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BACKGROUND: Microplastics (MPs) and nanoplastics (NPs) have become a growing concern in dermatology due to their widespread presence in cosmetic formulations and the environment. These minuscule synthetic polymer particles prompt an essential exploration of their potential impact on dermatological homeostasis. AIMS: This study aims to investigate the effects of MPs and NPs on the integumentary system. Specifically, it seeks to understand the potential cutaneous alterations, inflammatory responses, and disruptions to the skin's physiological functions caused by these synthetic particles. PATIENTS/METHODS: The investigation involves a comprehensive analysis of emerging research on MPs and NPs. This includes their presence in cosmetic formulations and environmental pervasiveness. The study delves into their capacity to breach the cutaneous barrier, raising concerns about the implications of prolonged exposure. RESULTS: Evidence suggests that MPs and NPs may indeed incite cutaneous alterations, provoke inflammatory responses, and disturb the homeostasis of the skin's physiological functions. Their small dimensions enhance their capability to breach the cutaneous barrier, further emphasizing the apprehensions associated with prolonged exposure. CONCLUSIONS: While a precise understanding of the implications of MPs and NPs on dermatological health remains an ongoing scientific endeavor, this study underscores the growing significance of these synthetic particles. The findings emphasize the need for proactive measures to safeguard both individual well-being and environmental preservation in the context of dermatological health.
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Dermatologia , Microplásticos , Humanos , Microplásticos/efeitos adversos , Plásticos , Pele , HomeostaseRESUMO
The inclusion of plant extracts that contain secondary compounds with the potential to modulate rumen fermentation and improve animal performance has gained attention in recent years. The aim of this study was to evaluate the effect of the inclusion of yerba mate extract (Ilex paraguariensis ST. Hilaire) (YME) on the ruminal parameters. Eight castrated cattle were divided into four groups, a control without YME (0%) and three treatment groups with 0.5, 1 and 2% inclusion of YME in the dry matter. The inclusion of YME did not show differences in ruminal methane emissions (CH4), and total apparent digestibility (p = 0.54). Likewise, YME did not modify ruminal pH, but positively affected NH3-N, which decreased linearly as the extract level in the diet increased (p = 0.01). No short chain fatty acids (SCFA) were influenced by YME, except isovaleric acid (p = 0.01), which showed a lower concentration in the inclusion of 2% YME. Our results show that up to 2% YME does not affect digestibility, ruminal fermentation parameters, or the concentration of short-chain fatty acids in the rumen.
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Hyperthermia using High-Intensity Focused Ultrasound (HIFU) is an acoustic therapy for cancer treatment. This technique consists of an increase in the temperature field of the tumor to achieve coagulative necrosis and immediate cell death. Therefore, for having a successful treatment, the physical problem requires to know several properties due to the high variability from individual to individual, or even for the same individual under different physiological conditions. This article presents a numerical simulation of hyperthermia therapy for cancer treatment using HIFU, as well as the estimation of parameters that influence the physical problem. Two mathematical models were considered to solve the forward problem. The acoustic model based on acoustic pressure performs a frequency-domain study, and the bioheat transfer model a time-dependent study. These models were solved using Comsol Multiphysics® software in a 2D-axisymmetric rectangular domain to determine the temperature field. Parameter estimation was coded in Matlab Mathworks® environment using a Bayesian approach. The Markov Chain Monte Carlo method by the Metropolis-Hastings algorithm was implemented, and the simulated temperature measurements were considered. Results suggest that specific HIFU therapy can be performed for each patient by estimating appropriate parameters for cancer treatment and provides the possibility to define procedures before and during the treatment.
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Tratamento por Ondas de Choque Extracorpóreas , Ablação por Ultrassom Focalizado de Alta Intensidade , Hipertermia Induzida/métodos , Neoplasias/terapia , Algoritmos , Teorema de Bayes , Simulação por Computador , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Humanos , Cadeias de Markov , Método de Monte CarloRESUMO
Negative pressure wound therapy (NPWT) is widely used in skin defects, active infection, and surgical reconstruction; lately, it is being used after skin graft to improve the adhesion on the receptor area. During the last decade, another indication has been identified: the use of NPTW to avoid complications after free flaps such as venous congestion and the risk of necrosis. NPWT can be used in the initial complication of a free flap, and the venous congestions can be treated with this technique, with very good outcomes. NPWT can be established as a part of a postoperative protocol in microsurgical procedures to avoid major complications.
