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The consumption of products with high nutritional value and antioxidant capacity has increased notably in recent years. Due to health problems such as triglycerides and cardiovascular problems, its use is becoming reduced. So that, chia (Salvia hispánica) and sachatomate (Cyphomandra betacea) have gained interest as an alternative to develop nutraceutical products, compared to conventional products. The objective of the study was to determine the effect of the partial substitution of mango (Mangifera indica) and ground chia (Salvia hispánica) on the antioxidant capacity in the elaboration of nectar based on Sachatomate. The physicochemical characteristics were determined where sample 11 complies with the established parameters: 13.4° Brix, pH 4.323, 0.354 of C6-H8-O7 and viscosity 3967.3 mPas, according to the NTP 203.110 standard. Regarding the antioxidant capacity, sample 12 was the most optimal, according to the DPPH method, it has been determined 104.3 micromoles Trolox equivalents; according to the ABTS method, it was determined with an antioxidant content of 187.4 micromoles Trolox equivalents. Regarding the proximal chemical evaluation, sample 12 was determined to be the most suitable with a moisture percentage of 87.45%, ash 0.32%, crude fiber 0.09%, fat 0.10%, protein 0.45% and carbohydrates 11.59%. Concluding that substituting sachatomate and ground chia significantly influences the antioxidant capacity, increasing to 104.3 and 187.4 micromoles Trolox equivalents, determined by both methods, indicates that nectar consumption can be used to improve the health of consumers.
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Antioxidantes , Mangifera , Antioxidantes/química , Néctar de Plantas , Suplementos Nutricionais , SementesRESUMO
Bioavailability of nutrients, the scarcity of synthetic fertilisers, and the rising cost of fuel have all contributed to an increase in production costs, which has in turn reduced crop productivity and led scientists to seek out new methods to ensure high-quality output. In this context, various cytokinins dosages were tested in Peru to see whether they affected the quality of caigua, in an effort to address these issues. To mitigate these problems, a pot experiment was carried out to check the effects of various doses of cytokinin in the quality of caigua in Peru. The experiment consisted of 5 treatments including (0, 50, 100, 150 and 200 mL of cytokinin) by using (Anthesis Plus per 200 L of water) as a source, each with three replicates and placed following a randomized complete block design (RCBD). Treatment with 100 mL of cytokinins foliar analysis resulted in a caigua length of 18.9 cm, an increase in diameter of 5.65 cm, and an improvement in pulp thickness of 7.60 millimeters. Physiological parameters of caigua plants taken after 45 days of sowing were considerably improved with the same treatment. Similarly, N, K and Zn concentration in leaf was higher in case of 100 mL of cytokinins foliar analysis. Therefore, policymakers must advise using the recommended quantity of cytokinins to bring about regime transition, and formers can gain by injecting 100 mL of cytokinins to boost production and the economy. It was concluded that the adequate dose of cytokinins is in treatment T3, which raised value of potassium concentration in leaves, this influenced optimal development, strengthening against environmental stress and therefore quality. For this reason, research was carried out on the comparative study of cytokinin doses in the quality of caigua in Peru; the objective was to determine the appropriate dose to obtain higher quality fruit. Likewise, it was underlined that the objective was to employ an ecological alternative of plant origin such as the usage of phytohormone that stimulates the growth of the plant and consequently the quality of the fruit. The obtained the results were served as a recommendation for farmers in the area.
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Citocininas , Reguladores de Crescimento de Plantas , Citocininas/farmacologia , Peru , Reguladores de Crescimento de Plantas/farmacologia , Folhas de Planta/fisiologia , Estresse FisiológicoRESUMO
There is little known about the time of the day and the nature of it (business day/non-business day) at which extubation is performed, and whether it is safe during the night. OBJECTIVE: to describe the frequency of nocturnal extubation (NE) and non-business day extubation (nBDE). In addition, to determine the association between these and clinical outcomes. PATIENTS AND METHOD: Retrospective cohort study of patients under 18 years of age who received invasive mechanical ventilation (MV) and underwent an extubation attempt in a high complexity Pediatric Critical Patient Unit (PCPU) between 01/01/2018 to 12/31/2021. Primary exposure: NE, which was defined as that performed between 20:01 and 8:00 hours. Its association with extubation failure (EF), duration of invasive MV, and length of stay in the PCPU was evaluated. RESULTS: 146 patients were included [58.9% males, age 1.14 (0.25 - 5.5) years]. NE was performed in 17.8%. Nocturnal extubation was not associated with EF nor was the day of extubation. The EF was 3.8% in NE and 5% in daytime extubation (DE) (p = 0.80). Duration of invasive MV was shorter in NE than DE [48 (24-73.5) vs. 72 (48-96) h, p = 0.02]. CONCLUSIONS: NE was not associated with EF. Patients with NE had shorter duration of invasive MV, and the latter was associated with EF. Withdrawal of invasive MV should be considered at the first opportunity and be determined by clinical factors, rather than time of day.
