RESUMO
INTRODUCTION AND AIM: Timely detection and diagnosis of hepatitis C virus (HCV) involves identifying the population that is predisposed to treatment and prevention, thus limiting complications and preventing infection. The aim of this study was to analyze and describe risk factors associated with anti-HCV antibody detection in a population with access to public healthcare that participated in a national screening program. MATERIAL AND METHODS: An analytic cross-sectional study was conducted that utilized data related to rapid tests carried out between September 2021 and October 2022 in 26 of the 32 states of Mexico. Anti-HCV reactive tests were selected, according to age and sex, for analyzing and comparing possible risk factors through descriptive and inferential statistics. The geographic distribution and density of the screening program at the state and municipal levels was analyzed. RESULTS: There were 75,185 anti-HCV antibody detections, 2,052 reactive tests, and mean participant age was 44.3 years (±15.1). Occupation: 32.3% were employees, 19% were housewives, and 18.2% were healthcare workers. Five out of every 10 cases had no indication of risk factors, but there was a 1.4 and 5-times greater likelihood of anti-HCV detection in men with a history of sharps injury or intravenous psychoactive substance use, compared with women. Regarding place of residence, 80% of the reactive tests were concentrated in the State of Mexico, Mexico City, and Guanajuato. CONCLUSIONS: The evidence herein helps determine the population and risk factors that should be focused on in carrying out the HCV microelimination strategy of continuous screening, diagnosis, medical treatment access, and epidemiologic surveillance.
Assuntos
Acessibilidade aos Serviços de Saúde , Anticorpos Anti-Hepatite C , Hepatite C , Humanos , México/epidemiologia , Masculino , Feminino , Estudos Transversais , Fatores de Risco , Adulto , Pessoa de Meia-Idade , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Adulto Jovem , Idoso , Adolescente , Programas de RastreamentoRESUMO
Chile, the world's leading copper producer, generates significant volumes of mining waters, some of which cannot be recirculated into the production process. These mining waters are characterized by elevated sulfate (SO42-) concentrations, requiring sustainable management strategies for potential reuse. This study aims to evaluate the rhizofiltration technique using Carpobrotus chilensis for treating mining waters with a high SO42- concentration. Initially, the mining waters exhibited a pH of 7.97 ± 0.16 and a SO42- concentration of 2,743 ± 137 mg L-1, while the control water had a pH of 7.88 ± 0.08 and a SO42- concentration of 775 ± 19.0 mg L-1. The plants were hydroponically cultivated in 40 L containers with mining waters and drinking water as a control. Over an 8-week period, the pH of the mining water decreased to 3.12 ± 0.01, and the SO42- concentration declined to 2,200 ± 110 mg L-1. Notably, the fresh weight of roots was significantly higher in plants grown in mining water (22.2 ± 6.66 g) compared to those in the control treatment (14.3 ± 4.28 g). However, an undesirable increase in the acidity was observed in the mining waters after rhizofiltration, which was attributed to hydrogen sulfate (HSO4-) and/or root exudates. Despite the unexpected increase in acidity, C. chilensis effectively reduced the concentration of SO42- in mining waters by 20%. Additionally, the C. chilensis roots accumulated 4.84 ± 1.40% of sulfur (S), a level comparable to thiophore plants. This study provides evidence that this non-aquatic plant can be used in sulfate rhizofiltration.
Caprobrotus chilensis is a good candidate for sulfate rhizolfiltration in mining waters.The accumulation of sulfur by the roots of Carpobrotus chilensis reached 4.84%Mining waters with a high concentration of sulfates require control of the redox potential.
Assuntos
Biodegradação Ambiental , Mineração , Sulfatos , Poluentes Químicos da Água , Sulfatos/metabolismo , Poluentes Químicos da Água/metabolismo , Filtração , Purificação da Água/métodosRESUMO
TITLE: Síndrome de encefalopatía posterior reversible hemorrágica y COVID-19.
Assuntos
COVID-19 , Síndrome da Leucoencefalopatia Posterior , Encéfalo , COVID-19/complicações , Humanos , Imageamento por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Síndrome da Leucoencefalopatia Posterior/etiologiaRESUMO
PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (pâ¯>â¯0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.
