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The present work deals with a comprehensive computational theoretical study of the molecular CO and O2 adsorption on 3d single atoms (M/MgO(100)). The study is based on the chemical elements of the 3d row, as they represent an economic advantage compared with the so-called noble metals. The present study has been performed employing density functional theory calculations. Through the representation of the metastable states, we perform a synergetic analysis of the CO oxidation reaction to find trends that suggest the possible use of new candidates such as Ni/MgO(100) or Cu/MgO(100) single-atom catalysts, for this type of redox reaction. We found that Ni and Cu produce energetically viable CO to CO2 reactions. Ni and Cu atoms show the greatest diffusion barrier and are the best candidates due to their low sintering capability. The energetic and electronic properties of the single Cu and Ni atoms on MgO (100) give them the best characteristics to help in the CO oxidation process.
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The incorporation of different amounts of Gum Arabic (GA) in thermoplastic starch (TPS) obtained by extrusion and subsequent thermocompression has been studied. The sheets have been characterized by means of XRD, FTIR, TGA, moisture content, SEM, mechanical properties, antimicrobial activity and biodegradability via composting. The FTIR analysis of the sheets shows the presence of ester groups, while the TGA shows the presence of new processes and a residue much higher than expected is obtained. No changes in crystallinity are observed by XRD. The inclusion of GA confers antimicrobial properties to thermoplastic starch against the Gram + and Gram - bacteria studied even at the smaller concentrations. For a low GA content (0.5 and 1 g GA/100 g TPS) a homogeneous material is observed by SEM, as well as an important increase in tensile strength, modulus and deformation at break, which are very interesting properties facing the applicability of this material in single use plastics which are in contact with food or other consumable goods. At higher contents of GA, hollows and cracks appear in the material, compromising the mechanical properties. In all cases, the inclusion of GA delays the biodegradation process in soil, which can be related to its antibacterial capacity and especially in case of GA concentrations of 2 and 5 g/100 g of TPS with lower humidity of these TPS sheets.
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Pseudomonas sp. strain RGM 3321 is a phyllosphere endophyte from Fragaria chiloensis subsp. chiloensis f. patagonica that harbors genes associated with plant growth promotion pathways, as well as genes typically found in plant pathogens.
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Irritable Bowel Syndrome (IBS) is a more frequent disorder in the brain-gut axis interaction in the world. COVID-19 has affected the population's mental health, and its impact on clinical severity in patients with IBS is unknown. Objective: To evaluate the effect of psychosocial stress produced by the pandemic on the severity of gastrointestinal symptoms. Methodology: 54 women and three men with IBS were interviewed by telephone. Factors associated with quality of life, comorbidities, IBS subtype, and COVID-19 diagnosis were asked. Calls were developed between June 2020 to January 2021. Results: 75% had Diarrheal IBS (IBS-D), 67% had comorbidities, 47% with busy work, and 70% in person, five patients (9%) were diagnosed with COVID-19. Of the total, 88% referred to change in gastrointestinal symptoms, 56% increased abdominal pain, and 95% bloating. Abdominal pain was negatively associated with quality of life (p < 0.036), and the incomplete evacuation's sensation positively with difficulty sleeping (p < 0.034). Conclusion: In this study, IBS patients interviewed by telephone reported higher abdominal pain and subjective bloating associated with the pandemic by SARS-CoV-2. Keywords: Irritable