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INTRODUCTION: Spinal meningiomas represent 25-45% of intradural spinal tumors and ~2% of meningiomas of the central nervous system (CNS), and their occurrence during pregnancy is unusual. We present an updated literature review. CASE REPORT: A 36-year-old woman, at 32.6 weeks of gestation, was hospitalized for urinary tract infection and urinary retention. One month earlier, she had decreased strength in lower limbs, and this weakness rapidly progressed to flaccid paraplegia without sphincters control. Magnetic resonance imaging (MRI) revealed a well-defined intradural extramedullary lesion in T3-T4. Using a posterolateral approach, the tumor was completely removed; however, there was no clinical improvement, and the patient was discharged with an impairment scale (AIS) grade A. Histopathology examination indicated a psammomatous meningioma. DISCUSSION: Meningiomas are benign tumors that are slowly progressive; however, the hemodynamic and hormonal changes of pregnancy are related to their accelerated growth. Reports show that the onset of the symptoms during the third trimester of pregnancy, including early neurological symptoms or signs of spinal cord compression, can be easily attributed to those of pregnancy by both the patient and the doctor. The time to diagnosis and medulla compression time are thus prolonged, which can be further compounded in middle-high income countries due to limitations in obtaining images for evaluation. Although rare, spinal meningiomas should be considered in the differential diagnosis of patients with neurological symptoms during pregnancy. Their early recognition is important to avoid irreversible neurological damage.
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Neoplasias Meníngeas , Meningioma , Neoplasias da Medula Espinal , Adulto , Feminino , Humanos , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico , Meningioma/complicações , Meningioma/diagnóstico , Paraplegia/etiologia , Gravidez , Terceiro Trimestre da Gravidez , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/diagnósticoRESUMO
Resumen Introducción. El parto pretérmino es aquel que ocurre antes de la semana 37 de gestación. Este tipo de parto se asocia a múltiples factores de riesgo, algunos de los cuales pueden ser prevenidos. En Colombia son escasos los estudios sobre los factores de riesgo asociados al parto pretérmino, de ahí la importancia de su análisis. Objetivo. Identificar los factores de riesgo para parto pretérmino en un grupo de gestantes de Bogotá D.C., Colombia. Materiales y métodos. Estudio de cohorte retrospectivo. La muestra estuvo compuesta por 452 pacientes que habían participado en un estudio primario y que ya habían dado a luz. Resultados. La incidencia de parto pretérmino fue de 10.40% (IC95%: 7.60-13.20) y los factores de riesgo asociados fueron los siguientes: ser diagnosticada con preeclampsia severa, con un riesgo relativo (RR) de 7.47 (IC95%: 4.59-11.95); tener preeclampsia (severa y no severa), con un RR=5.05 (IC95%: 3.0-8.51), y ocurrencia de restricción del crecimiento intrauterino (RCIU), con un RR=4.40 (IC95%: 2.44-7.98). Conclusiones. De acuerdo con los hallazgos reportados en el presente estudio, es necesario planear e implementar estrategias y políticas públicas en Bogotá D.C. que promuevan mejores prácticas de atención prenatal que, a su vez, permitan la detección temprana de condiciones como la preeclampsia y la RCIU, lo que hará posible reducir la incidencia de partos pretérmino en la ciudad y utilizar la experiencia y resultados obtenidos en el resto del país.
Abstract Introduction: A preterm birth occurs before the 37th week of pregnancy. It is associated with multiple risk factors, some of which can be prevented. In Colombia, few studies have addressed the risks factors associated with preterm birth, hence the importance of analyzing them. Objective: To identify risk factors for preterm birth in a population of pregnant women in Bogotá D.C., Colombia. Materials and methods: Retrospective cohort study. The sample was composed of 452 patients who had participated in a primary study and had already given birth. Results: The incidence of preterm birth was 10.40% (95%CI: 7.60-13.20). The following risk factors associated with preterm delivery were found: being diagnosed with severe preeclampsia, with a relative risk (RR)=7.47 (95%CI: 4.59-11.95); having preeclampsia (severe and non-severe), with a RR=5.05 (95%CI: 3.0-8.51); and occurrence of intrauterine growth restriction (IUGR), with a RR=4.40 (95%CI: 2.44-7.98). Conclusions: According to the findings reported in this study, it is necessary to plan and implement strategies and public policies in Bogotá D.C. that promote better prenatal care practices that, in turn, allow the early detection of conditions such as preeclampsia and IUGR. This will reduce the incidence of preterm birth in the city and will allow using the experience and results obtained here in the rest of the country.