Assuntos
Glaucoma de Ângulo Aberto , Interleucina-6 , Polimorfismo de Nucleotídeo Único , Frequência do Gene , Genótipo , Glaucoma de Ângulo Aberto/genética , Humanos , Interleucina-6/genética , México/epidemiologiaRESUMO
Resumen Debido al uso frecuente del triclabendazol (TCBZ) por parte de los productores, sumado al reporte reciente de resistencia de Fasciolahepatica al fármaco detectada en rodeos y majadas de Neuquén, se llevó a cabo el presente trabajo con el objetivo de evaluar la eficacia del TCBZ como fasciolicida en caprinos bajo un sistema de producción trashumante del norte de la provincia de Neuquén, Argentina. La eficacia se evaluó mediante un test de reducción de conteo de huevos de F. hepatica en caprinos Criollo Neuquino parasitados naturalmente. Se utilizaron dos grupos de animales: un Grupo Control (n: 10) que no recibió tratamiento y un Grupo Tratado (n: 10) al que se le administró TCBZ al 10% (Biofasiolex T10-Biogénesis Bagó ®) vía oral a dosis de 10 mg/kg PV. Al día 0 y 21 post tratamiento, se tomaron muestras de materia fecal para análisis coproparasitológicos. Se evidenció una reducción del conteo de huevos de F. hepatica del 100%, indicando el mantenimiento de la eficacia del fasciolicida en los caprinos evaluados. Se discuten los alcances del uso del test de reducción de conteo de huevos en zonas con producción trashumante del ganado.
Abstract Because of the frequent use of triclabendazole TCBZ by farmers and the recent reports of Fasciola hepatica resistance to this drug in herds and flocks from Neuquén, we carried out this study with the aim to evaluate the efficacy of TCBZ as fasciolicide in goats under a transhumance system from northern of Neuquén, Argentina. A fecal egg count reduction test (FECRT) was performed on Creale Neuquino goats naturally parasitized with F. hepatica. Twenty goats were divided into two groups: A control group (n: 10) which was left untreated, and a treatment group (n: 10) that was dosed orally with TCBZ 10% (Biofasiolex T10-Biogénesis Bagó ®). On Day 0 and Day 21 post-treatment, fecal samples were taken and analyzed by coproscopical examination. According to the FECRT, drug efficacy was 100 % and confirms that TCBZ maintains its efficacy against F. hepatica on goats. The usefulness of the FECRT in these zones under transhumance livestock production is discussed.
RESUMO
Cerebral malaria (CM) is a neurological complication derived from the Plasmodium falciparum infection in humans. The mechanisms involved in the disease progression are still not fully understood, but both the sequestration of infected red blood cells (iRBC) and leukocytes and an exacerbated host inflammatory immune response are significant factors. In this study, we investigated the effect of Monocyte Locomotion Inhibitory Factor (MLIF), an anti-inflammatory peptide, in a well-characterized murine model of CM. Our data showed that the administration of MLIF increased the survival and avoided the neurological signs of CM in Plasmodium berghei ANKA (PbA) infected C57BL/6 mice. MLIF administration down-regulated systemic inflammatory mediators such as IFN-γ, TNF-α, IL-6, CXCL2, and CCL2, as well as the in situ expression of TNF-α in the brain. In the same way, MLIF reduced the expression of CD31, CD36, CD54, and CD106 in the cerebral endothelium of infected animals and prevented the sequestration of iRBC and leucocytes in the brain microvasculature. Furthermore, MLIF inhibited the activation of astrocytes and microglia and preserved the integrity of the blood-brain barrier (BBB). In conclusion, our results demonstrated that the administration of MLIF increased survival and conferred neuroprotection by decreasing neuroinflammation in murine CM.
