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Abstract Osteoarthritis (OA) is the most common type of arthritis, is a growing disease in the industrialized world. OA is an incapacitate disease that affects more than 1 in 10 adults over 60 years old. X-ray medical imaging is a primary diagnose technique used on staging OA that the expert reads and quantify the stage of the disease. Some Computer-Aided Diagnosis (CADx) efforts to automate the OA detection have been made to aid the radiologist in the detection and control, nevertheless, the pain inherits to the disease progression is left behind. In this research, it's proposed a CADx system that quantify the bilateral similarity of the patient's knees to correlate the degree of asymmetry with the pain development. Firstly, the knee images were aligned using a B-spline image registration algorithm, then, a set of similarity measures were quantified, lastly, using this measures it's proposed a multivariate model to predict the pain development up to 48 months. The methodology was validated on a cohort of 131 patients from the Osteoarthritis Initiative (OAI) database. Results suggest that mutual information can be associated with K&L OAI scores, and Multivariate models predicted knee chronic pain with: AUC 0.756, 0.704, 0.713 at baseline, one year, and two years' follow-up.
Resumen La osteoartritis (OA) es el tipo de artritis más común. OA es una enfermedad limitante que afecta a 1 de 10 adultos con 60 años o más. Las imágenes de rayos-x son una técnica de diagnóstico primario que permite conocer el estado de OA, las cuales el experto lee y cuantifica así la etapa de la enfermedad. El Diagnóstico Asistido por Computadora (CADx, por sus siglas en inglés) ha buscado automatizar el diagnóstico de OA para ayudar al radiólogo en la detección y control; sin embargo, el dolor provocado por la progresión de la enfermedad es dejado atrás. En este trabajo se propone un sistema de CADx que cuantifica la similitud bilateral de las rodillas de los pacientes, con el fin de correlacionar el grado de asimetría con el dolor. Inicialmente, las imágenes de las rodillas fueron alineadas usando el algoritmo B-spline para su registro, después, un conjunto de métricas estándar fue cuantificado; finalmente, con estas métricas se propone un modelo multivariado para predecir el dolor de rodilla desarrollado en 48 meses. La metodología fue validada con 131 pacientes obtenidos de la base de datos de la Osteoarthritis Initiative (OAI). Los resultados sugieren que las métricas pueden ser asociadas con los puntajes de KellgrenLawrence; además, los modelos predicen significativamente el dolor crónico de rodilla con: AUC 0.756, 0.704 y 0.7113, al inicio, un año y dos años después, respectivamente.
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Objetivo: Evaluar la influencia de la contaminación con sangre en una capa de adhesivo formada sobre esmalte humano y su posterior descontaminación con NaOCl (2.5 por ciento) y etanol (70°) en la resistencia microtraccional. Métodos: La superficie vestibular de 80 premolares humanos fue fresada para obtener superficies planas sobre las que se aplicó un adhesivo de grabado y lavado siguiendo las indicaciones del fabricante (Adper Single Bond 2, 3M ESPE). Los premolares fueron distribuidos aleatoriamente en cuatro grupos: Grupo 1 (control), Grupo 2 (contaminación con sangre), Grupo 3 (descontaminación con NaOCl 2.5 por ciento) y Grupo 4 (descontaminación con etanol 70°). Luego, sobre cada premolar se confeccionó una corona de resina compuesta (Filtek Z350, 3M ESPE) y fueron cortados para obtener cuerpos de prueba de 1mm2 de sección transversal, los cuales fueron termociclados (5500 ciclos, 5-55°C) y traccionados hasta su límite de ruptura (Micro Tensile Tester, Bisco). Los resultados fueron analizados estadísticamente (ANOVA, Scheffe, p<0.05). Resultados: La resistencia microtraccional del Grupo 1 (24.8 MPa) fue significativamente superior al resto de los grupos (p<0.05). Las diferencias entre los grupos 2, 3 y 4 no fueron estadísticamente significativas (p>0.05). Conclusión: La contaminación con sangre de la capa de adhesivo interfiere significativamente en la resistencia microtraccional. La descontaminación con NaOCl o etanol no logró una recuperación de la resistencia microtraccional.