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Humanos , Fatores de Risco , Trabalho de Parto Prematuro , GravidezRESUMO
Abstract Introduction: Nutritional screening is a useful tool for determining the risk of hospital malnutrition; therefore, reviewing the guidelines on its use in the pediatric population is of great importance. Objective: To provide recommendations on the use of nutrition screening tools validated in Canada and Europe in the Colombian pediatric population. Materials and method: A systematic review was conducted using the PRISMA methodology. The quality of the evidence found in the review was assessed using the U.S. Preventive Services Task Force (USPSTF) tool, which was established by the Canadian Task Force on the Periodic Health Examination for assessing preventive actions. Results: Fifteen studies were included in the review as they met the inclusion criteria. In addition, 7 nutrition screening tools were identified (PYMS, iPYMS, PeDiSMART, PNR, STAMP, PMST and STRONGkids). According to guidelines of the European Society for Clinical Nutrition and Metabolism, the PYMS, iPYMS and STRONGkids tools simultaneously assess prognostic variables such as current nutritional status, stability, expected improvement or worsening of the condition, and the influence of the disease process in nutritional deterioration. Regarding concurrent validity, data analysis shows that PYMS, iPYMS and PMST have sensitivities >85%, and that PYMS has a specificity >85%. In terms of reproducibility, PEDISMART, STRONGkids, STAMP and PYMS have an acceptable interobserver agreement (k>0.41). Conclusion: Based on the evidence found, which was analyzed in terms of prognostic variables, concurrent validity and reproducibility, the use of the PYMS tool in the clinical practice is suggested. In contrast, hospitals must assess the applicability of the STAMP and iPYMS tools.
Resumen Introducción. El tamizaje nutricional es una herramienta efectiva que permite establecer el riesgo de desnutrición hospitalaria, por consiguiente es importante revisar las directrices respecto a su uso en pediatría. Objetivo. Ofrecer recomendaciones sobre el uso de las herramientas de tamizaje nutricional validadas en Canadá y Europa en población colombiana. Materiales y métodos. Se realizó una revisión sistemática siguiendo la metodología PRISMA. Para la evaluación de la calidad de la evidencia se utilizó la herramienta U.S Preventive Services Task Force, formulada para medir acciones preventivas por la Canadian Task Force on the Periodic Health Examination. Resultados. Se incluyeron 15 estudios que cumplían los criterios de selección y se identificaron 7 herramientas (PYMS, iPYMS, PeDiSMART, PNR, STAMP, PMST y STRONGkids). Según los lineamientos de la Sociedad Europea de Nutrición Clínica y Metabolismo, la PYMS, la iPYMS y la STRONGkids evalúan simultáneamente variables pronósticas como estado nutricional actual, estabilidad, progresión esperada e influencia de la enfermedad. En cuanto a validez concurrente, el análisis de datos muestra que la PYMS, la iPYMS y la PMST tienen sensibilidades >85% y que la PYMS tiene especificidad >85%. Respecto a reproducibilidad, la PEDISMART, la STRONGkids, la STAMP y la PYMS tienen una concordancia inter-observadores aceptable (k>0.41). Conclusión. Según la evidencia analizada en términos de variables pronósticas, validez concurrente y reproducibilidad, se sugiere el empleo en la práctica clínica de la herramienta PYMS, mientras que para el uso de la STAMP y la iPYMS las instituciones deben evaluar su aplicabilidad.
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A decline in pasture productivity is often associated with a reduction in vegetative cover. We hypothesize that nitrogen (N) in urine deposited by grazing cattle on degraded pastures, with low vegetative cover, is highly susceptible to losses. Here, we quantified the magnitude of urine-based nitrous oxide (N2O) lost from soil under paired degraded (low vegetative cover) and non-degraded (adequate vegetative cover) pastures across five countries of the Latin America and the Caribbean (LAC) region and estimated urine-N emission factors. Soil N2O emissions from simulated cattle urine patches were quantified with closed static chambers and gas chromatography. At the regional level, rainy season cumulative N2O emissions (3.31 versus 1.91 kg N2O-N ha-1) and emission factors (0.42 versus 0.18%) were higher for low vegetative cover compared to adequate vegetative cover pastures. Findings indicate that under rainy season conditions, adequate vegetative cover through proper pasture management could help reduce urine-induced N2O emissions from grazed pastures.
