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1.
World Neurosurg ; 158: e393-e415, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34763105

RESUMO

BACKGROUND: Discrimination, abuse, and mistreatment are prevailing problems reported in neurosurgical training programs globally. Moreover, the current coronavirus disease 2019 (COVID-19) pandemic may also show a negative impact on burnout levels in neurosurgery residents. This study aims to evaluate burnout, discrimination, and mistreatment in neurosurgical residents training in Latin America during the severe acute respiratory syndrome coronavirus 2 era. METHODS: A 33-item electronic survey was sent to neurosurgery residents from Latin America from May 10 to 25, 2021. Statistical analysis was performed using SPSS version 25. RESULTS: A total of 111 neurosurgery residents responded to the survey. Mean age was 29.39 ± 2.37 years; 22.5% were female and 36% were training in Mexico. Residents who reported experiencing discrimination for testing positive to COVID-19 had the highest levels of depersonalization (66.7%; P = 0.043) and emotional exhaustion (75%; P = 0.023). Female respondents reported higher rates of gender discrimination (80% vs. 1.2%; P = 0.001), abuse (84% vs. 58.1%; P < 0.005), and sexual harassment (24% vs. 0%; P < 0.001) than did male respondents. Residents training in Mexico reported lower rates of emotional or verbal abuse (59.2% vs. 32.5%; P = 0.007) and bullying (P < 0.005) than did those in other countries in Latin America. Older age was a protective factor for high depersonalization scores (odds ratio [OR], 0.133; 95% confidence interval [CI], 0.035-0.500). Experiencing discrimination represented a risk factor for presenting high emotional exhaustion scores (OR, 3.019; 95% CI, 1.057-8.629). High levels of depersonalization were associated with a 7-fold increased risk of suicidal ideation (OR, 7.869; 95% CI, 1.266-48.88). CONCLUSIONS: The COVID-19 pandemic has been a significant burden on several aspects of health care workers' lives. Our results provide a broad overview of its impact on burnout, discrimination, and mistreatment as experienced by neurosurgery residents training in Latin America, laying the groundwork for future studies and potential interventions.


Assuntos
Esgotamento Profissional , COVID-19 , Internato e Residência , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , COVID-19/epidemiologia , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pandemias , Inquéritos e Questionários
2.
Surg Neurol Int ; 12: 119, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33880224

RESUMO

BACKGROUND: Coccidioidal meningitis (CM) is a fungal infectious disease that rarely affects children. Even in endemic areas, coccidiomycosis rarely affects the pediatric population. However, 40% of affected children develop hydrocephalus. Here, we describe the clinical, serological, and neuroimaging findings in a series of Mexican children admitted to our neurosurgical service with hydrocephalus and subsequently diagnosed with CM. METHODS: We report a prospective series of pediatric patients with hydrocephalus secondary to CM in an endemic area at the north of Mexico. Our report includes children with CM who were hospitalized from 2015 to 2019 in a regional hospital in Torreón, Coahuila. Clinical evolution was monitored for 1 year after hospital discharge. RESULTS: Our series include five children with CM (2-17-years-old, three female), who were hospitalized for hydrocephalus and developed intracranial hypertension. The most frequent neuroimaging findings were leptomeningeal enhancement (5/5) and basal arachnoiditis (4/5), followed by asymmetric hydrocephalus (3/5), abnormalities in fourth ventricle morphology (3/5), and cerebral vasculitis (2/5). CM was diagnosed by positive serology or pathology studies. All children were initially managed with fluconazole and a shunt was placed for management of hydrocephalus. Four patients recovered without permanent neurological deficits and one subject developed persistent vegetative state. One year after hospital discharge, none of the subjects died. CONCLUSION: This series contributes to the limited number of pediatric CM cases reported in the literature, and describes neuroimaging findings in the pediatric population. The cases here presented show that the identification of Coccidioides as causal agent in pediatric meningitis is crucial for targeted treatment and can affect dramatically neurological prognosis. Furthermore, our report stresses that even in endemic areas pediatric coccidiomycosis represents a diagnostic challenge, which is further exacerbated by the limited availability of resources in these regions. Therefore, a positive immunoglobulin G by enzyme immunoassay is enough for diagnosis of CM in endemic areas without access to CF.