Assuntos
Anti-Inflamatórios/administração & dosagem , Malária Cerebral/prevenção & controle , Fármacos Neuroprotetores/administração & dosagem , Oligopeptídeos/administração & dosagem , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/imunologia , Encéfalo/efeitos dos fármacos , Encéfalo/imunologia , Encéfalo/patologia , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/imunologia , Feminino , Humanos , Mediadores da Inflamação/antagonistas & inibidores , Mediadores da Inflamação/metabolismo , Malária Cerebral/imunologia , Malária Cerebral/parasitologia , Malária Cerebral/patologia , Camundongos , Microglia/efeitos dos fármacos , Microglia/imunologia , Plasmodium berghei/imunologiaRESUMO
El Niño-Southern Oscillation has been treated as a disruptor of environmental and socioeconomic equilibrium both in ancient times and in modern-day Peru. Recent work in the coastal desert plain, known as the Pampa de Mocan, challenges this view by demonstrating that prehispanic irrigation systems were designed to incorporate floods and convert them into productive waters. Archaeological investigations in this landscape reveal a 2,000-y history of floodwater farming embedded in conventional canal systems. Together with a pollen record recovered from a prehispanic well, these data suggest that the Pampa de Mocan was a flexible landscape, capable of taking advantage of El Niño floodwaters as well as river water. In sharp contrast to modern-day flood mitigation efforts, ancient farmers used floodwaters to develop otherwise marginal landscapes, such as the Pampa de Mocan, which in turn mitigated risk during El Niño years. These archaeological data speak to contemporary policy debates in the face of increasingly intense and frequent natural disasters and question whether El Niño Southern Oscillation events should be approached as a form of temporary disorder or as a form of periodic abundance.
Assuntos
Irrigação Agrícola/história , Agricultura/história , El Niño Oscilação Sul , Plantas , Arqueologia , Etnobotânica , História Antiga , Peru , PólenRESUMO
The chemical characteristics of mine tailings, organic amendments (doses), and plants are the critical factors that must be evaluated and monitored to ensure the sustainability of phytostabilization. The aim of this study was to evaluate the mobility of copper (Cu) in mine tailings (MT) of the Zone Central of Chile to which commercial humic substances were added, examining their effect on the uptake of Atriplex halimus. Two commercial humic substances (HS1 and HS2) extracted from leonardite (highly oxidized lignite), of different pH and total organic carbon, were evaluated by adsorption curve for Cu. In columns, soluble Cu, pH, and electrical conductivity in leachates were evaluated for MT, MT + HS1, and MT + HS2, and HS1 and HS2 in doses of 120 mg kg-1. In pot assay, seeds were germinated directly in MT and cultivated for 140 days with the addition of HS2 in 120 and 240 mg kg-1. Mine tailing presents high concentration of Cu (2016 ± 223 mg kg-1, pH 6.3 ± 0.1). The results of sequential extraction indicate that Cu is associated with the sulfide fraction of low risk of mobility. The amount of Cu sorbed by HS1 was higher than that sorbed by HS2, and both humic substances showing better fit to the Freundlich than Langmuir model. Lixiviation of Cu was significantly lower in MT + HS1 (0.166 ± 0.043 mg kg-1) and MT + HS2 (0.157 ± 0.018 mg kg-1) than in MT (0.251 ± 0.052 mg kg-1). Copper concentration in plants reached 185.8 ± 37.8 mg kg-1 in the roots and 32.6 ± 7.4 mg kg-1 in the aerial parts cultivated in MT without effect of the humic substance addition in Cu uptake nor growth. Copper concentrations in the aerial parts were adjusted to sufficient or normal levels in plant. A good management of mine tailings through phytostabilization could consider an adequate mixture of humic substances (to avoid leaching of metals) and an organic amendment that provides essential nutrients and increases biomass generation.
