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1.
Bioengineering (Basel) ; 11(6)2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38927819

RESUMO

Ischemic heart disease remains a leading cause of mortality worldwide, which has promoted extensive therapeutic efforts. Stenting has emerged as the primary intervention, particularly among individuals aged 70 years and older. The geometric specifications of stents must align with various mechanical performance criteria outlined by regulatory agencies such as the Food and Drug Administration (FDA). Finite element method (FEM) analysis and computational fluid dynamics (CFD) serve as essential tools to assess the mechanical performance parameters of stents. However, the growing complexity of the numerical models presents significant challenges. Herein, we propose a method to determine the mechanical performance parameters of stents using a simplified FEM model comprising solid and shell elements. In addition, a baseline model of a stent is developed and validated with experimental data, considering parameters such as foreshortening, radial recoil, radial recoil index, and radial stiffness of stents. The results of the simplified FEM model agree well with the baseline model, decreasing up to 80% in computational time. This method can be employed to design stents with specific mechanical performance parameters that satisfy the requirements of each patient.

2.
Heliyon ; 10(7): e28482, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38601514

RESUMO

In recent years, the growth of Internet of Things devices has increased the use of sustainable energy sources. An alternative technology is offered by triboelectric nanogenerators (TENGs) that can harvest green energy and convert it into electrical energy. Herein, we assessed three different nopal powder types that were used as triboelectric layers of eco-friendly and sustainable TENGs for renewable energy harvesting from environmental vibrations and powering electronic devices. These nanogenerators were fabricated using waste and recycled materials with a compact design for easy transportation and collocation on non-homogeneous surfaces of different vibration or motion sources. In addition, these TENGs have advantages such as high output performance, stable output voltage, lightweight, low-cost materials, and a simple fabrication process. These nanogenerators use the contact-separation mode between two triboelectric layers to convert the vibration energy into electrical energy. TENG with the best output performance is based on dehydrated nopal powder, generating an output power density of 2.145 mWm-2 with a load resistance of 39.97 MΩ under 3g acceleration and 25 Hz operating frequency. The proposed TENGs have stable output voltages during 22500 operating cycles. These nanogenerators can light 116 ultra-bright blue commercial LEDs and power a digital calculator. Also, the TENGs can be used as a chess clock connected to a mobile phone app for smart motion sensing. These nanogenerators can harvest renewable vibration energy and power electronic devices, sensors, and smart motion sensing.

3.
Rev. bras. estud. popul ; 40: e0237, 2023. tab
Artigo em Espanhol | LILACS | ID: biblio-1431591

RESUMO

Resumen Se analiza la construcción, por parte de inmigrantes internacionales, de redes sociales en el país de destino, y las características de estas redes según el país de origen. Se estudia el caso de tres colectivos residentes en Chile, utilizando metodología cualitativa basada en entrevistas semiestructuradas, que se analizan mediante análisis narrativo. Los resultados muestran que quienes tienden a incorporarse con mayor rapidez en el lugar de destino, suelen establecer redes de vínculos débiles. Por el contrario, quienes tienen más dificultades para incorporarse en el lugar de destino, o lo hacen solo parcialmente, establecen redes densas más cerradas en lo cultural.


Resumo Este artigo analisa a construção, por imigrantes internacionais, de redes sociais no país de destino e as características dessas redes de acordo com o país de origem. O caso de três grupos residentes no Chile é estudado por meio de um desenho metodológico qualitativo baseado em entrevistas semiestruturadas, que são abordadas a partir da análise sociológica do discurso. Os resultados mostram que aqueles que se incorporam com mais facilidade e rapidez no local de destino tendem a estabelecer redes de vínculos fracos. Ao contrário, aqueles que têm mais dificuldade em se incorporar ao local de destino, ou o fazem apenas parcialmente, tendem a estabelecer redes culturalmente fechadas e coesas.


Abstract This article analyzes international immigrants' construction of social networks in the country of destination, and the characteristics of these networks according to the country of origin. The case of three groups residing in Chile is studied through a qualitative methodological design based on semi-structured interviews, examined by means of narrative analysis. Results show that those who adapt more easily and quickly to the place of destination tend to establish networks with weak ties. Conversely, those who have more difficulties in adapting to the place of destination, or do so only partially, tend to establish closed, tightly-knit cultural networks.


