RESUMO
The Speedy A (spdya) gene is a member of the Speedy/RINGO family, encoding a spdya protein associated with cellular cycle and meiosis in vertebrates. Results from genetic analyses indicated spdya conditional knockout mice are sterile, suggesting that this protein has essential functions in mammalian reproduction. There, however, are no published reports on the localization of spdya mRNA in the germline or in somatic cell lineages within the gonads from mollusks or other invertebrate species. Using a previously obtained transcriptome assembly from the scallop Argopecten purpuratus, an economically important hermaphroditic scallop species from Chile and Peru, there was identification of a complete coding sequence of the spdya mRNA. Phylogenetically spdya protein has sequence conservation homology with other scallops and mollusks. The relative mRNA transcript abundances at different gametogenic stages was assessed using quantitative PCR procedures. Results indicated there was an increase of spdya mRNA transcript abundance in testicular region samples at the late active stage, followed by a decrease in testis of reproductively mature individuals. To gain insight into the cellular localization of ap-spdya transcript within the gonads, specific RNA probes were synthesized for in situ hybridization analyses of gonad histological sections. Results indicated spdya mRNA is located exclusively in early germline (previtellogenic oocytes and spermatogonia) and somatic proliferative tissues of A. purpuratus ovarian and testicular regions. Overall, these results indicate there are putative functions of spdya in the early oogenesis and spermatogenesis of A. purpuratus and will contribute to furthering the understanding of gametogenesis in this species.
Assuntos
Gametogênese , Pectinidae/metabolismo , RNA Mensageiro/metabolismo , Animais , Gônadas/metabolismoRESUMO
BACKGROUND: Given the high rates of suicide in the adolescent population and the reluctance of this population to seek help, developing proactive and effective strategies to timely detect individuals at high risk for suicide in non-clinical contexts is a worldwide recognized need. A series of brief self-report questionnaires have been developed for this purpose, however there are few studies providing evidence on their capability to accurately classify suicidal risk levels in specific populations. One of the instruments frequently used to evaluate suicide risk is the Columbia-Suicide Severity Rating Scales (C-SSRS). The goal of this study is to provide psychometric evidence about the accuracy of the Suicidal Ideation subscale (SI) of the C-SSRS to classify suicidal risk levels in a sample of Chilean adolescents using Item Response Theory (IRT). METHODS AND MATERIALS: Through the two parameter logistic model (2-PLM), we analyzed the capability of a self-report questionnaire addressing suicidal ideation (SI) to differentiate and classify participants according to their SI severity levels. We tested two main parameters: difficulty (localization) and discriminating power of 6 items extracted and adapted from the Columbia-Suicide Severity Rating Scales (C-SSRS). We administered this questionnaire to a general sample of 1645 adolescents aged 13 to 18. RESULTS: Our results show that the items differentiate symptoms addressing suicidal thoughts according to their severity, providing an accurate classification of the SI risk level. CONCLUSIONS: These findings support the usage of the C-SSRS in Chilean adolescents. Further research is needed to test its predictive value in different populations.
Assuntos
Comportamento do Adolescente/psicologia , Escalas de Graduação Psiquiátrica , Autorrelato , Índice de Gravidade de Doença , Ideação Suicida , Adolescente , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica/normas , Reprodutibilidade dos Testes , Suicídio/psicologia , Tentativa de Suicídio/psicologia , Inquéritos e Questionários , Prevenção do SuicídioRESUMO
Piscirickettsiosis is a threatening infectious disease for the salmon industry, due to it being responsible for significant economic losses. The control of outbreaks also poses considerable environmental challenges. Despite Piscirickettsia salmonis having been discovered as the aetiological agent of the disease more than 25 years ago, its pathogenicity remains poorly understood. Among virulence factors identified so far, type four secretion systems (T4SS) seem to play a key role during the infection caused by the bacterium. We report here the genetic manipulation of P. salmonis by means of the transference of plasmid DNA in mating assays. An insertion cassette was engineered for targeting the icmB gene, which encodes a putative T4SS-ATPase and is carried by one of the chromosomal T4SS clusters found within the genome of P. salmonis PM15972A1, a virulent representative of the EM-90-like strain. The molecular characterization of the resulting mutant strain demonstrated that the insertion interrupted the target gene. Further in vitro testing of the icmB mutant showed a dramatic drop in infectivity as tested in CHSE-214 cells, which is in agreement with its attenuated behaviour observed in vivo. Altogether, our results demonstrate that, similar to other facultative intracellular pathogens, P. salmonis' virulence relies on an intact T4SS.
