicentricity/multifocality 28.6%). Seventy-four patients (80.4%) were HGG: 26% of all grade IV and 49% of all grade III tumours. For these patients, post-operative Karnofsky Performance Status of over 70%, median age and median survival were, respectively: 64 and 70%, 60.7 and 57 years old, and 23.1 and 42.7 weeks (p=0.0006). Patients lived longer if post-operative treatment was given, in all grades (p<0.0001). Nineteen patients (25.6%) died within 42 days after surgery. Only 60% of them initiated radiotherapy and 10% of them did not complete it. However, tumour grade, radiotherapy and temozolomide- based chemotherapy were independently associated with longer survival in multivariate analysis (p<0.05). CONCLUSION: Almost one third of HGG patients can undergo only a biopsy and not debulking surgery. Although radiotherapy improves survival, only 50% of them complete the treatment. An individualised approach to these patients is needed to facilitate a correct analysis of therapy results. New therapies must be investigated in these patients.
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Neoplasias Encefálicas/patologia , Glioma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Feminino , Glioma/radioterapia , Glioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
INTRODUCTION: To evaluate the efficacy and tolerability of weekly docetaxel concurrent with radiotherapy in inoperable oesophageal cancer patients. MATERIAL AND METHODS: Thirty-four oesophageal cancer patients with co-morbid medical conditions, locally advanced tumours (T4) or advanced age (older than 75 years) received docetaxel (20 mg/m2 weekly) plus concurrent radiotherapy (2 Gy daily, to a total dose of 66 Gy). Twenty-two patients (64%) were stage III, 19 of whom had T4 tumours. RESULTS: Twenty-seven patients (79%) completed the planned chemoradiotherapy treatment. Nine patients (26%) achieved a complete response and 8 (24%) achieved a partial response, for an overall response rate of 50%. Median survival was 6 months, and 1-year survival was 35%. Patients with T4 tumours had significantly shorter survival than other patients: 5 months for T4 tumours vs. 11 months for T1-3 (p=0.04). Grade 3-4 oesophagitis occurred in 6 patients (17%). There were two treatment-related deaths due to radiation pneumonitis. CONCLUSIONS: Docetaxel plus concurrent radiotherapy is active in poor-prognosis oesophageal cancer patients, with a lower incidence of severe oesophagitis than with cisplatin-based chemoradiotherapy regimens. This schedule can be considered, especially in patients with non-T4 tumours who are not candidates for oesophageal resection.
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Adenocarcinoma/terapia , Antineoplásicos Fitogênicos/uso terapêutico , Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Radioterapia de Alta Energia , Taxoides/uso terapêutico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/mortalidade , Adenocarcinoma/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/efeitos adversos , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Comorbidade , Docetaxel , Esquema de Medicação , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/radioterapia , Esofagite/etiologia , Feminino , Doenças Hematológicas/etiologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Pneumonite por Radiação/etiologia , Radioterapia de Alta Energia/efeitos adversos , Indução de Remissão , Análise de Sobrevida , Taxoides/administração & dosagem , Taxoides/efeitos adversos , Resultado do TratamentoRESUMO
This paper describes an experimental evaluation of anaerobic digestion technology as an option for the management of organic solid waste in developing countries. As raw material, a real and heterogeneous organic waste from urban solid wastes was used. In the first experimental phase, seed selection was achieved through an evaluation of three different anaerobic sludges coming from wastewater treatment plants. The methanization potential of these sludges was assessed in three different batch digesters of 500 mL, at two temperature levels. The results showed that by increasing the temperature to 15 degrees C above room temperature, the methane production increases to three times. So, the best results were obtained in the digester fed with a mixed sludge, working at mesophilic conditions (38-40 degrees C). Then, this selected seed was used at the next experimental phase, testing at different digestion times (DT) of 25, 20 and 18 days in a bigger batch digester of 20 L with a reaction volume of 13 L. The conversion rates were registered at the lowest DT (18 days), reaching 44.9 L/kg(-1) of wet wasteday(-1). Moreover, DT also has a strong influence over COD removal, because there is a direct relationship between solids removal inside the reactor and DT.