Assuntos
Atriplex/química , Atriplex/metabolismo , Monitoramento Ambiental/métodos , Substâncias Húmicas/análise , Poluentes do Solo/análise , Solo/química , Adsorção , Biodegradação Ambiental , Biomassa , Chile , Cobre/análise , Minerais/química , Mineração , Plantas/químicaRESUMO
La apertura de nuevos mercados para los productos hidrobiológicos chilenos ha impuesto el análisis del estatus sanitario de cámaras frigoríficas donde estos productos son almacenados. Para medir el estatus sanitario, la Unión Econó- mica Euroasiática (UEE) exige un recuento total de mohos e identificación de los géneros Cladosporium y Thamnidium en paredes y ambiente de las cámaras frigoríficas. Poco se sabe sobre los niveles de contaminación de mohos en cámaras frigoríficas de productos de exportación en Chile. Aquí, los resultados de 88 análisis de mohos en paredes y aire, realizados a 24 empresas diferentes que poseen cámaras frigoríficas conteniendo productos hidrobiológicos, son mostrados. El recuento total de mohos y el número de colonias de Cladosporium spp. y Thamnidium spp. fueron determinados. Además, los niveles de contaminación por mohos fueron comparados entre plantas procesadoras de alimentos y empresas frigoríficas. Thamnidium spp. no fue encontrado en ninguno de los análisis realizados. Los resultados indican que los niveles de contaminación por mohos son aceptables para la UEE. Este es el primer reporte de niveles de contaminación de mohos en cámaras frigoríficas de productos hidrobiológicos en el sur de Chile.
The opening of new markets for Chilean hydrobiological products had imposed the analysis of the sanitary status of frigorific chambers where those products are kept. To measure the sanitary status, the Euroasiatic Economical Union (EEU) requires a total mould count and identification of Cladosporium and Thamnidium in walls and air of the frigorific chambers. Little is known about contamination levels of moulds in frigorific chambers of export products in Chile. Here, the results of 88 mould analyses in walls and air, performed to 24 different enterprises that possess frigorific chambers containing hydrobiological products, are shown. Total mould count and Cladosporium spp. and Thamnidium spp. colony number were determined. Additionally the levels of moulds contamination were compared between food-processing plants and frigorific enterprises. Thamnidium spp. was not found in any of the analyses performed. The results indicate that levels of moulds contamination are acceptable to the EEU. This is the first report of mould contamination levels in frigorific chambers of hydrobiological products from south of Chile.
Assuntos
Humanos , Alimentos Marinhos/microbiologia , Cladosporium/isolamento & purificação , Contaminação de Equipamentos/prevenção & controle , Alimentos Congelados , Fungos/patogenicidade , Chile , Indústrias Extrativas e de Processamento , Qualidade dos AlimentosRESUMO
Outbreaks of soft tissue or skin infection due to non-tuberculous mycobacteria are reported frequently in scientific journals but in general the infection source in these outbreaks remains unknown. In Venezuela, in two distinct outbreaks, one after breast augmentation surgery and another after hydrolipoclasy therapy, 16 patients contracted a soft tissue infection due to Mycobacterium abscessus subsp. abscessus. Searching for the possible environmental infection sources in these outbreaks, initially the tap water (in the hydrolipoclasy therapy outbreak) and a surgical skin marker (in the breast implant surgery outbreak), were identified as the infection sources. Molecular typing of the strains with a variable number tandem repeat typing assay confirmed the tap water as the infection source but the molecular typing technique excluded the skin marker. We discuss the results and make a call for the implementation of stringent hygiene and disinfection guidelines for cosmetic procedures in Venezuela.
Assuntos
Surtos de Doenças , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas/isolamento & purificação , Dermatopatias Bacterianas/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Adulto , Feminino , Humanos , Tipagem Molecular , Infecções por Mycobacterium não Tuberculosas/microbiologia , Dermatopatias Bacterianas/microbiologia , Infecções dos Tecidos Moles/microbiologia , Venezuela/epidemiologia , Adulto JovemRESUMO
Metabolic syndrome is a combination of risk factors that increase an individual's chance of developing ischemic cardiovascular diseases which are the leading cause of death worldwide. In a number of metabolic syndrome abnormalities such as impaired secretion of acute phase reactants and certain hormones, such as the case of fibrinogen and insulin respectively. In this research fibrinogen levels were correlated with insulin and the factors that define the metabolic syndrome according to NCEP- ATP III in a population from the Municipality Francisco Linares Alcántara aged 35 and 60, the sample consisted of 30 patients and 29 controls. Was made comparison of means of anthropometric parameters and biochemical testing using the Wilcoxon signed ranks with a statistical significance (p < 0.05) and Spearman correlation analysis between insulin and fibrinogen levels with anthropometric and biochemical parameters studied was made it was found that patients had higher BMI, glucose , triglycerides, VLDL-C , insulin and fibrinogen compared to controls. Furthermore, the latter showed the highest HDL-C value compared with patients . On the other hand there was a positive association between insulin levels with BMI and glycemic variables . There was a negative association between levels of fibrinogen and LDL cholesterol variables in patients. No association between insulin levels and fibrinogen was found.