Assuntos
Doenças dos Peixes/microbiologia , Piscirickettsia/fisiologia , Piscirickettsia/patogenicidade , Infecções por Piscirickettsiaceae/veterinária , Salmo salar , Sistemas de Secreção Tipo IV/genética , Fatores de Virulência/genética , Animais , Proteínas de Bactérias/genética , Mutagênese , Piscirickettsia/genética , Infecções por Piscirickettsiaceae/microbiologia , VirulênciaAssuntos
Trypanosoma cruzi/metabolismo , Morte Celular/efeitos dos fármacos , Peptidil-Prolil Isomerase F , Ciclofilinas/metabolismo , Ciclosporina/farmacologia , Proteínas de Transporte da Membrana Mitocondrial/efeitos dos fármacos , Poro de Transição de Permeabilidade Mitocondrial , Trypanosoma cruzi/citologia , Trypanosoma cruzi/efeitos dos fármacosRESUMO
Early reports accounted for two main genotypes of Piscirickettsia salmonis, a fish pathogen and causative agent of piscirickettsiosis, placing the single isolate EM-90 apart from the prototypic LF-89 and related isolates. In this study, we provide evidence that, contrary to what has been supposed, the EM-90-like isolates are highly prevalent and disseminated across Chilean marine farms. Molecular analysis of 507 P. salmonis field isolates derived from main rearing areas, diverse hosts and collected over 6 years, revealed that nearly 50% of the entire collection were indeed typed as EM-90-like. Interestingly, these isolates showed a marked host preference, being recovered exclusively from Atlantic salmon (Salmo salar) samples. Although both strains produce undistinguishable pathological outcomes, differences regarding growth kinetics and susceptibility to the antibiotics and bactericidal action of serum could be identified. In sum, our results allow to conclude that the EM-90-like isolates represent an epidemiologically relevant group in the current situation of piscirickettsiosis. Based on the consistency between genotype and phenotype exhibited by this strain, we point out the need for genotypic studies that may be as important for the Chilean salmon industry as the continuous surveillance of antimicrobial susceptibility patterns.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Doenças dos Peixes/epidemiologia , Oncorhynchus , Piscirickettsia/fisiologia , Infecções por Piscirickettsiaceae/veterinária , Salmo salar , Animais , Chile/epidemiologia , Doenças dos Peixes/microbiologia , Genótipo , Piscirickettsia/efeitos dos fármacos , Piscirickettsia/genética , Infecções por Piscirickettsiaceae/epidemiologia , Infecções por Piscirickettsiaceae/microbiologia , Prevalência , Análise de Sequência de DNARESUMO
Antibiotics have been extensively used against infections produced by Piscirickettsia salmonis, a fish pathogen and causative agent of piscirickettsiosis and one of the major concerns for the Chilean salmon industry. Therefore, the emergence of resistant phenotypes is to be expected. With the aim of obtaining a landscape of the antimicrobial resistance of P. salmonis in Chile, the susceptibility profiles for quinolones, florfenicol and oxytetracycline (OTC) of 292 field isolates derived from main rearing areas, different hosts and collected over 5 years were assessed. The results allowed for the determination of epidemiological cut-off values that were used to characterize the pathogen population. This work represents the first large-scale field study addressing the antimicrobial susceptibility of P. salmonis, providing evidence of the existence of resistant types with a high incidence of resistance to quinolones. Remarkably, despite the amounts and frequency of therapies, our results disclosed that the issue of resistance to florfenicol and OTC is still in the onset.
