RESUMO
Different studies have provided evidence that implantation of bone-marrow mononuclear cells (BM-MNC) into ischaemic limbs can improve tissue vascularization. Based on these results we performed a pilot study in patients with critical lower limb ischaemia to assess efficacy and safety of implantation of autologous BM-MNC. The amount and efficacy of BM-MNC purified either by an automated method or by a manual procedure were compared. Twelve patients with severe unilateral lower limb ischaemia were entered into this study. They were randomly assigned to be injected with BM-MNC sorted on a blood cell separator or isolated by density gradient on Ficoll-Hypaque. BM-MNC were implanted into the ischaemic legs. Patients were monitored with resting ankle-brachial pressure index (ABI), arterial oxygen saturation (SaO(2)), pain-free walking time and rest pain scale evaluation. The automated and manual methods used for mononuclear cell separation gave results not significantly different. Monitored variables improved in both groups. Improvement of ischaemic condition persisted during 24 weeks follow-up. Limb salvage was achieved in five cases. Our results indicate that BM-MNC implantation into ischaemic limbs is a practical, safe and effective method that may significantly contribute to the management of patients with limb ischaemia. The Ficoll method is a simple and effective procedure for BM-MNC concentration that may be useful, mainly in hospitals without sophisticated facilities.
Assuntos
Transplante de Medula Óssea/métodos , Isquemia/terapia , Leucócitos Mononucleares/transplante , Neovascularização Fisiológica , Doenças Vasculares Periféricas/terapia , Transplante Autólogo/métodos , Idoso , Separação Celular/métodos , Feminino , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/irrigação sanguínea , Doenças Vasculares Periféricas/reabilitação , Projetos Piloto , Estudos Prospectivos , Resultado do TratamentoRESUMO
Malnutrition has a deleterious effect on the results of therapy for malignant diseases in childhood. The impact of radiotherapy on growth is well known but the impact of cytotoxic drugs on nutritional status is more controversial. The purpose of this study was to determine the nutritional status of a cohort of children treated for acute lymphoblastic leukaemia (ALL) in Cuba. The study involved 49 children admitted to a single center and treated with a Berlin-Frankfurt-Munster-based protocol. Nutritional assessment included measurements of height, weight, body mass index and skin-fold thickness, made at diagnosis, after the intensive phase of treatment and at the end of therapy. Z-scores were used for height and comparison of percentiles for the rest of the variables. All the patients were above the third percentile in all the measurements. There were no statistically significant differences between the results at diagnosis, after intensive therapy and at the end of treatment. Although the sample was small, there was no demonstrable effect of chemotherapy on nutritional status in this Cuban paediatric population, in contrast to that reported in children with ALL in other developing countries.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estado Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Índice de Massa Corporal , Criança , Pré-Escolar , Cuba , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Desnutrição/induzido quimicamenteRESUMO
This study draws from multiple data sources and analytic approaches to offer preliminary evidence on how to assess sexual harassment among Latinas working in the United States, particularly working-class Mexican American women with moderately low acculturation. First, focus group data were collected from 45 Latinas to identify culture-specific manifestations of sexually harassing behavior. These data informed the development of new items for the Sexual Experiences Questionnaire (SEQ: L. F. Fitzgerald et al., 1988), making it more appropriate for administration to Latinas with limited education. A 2nd Latina sample (N = 476) then completed this and other scales in a paper-and-pencil survey. Complete-link hierarchical cluster analyses of the SEQ data, based on a random half-sample of these women, revealed an underlying 3-factor structure. Confirmatory factor analyses on the 2nd half-sample confirmed that this factor model fit the data well, and both the individual factors and the larger scale appear highly reliable. Implications of both new and discarded SEQ-Latina items, the 3-factor structure, and relationships among the factors were discussed.
Assuntos
Hispânico ou Latino/psicologia , Assédio Sexual/etnologia , Inquéritos e Questionários , Adolescente , Adulto , California , Chicago , Análise por Conglomerados , Análise Fatorial , Feminino , Grupos Focais , Humanos , Americanos Mexicanos/psicologia , México/etnologia , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
We studied ten patients with Cystic fibrosis. The purposes of this study were to investigate the presence of gastroesophageal reflux and establish the probable association between gastroesophageal reflux and pulmonary and gastric involvement. All 10 patients underwent 24-hour esophageal pH recording, spirometry and gastric function. Abnormal reflux index was found in all these patients. Lung function was pathologic in the 3 older children. There were no relationship between the severity of the gastroesophageal reflux and the degree of pulmonary damage. No patient has gastric acid hypersecretion. Eight of 10 patients had steatorrhea. Our findings confirm the high frequence of gastroesophageal reflux in cystic fibrosis.
Assuntos
Fibrose Cística/complicações , Refluxo Gastroesofágico/etiologia , Pulmão/fisiopatologia , Estômago/fisiopatologia , Adolescente , Criança , Fibrose Cística/fisiopatologia , Feminino , Determinação da Acidez Gástrica , Refluxo Gastroesofágico/fisiopatologia , Humanos , Masculino , Testes de Função RespiratóriaRESUMO
All successful operations for relief of genuine stress urinary incontinence (SUI) have three objectives: elevation and retropubic maintenance during stress of the urethrovesical junction. The present study was realized at the Urogynecologic Service of the "Luis Castelazo Ayala" hospital IMSS to evaluate the results in a two years follow up of 597 patients that suffered from SUI treated by retropubic urethropexy, from February 1984 to May 1991. Patients were studied according to the service norms, previously published. We realized four types of procedures: Pereyra (379 cases), Burch (90 cases), Marchall-Marchetti-Kratz (60 cases) and Powell surgery (68 cases). Vaginal approach was realized in cases of pelvigenital statics disturbances like cysto- or rectocele; and abdominal approach was indicated in patients with enlarged uterus or pelvic masses. The complications rate was 15.3%. Success rate was 87.06% for all procedures and not statistic significance was found (p > or = 0.1 and X2 = 6.15), the best rate to the Burch and Pereyra procedures. We conclude the most important tip to successful rate in SUI surgery is correct choice of the procedure according to the patient.