Aim: To evaluate the influence of blood contamination of the adhesive layer and posterior decontamination with NaOCl (2.5 percent and ethanol (70º) on microtensile bond strength on human enamel. Methods: Vestibular surfaces of eighty human premolars were grounded to obtain flat surfaces. An etch-and-rinse adhesive was applied according to the manufacturers instructions (Adper Single bond 2, 3M ESPE). Teeth were randomly assigned into 4 groups: Group 1 (control), Group 2 (blood contamination), Group 3 (decontamination with NaOCl 2.5 percent) and Group 4 (decontamination with ethanol 70º). Then, a 4mm composite crown (Filtek Z350) was made and the teeth were vertically sectioned to obtain 1mm cross-section stick shape specimens. Specimens were thermocycled (5500 cycles, 5-55ºC) and pulled under tension until failure (Micro Tensile Tester, Bisco). Results were statistically analyzed (ANOVA, Scheffes test, p<0.05). Results: Microtensile bond strength in group 1 (24.8 MPa) was significantly higher than groups 2, 3 and 4 (p<0.05). The differences between groups 2, 3 and 4 were not significant (p>0.05). Conclusion: Blood contamination significantly interferes in microtensile bond strength. Decontaminating the blood residues with NaOCl or ethanol did not show a recovery of bond strength.
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Humanos , Masculino , Adulto , Feminino , Sangue , Cimentos Dentários/química , Colagem Dentária , Contaminação de Equipamentos , Resistência à Tração , Análise de Variância , Descontaminação , Propriedades de SuperfícieRESUMO
Objetivo: Evaluar la capacidad de sellado de una resina fluida autoadhesiva (Fusio Liquid Dentin, Pentron Clinical) utilizada como sellante de fosas y fisuras con distintos acondicionamientos de la superficie de esmalte. Materiales y Métodos: Se seleccionaron 140 terceros molares recientemente extraídos, los que fueron distribuidos aleatoriamente en cuatro grupos (n=35) y recibieron una técnica de acondicionamiento del esmalte y aplicación de un sellante. Se establecieron los siguientes grupos: Grupo 1, grabado ácido y aplicación de sellante (Clinpro, 3M ESPE); Grupo 2, grabado ácido y aplicación de resina autoadhesiva (Fusio Liquid Dentin, Pentron Clinical); Grupo 3, aplicación de resina autoadhesiva; Grupo 4, microarenado del esmalte y aplicación de resina autoadhesiva. Los dientes sellados fueron termociclados (500 ciclos, 5-55°C), y posteriormente sumergidos en solución de nitrato de plata amoniacal por 24 h (pH=14) y luego en revelador radiográfico (GBX, Kodak) por 8h. Posteriormente, los dientes fueron cortados para obtener 2 láminas por diente que fueron observadas bajo magnificación (4x) y analizadas digitalmente para evaluar la microinfiltración y la penetración en la fisura. Los resultados fueron analizados estadísticamente (ANOVA, Dunnett, p<0.05). Resultados: La microinfiltración del Grupo 1 (13.18 +/- 9.25 por ciento) fue significativamente menor que la de los grupos 2, 3 y 4 (p<0.05). La penetración en la fisura en el Grupo 1 (98.92 +/- 2.77 por ciento) fue mayor que en los otros grupos, siendo esta diferencia significativa sólo con el Grupo 4. Conclusión: Fusio Liquid Dentin tiene una capacidad de sellado inferior a la del sellante convencional Clinpro, independiente del acondicionamiento del esmalte que se utilice.