El síndrome metabólico es la conjunción de factores de riesgo en un individuo que aumentan su probabilidad de padecer enfermedades cardiovasculares isquémicas las cuales constituyen la primera causa de muerte a nivel mundial. En el síndrome metabólico se desencadenan una serie de anomalías como ejemplo alteración en la secreción de reactantes de fase aguda y de ciertas hormonas, como el caso del fibrinógeno y la insulina respectivamente. En esta investigación se correlacionaron los niveles de fibrinógeno y la insulina con los factores que definen al síndrome metabólico según la NCEP-ATP III en una población procedente del Municipio Francisco Linares Alcántara en edades comprendidas entre 35 y 60 años. La muestra estaba conformada entre 30 pacientes y 29 controles. Se hizo comparación de medias de los parámetros antropométricos y bioquímicos utilizando la prueba de los rangos con signo de Wilcoxon con una significancia estadística de (p<0,05). De igual modo se realizó análisis de correlación de Spearman entre los niveles de Insulina y fibrinógeno con los parámetros antropométricos y bioquímicos estudiados se encontró que los pacientes tenían más elevado el IMC, glicemia, triglicéridos, VLDLc, insulina y fibrinógeno con respecto a los controles. Además, estos últimos presentaron el valor de HDLc más elevado comparado con el de los pacientes. Por otro lado hubo asociación positiva entre los niveles de insulina con las variables IMC y glicemia. Hubo asociación negativa entre los niveles de fibrinógeno con las variables colesterol y LDLc en los pacientes. No se encontró asociación entre los niveles de insulina y fibrinógeno.
RESUMO
Rheumatoid disease affecting thoracic and lumbar spine (subcervical disease) is rare and clinically unapparent in general. There are some references in the literature in which more relevant lesions are described with severe clinical manifestations. We present three cases of long standing Rheumatoid Arthritis with manifestations in thoracic or lumbar spine and a review of literature. The first case presented with long standing dorsal and lumbar pain and signs of multiple discitis and arthritis of costovertebral and interapophyseal joints. The second patient presented a lumbar radicular pain related to a rheumatoid synovial cyst that was studied by pathologist after surgery. Finally the third patient presents a very symptomatic rheumatoid discitis due to interapophyseal arthritis.
La afectación vertebral reumatoide en región subcervical (columna vertebral toraco-lumbar) es poco frecuente y tiene por lo general una escasa expresión clínica. Sin embargo, algunas publicaciones sugieren una mayor importancia para estas lesiones, y en ocasiones graves repercusiones clínicas. Presentamos aquí tres casos de artritis reumatoide (AR) de larga evolución con afectación reumatoide torácica o lumbar y hacemos una revisión de la literatura al respecto. La paciente del Caso 1 presentó dorsolumbalgia crónica con signos de discitis múltiple y artritis de articulaciones costovertebrales e interapofisarias. La segunda paciente presentó dolor radicular lumbar en relación con un quiste sinovial reumatoide que precisó cirugía y pudo ser estudiado histopatológicamente. Finalmente, en el tercer caso se describe una discitis reumatoide lumbar muy sintomática con artritis interapofisaria.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Vértebras Lombares/patologia , Vértebras Torácicas/patologiaRESUMO
BACKGROUND: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. AIM: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. MATERIAL AND METHODS: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. RESULTS: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Of these, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two or more cardiovascular risk factors. A goal of HDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hg was achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using ß--blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. CONCLUSIONS: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Prescrições de Medicamentos/estatística & dados numéricos , Adulto , Idoso , Doenças Cardiovasculares/tratamento farmacológico , Doença das Coronárias/tratamento farmacológico , Estudos Transversais , Feminino , Objetivos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores SocioeconômicosRESUMO