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Extubação , Respiração Artificial , Masculino , Criança , Humanos , Adolescente , Lactente , Feminino , Estudos Retrospectivos , Tempo de Internação , Unidades de Terapia Intensiva PediátricaRESUMO
Functional beverages with added health benefits are popular among peoples and athletes because they help them recover faster from intense workouts and perform better overall. This research set out to determine how well heat-treated stem juice from Oxalis tuberosa Mol. "oca" and fruit juice from Gaultheria glomerata (Cav.) Sleumer "laqa-laqa" performed as an antioxidant in a functional drink. The "oca" stems and the "laqa-laqa" fruit were collected to obtain the juice. For this study, 30 semi-trained panellists used sensory evaluation to rate four treatments (Bo, B1, B2, and B3) with varying quantities of "oca" and "laqa-laqa" juice. The results concluded that the treatment B2, which included 300 ml of "oca" stem juice, 800 ml of "laqa-laqa" juice, 1000 ml of treated water, and 220 g of refined sugar, was given the highest score after a physicochemical evaluation of its colour, smell, taste, and overall appearance. Similarly, the results showed that the protein content increased by 1.38%, the fat content by 1.08%, the moisture percentage by 99.5%, the ash content by 1.82%, and the carbohydrate content by 6.22% after B2 treatment. Similarly, results revealed significant enhancement in antioxidant profiling such as total polyphenols: 1825 mg of gallic acid/100 g and antioxidant Activity: 89.56% µmol of trolox /100 g. In conclusion, due to its high energy content and antioxidant activity, it may be a viable nutritional option for athletes who engage in rigorous, frequent physical exertion.
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Antioxidantes , Gaultheria , Humanos , Antioxidantes/análise , Frutas/química , Gaultheria/metabolismo , Temperatura Alta , Bebidas/análiseRESUMO
Abstract Functional beverages with added health benefits are popular among peoples and athletes because they help them recover faster from intense workouts and perform better overall. This research set out to determine how well heat-treated stem juice from Oxalis tuberosa Mol. "oca" and fruit juice from Gaultheria glomerata (Cav.) Sleumer "laqa-laqa" performed as an antioxidant in a functional drink. The "oca" stems and the "laqa-laqa" fruit were collected to obtain the juice. For this study, 30 semi-trained panellists used sensory evaluation to rate four treatments (Bo, B1, B2, and B3) with varying quantities of "oca" and "laqa-laqa" juice. The results concluded that the treatment B2, which included 300 ml of "oca" stem juice, 800 ml of "laqa-laqa" juice, 1000 ml of treated water, and 220 g of refined sugar, was given the highest score after a physicochemical evaluation of its colour, smell, taste, and overall appearance. Similarly, the results showed that the protein content increased by 1.38%, the fat content by 1.08%, the moisture percentage by 99.5%, the ash content by 1.82%, and the carbohydrate content by 6.22% after B2 treatment. Similarly, results revealed significant enhancement in antioxidant profiling such as total polyphenols: 1825 mg of gallic acid/100 g and antioxidant Activity: 89.56% μmol of trolox /100 g. In conclusion, due to its high energy content and antioxidant activity, it may be a viable nutritional option for athletes who engage in rigorous, frequent physical exertion.
Resumo As bebidas funcionais com benefícios adicionais à saúde são populares entre as pessoas e os atletas porque os ajudam a se recuperar mais rapidamente de exercícios intensos e a ter um desempenho geral melhor. Esta pesquisa teve como objetivo determinar o quão beneficamente o suco do caule tratado termicamente de Oxalis tuberosa Mol. "oca" e o suco de fruta de Gaultheria glomerata (Cav.) Sleumer "laqa-laqa" atuaram como antioxidante em bebida funcional. Os caules da "oca" e os frutos da "laqa-laqa" foram coletados para a obtenção do suco. Para este estudo, 30 provadores semitreinados usaram a avaliação sensorial para avaliar quatro tratamentos (B0, B1, B2 e B3) com quantidades variadas de suco de "oca" e "laqa-laqa". Os resultados indicaram que o tratamento B2, que incluía 300 mL de suco de caule de "oca", 800 mL de suco de "laqa-laqa", 1.000 mL de água tratada e 220 g de açúcar refinado, obteve a maior pontuação após avaliação físico-química e avaliação de cor, cheiro, sabor e aparência geral. Da mesma forma, os resultados mostraram que o teor de proteína aumentou em 1,38%, o teor de gordura, em 1,08%, o percentual de umidade, em 99,5%, o teor de cinzas, em 1,82%, e o teor de carboidratos, em 6,22%, após o tratamento B2. Da mesma forma, os resultados revelaram aumento significativo no perfil antioxidante, como polifenóis totais: 1.825 mg de ácido gálico/100 g e atividade antioxidante de 89,56% μmol de trolox /100 g. Em conclusão, devido ao seu alto teor energético e à atividade antioxidante, pode ser uma opção nutricional viável para atletas que praticam esforço físico rigoroso e frequente.