Aim: To evaluate the sealing ability of a self-adhesive flowable composite-resin (Fusio Liquid Dentin, Pentron Clinical) with different conditioning treatments of the enamel surface used as a fissure sealant. Materials and Method: 140 recently extracted human third molars were selected and randomly divided into four groups (n=35). Each group received an enamel conditioning treatment and a sealant application. The following groups were established: Group 1, acid etching and sealant application (Clinpro, 3M ESPE); Group 2, acid etching and self-adhesive flowable composite-resin (Fusio Liquid Dentin, Pentron Clinical); Group 3, self-adhesive flowable composite-resin; Group 4, sandblasting and self-adhesive flowable composite-resin. Sealed teeth were thermocycled (500 cycles, 5-55ºC) and immersed in ammoniacal silver nitrate solution for 24 h (ph=14). After that, the teeth were immersed in radiographic developer solution (GBX, Kodak) for 8 h. Then, the teeth were vertically sectioned to obtain two slides each that were observed under magnification (4x) and digitally analyzed to assess microleakage and sealant penetration. Results were statistically analyzed (ANOVA, Dunnett, p<0.05). Results: Microleakage of Group 1 (13.18 +/- 9.25 percent) was significantly lower than groups 2, 3 and 4 (p<0.05). Group 1 had the highest sealant penetration mean (98.92 +/- 2.77 percent). Conclusion: Fusio Liquid Dentin had a worse sealing ability than Clinpro irrespective of their enamel conditioning treatment when used as a fissure sealant. Among Fusios groups, acid etching was the best enamel surface conditioning treatment.
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Humanos , Resinas Compostas , Infiltração Dentária , Selantes de Fossas e Fissuras , Teste de Materiais , Cimentos de Resina , Propriedades de SuperfícieRESUMO
INTRODUCTION: Two separate molecular pathways have been proposed for the early carcinogenic events observed in the oral cavity and pharynx: one is associated with chemical etiological factors such as smoking and drinking, and the other one is associated with HPV insertion. OBJECTIVE: A proof-of-principle study was performed to ascertain if global DNA methylation could be used to distinguish between the early molecular changes in premalignant oral lesions. METHODS: Personal histories of tobacco and alcohol use were obtained by questionnaire. HPV insertion in tumor tissue was detected by polymerase chain reaction (PCR). Global DNA methylation levels were obtained using HPLC for fraction separation and mass spectrometry for quantification. Predictive simulations were performed to explore potential associations between different etiological factors and the global DNA methylation index. Significance of results was ascertained using Pearson's Chi-squared test. RESULTS: The global methylation index was found to be 4.28 (95% CI, 4.1, 4.4) in an oral cancer case series. Pearson's chi squared test showed no statistically significant difference between cases that had smoking (p = 0.21), drinking (p = 0.31) or HPV insertion (p = 0.34) as etiologic risk factors, when compared to cases that did not. An inverse significant association between smoking and DNA methylation was observed. As the smoking effect increases, the global methylation index decreases, In addition, no associations between the probability of DNA methylation and drinking, or DNA methylation and HPV insertion were observed in simulations. CONCLUSIONS: The global DNA methylation index was shown to vary for oral cancer cases with different etiologies. Smoking was inversely correlated with DNA methylation levels when generalized linear model simulations were performed. Future studies should look at global DNA methylation alterations associated to the progression from normal to premalignant oral epithelium tissue in a cohort of smokers and nonsmokers.