Assuntos
Humanos , Emigração e Imigração , Rede Social , Peru , Argentina , Bolívia , Relatos de Casos , Chile
4.
Nanomaterials (Basel) ; 12(24)2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36558257

RESUMO

The internet of medical things (IoMT) is used for the acquisition, processing, transmission, and storage of medical data of patients. The medical information of each patient can be monitored by hospitals, family members, or medical centers, providing real-time data on the health condition of patients. However, the IoMT requires monitoring healthcare devices with features such as being lightweight, having a long lifetime, wearability, flexibility, safe behavior, and a stable electrical performance. For the continuous monitoring of the medical signals of patients, these devices need energy sources with a long lifetime and stable response. For this challenge, conventional batteries have disadvantages due to their limited-service time, considerable weight, and toxic materials. A replacement alternative to conventional batteries can be achieved for piezoelectric and triboelectric nanogenerators. These nanogenerators can convert green energy from various environmental sources (e.g., biomechanical energy, wind, and mechanical vibrations) into electrical energy. Generally, these nanogenerators have simple transduction mechanisms, uncomplicated manufacturing processes, are lightweight, have a long lifetime, and provide high output electrical performance. Thus, the piezoelectric and triboelectric nanogenerators could power future medical devices that monitor and process vital signs of patients. Herein, we review the working principle, materials, fabrication processes, and signal processing components of piezoelectric and triboelectric nanogenerators with potential medical applications. In addition, we discuss the main components and output electrical performance of various nanogenerators applied to the medical sector. Finally, the challenges and perspectives of the design, materials and fabrication process, signal processing, and reliability of nanogenerators are included.

5.
Salud UNINORTE ; 38(3)Sep.-Dec. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1536814

RESUMO

La audiología, como campo profesional reciente, ha estado profundamente arraigada al paradigma positivista y a las lógicas de la biomedicina que no permiten superar la visión asistencial, clínica, terapéutica e individualista de la salud. Esto ha dificultado intentar desplazamientos teóricos, epistemológicos y ético-políticos que permitan entender la salud auditiva desde perspectivas que se preocupen por trascender el individuo y su esencia biológica, así como entrar en los debates contemporáneos de la salud. Los Determinantes Sociales de la Salud, como corriente de pensamiento fundamentada en la epidemiología clásica, propone un marco interpretativo social que avanza al estudio de las desigualdades injustas y evitables, entre ellas las que se producen en el acceso y uso a los servicios de salud, los cuales operan de manera desigual en los sistemas sanitarios. Colombia no es la excepción, el asunto es que poco se estudian estas realidades en el sistema de salud desde la audiología, lo cual pone en evidencia las deudas en este campo que requiere de atención urgente de cara a lo que la misma organización propone frente a mejorar las condiciones de vida y luchar por la distribución desigual del dinero, los recursos y el poder.


Audiology, as a recent professional field, has been deeply rooted in the positivist paradigm and the logic of biomedicine that does not allow us to overcome the healthcare, clinical, therapeutic and individualistic vision of health. This has made it difficult to attempt theoretical, epistemological and ethical-political shifts that allow hearing health to be understood from perspectives that are concerned with transcending the individual and its biological essence, as well as entering contemporary health debates. The Social Determinants of Health as a current of thought based on classical epidemiology, proposes a social interpretive framework that advances the study of unfair and avoidable inequalities, including those that occur in access to and use of health services, which operate unequally in health systems. Colombia is no exception, the issue is that these realities are little studied in the health system from audiology, which highlights the debts in this field that requires urgent attention in the face of the recommendations of the Determinants Commission Social Health of the World Health Organization, confront, improve living conditions, and fight for the unequal distribution of money, resources and power. Joint efforts are needed to transform realities that pass through the health system every day.