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The antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by a hypercoagulability associated to vascular thrombosis and/or obstetric morbidity, is caused by the presence of antiphospholipid antibodies such as lupus anticoagulant, anti-ß-2-glycoprotein 1, and/or anticardiolipin antibodies. In the obstetrical APS, antiphospholipid antibodies induce the production of proinflammatory cytokines and tissue factor by placental tissues and recruited neutrophils. Moreover, antiphospholipid antibodies activate the complement system which, in turn, induces a positive feedback leading to recruitment of neutrophils as well as activation of the placenta. Activation of these cells triggers myometrial contractions and cervical ripening provoking the induction of labor. In thrombotic and obstetrical APS, antiphospholipid antibodies activate endothelial cells, platelets, and neutrophils and they may alter the multimeric pattern and concentration of von Willebrand factor, increase the concentration of thrombospondin 1, reduce the inactivation of factor XI by antithrombin, increase the activation of factor XII, and reduce the activity of tissue plasminogen activator with the subsequent production of plasmin. All these effects result in less permeable clots, denser, thinner, and with more branched fibrin fibers which are more difficult to lysate. As a consequence, thrombosis, the defining clinical criterion of APS, complicates the clinical course of the patient.
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Síndrome Antifosfolipídica , Ativador de Plasminogênio Tecidual , Síndrome Antifosfolipídica/complicações , Coagulação Sanguínea , Células Endoteliais , Feminino , Humanos , Placenta , GravidezRESUMO
Wegener's granulomatosis is an autoimmune disease where autoantibodies target human autoantigen PR3, a serine protease locates on the neutrophil membrane. This disease affects blood small vessels and could be deadly. The origin of these autoantibodies is unknown, but infections have been implicated with autoimmune disease. In this study, we explored potential molecular mimicry between human PR3 and homologous pathogens through in silico analysis. Thirteen serine proteases from human pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Salmonella sp., Streptococcus suis, Vibrio parahaemolyticus, Bacteroides fragilis, Enterobacter ludwigii, Vibrio alginolyticus, Staphylococcus haemolyticus, Enterobacter cloacae, Escherichia coli and Pseudomonas aeruginosa) shared structural homology and amino acid sequence identity with human PR3. Epitope prediction found an only conserved epitope IVGG, located between residues 59-74. However, multiple alignments showed conserved regions that could be involved in cross-reactivity between human and pathogens serine proteases (90-98, 101-108, 162-169, 267 and 262 residues positions). In conclusion, this is the first report providing in silico evidence about the existence of molecular mimicry between human and pathogens serine proteases, that could explain the origins of autoantibodies found in patients suffering from Wegener's granulomatosis.
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In this work, several mathematical models for the spread of viruses and diseases are presented. In particular, the work focuses on the coronavirus disease 2019 (COVID-19) pandemic. A multi-population model is presented for the study of the interaction of various populations and the contagion of the virus between them. A second model on vaccination is presented, which allows analyzing the behavior of the disease taking into account the effectiveness of the vaccine and the speed of COVID-19 after the vaccination process. Finally, both models are applied to analyze the epidemic in Cuba. For this study, the official data reported by the Cuban Ministry of Health from March 2020 to August 2021 is used.
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Incisional wound closure is a key surgical step to facilitate tissue healing, reduce the risk of infection and obtain esthetic and functional recovery. Cyanoacrylates such as Histoacryl® have become a popular choice in surgical veterinary practice. However, how Histoacryl® is affecting tissue regeneration and bacterial load in the wound in comparison to poliglecaprone (Monocryl®) traditional suture methods remains to be determined. This work aimed to evaluate how wounded tissue responds to traditional suture with Monocryl® (poliglecaprone 25/4-0) and Histoacryl®, as well as provide evidence of their effects on wound healing in mice. Fortyeight hours after the incisional procedure, wound tissue biopsies were prepared for histological and microbiological analysis. Biopsies were fixed and colored with Mallory's trichrome and hematoxylin-eosin stains. For microbiological assays, biopsies were suspended in tryptic soy broth (TSB) and 1/10 diluted to evaluate the number of CFU in nutrient agar plates. Our results show no differences between Histoacryl® and Monocryl® traditional suture suggesting that both methods could be used to treat wounds in small animals such as rodents.