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Carcinoma de Células Escamosas/genética , Metilação de DNA , Neoplasias Bucais/genética , Consumo de Bebidas Alcoólicas/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Humanos , Modelos Genéticos , Neoplasias Bucais/etiologia , Infecções por Papillomavirus/complicações , Fumar/efeitos adversosRESUMO
The parasite Trypanosoma cruzi is the causative agent of Chagas disease. T. cruzi invasion and replication in cardiomyocytes induce cellular injuries and cytotoxic reactions, with the production of inflammatory cytokines and nitric oxide, both source of reactive oxygen species. The myocyte response to oxidative stress involves the progression of cellular changes primarily targeting mitochondria. We studied the cardiac mitochondrial structure and the enzymatic activity of citrate synthase and respiratory chain CI-CIV complexes, in Albino Swiss mice infected with T. cruzi, Tulahuen strain and SGO Z12 isolate, in two periods of the acute infection. Changes in the mitochondrial structure were detected in both infected groups, reaching values of 71% for Tulahuen and 88% for SGO Z12 infected mice, 30 days post infection. The citrate synthase activity was different according to the evolution of the infection and the parasite strain, but the respiratory chain alterations were similar with either strain.
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Doença de Chagas/patologia , Citrato (si)-Sintase/metabolismo , Mitocôndrias Cardíacas/metabolismo , Mitocôndrias Cardíacas/patologia , Complexos Multienzimáticos/metabolismo , Doença Aguda , Animais , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Mitocôndrias Cardíacas/ultraestrutura , Parasitemia/patologia , Trypanosoma cruzi/classificação , Trypanosoma cruzi/patogenicidadeRESUMO
OBJECTIVE: The aim of this study was to discover the lead concentration in primary teeth extracted in the peripheral clinics of the Faculty of Dentistry, UNAM (Mexico City). DESIGN: One hundred healthy primary teeth were collected from 2 to 13-year-old children (52 girls and 48 boys). Sixty-six were maxillary teeth and 34 were mandibular teeth. Lead concentrations were measured by Graphite Furnace Atomic Absorption Spectrophotometry. RESULTS: Our results indicate that lead concentration in the 10-13-year-old group (7.7 micro g/g(-1)) was higher than in the other groups. Geometric mean lead concentration was higher in girls than in boys (7.3 micro g/g(-1) and 6.3 micro g/g(-1), respectively). Maxillary teeth had higher lead concentrations than mandibular teeth and primary canines showed the highest mean lead concentration followed by incisors and molars. Teeth from children living in the south-east area (which according to the Mexico City's Pollution Center data is the more polluted area), presented the highest lead concentration but no statistically significant difference was found among teeth from the different areas. CONCLUSIONS: Our results suggest that age, gender and place of residence are not related to the lead concentration in human primary teeth. This fact seems to indicate the ubiquitous presence of lead in the whole atmosphere of Mexico City and suggests that zones of residence do not appear to influence tooth lead concentration.
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Chumbo/análise , Dente Decíduo/química , Adolescente , Fatores Etários , Criança , Pré-Escolar , Dente Canino/química , Poluição Ambiental , Feminino , Humanos , Incisivo/química , Masculino , Mandíbula , Maxila , México , Dente Molar/química , Características de Residência , Fatores Sexuais , Classe Social , Espectrofotometria AtômicaRESUMO
OBJECTIVE: The purpose of this study is to characterize head and neck squamous cell carcinoma (HNSCC) in the Puerto Rican population. This is a follow-up to our initial published report on the first 134 patients. Specifically, demographic characteristics, stage at presentation, initial treatment given, and rate of recurrence were studied. METHODS: Relevant data was obtained from 445 histologically confirmed HNSCC cases identified through the University of Puerto Rico School of Medicine Otolaryngology Department Head and Neck Cancer Clinics between August 1993 and January 2003. Data collected after informed consent included demographic factors (sex, age, areas of residence, income); risk factors (occupation, alcohol intake, cigarette usage); and pathological variables (tumor location, histopathology, stage at presentation, current disease status, tumor recurrence). RESULTS: The average age at diagnosis was 64.0 years (range 18-98); 84.5 per cent of the patients were male, 16 per cent were females. The most frequent anatomical sites of the primary tumor were the larynx (36.4 per cent) and the oral cavity (29.9 per cent). The majority of patients (61.1 per cent) presented with