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Meio Ambiente , Herbivoria , Óxido Nitroso/urina , Chuva , Estações do Ano , Solo/química , Agricultura , Animais , Região do Caribe , Bovinos , Monitoramento Ambiental , América LatinaRESUMO
Abstract Introduction: Management of acute pain is essential in the treatment of burned patients. Current pain management approaches focus on the control of the somatic component reflecting the insult. However, the injury comprises emotional, physical, and psychological components that require multi-disciplinary management, including pharmacological and nonpharmacological interventions to break the vicious circle of pain and its complications. Objective: To perform a nonsystematic review of the literature on the pharmacological and nonpharmacological management of pain in patients with extensive burns. Methods: Nonsystematic review of the literature published between 2000 and 2016 in MEDLINE/PubMed, Embase, Sciencedirect, SciELO, LILACS, Google Scholar, academic books, and institutional management guidelines. Results: After analyzing the literature, it was found that the management of acute pain in the patients with severe burn injury should be based on a multidisciplinary approach. Conclusions: Management of acute pain in patients with severe burn injury should not focus only on the somatic components of pain but should also encompass the emotional, physical, and psychosocial components, in order to provide comprehensive management, both pharmacological and nonpharmacological.
Resumen Introducción: El manejo del dolor agudo es fundamental en el tratamiento de los pacientes quemados. Los esquemas actuales de manejo de dolor se enfocan en el control del componente somático que refleja la noxa, sin embargo es un evento con componentes emocionales, físico y psíquicos, que requiere manejo multidisciplinario incluyendo intervenciones farmacológicas y no farmacológicas, para romper el círculo vicioso del dolor y sus complicaciones. Objetivo: Realizar una revisión no sistemática de la literatura sobre el manejo farmacológico y no farmacológico del dolor agudo en el paciente gran quemado. Metodología: Se realizó una revisión no sistemática en MEDLINE/PubMed, Embase, Science Direct, SciELO, LILACS, Google Scholar, libros académicos, guías de manejo institucionales, desde el año 2000 hasta el 2016. Resultados: Luego de analizar la literatura se encuentra que el manejo del dolor agudo en el paciente gran quemado debe recibir un enfoque multidisciplinario. Conclusiones: El manejo agudo del dolor en el paciente gran quemado no se debe centrar solamente en los componentes somáticos del mismo, sino que debe extenderse a los componentes emocionales físicos y psicosociales, para brindar un manejo integral, tanto farmacológico como no farmacológico.
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HumanosRESUMO
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains. Adherence is defined as the proportion of patients included in the registry, completeness is defined as the proportion of data effectively recorded, and accuracy is defined as the proportion of data consistent with medical records. A random sample of 53 patients (25.4%) was selected to assess the latest 2 domains. A direct comparison between the registry's database and medical records was performed. RESULTS: In total, 324 variables containing information on demographic data, surgical procedure, clinical outcomes, and key performance indicators were analyzed. Two hundred nine of 212 patients who underwent surgery during the study period were included in the registry, accounting for an adherence of 98.6%. Completeness was 91.7% and accuracy was 85.8%. Most errors were found in the preoperative range of motion and timely administration of prophylactic antibiotics and thromboprophylaxis. CONCLUSION: This model provides useful information regarding the quality of the recorded data since it identified deficient areas within the IAR. We recommend that institutional arthroplasty registries be constantly monitored for data quality before using their information for research or quality improvement purposes.
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Artroplastia/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril , Artroplastia do Joelho , Confiabilidade dos Dados , Bases de Dados Factuais , Feminino , Humanos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Melhoria de Qualidade , Reoperação , Projetos de Pesquisa , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Increased risk of bleeding after major orthopedic surgery (MOS) has been widely documented in general population. However, this complication has not been studied in elderly patients. The purpose of this study is to determine whether the risk of major bleeding after MOS is higher in elderly patients, compared with those operated at a younger age. METHODS: This retrospective cohort study included total hip and total knee arthroplasty patients operated during 5 consecutive years. The main outcome was the occurrence of major bleeding. Patients with other causes of bleeding were excluded. Relative risks (RRs) and confidence intervals (CIs) were calculated, and a multivariate analysis was performed. RESULTS: A total of 1048 patients were included, 56% of patients were hip arthroplasties. At the time of surgery, 553 (53%) patients were older than 70 years. Patients aged >70 years showed an increased risk of major bleeding (RR: 2.42 [95% CI: 1.54-3.81]). For hip arthroplasty, the RR of bleeding was 2.61 (95%CI: 1.50-4.53) and 2.25 (95% CI: 1.03-4.94) for knee arthroplasty. After multivariate analysis, age was found to be independently associated with higher risk of major bleeding. CONCLUSION: According to European Medicines Agency criteria, patients aged ≥70 years are at a higher risk of major bleeding after MOS, result of a higher frequency of blood transfusions in this group of patients. Standardized protocols for blood transfusion in these patients are still required.