El Síndrome de Intestino Irritable (SII) es uno de los trastornos en la interacción cerebrointestino más frecuentes en el mundo. La pandemia COVID-19 ha afectado la salud mental de la población, siendo desconocido su impacto en la severidad clínica en pacientes con SII. Objetivo: Evaluar el efecto del estrés psicosocial producido por la pandemia en la severidad de síntomas gastrointestinales de pacientes con SII. Metodología: 54 mujeres y 3 hombres con SII fueron entrevistados vía telefónica. Se preguntó por factores asociados a calidad de vida, comorbilidades, subtipo de SII y diagnóstico de COVID-19. Las llamadas se realizaron entre junio de 2020 hasta enero de 2021. Resultados: Un 75% presentó SII Diarreico (SII-D), el 67% comorbilidades, el 47% con trabajo activo y 70% presencial, 5 pacientes (9%) diagnosticados COVID-19. Del total, 88% refirió cambio en síntomas gastrointestinales, 56% aumentó el dolor abdominal y 95% la distensión abdominal. El dolor abdominal se asoció negativamente con la calidad de vida (p < 0,036), y la sensación de evacuación incompleta positivamente con la dificultad para dormir (p < 0,034). Conclusión: En este estudio, los pacientes con SII entrevistados vía telefónica reportaron mayor dolor y distensión abdominal subjetiva asociado a la pandemia por SARS-CoV-2.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Estresse Psicológico/complicações , Síndrome do Intestino Irritável/etiologia , Síndrome do Intestino Irritável/psicologia , COVID-19 , Qualidade de Vida , Estudos Transversais , Síndrome do Intestino Irritável/epidemiologia , Pandemias , SARS-CoV-2RESUMO
RESUMEN Introducción: Hoy en día, las intervenciones terapéuticas son más especializadas y complejas. Se ha identificado que el Therapeutic Intervention Scoring System-28 (TISS-28) es un instrumento adecuado para planear las actividades de enfermería. Objetivo: Determinar mediante la aplicación del instrumento TISS-28 el grado de complejidad de las intervenciones realizadas al brindar cuidados de enfermería a pacientes en estado crítico. Métodos: Estudio descriptivo, 270 pacientes (adultos, pediátricos y neonatales) en estado crítico; se recabó información sociodemográfica tanto del personal de enfermería como de los pacientes a través de un instrumento, se aplicó el TISS-28 para identificar el grado de complejidad de las intervenciones que se le brindaron al paciente. El análisis estadístico fue descriptivo para variables sociodemográficas y laborales, para las acciones realizadas por enfermería mediante niveles de grados de complejidad se hizo uso del análisis bivariado y la regresión logística. Resultados: Las intervenciones brindadas por el personal de enfermería en el servicio de medicina interna en el Grado II es de 9.8 veces más que en el resto de los pacientes, grado III aumenta 68 veces cuando el paciente tiene una sobre estancia hospitalaria. Discusión: Los pacientes que se encuentran en los servicios de cuidados intensivos o quirúrgicos requieren mayores cuidados. Conclusión: El TISS-28 permite predecir el estado del paciente crítico y su evolución. Determina el tiempo de atención requerido según la gravedad de este, además facilita la asignación idónea de enfermera-paciente.
ABSTRACT Introduction: Currently, therapeutic interventions have become more complex and specialized, but the Therapeutic Intervention Scoring System-28 (TISS-28) has been identified as an adequate tool in the planning of the corresponding nursing activities. Objective: To estimate through the Therapeutic Intervention Scoring System-28 (TISS-28) the degree of complexity of the necessary nursing interventions to provide care to patients in critical status. Methods: This is a descriptive study on 270 adult, pediatric, and neonatal patients in critical status. The TISS-28, and nursing and patient sociodemographic instruments were used. A descriptive statistical analysis using the sociodemographic and work-related variables was carried out. Bi-variate analysis and logistic regression were calculated in order to analyze the nursing performance by levels of complexity. Results: The interventions provided by the nursing staff in the internal medicine service in Grade II is 9.8 times more than in the rest of the patients, grade III increases by 68 times when the patient has an excess hospital stay. Discussion: Patients in the intensive care or surgical services require more care. Conclusion: The TISS-28 offers an estimate on the evolution and attention time required by patients in critical status as well as the corresponding ideal nurse-patient ratios.