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OBJETIVO: La mastitis granulomatosa es una patología mamaria benigna y crónica de baja incidencia, cuyo diagnóstico es complejo y su tratamiento no está del todo establecido. Se presenta un caso clínico con el objetivo de hacer una revisión de la bibliografía sobre esta patología, su diagnóstico y tratamiento. MATERIAL Y MÉTODOS: Se presenta el caso de una paciente de 30 años con una mastitis refractaria a tratamiento antibiótico a la que finalmente se diagnosticó una mastitis granulomatosa idiopática gracias a la biopsia excisional. El tratamiento con corticoides a dosis altas tuvo buenos resultados en este caso. Se realizó una búsqueda bibliográfica en las bases de datos Medline vía PubMed, EMBASE y SciELO y también en libros de texto en papel. RESULTADOS: Se hallaron 598 referencias, la mayoría de ellas revisiones sistemáticas y casos clínicos. CONCLUSIONES: La mastitis granulomatosa es una patología poco frecuente cuyo diagnóstico se logra mediante estudio histológico de la misma. No hay consenso sobre cuál es el tratamiento óptimo, pero la tendencia actual es el tratamiento conservador con corticoides a altas dosis. Cada vez es más frecuente el uso de metotrexato cuando no hay buena respuesta con el tratamiento con corticoides.
OBJECTIVE: Granulomatous mastitis is a benign and chronic breast pathology with a low incidence, whose diagnosis is complex and its treatment is not fully established. A case report is presented with the aim of reviewing the literature on this pathology, its diagnosis and its treatment. MATERIAL AND METHODS: The patient is a 30-year-old woman with a mastitis refractory to antibiotic treatment. Finally, idiopathic granulomatous mastitis was diagnosed through excisional biopsy. Treatment with high-dose corticosteroids had good results in this patient. A literature search was performed in the Medline databases via PubMed, EMBASE and SciELO and also in paper textbooks. RESULTS: 598 references were found, most of them systematic reviews and case reports. CONCLUSIONS: Granulomatous mastitis is an uncommon pathology whose definitive diagnosis is achieved by histological study. Treatment is not fully established, but conservative treatment with high-dose corticosteroids is the current trend. The use of methotrexate has risen when there is no good evolution with corticosteroid treatment.
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Humanos , Feminino , Adulto , Mastite Granulomatosa/tratamento farmacológico , Mastite Granulomatosa/diagnóstico por imagem , Corticosteroides/uso terapêuticoRESUMO
INTRODUCCIÓN: En Chile, los efectos maternos y perinatales de la pandemia por SARS-CoV-2 son aún desconocidos. GESTACOVID es un estudio multicéntrico que incluye embarazadas y puérperas hasta el día 42 con COVID-19. El objetivo de este estudio es presentar un informe preliminar, describiendo el impacto de la enfermedad en las embarazadas, factores de riesgo asociados y resultados perinatales. MÉTODOS: Estudio de cohorte descriptivo que incluye 661 pacientes enroladas entre el 7 de marzo y el 6 de julio de 2020, en 23 centros hospitalarios del país. Se analizaron variables demográficas, comorbilidades, características clínicas y del diagnóstico de COVID-19 y resultado materno y perinatal. RESULTADOS: Las pacientes hospitalizadas por COVID-19 tuvieron mayor prevalencia de hipertensión arterial crónica [10% vs 3%; OR=3,1 (1,5-6,79); p=0,003] y de diabetes tipo 1 y 2 [7% vs 2%; OR=3,2 (1,3-7,7); p=0,009] que las pacientes manejadas ambulatoriamente. Un IMC >40 kg/mt2 se asoció con un riesgo dos veces mayor de requerir manejo hospitalizado [OR=2,4 (1,2 - 4,6); p=0,009]. Aproximadamente la mitad de las pacientes (54%) tuvo un parto por cesárea, y un 8% de las interrupciones del embarazo fueron por COVID-19. Hasta la fecha de esta publicación, 38% de las pacientes continuaban embarazadas. Hubo 21 PCR positivas en 316 neonatos (6,6%), la mayoría (17/21) en pacientes diagnosticadas por cribado universal. CONCLUSIONES: Las embarazadas con COVID-19 y comorbilidades como diabetes, hipertensión crónica y obesidad mórbida deben ser manejadas atentamente y deberán ser objeto de mayor investigación. La tasa de transmisión vertical requiere una mayor evaluación para diferenciar el mecanismo y tipo de infección involucrada.