Background: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. Aim: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. Material and Methods: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. Results: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Ofthese, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two ormore cardiovascular riskfactors. A goal ofHDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hgwas achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using β - blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. Conclusions: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/prevenção & controle , Prescrições de Medicamentos/estatística & dados numéricos , Doenças Cardiovasculares/tratamento farmacológico , Doença das Coronárias/tratamento farmacológico , Estudos Transversais , Objetivos , Fatores de Risco , Fatores SocioeconômicosRESUMO
Introducción: La hiperventilación ha sido una maniobra común en el manejo anestésico de procedimientos neuroquirúrgicos. Hace unos años había escepticismo entre los médicos sobre si esto resultaba en isquemia cerebral. Hoy sabemos que es perjudicial y deteriora el estado y el pronóstico del paciente. Objetivo: Hacer una revisión de los efectos adversos de la hipocapnia en diferentes órganos, principalmente el cerebro, e identificar las recomendaciones actuales de su utilidad. Métodos: Realizamos una búsqueda de la literatura en la base de datos de PubMed utilizando términos MeSH incluidos en las palabras clave; se amplió con la revisión de algunos textos y la bibliografía de los artículos más relevantes. Resultados: Con la revisión de la literatura, se ha demostrado que la hipocapnia es perjudicial tanto para el cerebro como para otros tejidos, y la recomendación actual es utilizarla sólo en dos situaciones (en caso de herniación inminente y para mejorar el campo quirúrgico) y por 20 min. Conclusiones: La hiperventilación no debe ser una intervención anestésica rutinaria en el manejo del paciente neuroquirúrgico; debe tener una indicación precisa y, una vez la indicación haya cesado, la intervención debe ser retirada lo más pronto posible.
Introduction: Hyperventilation has been a usual maneuver in the management of anesthesia in neurosurgical procedures. A few years back there used to be some medical skepticism about the potential of cerebral ischemia and today we know that it is detrimental and worsens the patient’s condition and prognosis. Objective: To review the adverse effects of hypocapnia on various organs -mainly the brain- and to identify the current recommendations about its use. Methodology: We conducted a PubMed literature search using MeSH terminology including the key words. The search was expanded to include a review of several texts and the bibliography of the most relevant articles. Results: The literature review showed that hypocapnia is harmful for the brain and for other tissues and the current recommendation is to use it for two situations only: in case of imminent herniation and to improve the surgical field, limited to 20 minutes. Conclusions: Hyperventilation should not be a routine anesthetic intervention for the management of the neurosurgical patient; there must be a precise indication and once the situation is corrected, the intervention must be immediately withdrawn.
Assuntos
HumanosRESUMO
The host response against Mycobacterium tuberculosis show a wide spectrum of clinical manifestations in those patients who fail to control the infection. The course of the infection and its epidemiological consequences depend upon a complex interplay of host, environmental and bacterial factors. Experimental animal models have helped to define the influence of bacterial genetic diversity on virulence and on the immune response that is induced. For this purpose, experimental animals such as mice, guinea pigs and rabbits have been infected with selected clinical isolates obtained from outbreaks or from clinical epidemiology settings. Here we review the contribution of mouse models to defining the variability in virulence and immune response in relation to mycobacterial genetic diversity. Low dose aerosol infection in C57Bl mice or high dose intratracheal infection in BALB/c mice have demonstrated wide variability in virulence and immune responses induced by different bacterial genotypes, and each genotype has different phenotypes, with high and low virulence variants. In general, these studies have shown that high prevalent strains from big clusters are more virulent than low prevalent sporadic clinical isolates, and highly virulent strains induce non-protective immune responses with some correlation with clinical-epidemiological data. In the future selected strains from these types of studies should be analyzed with molecular technologies. These kinds of study will contribute to the identification of mycobacterial genes associated with virulence and immunogenicity.