Assuntos
Antibacterianos/farmacologia , Doenças dos Peixes/microbiologia , Piscirickettsia/efeitos dos fármacos , Infecções por Piscirickettsiaceae/microbiologia , Animais , Chile , Farmacorresistência Bacteriana , Peixes/microbiologia , Testes de Sensibilidade Microbiana , Piscirickettsia/isolamento & purificação , Infecções por Piscirickettsiaceae/veterináriaRESUMO
Se presenta el caso de paciente con ascitis, masa pelviana y CA 125 elevado, sugerentes de cáncer ovárico avanzado. Se realizó laparoscopía que demostró lesiones compatibles con tuberculosis peritoneal. La biopsia laparoscópica de las lesiones demostró granulomas, por lo que no se realizó más cirugía y se inició tratamiento antituberculoso específico con buena respuesta clínica. Se revisa en la literatura tuberculosis peritoneal y su dificultad con el diagnóstico diferencial con cáncer de ovario avanzado.
It is presented the case of a patient with ascites, pelvic mass and elevated CA 125, all suggested of advanced ovarian cancer. It was made a laparoscopy that evidenced lesions of peritoneal tuberculosis. The laparoscopic biopsy of the lesions demostrated granulomas, for that there was no more surgery made and antituberculosis specific treatment was started, with good clinical response. It is revisited in the literature peritoneal tuberculosis and its difficult differential diagnoses with advanced ovarian cancer.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Peritonite Tuberculosa/diagnóstico , Peritonite Tuberculosa/terapia , Antibacterianos/uso terapêutico , Ascite/etiologia , Diagnóstico Diferencial , Laparoscopia , Neoplasias Ovarianas/diagnóstico , Peritonite Tuberculosa/complicaçõesAssuntos
DNA Girase/genética , Farmacorresistência Bacteriana/genética , Doenças dos Peixes/microbiologia , Piscirickettsia/genética , Infecções por Piscirickettsiaceae/veterinária , Polimorfismo Genético , Animais , Chile , Piscirickettsia/efeitos dos fármacos , Piscirickettsia/isolamento & purificação , Infecções por Piscirickettsiaceae/microbiologia , Quinolonas/farmacologiaRESUMO
Aquaculture is anticipated to be a critical element in future solutions to global food shortage. However, diseases can impede industry efficiency and sustainability. Consequently, diseases can and have led to dramatic re-structuring in industry or regulatory practices. The emergence of infectious salmon anemia (ISA) in Chile is one such example. As in other countries, many mitigations were instituted universally, and many incurred considerable costs as they introduced a new layer of coordination of farming activities of marine sites within common geographic areas (termed 'neighborhoods' or 'barrios'). The aggregate response led to a strong reduction in ISA incidence and impact. However, the relative value of individual mitigations is less clear, especially where response policies were universally applied and retrospective analyses are missing 'controls' (i.e., areas where a mitigation was not applied). Further, re-focusing policies around disease prevention following resolution of an outbreak is important to renew sustainable production; though, again, field data to guide this shift in purpose are often lacking. Expert panels can offer timely decision support in the absence of empirical data. We convened a panel of fish health experts to weight risk factors predictive of ISA virus (ISAV) introduction or spread between Atlantic salmon barrios in Chile. Barrios, rather than sites, were the unit of interest because many of the new mitigations operate at this level and few available studies examine their efficacy. Panelists identified barrio processing plant biosecurity, fallowing strategies, adult live fish transfers, fish and site density, smolt quality, hydrographic connection with other neighborhoods, presence of sea lice (Caligus rogercresseyi), and harvest vessel biosecurity as factors with the greatest predictive strength for ISAV virulent genotype ('HPR-deleted') occurrence. Fewer factors were considered predictive of ISAV HPR0 genotype ('HPR0') occurrence, with greatest strengths assigned to fish and site density, adult live fish transfers, and smolt facility HPR0 status. Field validation based on ISAV and risk factor occurrence after panel completion generally supports expert estimates, and highlights a few factors (e.g., broodstock HPR0 status) less conclusive in the original study. Results inform legislation, industry best management practices and surveillance design.