RESUMO Introdução: Atualmente as intervenções terapêuticas são mais especializadas e complexas, identificou-se que o Therapeutic Intervention Scoring System-28 (TISS-28) é um instrumento adequado para planejar as atividades de enfermagem. Objetivo: Determinar mediante a aplicação do instrumento TISS-28, o grau de complexidade das intervenções realizadas na assistência de cuidados de enfermagem a pacientes em estado crítico. Métodos: Estudo descritivo, 270 pacientes (adultos, pediátricos e neonatais) em estado crítico; foi coletada informação sociodemográfica tanto do pessoal de enfermagem quanto dos pacientes através de um instrumento, aplicou-se o TISS-28 para identificar o grau de complexidade das intervenções que foram prestadas ao paciente. A análise estatística foi descritiva para variáveis sociodemográficas e laborais; a análise bivariada e a regressão logística foi utilizada para as ações realizadas por enfermagem mediante níveis de graus de complexidade. Resultados: As intervenções realizadas pela equipe de enfermagem no serviço de clínica médica do Grau II são 9,8 vezes mais do que no restante dos pacientes, o grau III aumenta em 68 vezes quando o paciente tem um tempo de internação excessivo. Discussão: Os pacientes que se encontram nos serviços de cuidados intensivos ou cirúrgicos requerem maiores cuidados. Conclusão: O TISS-28 permite prever do estado do paciente crítico e sua evolução. Determina o tempo de atenção requerido conforme a gravidade deste, aliás facilita a atribuição idónea de enfermeira-paciente.
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In the present work, we discuss the electronic properties of supported dispersed bimetallic clusters with respect to their size, geometry, and Aun/Agm (n + m = 6) composition. We have studied with supercell-density functional theory calculations the role of the charge transfer from the MgO defective support toward the cluster in the activation of O2 by AunAgm clusters. We first considered gas-phase clusters with different atomic compositions; then, we deposited all of them on a pristine (100)MgO surface and finally on a more realistic (100)MgO F-center. We performed a global and unrestricted search of the (cluster + surface) geometry. The Mexican enhanced genetic algorithm has been used to exhaustively explore the potential energy surface. Our results show that O2 activation depends on the Aun/Agm ratio. It has been found that both metals involved play different and important roles toward (a) the actual O2 dissociation and (b) weakening of the oxygen-cluster bond, which, in turn, may promote the possibility of a catalytic process to take place, such as the oxidation process of CO and NOx among others.
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TITLE: Sindrome de vasoconstriccion cerebral reversible secundario a un paraganglioma yugular secretor de metanefrinas.
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Transtornos Cerebrovasculares/etiologia , Cefaleia/etiologia , Veias Jugulares , Paraganglioma/complicações , Neoplasias Vasculares/complicações , Vasoconstrição , Secreções Corporais , Feminino , Humanos , Pessoa de Meia-Idade , Paraganglioma/metabolismo , Síndrome , Neoplasias Vasculares/metabolismoRESUMO
In Puerto Rico, the first records of the transmission of Chikungunya (CHIKV) and Zika (ZIKV) viruses were confirmed in May 2014 and December 2015, respectively. Transmission of CHIKV peaked in September 2014, whereas that of ZIKV peaked in August 2016. The emergence of these mosquito-transmitted arboviruses in the context of a lack of human population immunity allowed observations of whether the outbreaks were associated with Aedes aegypti (Diptera: Culicidae) densities and weather. Mosquito density was monitored weekly in four communities using sentinel autocidal gravid ovitraps (AGO traps) during 2016 in order to provide data to be compared with the findings of a previous study carried out during the 2014 CHIKV epidemic. Findings in two communities protected against Ae. aegypti using mass AGO trapping (three traps per house in most houses) were compared with those in two nearby communities without vector control. Mosquito pools were collected to detect viral RNA of ZIKV, CHIKV and dengue virus. In areas without vector control, mosquito densities and rates of ZIKV detection in 2016 were significantly higher, similarly to those observed for CHIKV in 2014. The density of Ae. aegypti in treated sites was less than two females/trap/week, which is similar to the putative adult female threshold for CHIKV transmission. No significant differences in mosquito density or infection rates with ZIKV and CHIKV at the same sites between years were observed. Although 2016 was significantly wetter, mosquito densities were similar.