3.
Surg Neurol Int ; 12: 618, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34992934

RESUMO

BACKGROUND: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic. METHODS: An electronic survey of 18 questions was sent among residents registered in the Mexican Society of Neurological Surgery (MSNS), between October 2019 and July 2020. Statistical analysis was made in IBM SPSS Statistics 25. The survey focused on demographic characteristics, discrimination, personal satisfaction, and expectations of residents. RESULTS: A response rate of 50% (132 of 264 residents' members of MSNS) was obtained and considered for analysis. Median age was 30.06 ± 2.48 years, 5.3% (n = 7) were female and 16.7% (n = 22) were foreigners undergoing neurosurgical training in Mexico. Approximately 27% of respondents suffered any form of discrimination, mainly by place of origin (9.1%), by gender (8.3%) or by physical appearance (6.1%). About 42.9% (n = 3) of female residents were discriminated by gender versus 6.4% (n = 8) of male residents (P = 0.001); while foreign residents mentioned having suffered 10 times more an event of discrimination by place of origin compared to native Mexican residents (36.4% vs. 3.6%, P < 0.001). CONCLUSION: This manuscript represents the first approximation to determine the impact of discrimination suffered by residents undergoing neurosurgical training in Mexico before the SARS-CoV-2 pandemic.

5.
Rev. medica electron ; 40(1): 200-205, ene.-feb. 2018. ilus
Artigo em Espanhol | CUMED | ID: cum-77169

RESUMO

RESUMEN Se presenta el caso de gestante de 26 años de edad, afecta del síndrome Klippel Trenaunay Weber congénito, con su primer embarazo el cual concluyó a las 39 semanas, mediante cesárea, obteniéndose recién nacido de 3450 gramos, buen Apgar al nacer, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los riesgos potenciales para la madre y su producto. Aún cuando la frecuencia de aparición de esta entidad es rara, resulta importante su conocimiento para los profesionales que laboran, tanto en la atención primaria de salud, como en la atención secundaria (AU).


ABSTRACT The case of a 26-years-old woman is presented. She presented the Klippel-Trenaunay-Weber syndrome in her first pregnancy finished at the 39th week through caesarian section; the newborn was 3450 grams, with good Apgar at birth: the mother-child binomial had a satisfactory evolution. The universal bibliography on this disease was reviewed, highlighting the potential risk for mother and child. Even when the frequency of this entity is rare, it is important its knowledge for the professionals working in the primary health care as much as in the secondary health care (AU).


Assuntos
Humanos , Adulto , Feminino , Gravidez , Recém-Nascido , Complicações na Gravidez , Cesárea , Fatores de Risco , Síndrome de Klippel-Trenaunay-Weber/complicações , Síndrome de Klippel-Trenaunay-Weber/diagnóstico , Síndrome de Klippel-Trenaunay-Weber/etiologia , Nascimento a Termo , Cuidado Pré-Natal , Atenção Primária à Saúde , Sinais e Sintomas , Atenção Secundária à Saúde , Cuidados Médicos
6.
Rev. medica electron ; 40(1): 200-205, ene.-feb. 2018. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-902281

RESUMO

RESUMEN Se presenta el caso de gestante de 26 años de edad, afecta del síndrome Klippel Trenaunay Weber congénito, con su primer embarazo el cual concluyó a las 39 semanas, mediante cesárea, obteniéndose recién nacido de 3450 gramos, buen Apgar al nacer, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los riesgos potenciales para la madre y su producto. Aún cuando la frecuencia de aparición de esta entidad es rara, resulta importante su conocimiento para los profesionales que laboran, tanto en la atención primaria de salud, como en la atención secundaria (AU).


ABSTRACT The case of a 26-years-old woman is presented. She presented the Klippel-Trenaunay-Weber syndrome in her first pregnancy finished at the 39th week through caesarian section; the newborn was 3450 grams, with good Apgar at birth: the mother-child binomial had a satisfactory evolution. The universal bibliography on this disease was reviewed, highlighting the potential risk for mother and child. Even when the frequency of this entity is rare, it is important its knowledge for the professionals working in the primary health care as much as in the secondary health care. (AU)


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Complicações na Gravidez , Cesárea , Fatores de Risco , Síndrome de Klippel-Trenaunay-Weber/complicações , Síndrome de Klippel-Trenaunay-Weber/diagnóstico , Síndrome de Klippel-Trenaunay-Weber/etiologia , Nascimento a Termo , Cuidado Pré-Natal , Atenção Primária à Saúde , Sinais e Sintomas , Atenção Secundária à Saúde , Cuidados Médicos
7.
Biochem Biophys Res Commun ; 453(4): 754-60, 2014 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-25305496