Assuntos
Doenças dos Peixes/virologia , Isavirus , Infecções por Orthomyxoviridae/veterinária , Salmão , Animais , Chile/epidemiologia , Doenças dos Peixes/epidemiologia , Doenças dos Peixes/prevenção & controle , Modelos Biológicos , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/prevenção & controle , Infecções por Orthomyxoviridae/virologia , Vigilância da População , Fatores de RiscoRESUMO
We present the problem of viral croup or acute laryngotracheitis as an important respiratory issue in children that often prompts parents to seek physician consultation. Despite its frequency, there is still controversy among the medical team regarding its treatment. The problem will be defined and analyzed in-depth in terms of pathogenesis, to finally suggest a simple, clinically effective treatment than can be applied in any emergency service. We highlight the importance of epinephrine and corticosteroids in the acute treatment of these patients...
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Crupe/epidemiologia , Crupe/prevenção & controle , Laringite/diagnóstico , Laringite/epidemiologia , Laringite/etiologia , Laringite/prevenção & controle , Laringite/terapiaRESUMO
Between April and June 2009, 1,075 feral rainbow trout from 10 different lakes involved with aquaculture activities in Los Lagos Region, Chile, were inspected for Diphyllobothrium species. All viscera and muscles of the fish were examined using stereomicroscopy; pyloric cecae and stomachs infected with plerocercoids were checked by histology and scanning electron microscopy. Plerocercoids of Diphyllobothrium dendriticum were confirmed by PCR and sequencing of COI and 18S rRNA + ITS1 + 5.8S rRNA + ITS2 genes for the first time in Chile. Overall prevalence of plerocercoids of D. dendriticum was 9.2% (99/1,075) in Los Lagos Region and 17.4% (99/570) for Chiloe Island. Plerocercoids were not detected in the continental lakes of the Los Lagos Region (Chapo, Rupanco, and Llanquihue). Tarahuín Lake exhibited a prevalence of 50.9% (81/159), Cucao Lake 5.1% (4/79), Natri Lake 4.7% (5/107), Huillinco Lake 3.6% (5/138), and San Antonio Lake 66.7% (4/6). Abundance was 1.1 plerocercoid larvae per fish (1,169 larvae/1,075 fish). All the plerocercoids were found encysted in the viscera of the fish. Plerocercoids were 10.9 ± 3 (7-16) mm long by 0.4 ± 0.2 (0.2-0.6) mm wide. The scolex was enlarged, with 2 bothria and a frontal pit. The body was covered with short capilliform filitriches, 4-6 mm long. The Chilean COI and 18SrRNA + ITS1 + 5.8SrRNA + ITS2 gene sequences indicated 96.34-96.52% and 99% similarity with D. dendriticum sequences, respectively. Diphyllobothrium dendriticum is reported for the first time in freshwater ecosystems as far as 43 ° S on Chiloe Island. These findings and previous reports of plerocercoids of Diphyllobothrium spp. in farmed rainbow trout at Tarahuín Lake support the putative life cycle of this parasite in lakes of southern Chile where there are aquaculture activities.