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Aedes , Febre de Chikungunya/epidemiologia , Epidemias , Controle de Mosquitos , Tempo (Meteorologia) , Infecção por Zika virus/epidemiologia , Aedes/fisiologia , Aedes/virologia , Animais , Febre de Chikungunya/virologia , Mosquitos Vetores/fisiologia , Mosquitos Vetores/virologia , Densidade Demográfica , Porto Rico/epidemiologia , Infecção por Zika virus/virologiaRESUMO
Non-alcoholic fatty liver disease (NAFLD) is currently considered in Chile and worldwide, as the main cause of cirrhosis and liver transplantation. It is therefore one of the main public health objectives for reducing its prevalence. In last years, it was suggested that the intestinal microbiota (IM) might contribute to the pathophysiology of NAFLD, as well as in the progression toward nonalcoholic steatohepatitis (NASH) and cirrhosis. It is known that changes in the composition of IM are associated with alterations in intestinal permeability and the production of inflammatory metabolites. These alterations are part of the pathophysiological mechanisms leading to the development of NASH. However studies on MI in patients with NAFLD and NASH in Chile are scarce. Through a research grant, recently awarded at the Hospital Clínico Universidad de Chile, we aim to confirm and characterize the intestinal dysbiosis associated with NAFLD in Chilean patients and to establish the relationship between the changes in microbial composition with the progression of liver damage. The description of these alterations represents an opportunity to explore new therapeutic approaches for future interventions. In effect, through the restoration of an intestinal microbial environment towards homeostasis in these patients, we expect to reverse or improve the progression of damage provoked by this disease. (AU)
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Disbiose/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/microbiologia , Hepatopatia Gordurosa não Alcoólica/patologiaRESUMO
Introducción: Los niños con síndrome de Down (SD) tienen mayor riesgo de desarrollar enfermedad otorrinolaringológica (ORL). Recomendaciones internacionales sugieren realizar tamizaje auditivo precoz y control periódico por especialista. Nuestro objetivo fue caracterizar la enfermedad ORL en niños con SD y proponer una recomendación adaptada a nuestra realidad. Pacientes y método: Estudio transversal, descriptivo, en niños de 6 meses a 15 años con SD. Los datos se obtuvieron por medio de entrevista a los padres y revisión de fichas clínicas. Resultados: Se analizaron 134 pacientes, con una edad promedio de 44,5 meses. El 78,8% de ellos presentaba enfermedad ORL, siendo la más frecuente la rinitis alérgica y otitis con efusión. El tamizaje auditivo estaba alterado en un 25% de ellos, el 50% de los mayores de 3 años con estudio de sueño tenían apnea obstructiva del sueño. Los niños de mayor edad tuvieron estadísticamente mayor frecuencia de enfermedad ORL. Conclusiones: Esta serie muestra una alta frecuencia de enfermedad ORL en niños con SD, lo que refuerza la necesidad de realizar tamizaje auditivo, sospechar e identificar las apneas obstructivas del sueño y derivación rutinaria al especialista para optimización de las condiciones auditivas que permitan el mejor desarrollo del niño con SD.
Introduction: The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. Patients and method: Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. Results: We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. Conclusions: This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS.
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Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Otorrinolaringopatias/epidemiologia , Otite Média com Derrame/epidemiologia , Síndrome de Down/complicações , Rinite Alérgica/epidemiologia , Otorrinolaringopatias/etiologia , Otorrinolaringopatias/fisiopatologia , Chile , Estudos Transversais , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/epidemiologia , Perda Auditiva/epidemiologia , Testes AuditivosRESUMO
INTRODUCTION: The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. PATIENTS AND METHOD: Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. RESULTS: We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. CONCLUSIONS: This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS.