6.
Rev. méd. Chile ; 150(11): 1431-1437, nov. 2022. tab
Artigo em Espanhol | LILACS | ID: biblio-1442049

RESUMO

Background: Cholangiocarcinoma (CCA) is a primary hepatic tumor, frequently found in patients with liver cirrhosis and biliary tract diseases. Its varieties include isolated CCA or "combined hepatocellular-cholangiocarcinoma" (cHCC-CCA). The latter is uncommon, with poorly defined diagnostic criteria and natural history. Aim: To characterize patients with cirrhosis with a pathological diagnosis of CCA and cHCC-CCA. Material and Methods: Forty-nine liver biopsies with a pathological diagnosis of CCA were reviewed. The clinical records of patients were reviewed to fetch demographic variables, etiology of cirrhosis and clinical presentation. Results: Eight of the 49 patients had cirrhosis (16% of CCA biopsies reviewed). Their median age was 64 (27-71) years and five were females. Four patients had CCA, three patients cHCC-CCA and one had a bifocal tumor. Patients in the CCA group were more commonly symptomatic. Alpha-fetoprotein and CA 19-9 levels were elevated in one of eight and four of six patients, respectively. Within 12 months from diagnosis, five of eight patients died. Conclusions: In most of these cases, the diagnosis of cHCC-CCA and CCA was made in the liver explant study without previous imaging diagnosis. This reinforces the usefulness of the histological study, in specific cases, prior to liver transplantation and emphasizes the importance of systematic explant exploration in these cases.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/diagnóstico , Colangiocarcinoma/complicações , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/patologia , Carcinoma Hepatocelular/etiologia , Neoplasias Hepáticas/diagnóstico , Ductos Biliares Intra-Hepáticos/patologia , Estudos Retrospectivos , Cirrose Hepática/complicações
7.
Nanomaterials (Basel) ; 12(15)2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35893517

RESUMO

Natural sources of green energy include sunshine, water, biomass, geothermal heat, and wind. These energies are alternate forms of electrical energy that do not rely on fossil fuels. Green energy is environmentally benign, as it avoids the generation of greenhouse gases and pollutants. Various systems and equipment have been utilized to gather natural energy. However, most technologies need a huge amount of infrastructure and expensive equipment in order to power electronic gadgets, smart sensors, and wearable devices. Nanogenerators have recently emerged as an alternative technique for collecting energy from both natural and artificial sources, with significant benefits such as light weight, low-cost production, simple operation, easy signal processing, and low-cost materials. These nanogenerators might power electronic components and wearable devices used in a variety of applications such as telecommunications, the medical sector, the military and automotive industries, and internet of things (IoT) devices. We describe new research on the performance of nanogenerators employing several green energy acquisition processes such as piezoelectric, electromagnetic, thermoelectric, and triboelectric. Furthermore, the materials, applications, challenges, and future prospects of several nanogenerators are discussed.

8.
Rev Med Chil ; 150(11): 1431-1437, 2022 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-37358168

RESUMO

BACKGROUND: Cholangiocarcinoma (CCA) is a primary hepatic tumor, frequently found in patients with liver cirrhosis and biliary tract diseases. Its varieties include isolated CCA or "combined hepatocellular-cholangiocarcinoma" (cHCC-CCA). The latter is uncommon, with poorly defined diagnostic criteria and natural history. AIM: To characterize patients with cirrhosis with a pathological diagnosis of CCA and cHCC-CCA. MATERIAL AND METHODS: Forty-nine liver biopsies with a pathological diagnosis of CCA were reviewed. The clinical records of patients were reviewed to fetch demographic variables, etiology of cirrhosis and clinical presentation. RESULTS: Eight of the 49 patients had cirrhosis (16% of CCA biopsies reviewed). Their median age was 64 (27-71) years and five were females. Four patients had CCA, three patients cHCC-CCA and one had a bifocal tumor. Patients in the CCA group were more commonly symptomatic. Alpha-fetoprotein and CA 19-9 levels were elevated in one of eight and four of six patients, respectively. Within 12 months from diagnosis, five of eight patients died. CONCLUSIONS: In most of these cases, the diagnosis of cHCC-CCA and CCA was made in the liver explant study without previous imaging diagnosis. This reinforces the usefulness of the histological study, in specific cases, prior to liver transplantation and emphasizes the importance of systematic explant exploration in these cases.