Assuntos
DNA de Helmintos/química , Difilobotríase/veterinária , Diphyllobothrium/isolamento & purificação , Doenças dos Peixes/parasitologia , Oncorhynchus mykiss/parasitologia , Animais , Chile/epidemiologia , Ciclo-Oxigenase 1/genética , DNA de Helmintos/isolamento & purificação , DNA Espaçador Ribossômico/genética , Difilobotríase/epidemiologia , Difilobotríase/parasitologia , Diphyllobothrium/anatomia & histologia , Diphyllobothrium/classificação , Diphyllobothrium/genética , Doenças dos Peixes/epidemiologia , Lagos , Microscopia Eletrônica de Varredura/veterinária , Dados de Sequência Molecular , Músculos/parasitologia , Filogenia , Reação em Cadeia da Polimerase/veterinária , Prevalência , RNA Ribossômico 18S/genética , RNA Ribossômico 5,8S/genética , Vísceras/parasitologiaRESUMO
BACKGROUND AND AIMS: Although studies have shown association of birth weight (BW) and adult body mass index (BMI) with insulin sensitivity in adults, there is limited evidence that BW is associated with insulin secretion. We assessed the associations between BW and current BMI with insulin sensitivity and secretion in young Latin American adults. METHODS AND RESULTS: Two birth cohorts, one from Ribeirao Preto, Brazil, based on 1984 participants aged 23-25 years, and another from Limache, Chile, based on 965 participants aged 22-28 years were studied. Weight and height at birth, and current fasting plasma glucose and insulin levels were measured. Insulin sensitivity (HOMA%S) and secretion (HOMA%ß) were estimated using the Homeostatic Model Assessment (HOMA2). Multiple linear regression analyses were carried out to test the associations between BW and adult BMI z-scores on log HOMA%S and log HOMA%ß. BW z-score was associated with HOMA%S in the two populations and HOMA%ß in Ribeirao Preto when adult BMI z-score was included in the model. BW z-score was associated with decreasing insulin secretion even without adjusting for adult BMI, but only in Ribeirao Preto. BMI z-score was associated with low HOMA%S and high HOMA%ß. No interactions between BW and BMI z-scores on insulin sensitivity were shown. CONCLUSIONS: This study supports the finding that BW may affect insulin sensitivity and secretion in young adults. The effect size of BW on insulin status is small in comparison to current BMI.
Assuntos
Peso ao Nascer , Composição Corporal , Índice de Massa Corporal , Resistência à Insulina , Insulina/sangue , Insulina/metabolismo , Adulto , Glicemia/análise , Brasil/epidemiologia , Chile/epidemiologia , Estudos de Coortes , Jejum , Feminino , Seguimentos , Humanos , Secreção de Insulina , América Latina/epidemiologia , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
El cáncer linfoepitelial del cuello uterino es excepcional en nuestro continente, el propósito de la presente publicación es evaluar la etiología, diagnóstico y tratamiento de un caso clínico. El estudio anátomo-patológico ofreció ciertas dificultades, por lo que se recurrió a la inmunohistoquímica para hacer el diagnóstico diferencial con el carcinoma epidermoide, el carcinoide de células grandes y el linfoma anaplásico. El compromiso del virus de Epstein-Barr y el virus del Papiloma Humano, con el cáncer linfoepitelial, no fueron con-cluyentes. Se encontró tinción positiva granular en el citoplasma de células epiteliodeas aisladas en relación al primero, e indicios de daño coilocitico en el epitelio pavimentoso en relación al segundo. La enfermedad se presentó como lesión única sangrante en el labio anterior del cuello uterino. El tratamiento fue quirúrgico con erradicación completa, lo que favorece el pronóstico.
Linfoepitelial cancer of the cervix is exceptional in our continent. The purpose of this publication is to evaluate the etiology, diagnosis and treatment. Anatomical and pathological study offered certain difficulties; immunohistochemistry was used to make the differential diagnosis with squamous carcinoma, large cell carcinoid and anaplastic lymphoma. Compromise of Epstein - Barr virus and virus of Human Papilloma, with linfoepitelial cancer, were not conclusive. We found positive granular staining in the cytoplasm of isolated epithelioid cells in relation to the first virus and koilocytic damage of the squamous epithelium in regard to the second. The disease was presented as unique, bloody injury, in the anterior lip of the cervix. The treatment was surgical with complete eradication, which favors the prognosis.