RESUMO

Two pore domain potassium (K2P) channels are mostly present in the central nervous system (CNS) where they play important roles in modulating neuronal excitability. K2P channels give rise to background K(+) currents (IKSO) a key component in setting and maintaining the resting membrane potential in excitable cells. Here, we studied the expression and relative abundances of K2P channels in cerebellar granule neurons (CGNs), combining molecular biology, electrophysiology and immunologic techniques. The CGN IKSO was very sensitive to external pH, as previously reported. Quantitative determination of mRNA expression level demonstrated the existence of an accumulation pattern of transcripts in CGN that encode K2P9>K2P1>K2P3>K2P18>K2P2=K2P10>K2P4>K2P5 subunits. The presence of the major K2P subunits expressed was then confirmed by Western blot and immunofluorescence analysis, demonstrating robust expression of K2P1 (TWIK-1), K2P3 (TASK-1), K2P9 (TASK-3) and K2P18 (TRESK) channel protein. Based, on these results, it is concluded that K2P1, -3, -9 and -18 subunits represent the majority component of IKSO current in CGN.


Assuntos
Cerebelo/citologia , Cerebelo/metabolismo , Neurônios/metabolismo , Canais de Potássio de Domínios Poros em Tandem/química , Canais de Potássio de Domínios Poros em Tandem/metabolismo , Canais de Potássio/química , Canais de Potássio/metabolismo , Animais , Células Cultivadas , Regulação da Expressão Gênica/fisiologia , Ativação do Canal Iônico/fisiologia , Porosidade , Canais de Potássio/classificação , Estrutura Terciária de Proteína , Ratos , Ratos Sprague-Dawley
8.
Ginecol Obstet Mex ; 82(6): 397-400, 2014 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-25016900

RESUMO

Ovarian small cell pulmonary type carcinoma is a rare and aggressive tumor with higher incidence in young women. Multidisciplinary treatment seems to increase survival in a small number of cases. We present the case of a woman diagnosed with this type of tumor of small cells, their clinical evolution and the treatment he received.


Assuntos
Carcinoma de Células Pequenas/patologia , Neoplasias Ovarianas/patologia , Adulto , Carcinoma de Células Pequenas/terapia , Feminino , Humanos , Comunicação Interdisciplinar , Neoplasias Ovarianas/terapia
9.
Rev. medica electron ; 35(2)mar.-abr. 2013. tab
Artigo em Espanhol | CUMED | ID: cum-53451

RESUMO

Introducción: los defectos del cierre del tubo neural son malformaciones graves del cerebro y la columna vertebral. La suplementación periconcepcional con ácido fólico, a dosis adecuada, ha demostrado que disminuye la incidencia de estos defectos. Objetivo: realizar una caracterización de las gestantes del policlínico Milanés del municipio Matanzas y describir el conocimiento y uso del acido fólico previo al embarazo en estas mujeres. Metodología: estudio descriptivo transversal a 165 gestantes, procedentes del área de salud José Jacinto Milanés de Matanzas, a las cuales, previo su consentimiento, se les aplicó modelo de cuestionario para conocer características del embarazo y el conocimiento y uso preventivo del ácido fólico. Resultados: la edad media de fue de 24,2 años. El 58,2 por ciento de estas féminas desconocía los beneficios del ácido fólico para prevenir defectos del tubo neural y solamente 18,8 por ciento usaron el fármaco previo al embarazo. Más de la mitad de las entrevistadas tuvieron gestaciones imprevistas, no planificadas (54,5 por ciento). Hubo pobre asistencia a consulta preconcepcional (9,1 por ciento) Conclusiones: el uso preconcepcional del ácido fólico fue bajo y la población estudiada no estuvo consciente de los beneficios de la ingesta preconcepcional de este medicamento. Teniendo en cuenta la alta incidencia de embarazos no planificados, es recomendable la suplementación con ácido fólico a toda fémina en edad fértil(AU)


Introduction: The defects of neural tube closing are serious brain and spinal column malformations. Periconceptional supplementation with folic acid, in adequate doses, has showed a reduction of these defects incidence. Objective: to characterize pregnant women of the policlinic Milanes, municipality of Matanzas, and to describe their knowledge and usage of the folic acid before their pregnancy. Methodology: cross-sectional descriptive study applied to 165 pregnant women from the health area José Jacinto Milanes of Matanzas, who answered a questionnaire to know their pregnancy characteristics and their knowledge and preventive usage of the folic acid.Results: the average age was 24,2 years. 58,2 percent of these women did not know the benefits of the folic acid to prevent the neural tube defects, and only 18,8 percent used the drug before pregnancy. More than half of the interviewed women got pregnant unexpectedly, without planning it (54,5 percent). There it was a poor assistance to the pre-conception consultation (9,1 percent).Conclusions: the preconception usage of the folic acid was low and the studied population was not conscious of the benefits of the preconception intake of this drug. Taking into account the high incidence of the non-planned pregnancy, it is recommended the folic acid supplementation to all the fertile aged women(AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Defeitos do Tubo Neural/tratamento farmacológico , Ácido Fólico/uso terapêutico , Epidemiologia Descritiva , Estudos Transversais
10.
Rev. medica electron ; 35(2): 105-113, mar.-abr. 2013.
Artigo em Espanhol | LILACS | ID: lil-670235