Assuntos
Genótipo , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/patogenicidade , Tuberculose/microbiologia , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Mycobacterium tuberculosis/imunologia , Tuberculose/epidemiologia , VirulênciaRESUMO
Introducción: El propósito del estudio fue determinar la prevalencia de causas de hospitalización del adulto con diabetes mellitus tipo 2. Metodología: El diseño fue de tipo epidemiológico, por encuesta de prevalencia. La muestra fue a través del censo de pacientes que ingresaron a un hospital de segundo nivel. Las mediciones fueron: la cédula de identificación del paciente dividida en tres apartados: datos sociodemográficos, datos clínicos y datos de hospitalización para estimar la prevalencia. Cuestionario de Identificación de Trastornos por uso de Alcohol (AUDIT) y el cuestionario del uso de Tabaco de Fagerstrom. Resultados: Corresponden a 40 adultos hospitalizados (50% hombres y 50% mujeres). Al estimar de prevalencia por causa de hospitalización, se posicionó el pie diabético con 45% como principal, seguido de la insuficiencia renal crónica con el 40%. El consumo de alcohol y tabaco no se relacionó con la causa de hospitalización. Conclusiones: Las complicaciones que llevan a la hospitalización son importantes de valorar por el personal de enfermería, debido a la complejidad que presentan éstas, lo cual amerita intervenciones de tipo preventivo que ayuden disminuir el problema.
Introduction: The purpose of the study was to determine the hospitalization prevalence causes of an adult with diabetes mellitus type 2. Methodology: The design was of an epidemiological type, by a survey of prevalence. The sample went through the census of patients that entered to a hospital of second level. The measurements were by: The decree of identiication of the patient divided into three sections: Social demographic data, clinical data and data of hospitalization to reckon the prevalence. The Identiication questionnaire were by the use of Alcohol (AUDIT) and the use of Tobacco of Fagerstrom. Results: They correspond to 40 hospitalized adults (50% men and 50% women). Upon reckoning of prevalence because of hospitalization, the diabetic foot with 45% was positioned like main, followed by the chronic kidney failure with a 40%. The consumption of alcohol and tobacco did not relate to the cause of hospitalization. Conclusions: The complications that carry to the hospitalization are important to signiicance for the nursing personnel, due to the complexity that represent these, which deserves a search of preventive measures to help to diminish the problem.
Assuntos
Humanos , Masculino , Feminino , Adulto , Hospitalização , PrevalênciaRESUMO
Antecedentes: La quimioterapia (QT) adyuvante mejora la sobrevida global y libre de enfermedad de los pacientes con cáncer de colon resecados con intención curativa. El objetivo de este estudio es analizar el perfil de los pacientes que reciben QT adyuvante y evaluar el impacto en la sobrevida. Pacientes y Método: Se incluyen todos los pacientes intervenidos por un adenocarcinoma de colon estadio II y III. Se comparan las características clínico-patológicas, la recidiva y la sobrevida del grupo que recibió QT (grupo QT) con el grupo tratado con cirugía exclusiva (grupo no-QT) por estadio. Resultados: Se trata de 270 pacientes, 168 en estadio II y 102 en estadio III. En forma global 92 pacientes recibieron QT postoperatoria adyuvante (28 en estadio II y 64 en estadio III). En ambos estadios los pacientes del grupo QT son más jóvenes (p = 0,0002 y p = 0,0006) y tienen un mejor estado nutritivo preoperatorio (p = 0,03 y p = 0,009). En el seguimiento con una media de 67 meses recidivan y fallecen por cáncer 2/28 pacientes del grupo QT y 5/140 del grupo control en estadio II, sin diferencias en la recidiva y la sobrevida al comparar ambos grupos (p = 0,91). En el grupo de pacientes en estadio III recidivan 9/64 (14 por ciento) pacientes QT versus 13/38 (34 por ciento) del grupo no-QT (p = 0,017) y fallecen 6 (9,4 por ciento) y 10 (26,3 por ciento) pacientes, respectivamente (p = 0,07). En el análisis multivariado se aprecia que el número de ganglios metastásicos > de 3 (RD = 4,85; IC 95 por ciento 1,48 -15,90; p = 0,009) y la quimioterapia adyuvante (RD = 5,37; IC 95 por ciento = 1,50 -19,22; p = 0,01) mantienen una significación estadística como variable independientes con un claro impacto en la sobrevida. Conclusión: La QT adyuvante mejora la sobrevida a 5 años de 67,5 por ciento a 80 por ciento en el estadio III. La QT adyuvante en pacientes en estadio II con factores pronósticos adversos no muestra un beneficio en la sobrevida.