Assuntos
Humanos , Feminino , Adulto , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/diagnóstico , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/diagnóstico , Diagnóstico Diferencial , Imuno-HistoquímicaRESUMO
INTRODUCTION: Delayed ischemic neurological deficit associated to cerebral vasospasm is the most common cause of sequelae and death that follows the rupture of an aneurysm. The objective of this study was to evaluate the safety and efficacy of intra-arterial Milrinone in patients with symptomatic refractory cerebral vasospasm. PATIENTS AND METHOD: Eight patients diagnosed with aneurysmal subarachnoid hemorrhage who developed symptomatic cerebral vasospasm refractory to conventional medical therapy were enrolled. They received an intra-arterial infusion of Milrinone at a rate of 0.25 mg/min, with a total dose of 10-15 mg. Qualitative evaluation of angiographic response, neurological and systemic complications as well as functional outcome at 3 months were documented. RESULTS: All patients had a significant angiographic response. This was evidenced by a pre-treatment vessel stenosis greater than 70%, that improved to less than 50% after the intra-arterial Milrinone infusion. Three patients developed recurrent vasospasm that improved after a second intra-arterial Milrinone infusion. None of the patients developed neurologic or systemic complications attributed to the intervention. At 3 months follow-up all patients were alive and had a mean modified Rankin scale of 2 +/- 1 and a Barthel index of 83 +/- 10. CONCLUSION: Intra-arterial Milrinone infusion seems to be a safe and effective treatment for patients who develop refractory symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
Assuntos
Aneurisma Intracraniano/tratamento farmacológico , Milrinona/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Vasoespasmo Intracraniano/tratamento farmacológico , Adulto , Pressão Sanguínea , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/tratamento farmacológico , Angiografia Cerebral , Feminino , Frequência Cardíaca , Humanos , Infusões Intra-Arteriais , Pressão Intracraniana/efeitos dos fármacos , Pressão Intracraniana/fisiologia , Pessoa de Meia-Idade , Milrinona/administração & dosagem , Inibidores da Agregação Plaquetária/administração & dosagem , Estudos Prospectivos , Segurança , Vasoespasmo Intracraniano/diagnóstico por imagem , Vasoespasmo Intracraniano/fisiopatologiaRESUMO
BACKGROUND: The pattern of associations and the attributable fractions (AF) of atopic conditions due to specific sensitizations vary between countries. OBJECTIVE: To assess the level of associations and AF between sensitization to five allergens and atopic conditions in two settings. METHODS: We studied 2063 Brazilians and 1231 Chileans of both sexes using representative samples selected at birth in the 1970s. Information on asthma and rhinitis was based on the European Community Respiratory Health Survey questionnaire. We assessed bronchial hyperresponsiveness (BHR) to methacholine and sensitization to Dermatophagoides pteronyssinus, cat, dog, grass blend and Alternaria alternata. RESULTS: The prevalence of sensitization to one or more allergens was 50% in Brazilians and 22% in Chileans. The level of associations varied according to the outcome used. Strong associations between sensitization and asthma, defined as wheeze or awakening with breathlessness at night and positive BHR, were found for each of the five allergens in Chileans [varying from odds ratio (OR) 3.24, 95% confidence interval (CI) 1.47, 7.15 for D. pteronyssinus to 8.44, 95% CI 3.82, 18.66 for cat], whereas the level of associations was restricted to D. pteronyssinus, cat and dog in Brazilians and was somewhat weaker (highest OR 3.90, 95% CI 2.80-5.44). The AF of sensitization on asthma was 54% in Brazil and 44% in Chile. D. pteronyssinus and cat made an independent contribution to asthma in the two samples. The patterns of associations between sensitization and rhino-conjunctivitis were similar to those for asthma. CONCLUSION: The associations between sensitization, and asthma and rhinitis were high in Chile and moderately high in Brazil, but the AF were higher in Brazil, reflecting a higher prevalence of sensitization. In Brazil, dust mite had the greatest impact on atopic conditions while in Chile several allergens had an impact. Sensitization is as serious a problem in Chile and Brazil as in developed countries.