Assuntos
Neoplasias dos Ductos Biliares , Carcinoma Hepatocelular , Colangiocarcinoma , Neoplasias Hepáticas , Feminino , Humanos , Pessoa de Meia-Idade , Masculino , Neoplasias Hepáticas/diagnóstico , Carcinoma Hepatocelular/etiologia , Colangiocarcinoma/complicações , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/patologia , Cirrose Hepática/complicações , Ductos Biliares Intra-Hepáticos/patologia , Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/diagnóstico , Estudos Retrospectivos
9.
PeerJ ; 9: e12088, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34616606

RESUMO

Plant-insect interactions are a determining factor for sustainable crop production. Although plants can resist or tolerate herbivorous insects to varying degrees, even with the use of pesticides, insects can reduce plant net productivity by as much as 20%, so sustainable strategies for pest control with less dependence on chemicals are needed. Selecting plants with optimal resistance and photosynthetic traits can help minimize damage and maintain productivity. Here, 27 landrace accessions of lima beans, Phaseolus lunatus L., from the Yucatan Peninsula were evaluated in the field for morphological resistance traits, photosynthetic characteristics, insect damage and seed yield. Variation was found in physical leaf traits (number, area, and dry mass of leaves; trichome density, specific leaf thickness and hardness) and in physiological traits (photosynthetic rate, stomatal conductance, intercellular carbon, water-use efficiency, and transpiration). Five accessions (JMC1325, JMC1288, JMC1339, JMC1208 and JMC1264) had the lowest index for cumulative damage with the highest seed yield, although RDA analysis uncovered two accessions (JMC1339, JMC1288) with strong positive association of seed yield and the cumulative damage index with leaf production, specific leaf area (SLA) and total leaf area. Leaf traits, including SLA and total leaf area are important drivers for optimizing seed yield. This study identified 12 important morphological and physiological leaf traits for selecting landrace accessions of P. lunatus for high yields (regardless of damage level) to achieve sustainable, environmentally safe crop production.

10.
Nanomaterials (Basel) ; 11(6)2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200636

RESUMO

The smart healthcare devices connected with the internet of things (IoT) for medical services can obtain physiological data of risk patients and communicate these data in real-time to doctors and hospitals. These devices require power sources with a sufficient lifetime to supply them energy, limiting the conventional electrochemical batteries. Additionally, these batteries may contain toxic materials that damage the health of patients and environment. An alternative solution to gradually substitute these electrochemical batteries is the development of triboelectric energy harvesters (TEHs), which can convert the kinetic energy of ambient into electrical energy. Here, we present the fabrication of a TEH formed by a stainless steel substrate (25 mm × 15 mm) coated with a molybdenum disulfide (MoS2) film as top element and a polydimethylsiloxane (PDMS) film deposited on indium tin oxide coated polyethylene terephthalate substrate (PET/ITO). This TEH has a generated maximum voltage of 2.3 V and maximum output power of 112.55 µW using a load resistance of 47 kΩ and a mechanical vibration to 59.7 Hz. The proposed TEH could be used to power potential smart healthcare devices.

11.
World J Clin Cases ; 9(15): 3716-3725, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34046475

RESUMO

BACKGROUND: Sarcomatoid carcinoma of the pancreas (SCP) is a rare type of pancreatic neoplasm, and only a few cases have been described in the literature. Histologically, it is composed mostly of atypical spindle cells with apparent sarcomatous features. CASE SUMMARY: This is a report of a 61-year-old Chilean woman who underwent medical investigation for acute abdominal pain. Computed tomography identified a solid tumor in the tail of the pancreas with features suspicious of malignancy. En-bloc distal pancreatectomy and splenectomy were performed to excise the tumor. Histopathology and immunohistochemistry were confirmatory of sarcomatoid carcinoma with lymphovascular invasion. After surgery, the patient did not receive chemotherapy. Previous studies indicate a poor prognosis for this type of malignancy. However, our patient has survived for 35 mo with no recurrence to date. CONCLUSION: The case presented herein is a patient with an SCP with a rare presentation and long-term survival after surgery despite not receiving adjuvant chemotherapy.

12.
Nat Commun ; 12(1): 702, 2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514713

RESUMO

Lima bean (Phaseolus lunatus L.), one of the five domesticated Phaseolus bean crops, shows a wide range of ecological adaptations along its distribution range from Mexico to Argentina. These adaptations make it a promising crop for improving food security under predicted scenarios of climate change in Latin America and elsewhere. In this work, we combine long and short read sequencing technologies with a dense genetic map from a biparental population to obtain the chromosome-level genome assembly for Lima bean. Annotation of 28,326 gene models show high diversity among 1917 genes with conserved domains related to disease resistance. Structural comparison across 22,180 orthologs with common bean reveals high genome synteny and five large intrachromosomal rearrangements. Population genomic analyses show that wild Lima bean is organized into six clusters with mostly non-overlapping distributions and that Mesomerican landraces can be further subdivided into three subclusters. RNA-seq data reveal 4275 differentially expressed genes, which can be related to pod dehiscence and seed development. We expect the resources presented here to serve as a solid basis to achieve a comprehensive view of the degree of convergent evolution of Phaseolus species under domestication and provide tools and information for breeding for climate change resiliency.