advanced stage (III-IV) disease at the time of diagnosis and over half (55.5 per cent) had moderately-differentiated tumors. Most patients had less than 12 years of formal education (81.2 per cent). Prolonged use of tobacco and alcohol identified in 88.1 per cent and 79.8 per cent of patients, respectively. The most frequent therapeutic modality used was radiation therapy followed by the combination of radiation and surgery. Twenty five percent of the cases experienced a recurrence of disease during the follow-up period. CONCLUSIONS: These findings emphasize the need for early detection programs for HNSCC in Puerto Rican patients given the high rate of advanced-stage disease at time of diagnosis. The key role of heavy alcohol intake and tobacco use as risk factors in the development of HNSCC is once again highlighted.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Alcoolismo/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Demografia , Seguimentos , Incidência , Recidiva Local de Neoplasia , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Porto Rico/epidemiologia , Fatores de Risco , Tabagismo/epidemiologiaRESUMO
TRH-like immunoreactivity distinct from TRH is present in various tissues and fluids. In order to determine whether TRH-like molecules are secreted by the hypothalamus, we analyzed tissues and media from hypothalamic slices incubated in Krebs Ringer bicarbonate. Media from basal or high KCl conditions contained 3 TRH-like molecules evidenced by reverse phase high performance liquid chromatography followed by TRH radioimmunoassay. Peak I corresponded to authentic TRH (73% of total immunoreactivity) and peaks II and III had a higher retention time. These additional TRH-like forms were neither detected in hypothalamic tissue nor in tissue or medium from olfactory bulb. Gel filtration analysis of hypothalamic media revealed only one TRH-like peak eluting as TRH, suggesting that the molecular weights of peaks II and III are similar to that of TRH. Peak II retention time was similar to that of pglu-phe-proNH2. We analysed if they could be produced by post secretory metabolism of TRH. Incubation of hypothalamic slices with [3H-Pro]-TRH did not produce radioactive species comigrating with peaks II or III. However, it induced rapid degradation to [3H-Pro]-his-prodiketopiperazine ([3H]-HPDKP). Inhibitor profile suggested that pyroglutamyl aminopeptidase II, but not pyroglutamyl aminopeptidase I, is responsible for [3H]-HPDKP production. These data are consistent with the hypothesis that pyroglutamyl aminopeptidase II is the main aminopeptidase degrading TRH in hypothalamic extracellular fluid. Furthermore, we suggest that the hypothalamus releases additional TRH-like molecules, one of them possibly pglu-phe-proNH2, which may participate in control of adenohypophyseal secretions.
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Hipotálamo/metabolismo , Extratos Placentários/metabolismo , Aminopeptidases/metabolismo , Animais , Cromatografia em Gel , Cromatografia Líquida de Alta Pressão , Dipeptídeos/metabolismo , Técnicas In Vitro , Masculino , Bulbo Olfatório/metabolismo , Ácido Pirrolidonocarboxílico/análogos & derivados , Ratos , Ratos WistarRESUMO
OBJECTIVE: To determine the concentration of lead (Pb), cadmium (Cd), and chromium (Cr) and establish the possible association of these heavy metals with some sociodemographic factors. MATERIAL AND METHODS: A representative sample of one hundred dental students from the National Autonomous University of Mexico living in Mexico City participated in this study. Unstimulated human whole saliva samples were analyzed by Atomic Absorption Spectroscopy. RESULTS: Concentrations of Pb, Cd, and Cr were higher than those reported elsewhere: Pb (X = 3.10 micrograms/dL-1; Maximum: 16.8 micrograms/dL-1 and Minimum: 0.04 microgram/dL-1), Cd (X = 0.25 microgram/dL-1; Maximum: 2.04 micrograms/dL-1 and Minimum: 0.004 microgram/dL-1) and Cr (X = 1.43 micrograms/dL-1; Maximum: 4.82 micrograms/dL-1 and Minimum: 0.05 microgram/dL-1). No association was found between the variables studied (age, sex, geographic area and canned food consumption) with Pb and Cr. However, an inverse association was found between Cd and age (Chi 2 = 5.9012, p < or = 0.05); (gamma = -0.5224, p < or = 0.05). CONCLUSIONS: Salivary monitoring can be used for detection of environmental pollutants (atmospheric or occupational), in addition for detection of drugs, and local and systemic diseases. Heavy metal pollution continues to be a public health problem, and therefore the government should form a program for eliminating pollutants from the environment. Likewise, other studies should be carried out to verify the association between variables such as sex, age, use of glazed ceramics, nutrition, and home address with the concentrations of heavy metals in saliva.