Assuntos
Asma/etiologia , Hipersensibilidade Imediata/complicações , Hipersensibilidade Imediata/imunologia , Rinite Alérgica Perene/etiologia , Rinite Alérgica Sazonal/etiologia , Adulto , Alérgenos/imunologia , Alternaria/imunologia , Animais , Animais Domésticos/imunologia , Antígenos de Dermatophagoides/imunologia , Antígenos de Plantas/imunologia , Asma/epidemiologia , Brasil , Hiper-Reatividade Brônquica/epidemiologia , Hiper-Reatividade Brônquica/etiologia , Testes de Provocação Brônquica , Gatos , Chile , Conjuntivite Alérgica/epidemiologia , Conjuntivite Alérgica/etiologia , Estudos Transversais , Cães , Feminino , Humanos , Hipersensibilidade Imediata/epidemiologia , Masculino , Sons Respiratórios/etiologia , Rinite Alérgica Perene/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Testes Cutâneos , Adulto JovemRESUMO
OBJECTIVE: The study assessed the impact of body mass index (BMI) at birth, infancy, and adulthood, and waist circumference on lung function. METHODS: Using a longitudinal design 1221 Chilean young adults were studied. A standardized respiratory questionnaire was used. Forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), height, weight and waist circumference were measured. Data at birth and at 1 year were obtained from clinical notes. RESULTS: Males with a BMI > or = 30 and women with a BMI < 20 had a lower FEV(1) (-230 mL, 95% CI -363 to -98; -106 mL, 95% CI -211 to -0.18, respectively). In both sexes those with a BMI 20-25 had the highest FEV(1) and FVC. In males there was a negative association between waist circumference and FEV(1) and FVC while in women the middle tertile had the highest FEV(1) and FVC. There was an association between birthweight and BMI at birth, and FEV(1) in men, when unadjusted for other measurements. CONCLUSIONS: BMI and waist circumference in adulthood make a greater impact on lung function in adulthood than anthropometric measurements at birth and infancy. Proxy measures of fatness in adulthood reduce lung function, but the pattern between fatness and lung function by sex may be different.
Assuntos
Índice de Massa Corporal , Pulmão/fisiologia , Pulmão/fisiopatologia , Estado Nutricional , Gordura Abdominal , Adulto , Fatores Etários , Estatura , Feminino , Idade Gestacional , Humanos , Estudos Longitudinais , Masculino , Fluxo Máximo Médio Expiratório/fisiologia , Estado Nutricional/fisiologia , Sobrepeso/complicações , Gravidez , Transtornos Respiratórios/etiologia , Transtornos Respiratórios/fisiopatologia , Espirometria , Magreza , Capacidade Vital/fisiologia , Relação Cintura-Quadril/efeitos adversosRESUMO
Traumatology is a frecuent topic in primary care in urgency and in the ambulatorie setting. In this days, a less of assitents hours are disponible in the formation of generals doctors, and in the residence of Primary care doctors, about management of traumalologic disease. In this study, we present the traumatologic consult reason of the health family center Madre Teresa de Calcuta, Puente Alto, during the year 2007. Pain and functional impotence were the most frecuent consult reason. In thirth place were fractures, with a predominant place of upper limb. Actually, we disposed a few national and international epidemiology information, about this matter.
La consulta traumatológica es altamente frecuente en el ámbito de la atención primaria tanto a nivel ambulatorio como de urgencias. Actualmente, se disponen de pocas horas asistenciales en la formación del clínico general así como en el de atención primaria, en el manejo de patologías traumatológicas. En el presente trabajo, se presentan los diagnósticos y motivos de consulta traumatológicos del año 2007, ocurridos en el centro de salud familiar Madre Teresa de Calcuta de Puente Alto. Destacan como principales motivos de consulta el dolor y la impotencia funcional. Las fracturas se situaron en tercer lugar, con clara predominancia de estas, en la región correspondiente a la extremidad superior del aparato locomotor. En la actualidad, se dispone de poca información epidemiológica nacional y extranjera al respecto.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Centros de Traumatologia/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Ferimentos e Lesões/epidemiologia , Medicina de Família e Comunidade/estatística & dados numéricos , Atenção Primária à Saúde , Distribuição por Idade e Sexo , Anormalidades Congênitas/epidemiologia , Chile/epidemiologia , Ferimentos e Lesões/classificação , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia , Ortopedia/estatística & dados numéricos , Traumatologia/estatística & dados numéricosRESUMO
OBJECTIVE: To assess the association between smoking and respiratory symptoms, lung function and bronchial hyperresponsiveness (BHR) in young adults in Chile. SETTING: Selected sample of 1232 subjects aged 22-28 years. DESIGN: In this cross-sectional study, the outcome measures were: respiratory symptoms, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow between 25% and 75% (FEF25-75), FEV1/FVC and BHR. RESULTS: Among the 1232 subjects, 67.7% of the men and 49.4% of the women were smokers; the median cigarettes smoked per day was four for men and three for women. Smoking was associated with wheezing, waking up with a cough, breathlessness following exercise and persistent cough, with odds ratios (OR) between 1.94 (95% CI 1.41-2.66) and 3.12 (95% CI 2.21-4.40) among those smoking > or = 5 cigarettes per day, compared to non-smokers. Smoking < 5 cigarettes was significantly associated with wheezing and waking up with a cough. Smokers had a lower FEV1/FVC than non-smokers by approximately 0.8%. Smoking was not associated with FEV1, FEF25-75 or BHR status. CONCLUSIONS: This study highlights the early effects of smoking on respiratory symptoms. It could help governments in Latin America take vigorous action to deter young people from starting smoking.