Assuntos
Aclimatação/genética , Produtos Agrícolas/genética , Phaseolus/genética , Melhoramento Vegetal , Locos de Características Quantitativas , Argentina , Mapeamento Cromossômico , Mudança Climática , Domesticação , Genes de Plantas/genética , México , Dispersão Vegetal , RNA-Seq , Sementes , Sintenia
13.
Front Neurosci ; 14: 38, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32076397

RESUMO

The hemodynamic response is a neurovascular and metabolic process in which there is rapid delivery of blood flow to a neuronal tissue in response to neuronal activation. The functional magnetic resonance imaging (fMRI) and the functional near-infrared spectroscopy (fNIRS), for instance, are based on the physiological principles of such hemodynamic responses. Both techniques allow the mapping of active neuronal regions in which the neurovascular and metabolic events are occurring. However, although both techniques have revolutionized the neurosciences, they are mostly employed for neuroimaging of the human brain but not for the spinal cord during functional tasks. Moreover, little is known about other techniques measuring the hemodynamic response in the spinal cord. The purpose of the present study was to show for the first time that a simple optical system termed direct current photoplethysmography (DC-PPG) can be employed to detect hemodynamic responses of the spinal cord and the brainstem during the functional activation of the spinal central pattern generator (CPG). In particular, we positioned two DC-PPG systems directly on the brainstem and spinal cord during fictive scratching in the cat. The optical DC-PPG systems allowed the trial-by-trial recording of massive hemodynamic signals. We found that the "strength" of the flexor-plus-extensor motoneuron activities during motor episodes of fictive scratching was significantly correlated to the "strengths" of the brainstem and spinal DC-PPG signals. Because the DC-PPG was robustly detected in real-time, we claim that such a functional signal reflects the hemodynamic mass action of the brainstem and spinal cord associated with the CPG motor action. Our findings shed light on an unexplored hemodynamic observable of the spinal CPGs, providing a proof of concept that the DC-PPG can be used for the assessment of the integrity of the human CPGs.

14.
J Tissue Eng Regen Med ; 14(4): 600-608, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32068332

RESUMO

Peripheral blood mononuclear cells (PBMCs) contain a cell fraction of mononuclear progenitor cells (MPCs), which own significant angiogenic potential. Autologous transplant of PBMC and/or platelet-rich plasma (PRP) promotes endothelial cells differentiation in experimental lower limb ischemia, which is considered a safe and effective strategy to support revascularization, either in animal models or clinical trials. In addition, thrombin has been proposed to enrich biological scaffolds, hence increasing MPC viability after intramuscular administration, whereas proangiogenic mediators such as vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF-α), inhibitor of the plasminogen activator-1 (PAI-1), and chemokine (CXCL1; GRO-α) participate in the endothelial response to ischemia, through their proangiogenic effects over endothelial cells proliferation, survival, migration, endothelial integrity maintenance, and physiologic vascular response to injury. In the present study, we describe the effect of autologous PBMCs transplant and PRP, either with or without thrombin, over proangiogenic mediators (measured by enzyme-linked immunosorbent assay) and revascularization response (angiographic vascular pattern at 30 days after vascular occlusion) in a rat model of lower limb ischemia. The group treated with PBMC + PRP significantly induced PAI-1, an effect that was prevented by the addition of thrombin. Furthermore, treatment with PBMC + PRP + thrombin resulted in the induction of VEGF. GRO-α showed a sensitive induction of all proangiogenic mediators. All treatments significantly stimulated revascularization, according to angiographic assessment, whereas higher effect was observed with PBMC + PRP treatment (p < .0001). In conclusion, autologous PBMC transplant stimulates revascularization during experimental ischemia of the lower limb, whereas particular effects over proangiogenic and fibrinolytic mediators may be attributed to PBMCs and its combination with PRP and thrombin.