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Cádmio/análise , Cromo/análise , Chumbo/análise , Saliva/química , Adulto , Fatores Etários , Interpretação Estatística de Dados , Poluentes Ambientais/análise , Feminino , Humanos , Masculino , México , Fatores Sexuais , Espectrofotometria AtômicaRESUMO
Mexico city has a very high pollution index. Based on the view 'that salivary monitoring can be extended to environmental pollutants', we performed this study in order to determine not only the concentrations of lead and cadmium in human saliva, but also to establish their possible association with some socio-demographic factors. One hundred dental students from the National Autonomous University of Mexico living in Mexico city participated in the study. Stimulated human whole saliva samples were analyzed by atomic absorption spectroscopy. The results show that Pb (x = 3.10 microg/dl(-1); maximum x = 16.8 microg/dl(-1) and minimum x = 0.04 microg/dl[-1]) and Cd (x = 0.25 microg/dl(-1); maximum x = 2.04 microg/dl(-1) and minimum x = 0.004 microg/dl[-1]) concentrations were higher than those reported elsewhere, and that there was no association between several variables studied (age, gender, geographic area and consumption of canned food) and salivary Pb. However, an inverse association was found between Cd and age (chi2 = 5.9012; P < or = 0.05; gamma = -0.5224, P < or = 0.05). From this study it can be concluded that saliva has potential as a technique for monitoring ambient pollutants recent exposure, since circulating levels of certain polluting chemicals can be transported into salivary glands and secretions.
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Cádmio/análise , Poluentes Ambientais , Chumbo/análise , Saliva/química , Adulto , Exposição Ambiental/prevenção & controle , Monitoramento Ambiental/métodos , Feminino , Humanos , Masculino , México , Valores de Referência , Espectrofotometria AtômicaRESUMO
This study comprised 134 patients who had developed head and neck squamous carcinoma (HNSCC), and attended the cancer clinics of the Otolaryngology Department at the Isaac González Martínez Oncologic Hospital between August 1993 and November 1995. In-person interviews, and medical record review of the HNSCC patients provided data on demography, family history of cancer, history of a second primary cancer, history of environmental, tobacco and ethanol exposure, and current disease status. The average age at the time of diagnosis was 62.3 (range 18-94), and eighty percent of the subjects were male. Most (59%) of the patients had moderately differentiated tumors and 14% had a recurrence of the carcinoma. The most frequent primary site in males was the laryngeal area, and the oral cavity in females. Exposure to alcohol and smoking were identified as predisposing factors in 95% of the patients.
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Carcinoma de Células Escamosas/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Feminino , Humanos , Neoplasias Laríngeas/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Porto Rico/epidemiologia , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversosRESUMO
OBJECTIVES: A case of tuberculosis of the prostate is described. The rarity of this condition and the problems encountered in making the differential diagnosis prompted us to report on this case. METHODS/RESULTS: The clinical features and the diagnostic and therapeutic aspects of a patient with tuberculosis of the prostate are presented. CONCLUSIONS: Tuberculosis of the prostate is an extremely rare condition.