Assuntos
Testes de Função Respiratória , Fumar/fisiopatologia , Adulto , Chile , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
Los quistes de cuerda vocal son un motivo de consulta frecuente en Otorrinolaringología. Su clínica se caracteriza por disfonía de larga evolución, en un paciente con antecedentes de mala respuesta a tratamientos foniátricos previos. El diagnóstico se realiza mediante la visualización de la lesión, con exámenes como laringoscopía indirecta, idealmente nasofibroscopía, telaringoscopía y estraboscopía. El tratamiento es mediante microcirugía. El presente estudio tiene como objetivo mostrar la experiencia de la Unidad Docente Asociada de Otorrinolaringología de la Facultad de Medicina de la Pontificia Universidad Católica de Chile en el diagnóstico y manejo de los quistes de Cuerda vocal. Se realizó un análisis retrospectivo de todos los pacientes (N=33) con diagnóstico de quiste de cuerda vocal tratados entre junio de 2000 y julio de 2004. El promedio de edad fue de 34,7 años. En el 59 por ciento de los casos, el diagnóstico fue efectuado mediante telelaringoscopía asociada a estroboscopía. En el 20 por ciento de los pacientes (N=7) el diagnóstico inicial realizado con nasofibroscopía cambió con el uso de telelaringoscopía asociada a estroboscopía. El 79 por ciento de los pacientes operados refirió sentirse mejor con respecto a su condición previa.
Assuntos
Humanos , Prega Vocal/fisiopatologia , Cistos/complicações , Distúrbios da Voz/etiologia , Distúrbios da Voz/terapia , Doenças da Laringe/terapia , Estudos Retrospectivos , Seguimentos , Laringoscopia/métodos , Logoterapia , Resultado do TratamentoRESUMO
BACKGROUND: There is uncertainty about the impact of the programming hypothesis in terms of nutritional status at birth, rate of growth in the first year of life, length of gestation, breast feeding, and episodes of illness on asthma. An analysis was therefore carried out to test this hypothesis. METHODS: Data were collected on 1232 children born between 1974 and 1978 in a semi-rural area of Chile. Measurements at birth and growth in the first year of life were obtained from a birth registry and clinical notes. Information on asthma was collected using the European Community Respiratory Health Survey questionnaire. Sensitisation to eight allergens and bronchial hyperresponsiveness (BHR) to methacholine were determined. All other information was obtained using a questionnaire. Polytomous logistic analyses were carried out to explore the association of factors at birth and during the first year of life with asthma symptoms, atopy, and BHR. RESULTS: Weight and length gain in the first year were positively associated with wheeze (odds ratio (OR) 1.004, 95% CI 1.001 to 1.007 and OR 1.11, 95% CI 0.98 to 1.25, respectively). A higher body mass index (BMI) at birth was protective in subjects reporting both wheeze and waking with breathlessness (OR 0.54, 95% CI 0.35 to 0.84). Length rate in tertiles divided by length at birth in tertiles was related to asthma symptoms (OR 1.68, 95% CI 1.19 to 2.37). Most other assessments were not associated with asthma. CONCLUSION: These results show promising but inconclusive evidence that a rapid rate of growth in length, especially in newborn infants of low length, might be involved in the aetiology of asthma.