INTRODUCTION: In Chile, effects of the SARS-CoV-2 infection in pregnant women are unknown. GESTACOVID is a multicenter collaborative study including pregnant women and those in the postpartum period (until 42 days) who have had COVID-19. The purpose of this study is to report our preliminary results describing the clinical impact of COVID-19 in pregnant women, the associated risk factors and perinatal results. METHODS: Descriptive cohort study including 661 patients between April 7th and July 6th, 2020, in 23 hospitals. Demographical, comorbidities, clinical and diagnostic characteristics of COVID-19 disease and maternal and perinatal outcomes were analyzed. RESULTS: Pregnant women with COVID-19 admitted to the hospital were more likely to have chronic hypertension [10% vs 3%; OR=3.1 (1.5-6.79); p=0,003] and diabetes type 1 and 2 [7% vs 2%; OR=3.2 (1.3-7.7); p=0.009] than those with outpatient management. A body mass index of >40 kg/mt2 was associated with two-fold higher risk of hospitalization [OR=2.4 (1.2-4.6); p=0.009]. Almost half of patients (54%) were delivered by cesarean section, and 8% of the medically indicated deliveries were due to COVID-19. So far, 38% of the patients are still pregnant. Among 316 newborns, there were 21 positive PCR tests (6.6%), mostly from asymptomatic mothers undergoing universal screening. CONCLUSIONS: Pregnant women with COVID-19 and comorbidities such as diabetes, chronic hypertension and morbid obesity need a close follow up and should be a matter for further research. Vertical transmission of COVID-19 should be thoroughly studied to define the mechanisms and type of infection involved.
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Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pacientes Ambulatoriais , Sinais e Sintomas , Resultado da Gravidez , Comorbidade , Cesárea/estatística & dados numéricos , Chile/epidemiologia , Programas de Rastreamento , Epidemiologia Descritiva , Fatores de Risco , Estudos de Coortes , Aborto Induzido/estatística & dados numéricos , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Cuidados Críticos , Diabetes Mellitus/epidemiologia , Betacoronavirus , Hospitalização , Hipertensão/epidemiologia , Obesidade/epidemiologiaRESUMO
INTRODUCCIÓN: Actualmente la cirugía laparoscópica es el gold standard de la mayoría de las cirugías ginecológicas benignas. Se estima una tasa de complicaciones en cirugía ginecológica por laparoscopía de 3.2 por 1000 pacientes, donde alrededor del 50% ocurren al momento de la primera entrada. Existen numerosas clasificaciones de las complicaciones quirúrgicas, entre ellas, la clasificación Clavien-Dindo se centra en el tratamiento postquirúrgico y tiene como objetivo unificar criterios y hacerlas comparables entre distintos centros. OBJETIVO: Describir las complicaciones en cirugía laparoscópica ginecológica en el Hospital Padre Hurtado, destacando el subgrupo de primera entrada y su clasificación Clavien-Dindo. METODOLOGÍA: Cohorte retrospectiva que incluyó a todas las pacientes operadas por laparoscopía en el pabellón de ginecología del Hospital Padre Hurtado desde el año 2014 al 2017. Se utilizó el software SPSS statistics v25, con prueba X2 para el análisis de las variables no paramétricas y t de Student para las variables paramétrica, considerando una significación estadística con p<0,05. RESULTADOS: De las 513 cirugías laparoscópicas ginecológicas realizadas en el período evaluado, sólo el 4,3% del total de las pacientes tuvieron complicaciones. De éstas, un 9% fueron de primera entrada, y en todos los casos fueron complicaciones menores o Clavien-Dindo I y II. Hubo 2 complicaciones Clavien-Dindo >III B, lo que correspondió a un 0,39%. CONCLUSIÓN: En nuestro grupo hubo una baja incidencia de complicaciones quirúrgicas y de primera entrada lo que es comparable con otras series publicadas.