Background: Adjuvant chemotherapy improves overall and disease free survival in patients with colon cancer subjected to curative surgery. Aim: To assess the effects of chemotherapy on the survival of patients with colon cancer. Material and Methods: All patients operated for a colon cancer stage II or lll are included. The clinical and pathological features, relapse and survival of patients receiving chemotherapy and patients treated exclusively with surgical excision, are compared. Results: Two hundred and seventy patients, 168 in stage II and 102 in stage lll, were studied. Ninety two (28 in stage II and 64 in stage lll), received adjuvant chemotherapy. Patients that received chemotherapy were significantly younger and had significantly better preoperative nutritional status. During a mean follow up of 67 months, among patients in stage II, two of 28 with chemotherapy and five of 140 without chemotherapy, relapsed and died (p = NS). Among patients in stage lll, a relapse was observed in nine of 64 patients (14 percent) in chemotherapy and 13 of 38 patients without chemotherapy (34 percent, p = 0.02). In this same stage, 6 patients with and 10 patients without chemotherapy, died (9 and 26 percent respectively, p = 0.07). In a multivariate analysis, more than three involved lymph nodes and chemotherapy had a significant and independent impact on survival, with odds ratios of 4.8 (95 percent confidence intervals (Cl) of 1.5-15.9) and 5.4 (95 percent Cl 1.5-19.2), respectively. Conclusions: Adjuvant chemotherapy improves survival of patients with stage lll colon cancer. Among patients in stage II, chemotherapy does not influence survival.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adenocarcinoma/mortalidade , Adenocarcinoma/tratamento farmacológico , Neoplasias do Colo/mortalidade , Neoplasias do Colo/tratamento farmacológico , Adenocarcinoma/cirurgia , Quimioterapia Adjuvante , Seguimentos , Estadiamento de Neoplasias , Neoplasias do Colo/cirurgia , Período Pós-Operatório , Análise de Regressão , Análise de Sobrevida , Resultado do TratamentoRESUMO
Introducción: El propósito de este estudio fue evaluar la calidad de vida de niños y adolescentes con asma en la esfera biopsicosocial en una población mexicana. Metodología: Diseño del estudio descriptivo y correlacional. Muestreo no probabilístico, por conveniencia. Muestra de 108 participantes. Las mediciones fueron: Inventario de Calidad de Vida PedsQLTM y cedula de datos sociodemográficos. Resultados: el 81.4% de los participantes reportaron tres a más años de padecer asma, se identificó que 35.2% habían estado internados de una a dos veces en el último año. Las subescalas de funcionamiento físico (33.27%) y la emocional (33.24%) son más altas que la social y la escolar. La consistencia interna del instrumento PedsQLTM es aceptable con un Alpha de Cronbach de .86. Conclusiones: La media de calidad de vida de niños y adolescentes es alta en las subescalas de funcionalidad física y emocional. El Instrumento de Calidad de Vida en Pediatría, reportó confiabilidad aceptable y puede utilizarse en población mexicana. Se recomienda considerar en estudios con población pediátrica sean realizados en diversos periodos del año para precisar mejor la variable.
Quality of life in children and teenagers with asthma in a Mexican town Introduction: The purpose of this study was to evaluate the quality of life of children and teenagers with asthma on the biopsychosocial sphere in a Mexican town. Methodology: Design of descriptive study and co relational, not probabilistic sample for convenience. A sample with 108 participants. The measurements were: quality life inventory PedsQL and social demographic data schedule. Results: 81.4% of participants reported 3 thru more years suffering asthma, a 35.2% was indentified were in hospitals once to twice during the last year. The sub-scales of physical functioning (33.27%) and emotional (33.24%) are higher than social and scholar. The internal consistency of the instrument PedsQL is acceptable with an alpha Cronbach of .86. Conclusions: The average of quality of life of children and teenagers is high on the sub-scales of physical functionality and emotional. The quality of life in pediatrics instrument, reported acceptable trust and can be used on Mexican population. Is recommended to consider in studies with pediatric population to be made in different seasons of the year to precise the variable.