Assuntos
Uretra/cirurgia , Bexiga Urinária/cirurgia , Incontinência Urinária por Estresse/cirurgia , Adulto , Idoso , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Humanos , Métodos , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Intestinal permeability was studied in a group of 10 children diagnosed of coeliac disease either when they presented an intestinal villi atrophy while receiving a gluten-containing diet and after, when they had a normal mucosa with the withdrawal of gluten from the diet. Ten healthy children served as controls. The 51 Cr-EDTA (51 Cr-ethylenediaminetetraacetate) was used as probe molecule and it was administered orally. Its urinary excretion showed clear differences between patients with an altered intestinal biopsy and those with a normal histopathology. The excretion of 51 Cr-EDTA remained elevated in celiac patients with a gluten-free diet and normal villi.
Assuntos
Doença Celíaca/fisiopatologia , Ácido Edético/farmacocinética , Glutens/administração & dosagem , Absorção Intestinal , Administração Oral , Biópsia , Estudos de Casos e Controles , Doença Celíaca/metabolismo , Criança , Pré-Escolar , Dieta , Ácido Edético/administração & dosagem , Ácido Edético/análise , Feminino , Humanos , Mucosa Intestinal/patologia , MasculinoRESUMO
Intestinal permeability was studied in a group of 10 children diagnosed of coeliac disease either when they presented an intestinal villi atrophy while receiving a gluten-containing diet and after, when they had a normal mucosa with the withdrawal of gluten from the diet. Ten healthy children served as controls. The 51 Cr-EDTA (51 Cr-ethylenediaminetetraacetate) was used as probe molecule and it was administered orally. Its urinary excretion showed clear differences between patients with an altered intestinal biopsy and those with a normal histopathology. The excretion of 51 Cr-EDTA remained elevated in celiac patients with a gluten-free diet and normal villi.
RESUMO
Presentamos un estudio sobre la permeabilidad intestinal en una serie de diez niños diagnosticados de enfermedad celiaca cuando tomaban una dieta con gluten y tenían una atrofia severa de las vellosidades intestinales y posteriormente durante un período con dieta sin gluten y vellosidades intestinales normales. Tomamaos como grupo control a diez niños sanos. Se utilizó como marcador el EDTA-Cr51 (Etiléndiaminotetracetato Cr51) administrado por vía oral. Su excreción urinaria estaba signficativamente elevada en los pacientes con biopsia alterada, manteniéndose una moderada elevación en los pacientes celiacos con dieta exenta de gluten y sin atrofia de las vellosidades
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Absorção Intestinal , Ácido Edético/administração & dosagem , Doença Celíaca/complicações , Glutens/administração & dosagem , Ácido Edético/análise , Administração Oral , Biópsia , Estudos de Casos e Controles , Dieta , Mucosa Intestinal/patologiaRESUMO
Presentamos un estudio sobre la permeabilidad intestinal en una serie de diez niños diagnosticados de enfermedad celiaca cuando tomaban una dieta con gluten y tenían una atrofia severa de las vellosidades intestinales y posteriormente durante un período con dieta sin gluten y vellosidades intestinales normales. Tomamaos como grupo control a diez niños sanos. Se utilizó como marcador el EDTA-Cr51 (Etiléndiaminotetracetato Cr51) administrado por vía oral. Su excreción urinaria estaba signficativamente elevada en los pacientes con biopsia alterada, manteniéndose una moderada elevación en los pacientes celiacos con dieta exenta de gluten y sin atrofia de las vellosidades (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Absorção Intestinal/efeitos dos fármacos , Ácido Edético/administração & dosagem , Doença Celíaca/complicações , Glutens/administração & dosagem , Ácido Edético/análise , Mucosa Intestinal/patologia , Biópsia , Dieta , Administração Oral , Estudos de Casos e ControlesRESUMO
Posterm pregnancy still is a topic full of controversies in many aspects, such as diagnosis, perinatal risk and management. This paper suggests that a great number of fetuses from prolonged pregnancies, still grow after term, secondary to a persistent and adequate placental function; it's demonstrated, by comparing the distribution of newborn weights between term and posterm pregnancies. In the posterm group a significant increase in the incidence of hypertrophic newborns, is found. Dismature newborns, products of the placentary insufficiency in posterm pregnancy, although the point of interest of obstetricians, pediatricians and perinatologists because of its high rates of morbimortality, constitute a minority in comparison with fetus of posterm pregnancies with high newborn weights. It is possible that fetal hypertrophy by it self may be another cause of morbimortality in posterm pregnancies (because of dystocias, prolonged labor, altered fetopelvic relations, increased rates of cesarean sections, and others) that must be determined in future longterm, prospective analysis.
Assuntos
Peso ao Nascer , Desenvolvimento Embrionário e Fetal , Gravidez Prolongada , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos , Estatística como AssuntoRESUMO
Se informa el caso clinico de una paciente con tumoracion ovarica (quiste dermoide), con imagem ultraecosonografica de embarazo ectopico. En la trompa contralateral existia un embarazo ectopico roto y organizado que no fue diagnosticado mediante el estudio ultraecosonografico. Este caso confirma una vez mas la importancia de la clinica y ubica perfectamente a la ultraecosonografia como auxiliar de diagnostico a la vez que demuestra el inconveniente de aceptar imagenes patognomonicas