RESUMO

Introducción: los defectos del cierre del tubo neural son malformaciones graves del cerebro y la columna vertebral. La suplementación periconcepcional con ácido fólico, a dosis adecuada, ha demostrado que disminuye la incidencia de estos defectos. Objetivo: realizar una caracterización de las gestantes del policlínico Milanés del municipio Matanzas y describir el conocimiento y uso del acido fólico previo al embarazo en estas mujeres. Metodología: estudio descriptivo transversal a 165 gestantes, procedentes del área de salud José Jacinto Milanés de Matanzas, a las cuales, previo su consentimiento, se les aplicó modelo de cuestionario para conocer características del embarazo y el conocimiento y uso preventivo del ácido fólico. Resultados: la edad media de fue de 24,2 años. El 58,2 por ciento de estas féminas desconocía los beneficios del ácido fólico para prevenir defectos del tubo neural y solamente 18,8 por ciento usaron el fármaco previo al embarazo. Más de la mitad de las entrevistadas tuvieron gestaciones imprevistas, no planificadas (54,5 por ciento). Hubo pobre asistencia a consulta preconcepcional (9,1 por ciento) Conclusiones: el uso preconcepcional del ácido fólico fue bajo y la población estudiada no estuvo consciente de los beneficios de la ingesta preconcepcional de este medicamento. Teniendo en cuenta la alta incidencia de embarazos no planificados, es recomendable la suplementación con ácido fólico a toda fémina en edad fértil.


Introduction: The defects of neural tube closing are serious brain and spinal column malformations. Periconceptional supplementation with folic acid, in adequate doses, has showed a reduction of these defects incidence. Objective: to characterize pregnant women of the policlinic Milanes, municipality of Matanzas, and to describe their knowledge and usage of the folic acid before their pregnancy. Methodology: cross-sectional descriptive study applied to 165 pregnant women from the health area José Jacinto Milanes of Matanzas, who answered a questionnaire to know their pregnancy characteristics and their knowledge and preventive usage of the folic acid.Results: the average age was 24,2 years. 58,2 percent of these women did not know the benefits of the folic acid to prevent the neural tube defects, and only 18,8 percent used the drug before pregnancy. More than half of the interviewed women got pregnant unexpectedly, without planning it (54,5 percent). There it was a poor assistance to the pre-conception consultation (9,1 percent).Conclusions: the preconception usage of the folic acid was low and the studied population was not conscious of the benefits of the preconception intake of this drug. Taking into account the high incidence of the non-planned pregnancy, it is recommended the folic acid supplementation to all the fertile aged women.


Assuntos
Humanos , Adulto , Feminino , Gravidez , Defeitos do Tubo Neural/tratamento farmacológico , Ácido Fólico/uso terapêutico , Epidemiologia Descritiva , Estudos Transversais
11.
Rev. cuba. obstet. ginecol ; 38(4)oct.-dic. 2012.
Artigo em Espanhol | CUMED | ID: cum-66950

RESUMO

Introducción: el bajo peso del recién nacido aumenta varias veces el riesgo de morbilidad neonatal e infantil, causa trastornos familiares y sobrecarga en los presupuestos de cuidados intensivos y neonatales especiales del país. Por ello, la atención a estos pequeños constituye un problema de salud pública. Objetivo: elaborar una propuesta de acción para la reducción de factores o causas maternas relacionadas con el bajo peso al nacer. Métodos: se realizó estudio prospectivo descriptivo para caracterizar el comportamiento del bajo peso al nacer y su relación con causas maternas predisponentes en 123 recién nacidos bajo peso que se compararon con igual número de neonatos con peso igual o superior a 2 500 g, durante los años 2001 al 2007, procedentes del área de salud "José Jacinto Milanés" de Matanzas. Entre las variables estudiadas se señala edad materna, valoración nutricional, ganancia de peso e intervalo intergenésico, antecedentes obstétricos, enfermedad materna asociada y hábito de fumar. Resultados: existió estrecha relación entre el bajo peso al nacer y la desnutrición materna, ganancia insuficiente de peso y embarazos muy próximos, en nulíparas, con abortos inducidos, trastornos hipertensivos y tabaquismo asociados. Conclusiones: se elaboró una propuesta de acción educativa y médica para proceder sobre los factores maternos relacionados con el bajo peso al nacer. Se recomienda continuar el estudio en otras áreas de salud, divulgación de los resultados y propuesta en eventos y generalizarlos a otras instituciones(AU)