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Anticoagulantes/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Hemorragia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue , Colômbia/epidemiologia , Feminino , Hemorragia/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fatores de Risco , Tromboembolia Venosa/prevenção & controleRESUMO
Introduction: La caries dental es definida como un proceso infeccioso, multifactorial y crónico. Actualmente se realiza el recuento en saliva del grupo Streptococcus mutans, Lactobacillus y Candida. El género Actinomyces se considera agente etiológico de caries, pero no existen pruebas que hayan evaluado el nivelde este microorganismo en saliva. El objetivo de este trabajo es determinar la correlación entre los nivelesde Actinomyces en saliva y los indicadores clínicos de riesgo y actividad cariogénica para utilizar el recuentode estos microorganismos como predictor de riesgo de caries. Métodos: 33 estudiantes entre 19 y 24 años, de ambos sexos, fueron incluidos en este estudio. Los mismos se clasificaron en 3 grupos: sanos, con riesgo cariogénico y con actividad cariogénica según los siguientes indicadores clínicos: Índice O?Leary, Nº decaries amelodentinarias abiertas, frecuencia de cepillado y momentos de azúcar. Muestras de saliva fueron sembradas en Agar Brucella con hemina, vitamina K y 5% de sangre. Se incubó en anaerobiosis por 7 díasy se realizó el recuento de Actinomyces y microbiota acompañante. Resultados: Hubo diferencias estadísticamente significativas en el recuento de la microbiota total y los niveles en saliva de Actinomyces, entre losestudiantes sanos con los que poseen riesgo y aquellos con actividad cariogénica. Conclusión: El presenteestudio conduce a proponer la utilización del recuento de Actinomyces como predictores de riesgo de caries conjuntamente con el recuento del grupo Streptococcus mutans, Lactobacillus y Candida
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Actinomyces naeslundii, Actinomyces viscosus and Candida albicans are associated with root cavity. The aim of this study was to determine, in vitro, the effect produced by the metabolic substances elaborated by Actinomyces naeslundii and Actinomyces viscosus on Candida albicans. The strains were isolated of saliva. There were used the double plaque diffusion method (DPDM) and the method of radial diffusion (MRD). The effect of the time of incubation and of different concentrations of metabolic substances elaborated by Actinomyces naeslundii and Actinomyces viscosus on the kinetics of growth of C. albicans were studied. Later, the nature of the substances produced by the two strains of Actinomyces was determined. It was found that there was no inhibition of the growth of C. albicans by A. naeslundii and A. viscosus in the DPDM and the MRD. There was stimulation of the growth of C. albicans by the two strains of Actinomyces when the DPDM was used. In the MRD the results were negative. Metabolic substances produced by both species stimulated the growth of C. albicans in low concentrations but at high concentrations inhibition was observed. The best concentration of the stimulating factor, a protein substance stable to 70 degrees C, corresponds to a dilution of 1/80. The inhibition of the growth of C. albicans was produced by the decrease of the pH, the higher effect being obtained with the dilution 1/5. The metabolic substances produced by A. naeslundii and A. viscosus can have both inhibitory and stimulant effects on C. albicans, according to their concentration. These metabolic interactions would condition the proportion of C. albicans in the oral microbial ecosystems.
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Actinomyces/metabolismo , Fatores Biológicos/farmacologia , Candida albicans/efeitos dos fármacos , Actinomyces/isolamento & purificação , Fatores Biológicos/biossíntese , Humanos , Saliva/microbiologiaRESUMO
El propósito de este estudio fue establecer si se debe modificar la longitud apical en dientes con periodontitis apical crónica, que presenta reabsorción apical del cemento, de dentina radicular o de dentina intraconducto, o de la combinación de estas, y que pueden afectar la unión cemento dentinarias se tomaron 18 dientes humanos que se dividieron en 10 casos experimentales y 8 controles. Se sometieron a un proceso de desmineralización y fijación para obtener placas histológicas que se observaron al microscopio de luz. En el grupo control no hubo inflamación apical en el 100 por ciento y, el 50 por ciento presento reabsorción superficial que afectó solamente el cemento, el 12.5 por ciento mostró reabsorción intraconducto.