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Síndrome de Down/complicações , Otite Média com Derrame/epidemiologia , Otorrinolaringopatias/epidemiologia , Rinite Alérgica/epidemiologia , Adolescente , Criança , Pré-Escolar , Chile , Estudos Transversais , Feminino , Perda Auditiva/epidemiologia , Testes Auditivos , Humanos , Lactente , Masculino , Otorrinolaringopatias/etiologia , Otorrinolaringopatias/fisiopatologia , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/etiologiaRESUMO
Irritable Bowel Syndrome (IBS) is a functional disorder characterized by abdominal discomfort associated with changes in bowel habit and increased intestinal sensitivity. It is one of the most common disorders of digestive health in Chile as well as in the world. Although the pathophysiological mechanisms of IBS have yet to be fully established, it is known that (epi-) genetic factors are involved in the development of the disorder. Bcl3 (B-cell leukemia/lymphoma 3) is a regulatory protein of the intestinal inflammatory response, specifically, with regard to the signaling pathways of NF-kB (Nuclear Factor-kB). Among the variability of the human genome, the gene encoding Bcl3 contains the polymorphism SNPs rs2927488 (variants A/G) which has been associated with susceptibility to developing Inflammatory Bowel Disease (IBD). Furthermore, the presence of this polymorphic variant has been correlated with increased levels of Bcl3 gene expression in patients with Crohns Disease. Our laboratory is focused on understanding the potential relationship between Bcl3 and IBS. Our preliminary studies describe an increased expression of Bcl3 at the intestinal mucosal epithelium in IBS patients with a diarrheal-phenotype (IBS-D). We are now interested to investigate if the presence of the variant SNP rs2927488(A/G) is a susceptibility factor for IBS development and to understand the significance of its relationship with Bcl3 expression, in Chilean IBS patients. In this review, we focus primarily on the relationship between rs2927488(A/G) polymorphism of Bcl3 gene, its protein expression and its mechanisms of control over the inflammatory response...
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Humanos , Polimorfismo Genético , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/genéticaRESUMO
Immunologic and genetic factors are involved in HIV-1/AIDS pathogenesis. Defensins are key molecules in innate immunity that participate in the control and/or development of infection and disease. Using PCR-RFLPs, we determined the association between HIV-1/AIDS and human ß-defensin 1 (DEFB1) 5'UTR -52 G/A (rs1799946), -44 C/G (rs1800972), and -20 G/A (rs11362) polymorphisms in three groups of women from the state of Sinaloa, located in the Northwest region of Mexico: i) healthy blood donors; ii) sex-workers; and iii) HIV-1 patients. The -52GG genotype was more frequent in blood donors than in patients (p= 0.023; Odds Ratio, OR= 0.49; 95% CI= 0.25-0.95), whereas the - 52GA genotype was significantly higher in patients (p= 0.013; OR= 2.03; 95% CI= 1.11-3.79, statistical power SP= 98.8%), as well as the frequencies of -20A allele (p= 0.017; OR= 1.60; 95% CI= 1.06-2.40), -20AA genotype (p= 0.047; OR = 2.02; 95% CI= 0.93-4.33) and the ACA haplotype with respect to healthy blood donors (p= 0.000012; OR= 5.82; 95% CI= 2.33-16.43, SP= 99.89%) and sex-workers (p= 0.019; OR= 2.18; 95% CI= 1.07-4.46). Conversely, the ACG haplotype was higher in healthy blood donors than in patients (p= 0.009; OR= 0.55; 95% CI= 0.34-0.89). In addition, the -44CC genotype was associated with a low plasma viral load (p= 0.015), whereas AGA, AGG and GGA haplotypes were more prevalent in individuals with high CD4 counts (p= 0.004, 0.046, and 0.029, respectively). These findings associate DEFB1 5'UTR polymorphisms with HIV-1/AIDS in Mexican women for the first time.
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Regiões 5' não Traduzidas , Predisposição Genética para Doença , Infecções por HIV/epidemiologia , Infecções por HIV/genética , HIV-1/isolamento & purificação , Polimorfismo Genético , beta-Defensinas/genética , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Genótipo , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , México , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Medição de Risco , Adulto JovemRESUMO
Borderline resectable pancreatic head carcinoma is a challenging disease that requires multidisciplinary approach to obtain maximal benefits from current therapeutical possibilities. We review current knowledge and therapeutic options for the patients from the surgical, medical oncology and radiotherapy views and emphasize the need for a coordinated multidisciplinary approach to obtain optimal results.