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Reatores Biológicos , Eliminação de Resíduos , Animais , Bactérias Anaeróbias/metabolismo , Biodegradação Ambiental , Dióxido de Carbono/análise , Dióxido de Carbono/metabolismo , Cidades , Colômbia , Ácidos Graxos Voláteis/análise , Concentração de Íons de Hidrogênio , Esterco , Metano/análise , Metano/metabolismo , Esgotos , Suínos , TemperaturaRESUMO
In order to compare the antihypertensive effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa with captopril, a controlled and randomized clinical trial was done. Patients from 30 to 80 years old with diagnosed hypertension and without antihypertensive treatment for at least 1 month before were included. The experimental procedure consisted of the administration of an infusion prepared with 10 g of dry calyx from H. sabdariffa on 0.51 water (9.6 mg anthocyanins content), daily before breakfast, or captopril 25 mg twice a day, for 4 weeks. The outcome variables were tolerability, therapeutic effectiveness (diastolic reduction > or = 10 mm Hg) and, in the experimental group, urinary electrolytes modification. Ninety subjects were included, 15 withdrew from the study due to non-medical reasons; so, the analysis included 39 and 36 patients from the experimental and control group, respectively. The results showed that H. sabdariffa was able to decrease the systolic blood pressure (BP) from 139.05 to 123.73mm Hg (ANOVA p < 0.03) and the diastolic BP from 90.81 to 79.52mm Hg (ANOVA p < 0.06). At the end of the study, there were no significant differences between the BP detected in both treatment groups (ANOVA p > 0.25). The rates of therapeutic effectiveness were 0.7895 and 0.8438 with H. sabdariffa and captopril, respectively (chi2, p > 0.560), whilst the tolerability was 100% for both treatments. A natriuretic effect was observed with the experimental treatment. The obtained data confirm that the H. sabdariffa extract, standardized on 9.6mg of total anthocyanins, and captopril 50 mg/day, did not show significant differences relative to hypotensive effect, antihypertensive effectiveness, and tolerability.
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Anti-Hipertensivos/uso terapêutico , Hibiscus , Hipertensão/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Captopril/administração & dosagem , Captopril/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Hipertensão/patologia , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/administração & dosagem , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Presentamos un caso de abscesos cervicales múltiples por actinomyces israeliII, en un varón, joven sin antecedentes. Revisamos a propósito las características clínicas, microbiológicas y el tratamiento de esta enfermedad. El actinomyces israelí es una bacteria anaerobia gram-positiva, microscópicamente aparece con filamentos y ramas causando su primera impresión como un hongo en forma de gránulos. Es un saprofito oral y toma ventaja luego de una infección, trauma o cirugía generalmente odontológica que penetra en la mucosa intacta e invade el tejido adyacente. Esta bacteria es responsable de la ctinomicosis cérvico facial, la cual se manifiesta como un flegón, absceso y drenaje sinusal con la presencia de gránulos de azufre...
Assuntos
Actinomicose , PescoçoRESUMO
HYPOTHESIS: Differences in the hemodynamic effects of induction agents may cause them to affect the onset of action of rocuronium differently. OBJECTIVES: To compare the onset of action of rocuronium after induction with etomidate and thiopental. PATIENTS AND METHODS: Forty adult ASA I patients received 3 micrograms.kg-1. Three minutes later anesthesia was induced randomly with either 5 mg.kg-1 of thiopental (group I, n = 20) or 0.3 mg.kg-1 of etomidate (group II, n = 20). Rocuronium 0.6 mg.kg-1 was administered over 5 s. Baseline blood pressure and heart rate were measured just before delivery of rocuronium and just before intubation. Onset of action was defined as the time from injection of rocuronium until achievement of a blockade > or = 95% of the first electromyographic response in a trian-of-four stimulus of the short adductor of the thumb. We also studied intubation conditions. RESULTS: Etomidate was associated with a smaller decrease in systolic arterial pressure than was thiopental. Onset of action was 81 +/- 29 s in group I versus 72 +/- 23 s in group II (NS). Similar intubation conditions were observed in both groups. CONCLUSIONS: These results suggest that the induction drug does not affect rocuronium's onset of action.