INTRODUCTION: Laparoscopic surgery is currently the gold standard of most benign gynecological surgeries. A complication rate in gynecological laparoscopy is 3.2 per 1000 patients, where around 50% occur at the time of the first entry. There are numerous classifications of surgical complications, among them, Clavien-Dindo classification focuses on post-surgical treatment and aims to unify criteria and lets compare between different centers. OBJECTIVE: To describe the complications in gynecological laparoscopic surgery at the Padre Hurtado Hospital, highlighting the first entry subgroup and Clavien-Dindo classification. METHODOLOGY: Retrospective cohort that included all gynecological laparoscopy patients in Padre Hurtado Hospital from 2014 to 2017. The SPSS statistics v25 software was used, with X2 test for the analysis of non-parametric variables and t Student for the parametric variables, considering a statistical significance with p <0.05. RESULTS: 513 gynecological laparoscopic surgeries was performed in the evaluated period, only 4.3% of the total patients had complications. Of these, 9% were first entry, and in all cases were minor complications or Clavien-Dindo I and II. There were 2 patients with Clavien-Dindo complications > III B, which corresponded to 0.39%. CONCLUSION: In our group there was a low incidence of surgical complications and first entry which is comparable with other published series.
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Humanos , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Laparoscopia/efeitos adversos , Doenças dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Chile , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos de Coortes , Laparoscopia/estatística & dados numéricos , Complicações Intraoperatórias/classificação , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/epidemiologiaRESUMO
BACKGROUND: To our knowledge, no previous study has prospectively documented the incidence of common diseases and related mortality in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) with standardised approaches. Such information is key to developing global and context-specific health strategies. In our analysis of the Prospective Urban Rural Epidemiology (PURE) study, we aimed to evaluate differences in the incidence of common diseases, related hospital admissions, and related mortality in a large contemporary cohort of adults from 21 HICs, MICs, and LICs across five continents by use of standardised approaches. METHODS: The PURE study is a prospective, population-based cohort study of individuals aged 35-70 years who have been enrolled from 21 countries across five continents. The key outcomes were the incidence of fatal and non-fatal cardiovascular diseases, cancers, injuries, respiratory diseases, and hospital admissions, and we calculated the age-standardised and sex-standardised incidence of these events per 1000 person-years. FINDINGS: This analysis assesses the incidence of events in 162â534 participants who were enrolled in the first two phases of the PURE core study, between Jan 6, 2005, and Dec 4, 2016, and who were assessed for a median of 9·5 years (IQR 8·5-10·9). During follow-up, 11â307 (7·0%) participants died, 9329 (5·7%) participants had cardiovascular disease, 5151 (3·2%) participants had a cancer, 4386 (2·7%) participants had injuries requiring hospital admission, 2911 (1·8%) participants had pneumonia, and 1830 (1·1%) participants had chronic obstructive pulmonary disease (COPD). Cardiovascular disease occurred more often in LICs (7·1 cases per 1000 person-years) and in MICs (6·8 cases per 1000 person-years) than in HICs (4·3 cases per 1000 person-years). However, incident cancers, injuries, COPD, and pneumonia were most common in HICs and least common in LICs. Overall mortality rates in LICs (13·3 deaths per 1000 person-years) were double those in MICs (6·9 deaths per 1000 person-years) and four times higher than in HICs (3·4 deaths per 1000 person-years). This pattern of the highest mortality in LICs and the lowest in HICs was observed for all causes of death except cancer, where mortality was similar across country income levels. Cardiovascular disease was the most common cause of deaths overall (40%) but accounted for only 23% of deaths in HICs (vs 41% in MICs and 43% in LICs), despite more cardiovascular disease risk factors (as judged by INTERHEART risk scores) in HICs and the fewest such risk factors in LICs. The ratio of deaths from cardiovascular disease to those from cancer was 0·4 in HICs, 1·3 in MICs, and 3·0 in LICs, and four upper-MICs (Argentina, Chile, Turkey, and Poland) showed ratios similar to the HICs. Rates of first hospital admission and cardiovascular disease medication use were lowest in LICs and highest in HICs. INTERPRETATION: Among adults aged 35-70 years, cardiovascular disease is the major cause of mortality globally. However, in HICs and some upper-MICs, deaths from cancer are now more common than those from cardiovascular disease, indicating a transition in the predominant causes of deaths in middle-age. As cardiovascular disease decreases in many countries, mortality from cancer will probably become the leading cause of death. The high mortality in poorer countries is not related to risk factors, but it might be related to poorer access to health care. (AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doenças Cardiovasculares , Neoplasias/mortalidadeRESUMO
La pandemia de COVID-19 producida por SARS-CoV-2 actualmente en curso anticipa una gran demanda por ventiladores mecánicos (VM), ya que un porcentaje relevante de los contagiados cae rápidamente en insuficiencia respiratoria y requiere de cuidados intensivos. Anticipándose a ese exceso de demanda y considerando que es muy probable que el número actual de ventiladores mecánicos en las unidades de cuidados intensivos (UCI) sean insuficientes, se ha solicitado a la SACH un informe técnico en relación al uso de las máquinas de anestesia como VM.