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Doenças Prostáticas/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Idoso , Humanos , MasculinoRESUMO
Ambient levels of carbonyls were measured at the University of Mexico campus, Mexico City. Only formaldehyde and acetaldehyde were measured, since aldehydes with higher molecular weight were not detected. The most abundant aldehyde was formaldehyde, with an overall ratio CH3CHO/H2CO of 0.43. Maximum concentrations occurred for formaldehyde at 10:00 h while for acetaldehyde at 8:00 h. Comparing the concentration measured in this work with those in urban areas it was found that the formaldehyde and acetaldehyde levels in Mexico City are among the highest reported in the literature.
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Results from the application of risk approach for the analysis of early maternity are reported. This analysis is made from the available medical records. Based on data obtained from the Registry of Deliveries of the Obstetric ward of "Madariaga de Posadas" hospital, Misiones, Argentina, a cross-sectional study of analytical observation was conducted. All records regarding deliveries occurring during the first semester of 1991, i,e, 507 cases were considered for the study and 3 characteristics were chosen: age, parity, and complications due to an inadequate prenatal monitoring. The first two characteristics, in combination, were used as an indicator of risk level and the third was crossed in a contingency table. The most significant findings were that 20% of 2 513 deliveries cared for within the aforementioned period of time corresponded to early maternity. Average age of the adolescents was 17 years ranging from 12-19 and standard deviation 1.5 years, modal parity was placed in the rank of 0. Of 507 deliveries at risk, 69 were considered high risk deliveries because of the age and 305 because of parity. Overall, 61 deliveries presented with complications due to inadequeate prenatal care. In general, it is concluded that the technique and the data source used are quite useful to quantitate the occurrence of early maternity and to design strategies for nursing intervention in the community. These women who receive medical care in the public hospital come from popular sectors and represent a well defined risk group requiring specific preventive medical care for the reproductive process as a whole.
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Complicações na Gravidez , Gravidez na Adolescência , Gravidez de Alto Risco , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Enfermagem Materno-Infantil , Paridade , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/prevenção & controle , Prevenção Primária , Fatores de RiscoRESUMO
An evaluation of water quality and phytoplankton composition position was carried out in order to determine the trophic conditions of Lake Patzcuaro (2035 m above sea level), a high altitude tropical lake. Temperatures ranged from 15 to 23 degrees C. Total phosphorus and inorganic nitrogen showed a seasonal variation; highest values coincided with the rainy season (0.48 and 2.1 mg litre(-1), respectively). Dissolved oxygen ranged from 2 to 7.9 mg litre(-1) at the surface and from 0.6 to 7.3 mg litre(-1) on the bottom, the lowest values being found in shallow zones. Average transparency varied from 0.62 to 1.4 m Secchi depth. Rainfall was a primary factor in seasonal variability as it influenced both physical and biological conditions by contributing to the transport and deposition of silt, which mixed with sinking algal cells. The composition of the surface phytoplankton segregated along five major divisions comprising a total of 49 species. General seasonal patterns of dominance alternated in a sequence beginning with Bacillariophyta, through Chlorophyta to Cyanophyta. Diatoms, the dominant group from February to early June, included Melosira granulata, Stephanodiscus sp., Synedra sp. and Fragilaria sp. During the rainy season (late June to September), Microcystis aeruginosa, Oscillatoria sp., Anabaena sp., Merismopedia sp., Crucigenia cuadrata, Oocystis lacustris, Selenastrum gracile, Mallomonas sp. and Tetraediella sp. were important. Melosira granulata was present throughout the period of study. Spatial and temporal variability in both physical and biological conditions make it difficult to assign a specific trophic state to Lake Patzcuaro. Nevertheless, analysis of the algal community indicates a generally mesotrophic condition.
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We present a case of a female patient who presented with Kikuchi's necrotic lymphadenitis a rare disease in our country and whose diagnosis fundamentally is histological, which itself is also difficult because of the wide range of differential diagnosis which has to be considered. This entity is frequent during the adolescent period in females and its clinical manifestations are few apart from that related to the lymphadenitis.