Assuntos
Indutores da Angiogênese/farmacologia , Isquemia/terapia , Leucócitos Mononucleares/transplante , Extremidade Inferior/irrigação sanguínea , Neovascularização Fisiológica/efeitos dos fármacos , Animais , Autoenxertos , Masculino , Ratos , Ratos Wistar
15.
Rev. méd. Chile ; 147(9): 1099-1106, set. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1058651

RESUMO

Background: Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications. Aim: To describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital. Patients and Methods: Review of medical records of 102 cirrhotic patients aged 60 ± 11 years (52% males) who underwent elective or urgency surgery at an university hospital between 2010 and 2016. General, pre-surgical, and post-surgical complications were recorded. Results: The main etiologies of cirrhosis were non-alcoholic steatohepatitis (31%), and alcoholic cirrhosis (28%). Child-Pugh scores were A, B and C in 50, 28 and 22% of cases respectively. Median MELD (Model for End-stage Liver Disease) score was 11 (interquartile range: 10-15). The surgical procedure was elective in 71% of cases, with predominance of abdominal surgery (86%). The American Society of Anesthesiologists (ASA) score was three or more in 52% of patients. The frequency of any adverse outcome was 62%. The frequency increased along with the severity of cirrhosis and when surgery was urgent. The most common complications were acute renal failure (24%), increased ascites (23%) and encephalopathy (22%). Admission to intensive care unit occurred on 26% of patients, with six hospital deaths. Conclusions: In these patients, surgical complications were common, although with low mortality.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença Hepática Terminal , Índice de Gravidade de Doença , Chile/epidemiologia , Procedimentos Cirúrgicos Eletivos , Cirrose Hepática/cirurgia , Cirrose Hepática/complicações
16.
Rev Med Chil ; 147(9): 1099-1106, 2019 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-33625442

RESUMO

BACKGROUND: Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications. AIM: To describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital. PATIENTS AND METHODS: Review of medical records of 102 cirrhotic patients aged 60 ± 11 years (52% males) who underwent elective or urgency surgery at an university hospital between 2010 and 2016. General, pre-surgical, and post-surgical complications were recorded. RESULTS: The main etiologies of cirrhosis were non-alcoholic steatohepatitis (31%), and alcoholic cirrhosis (28%). Child-Pugh scores were A, B and C in 50, 28 and 22% of cases respectively. Median MELD (Model for End-stage Liver Disease) score was 11 (interquartile range: 10-15). The surgical procedure was elective in 71% of cases, with predominance of abdominal surgery (86%). The American Society of Anesthesiologists (ASA) score was three or more in 52% of patients. The frequency of any adverse outcome was 62%. The frequency increased along with the severity of cirrhosis and when surgery was urgent. The most common complications were acute renal failure (24%), increased ascites (23%) and encephalopathy (22%). Admission to intensive care unit occurred on 26% of patients, with six hospital deaths. CONCLUSIONS: In these patients, surgical complications were common, although with low mortality.


Assuntos
Doença Hepática Terminal , Idoso , Chile/epidemiologia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
17.
Rev. Fac. Med. (Bogotá) ; 66(3): 375-383, jul.-set. 2018.
Artigo em Espanhol | LILACS | ID: biblio-976969

RESUMO

Resumen En el marco de la conmemoración de los 50 años de la institucionalización de la terapia ocupacional en el país, el presente escrito pretende reflexionar sobre algunos retos que deben enfrentar los profesionales del desempeño ocupacional en el futuro próximo; se pone énfasis en elementos que pueden aportar a la salud pública para repensar el saber y la práctica, tanto académica como profesional. Al considerar la herencia del paradigma positivista y el modelo biomédico que ha inspirado el conocimiento y hacer de la terapia ocupacional alrededor de la rehabilitación, se plantea que parte de los desafíos involucran concebir la salud como algo más que el opuesto de enfermedad; estudiar y comprender el desempeño ocupacional de todos los seres humanos, no solo de aquellos con discapacidad en procesos de rehabilitación; posicionar la ocupación como determinante fundamental de la promoción de la salud y la prevención de enfermedades, tanto en individuos como en poblaciones sanas; participar de la formulación e implementación de políticas y programas de salud, y comprender la influencia que tiene la organización económica, política y social de la sociedad sobre el quehacer humano. Estas deudas pendientes se corresponden con oportunidades de una comunidad receptiva, dispuesta a crecer día a día para consolidarse socialmente.