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Pneumonia Viral/terapia , Pneumonia Viral/epidemiologia , Ventiladores Mecânicos/provisão & distribuição , Infecções por Coronavirus/terapia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Anestesia/métodos , Chile/epidemiologiaRESUMO
Resumen: Introducción: El dedo en gatillo es muy frecuente en la población, con un riesgo de vida de padecer la enfermedad de 2.6% en la población general y con un aumento de 4 a 10% en diabéticos. Dado que no hay un estándar de oro de tratamiento quirúrgico y aún hay controversia en ello, es importante evaluar los resultados de las distintas técnicas quirúrgicas. El objetivo de este estudio es evaluar resultados postoperatorios de ambas técnicas quirúrgicas en pacientes con seguimiento de uno a 12 meses de postoperatorio. Material y métodos: Se trata de un estudio prospectivo, longitudinal, descriptivo y observacional realizado en un período de Enero de 2015 a Diciembre de 2017. Se incluyeron pacientes postoperados de liberación con técnica abierta (grupo 1) y percutánea con aguja (grupo 2). Se llevó a cabo la revisión de expedientes de todos los pacientes y se les hizo una encuesta mediante vía telefónica. Los resultados de la comparación de ambas técnicas se analizaron mediante χ2 para resultados paramétricos y mediante la prueba de Fisher para los no paramétricos. Resultados: Se encontró que los pacientes del grupo 2 manifestaron mayor satisfacción, de los cuales 21.8% (n = 12) estuvieron totalmente satisfechos con el procedimiento percutáneo, a diferencia de los del grupo 1 quienes manifestaron satisfacción total sólo en 3.8% (n = 2). Conclusiones: En este estudio podemos concluir que ambas técnicas son efectivas para el tratamiento de dedo en gatillo, siendo la liberación percutánea con aguja la que ofrece mayor grado de satisfacción en los pacientes.
Abstract: Indroduction: Trigger finger is very common in the population, with a life-threatening risk of developing the disease of 2.6% in the general population and increasing to 4 to 10% in diabetics. Since there is no standard gold of surgical treatment and there is still controversy in this, it is important to evaluate the results of the different surgical techniques. The objective of this study is to evaluate postoperative results of both surgical techniques in patients with follow-up of 1 to 12 months postoperative. Material and methods: It is a prospective, longitudinal, descriptive and observational study carried out in a period from January 2015 to December 2017. Postoperative open (group 1) and percutaneous needle (group 2) patients were included. All patients were reviewed and surveyed by telephone. The comparison results of both techniques were analyzed using χ2 for parametric results and by the Fisher test for nonparametric results. Results: It was found that patients in group 2 expressed greater satisfaction, where 21.8% (n = 12) were fully satisfied with the percutaneous procedure, unlike those in group 1 where total satisfaction was only manifested at 3.8% (n = 2). Conclusions: In this study we can conclude that both techniques are effective for the treatment of trigger finger, with percutaneous needle release offering the highest degree of satisfaction in patients.
Assuntos
Humanos , Procedimentos Ortopédicos , Dedo em Gatilho/cirurgia , Período Pós-Operatório , Estudos Prospectivos , Resultado do TratamentoRESUMO
AIM: The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). METHODS: A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. RESULTS: Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20-37) years and 47.8 (17.9-68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48-0.99; p = 0.0440) was protective, while doses of prednisone >15 and ≤60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69-10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35-16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10-2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01-1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11-1.34; p < 0.0001) were predictive factors of serious infections. CONCLUSIONS: Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.