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Adenocarcinoma/terapia , Neoplasias Pancreáticas/terapia , Terapia Combinada , Gerenciamento Clínico , HumanosRESUMO
Irritable bowel syndrome (IBS) is one of the most prevalent functional disorders in Chile impacting on socio-economic development due to significantly impaired quality of life of the individual. It is characterised by abdominal discomfort associated with alterations in bowel habit and increased visceral hypersensitivity. One of the outstanding features of IBS is the presence of a bi-directional imbalance of gut-brain interactions, which can induce alterations in the intestinal immune response. IBS is characterised by increased intestinal mast cell activity associated with alterations of para-cellular permeability and activation of sensory nerve endings. The increased proximity of mast cell to colonic nerves is correlated with abdominal pain and increased visceral hypersensitivity of the patients. In spite of the well-described role of mast cell in the induction of mucosal inflammation, in IBS only a low-grade inflammation is observed. The present review discuses the possible immune-regulatory mechanisms that are involved in IBS pathophysiology.
El síndrome de intestino irritable (SII) es considerado uno de los trastornos funcionales más prevalente en Chile, que impacta el desarrollo socio-económico del país debido al deterioro de la calidad de vida de los individuos que lo portan. Es caracterizado por molestias abdominales asociadas a alteraciones en el hábito de defecación e hipersensibilidad visceral. Una de las características más destacadas en el SII es la presencia de un desequilibrio de las interacciones en el eje intestino-cerebro, el cual puede inducir alteraciones en la respuesta inmune intestinal. El SII es caracterizado por una aumentada actividad de los mastocitos en el intestino, asociada con alteraciones en la permeabilidad para-celular epitelial y la activación de terminaciones nerviosas en la mucosa intestinal. El aumento de la cercanía de los mastocitos a nervios colónicos está relacionado con el dolor abdominal y la hipersensibilidad visceral de los pacientes. Pese a que está muy bien descrito el papel del mastocito en la inducción de la inflamación en mucosas, en el SII se observa sólo un bajo-grado de inflamación. En la presente revisión se discute los posibles mecanismos regulatorios inmunes que están involucrados en la fisiopatología del SII.
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Humanos , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/imunologia , Colo/inervação , Hipersensibilidade , Inflamação , Mastócitos/patologia , Sistema Nervoso/fisiopatologiaRESUMO
INTRODUCTION AND GOALS: Adenotonsillar surgery represents a major haemostatic challenge in paediatric patients with mild inherited platelet dysfunction. While there are recommendations for perioperative haemostatic management, there are no reports of the outcomes with the different recommendations in these children when undergoing adenotonsillectomy. Our objective was to evaluate the management of perioperative bleeding with desmopressin in children with mild platelet dysfunctions who underwent adenotonsillar surgery in our hospital. METHODS: We performed a retrospective study aimed at determining the perioperative bleeding and complication rate in children with mild inherited platelet dysfunction in whom desmopressin was used while undergoing adenotonsillar procedures. RESULTS: Between 2004 and 2010, 27 children with mild inherited platelet dysfunction underwent adenotonsillar procedures in our hospital and were treated with desmopressin. One patient developed perioperative bleeding (3.7%) and there was 1 child (3.7%) who presented transitory hypotension as a side effect of desmopressin. CONCLUSIONS: The use of desmopressin allowed adequate perioperative bleeding prophylaxis management in children with mild inherited platelet dysfunction who underwent adenotonsillar procedures without presenting severe complications.