Assuntos
Androstanóis/farmacologia , Anestésicos Intravenosos/farmacologia , Etomidato/farmacologia , Hemodinâmica/efeitos dos fármacos , Hipnóticos e Sedativos/farmacologia , Fármacos Neuromusculares não Despolarizantes/farmacologia , Tiopental/farmacologia , Adulto , Interações Medicamentosas , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rocurônio , Fatores de TempoRESUMO
The mortality data for 1996 and 1997 reveal that Puerto Ricans in the United States lag behind other Hispanics in terms of age-adjusted death rates. The better health status of Cubans in the United States can be explained by their immigration history and more favorable socio-economic conditions. The greater mortality risks of mainland Puerto Ricans compared to Mexican-Americans is more difficult to explain. While Puerto Ricans have more entitlements, higher incomes, and more education than their Mexican counterparts, the Mexicans have higher levels of employment and more stable families, indicators which apparently affect the relative risk of death. The data also show that, of all the Hispanic subgroups, the Puerto Ricans exhibit the most marked gender differentials, mainland Puerto Rican men being significantly more at risk than females. Finally, the data on infant mortality show that babies born to Puerto Rican women are less likely to survive their first year of life than infants born to women of other Hispanic origins. Each of these indicators suggests the greater vulnerability of mainland Puerto Ricans and confirms the disadvantaged status of this population vis-a-vis other groups.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Mortalidade/tendências , Vigilância de Evento Sentinela , Causas de Morte , Feminino , Humanos , Mortalidade Infantil/tendências , Recém-Nascido , Masculino , Porto Rico/etnologia , Distribuição por Sexo , Estados Unidos/epidemiologiaRESUMO
This article examines the available data on the health status of Puerto Rican women in the United States. Statistics on reproductive health, cancer and AIDS indicate that the health status of these women is lower than that of both their U.S. and island counterparts. Usually, the health of immigrants lies somewhere between that of the population of the country of origin, and that of the 'host' country. Puerto Rican women, however, deviate from this pattern. The health lag which U.S. Puerto Rican women are experiencing suggests that the social dislocation which accompanies migration has not diminished over time. Puerto Rican women in the U.S., on the contrary, seem to have lost protective factors that shielded them from certain risks without acquiring the monetary, psycological, and information resources which would allow them to adopt preventive measures and make a more effective use of the existing health services.
Assuntos
Emigração e Imigração , Nível de Saúde , Síndrome da Imunodeficiência Adquirida/mortalidade , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Neoplasias/mortalidade , Gravidez , Porto Rico , Reprodução , Estados Unidos/etnologiaRESUMO
OBJECTIVE: A prospective study of the demographic and epidemiologic characteristics of patients with liver cirrhosis at the Hospital Civil de Guadalajara within a period of one year. MATERIAL AND METHODS: A total of 157 patients (48 women, and 109 men) from the Departments of Internal Medicine, Gastroenterology and Liver Clinic were studied. Diagnosis of liver cirrhosis had been previously established based on clinical, biochemical or histopathological information. Additionally, a questionnaire specialized on liver diseases was applied to all patients. RESULTS: Alcoholism was the main cause for cirrhosis (38% in women and 95% in men) followed by viral etiology. The alcoholic beverages consumed with greater frequency were tequila and 96 degrees G.L. alcohol. Women were in the Child-Pugh's "B" class while men were in class "C". Complications were mostly gastrointestinal bleeding, ascites and hepatic encephalopathy. Differences between sexes were observed for various characteristics. CONCLUSIONS: Alcoholism was by far the most frequent cause of liver cirrhosis. The second cause, in women, was of viral origin (16.7%). A national committee of vigilance of liver diseases is proposed to generate more complete and detailed information on the epidemiology of liver cirrhosis.