Assuntos
Hospitalização/estatística & dados numéricos , Infecções/epidemiologia , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Adulto , Antimaláricos/administração & dosagem , Estudos de Coortes , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Imunossupressores/administração & dosagem , Infecções/etiologia , América Latina , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Metilprednisolona/administração & dosagem , Prednisona/administração & dosagem , Fatores de Proteção , Fatores de Risco , Índice de Gravidade de Doença , Adulto JovemRESUMO
Cutaneous leishmaniasis (CL) is one of the most frequent parasitic zoonoses in Panama. Currently, conventional, molecular and histopathological tests are performed to diagnose CL. Immunohistochemistry (IHC) has proven to be a valuable tool to facilitate the diagnosis of leishmaniasis and to study the cellular immune response developed during the infection. Therefore, considering the absence of IHC in the diagnostic routine in Panama, the objective of this study is to demonstrate the usefulness of this test as a complementary diagnostic tool for improving the sensitivity of histopathology (HP) and helping to study the cellular immune response of patients. Samples from patients with suspected CL were analysed by intradermal reaction of Montenegro (IDRM), smears, culture, PCR (Viannia, Hsp-70), HP and IHC. According to the diagnostic criteria, 95.8% of patients were positive for Leishmania sp., that was characterized as Leishmania (V.) panamensis by PCR-HSP70/RFLP. From positive samples, Leishmania was detected by the tested diagnostic methods in the following degrees: 100% by IDRM, 60% by smears, 93.3% by culture, 100% by kDNA PCR, 78.3% by PCR Hsp-70, 50% by HP and 73.9% by IHC. Although IHC had a poor correlation (kâ¯=â¯0.191) with the diagnostic criteria, the sensitivities of both HP (76.1%) and smears (89.1%) were improved by combining them with IHC. IHC considerably improved the detection of the Leishmania parasites in the histopathological sections, supporting the need to implement this diagnostic tool in Panama. In addition, immunohistochemistry allows evaluation of the patient's immune response and thus provides new guidelines for the treatment and control of CL in Panama.
Assuntos
Imuno-Histoquímica/normas , Leishmania/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Pele/patologia , Adulto , Idoso , Antígenos de Protozoários/imunologia , Biópsia , DNA de Protozoário/genética , Feminino , Técnicas Histológicas , Humanos , Imunidade Celular , Leishmania/genética , Masculino , Pessoa de Meia-Idade , Panamá , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Sensibilidade e Especificidade , Pele/parasitologia , Adulto JovemRESUMO
Objetivo: Explorar la práctica pedagógica docente en la formación para el cuidado de enfermería en la Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas. Material y método: Estudio cualitativo, exploratorio, descriptivo: la muestra la conformaron 21 informantes. La recolección de información fue por medio de entrevista semi estructurada. El análisis siguió un proceso de codificación abierta, axial y selectiva hasta obtener categorías emergentes. Resultados: Se identificaron las siguientes categorías: I) Convivencia y relaciones de cuidado/descuido en la formación de enfermería; II) (Des)articulación teórico- práctica en la enseñanza/aprendizaje del cuidado de enfermería: hacia la integración docente-asistente; III) Complementariedad docente/estudiante para la construcción de conocimiento y estrategias didácticas. Conclusiones: La pedagogía para el cuidado de enfermería se evidencia en un espacio de cuidado/descuido, demandan integración docencia-asistencia y se motivan para el fortalecimiento de competencias pedagógico didácticas, a través del aprendizaje basado en problemas, casos hipotéticos, laboratorios vivenciales y sociodramas e incluir como ejes trasversales el cuidado y la investigación.
Objective: To explore the pedagogical practice in nursing care formation among teachers of the Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas. Method and materials: This is a qualitative, exploratory and descriptive study, with a sample of 21 informants. Data were gathered using semi-structured interviews. The analysis followed an open, axial, and selective coding process, until emerging categories were identified. Results: The following categories emerged: I) Co-living and care/negligence relationships in nursing formation; II) (Lack of) theory-practice articulation in teaching/learning nursing care: towards the teacher-assistant integration; III) Teacher/student complementarity in the construction of knowledge and didactical strategies. Conclusions: Pedagogy in nursing care is evidenced within a care/negligence space, and thus, it is necessary to strengthen the integration among teaching and assistance improving the pedagogical competencies through methodologies such as learning based on problem solving, presentation of hypothetical cases, use of laboratories, including those for high-fidelity simulation, among others.
Objetivo: Explorar a prática pedagógica docente na formação para o cuidado de enfermagem na Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas. Material e método: Estudo qualitativo, exploratório, descritivo: a amostra a conformaram 21 informantes. A recolecção de informação foi por meio de entrevista semiestruturada. A análise seguiu um processo de codificação aberta, axial e seletiva até obter categorias emergentes. Resultados: Identificaram-se as seguintes categorias: I) Convivência e relações de cuidado/descuido na formação de enfermagem; II) (Des)articulação teórico -prática no ensino/aprendizagem do cuidado de enfermagem: para a integração docente- assistente; III) Complementaridade docente/estudante para a construção de conhecimento e estratégias didáticas. Conclusões: A pedagogia para o cuidado de enfermagem evidencia-se em um espaço de cuidado/descuido, demandam integração, docência-assistência e motivam-se para o fortalecimento de competências pedagógico didáticas, através da aprendizagem, baseada em problemas, casos hipotéticos, laboratórios vivenciais e sociodramas e incluir como eixos transversais o cuidado e a pesquisa.