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Adenoidectomia , Perda Sanguínea Cirúrgica/prevenção & controle , Transtornos Plaquetários/tratamento farmacológico , Desamino Arginina Vasopressina/uso terapêutico , Transtornos Hemorrágicos/tratamento farmacológico , Hemorragia Pós-Operatória/prevenção & controle , Medicação Pré-Anestésica , Tonsilectomia , Acetaminofen/uso terapêutico , Adolescente , Analgésicos/uso terapêutico , Transtornos Plaquetários/complicações , Criança , Pré-Escolar , Codeína/uso terapêutico , Desamino Arginina Vasopressina/efeitos adversos , Avaliação de Medicamentos , Feminino , Transtornos Hemorrágicos/etiologia , Humanos , Hipotensão/induzido quimicamente , Masculino , Dor Pós-Operatória/tratamento farmacológico , Complicações Pós-Operatórias/induzido quimicamente , Hemorragia Pós-Operatória/epidemiologia , Receptores de Vasopressinas/efeitos dos fármacos , Ácido Tranexâmico/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the incidence of perioperative bleeding among children with mild bleeding disorders who underwent adenotonsillar surgery in our hospital and were treated with our perioperative bleeding prophylaxis protocol. METHODS: Retrospective chart review was aimed at determining the perioperative bleeding rate in children with mild bleeding disorders subjected to our prophylactic protocol while undergoing adenotonsillar procedures. Low von Willebrand factor (LVWF), unspecific platelet function disorders (UPFD) and mild factor VII deficiency were considered as mild bleeding disorders. The protocol utilizes intravenous desmopressin, tranexamic acid, NSAID avoidance, and overnight observation. RESULTS: Between 2004 and 2009, 44 children with mild bleeding disorders underwent adenotonsillar procedures in our hospital and were treated with the protocol. One patient (LVWF+UPFD) developed perioperative bleeding (2.3%). CONCLUSIONS: It is possible to obtain low rates of perioperative bleeding in children with mild bleeding disorders undergoing adenotonsillar procedures, provided there is a well-timed diagnosis and an adequate prophylaxis protocol. We believe that further efforts must be directed at preoperative diagnosis of mild bleeding disorders to ensure safer surgeries.
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Adenoidectomia/efeitos adversos , Transtornos Hemorrágicos/diagnóstico , Transtornos Hemorrágicos/cirurgia , Hemorragia Pós-Operatória/prevenção & controle , Prevenção Primária/métodos , Tonsilectomia/efeitos adversos , Adenoidectomia/métodos , Transtornos da Coagulação Sanguínea/diagnóstico , Transtornos da Coagulação Sanguínea/cirurgia , Transtornos Plaquetários/diagnóstico , Transtornos Plaquetários/cirurgia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Assistência Perioperatória/métodos , Hemorragia Pós-Operatória/etiologia , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Tonsilectomia/métodos , Resultado do Tratamento , Doenças de von Willebrand/diagnóstico , Doenças de von Willebrand/cirurgiaRESUMO
Paratuberculosis is a chronic intestinal disease of animals caused by Mycobacte-rium avium subsp. paratuberculosis (MAP), which has some pathological features similar to Crohn's disease (CD) in humans. The presence of MAP in food for human consumption and in affected tissues of patients with CD has been detected. Therefore, a causal association between this microorganism and the disease in humans, has been postulated. However, several related studies have failed to confirm this hypothesis and the scientific acceptance of MAP as a zoonotic agent remains controversial. This review presents the main findings related to this issue, contrasting evidences for and against an association between MAP and CD. The need to promote national studies focusing on this area is suggested.
Assuntos
Animais , Humanos , Doença de Crohn/microbiologia , Mycobacterium avium subsp. paratuberculosis/patogenicidade , Paratuberculose/transmissão , Chile/epidemiologia , Contaminação de Alimentos , ZoonosesRESUMO
Invasive fungal rhinosinusitis (IFR) is a complication that presents mainly in immunocompromised patients. Paranasal sinuses computed tomography (PCT) is frequently obtained during initial evaluation of suspected cases. The objective of the study was to determine the imaging findings that suggest IFR in patients with hematological malignancies. In the retrospective case/control study, we included 14 patients with hematological malignancies that developed IFR in the Hospital Clínico de la Pontificia Universidad Católica de Chile between January 2005 and June 2009. Twenty patients with hematological malignancies, with suspected sinonasal infectious involvement requiring a PCT for initial evaluation, were chosen as the control group. Thirteen imaging parameters were compared between both groups. Osseous erosion and facial soft tissue thickening were statistically associated with the presence of IFR (p < 0.05). The presence of osseous erosion, facial soft tissue thickening, extrasinus extension or unilateral involvement had a positive predictive value of 100%, with an incidence among the total group of 12, 15, 9 and 9%, respectively. No patients with IFR had a normal PCT. Most PCTs in the initial evaluation of suspected IFR had nonspecific findings. The clinician must have a high index of suspicion and complement the workup with other diagnostic techniques to initiate appropriate treatment.