Abstract Within the framework of the commemoration of the 50th anniversary of Occupational Therapy in Colombia, this article aims to reflect on some challenges that occupational therapists may face in the near future, emphasizing on public health elements that may contribute to reconsider both academic and professional knowledge and practice. Considering the legacy of positivism and the biomedical model that has inspired the knowledge and construction of Occupational Therapy around rehabilitation, some of said challenges involve conceiving health as something more than the opposite of illness; studying and understanding occupational performance in all human beings, not only in people with disabilities undergoing rehabilitation processes; positioning occupation as a fundamental determinant of health promotion and disease prevention, both in healthy individuals and populations; participating in the formulation and implementation of health policies and programs; and understanding the influence of the economic, political and social organization of society on human activity. These debts are opportunities for a receptive community, willing to grow and consolidate socially.

18.
Bioorg Med Chem Lett ; 28(18): 3094-3098, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30082123

RESUMO

A combination of antibacterial agents should make the emergence of resistance in bacteria less probable. Thus we have analyzed the synergistic effects between antibacterial antisense peptide nucleic acids (PNA) and conventional antibiotics against Escherichia coli AS19 (lipopolysaccharide defective) strain and a derivative of a pathogenic strain E. coli O157:H7. PNAs were designed to target mRNA transcripts encoding the essential acyl carrier protein (gene acpP) and conjugated to the cell-penetrating peptide (KFF)3K for cellular uptake. Antibiotics included aminoglycosides, aminopenicillins, polymyxins, rifamycins, sulfonamides and trimethoprim. Synergies were evaluated using the checkerboard technique. Fractional Inhibitory Concentration indices (FICi) were calculated for all combinations based on the minimal inhibitory concentration of each individual agent. The results demonstrate two novel synergistic combinations of antimicrobial agents, namely, (KFF)3K-PNA anti-acpP with polymyxin B and (KFF)3K-PNA anti-acpP with trimethoprim (both with FICi = 0.38). Polymyxin B's synergy postulates cell wall targeted antibiotics as attractive agents to improve the uptake of PNA while trimethoprim's interaction with PNA my reveal a new inhibitory mechanism.


Assuntos
Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Ácidos Nucleicos Peptídicos/farmacologia , RNA Mensageiro/efeitos dos fármacos , Antibacterianos/síntese química , Antibacterianos/química , Relação Dose-Resposta a Droga , Escherichia coli/genética , Testes de Sensibilidade Microbiana , Estrutura Molecular , Ácidos Nucleicos Peptídicos/síntese química , Ácidos Nucleicos Peptídicos/química , RNA Mensageiro/genética , Relação Estrutura-Atividade
20.
Obes Surg ; 28(11): 3424-3430, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29956106

RESUMO

INTRODUCTION: The long-term results in sleeve gastrectomy (SG) have been reported in few publications. None of them has evaluated the importance of preoperative BMI (kg/m2) in the final results. OBJECTIVE: To determine the loss and regain of weight after SG, determining the influence of preoperative BMI in final results. MATERIAL AND METHODS: This prospective study included all patients operated between 2006 and 2010. Exclusion criteria corresponded to patients with Barrett's esophagus, type 2 diabetes, and hiatal hernia greater than 3 cm. Patients were followed and controlled "face to face" by the main author. RESULTS: From 109 original patients included in this study, 102 (93.5%) completed the late follow-up. Patients were divided into four groups: (a) I-29 patients with BMI 32.1-34.9; (b) II-56 patients with BMI 35-39.9; (c) III-20 patients with BMI 40-49.9; and (d) IV-4 patients with BMI > 50. There was a significant decrease in the BMI 12 to 24 months after surgery. At the late control, patients in groups III and IV regained weight in 85 and 100%, respectively. Patients in groups I and II had 3.6 and 38% of weight regain. CONCLUSION: The changes in weight after SG are directly related to preoperative BMI: the higher this value, the higher the percentage of failure and weight regain late after surgery. Besides, laparoscopic SG seems to be an adequate operation at late control in terms of loose of weight after surgery in patients with a BMI less than 40 kg/m2 before surgery.


Assuntos
Cirurgia Bariátrica , Gastrectomia , Laparoscopia , Obesidade Mórbida , Aumento de Peso/fisiologia , Redução de Peso/fisiologia , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/estatística & dados numéricos , Índice de Massa Corporal , Seguimentos , Gastrectomia/efeitos adversos , Gastrectomia/estatística & dados numéricos , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/estatística & dados numéricos , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos
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