Introduction: low birth weight increases significantly the risk of neonatal and infant morbidity, causing family disruption and overhead budgets for neonatal intensive and special care in our country. Therefore, attention to the little ones constitutes a public health problem. Objective: to develop a proposal for action to reduce maternal factors or causes related to low birth weight. Methods: a prospective study was performed to characterize the behavior of low birth weight and its relationship to maternal causes predisposing lightweight in 123 infants, who were compared with an equal number of infants weighing less than 2 500 g, from 2001 to 2007, from the health area "Jose Jacinto Milanes" in Matanzas. The variables studied included maternal age, nutritional assessment, weight gain and birth intervals, obstetric history, maternal disease, and smoking habit. Results: there was close relationship between low birth weight and maternal malnutrition, poor weight gain and short time intervals between pregnancies, in nulliparous women with history of induced abortions, hypertensive disorders, and smoking. Conclusions: an educational and medical action plan was proposed to work on maternal factors associated with low birth weight. We recommend to further study other health areas, to communicate results, to present this proposal in events and to generalize it to other institutions(AU)


Assuntos
Humanos , Feminino , Recém-Nascido , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Comportamento de Redução do Risco , Epidemiologia Descritiva
12.
Rev. cuba. obstet. ginecol ; 38(4): 488-498, oct.-dic. 2012.
Artigo em Espanhol | LILACS | ID: lil-665690

RESUMO

Introducción: el bajo peso del recién nacido aumenta varias veces el riesgo de morbilidad neonatal e infantil, causa trastornos familiares y sobrecarga en los presupuestos de cuidados intensivos y neonatales especiales del país. Por ello, la atención a estos pequeños constituye un problema de salud pública. Objetivo: elaborar una propuesta de acción para la reducción de factores o causas maternas relacionadas con el bajo peso al nacer. Métodos: se realizó estudio prospectivo descriptivo para caracterizar el comportamiento del bajo peso al nacer y su relación con causas maternas predisponentes en 123 recién nacidos bajo peso que se compararon con igual número de neonatos con peso igual o superior a 2 500 g, durante los años 2001 al 2007, procedentes del área de salud "José Jacinto Milanés" de Matanzas. Entre las variables estudiadas se señala edad materna, valoración nutricional, ganancia de peso e intervalo intergenésico, antecedentes obstétricos, enfermedad materna asociada y hábito de fumar. Resultados: existió estrecha relación entre el bajo peso al nacer y la desnutrición materna, ganancia insuficiente de peso y embarazos muy próximos, en nulíparas, con abortos inducidos, trastornos hipertensivos y tabaquismo asociados. Conclusiones: se elaboró una propuesta de acción educativa y médica para proceder sobre los factores maternos relacionados con el bajo peso al nacer. Se recomienda continuar el estudio en otras áreas de salud, divulgación de los resultados y propuesta en eventos y generalizarlos a otras instituciones.


Introduction: low birth weight increases significantly the risk of neonatal and infant morbidity, causing family disruption and overhead budgets for neonatal intensive and special care in our country. Therefore, attention to the little ones constitutes a public health problem. Objective: to develop a proposal for action to reduce maternal factors or causes related to low birth weight. Methods: a prospective study was performed to characterize the behavior of low birth weight and its relationship to maternal causes predisposing lightweight in 123 infants, who were compared with an equal number of infants weighing less than 2 500 g, from 2001 to 2007, from the health area "Jose Jacinto Milanés" in Matanzas. The variables studied included maternal age, nutritional assessment, weight gain and birth intervals, obstetric history, maternal disease, and smoking habit. Results: there was close relationship between low birth weight and maternal malnutrition, poor weight gain and short time intervals between pregnancies, in nulliparous women with history of induced abortions, hypertensive disorders, and smoking. Conclusions: an educational and medical action plan was proposed to work on maternal factors associated with low birth weight. We recommend to further study other health areas, to communicate results, to present this proposal in events and to generalize it to other institutions.

13.
Rev. medica electron ; 34(3)mayo-jun. 2012.
Artigo em Espanhol | CUMED | ID: cum-51393

RESUMO

Se presenta el caso de gestante de 27 años de edad, afecta de neurofibromatosis tipo 1, diagnosticada preconcepcionalmente, la cual fue atendida en el consultorio del médico de familia no. 80, perteneciente al Policlínico Universitario Milanés, de Matanzas. El embarazo concluyó a la semana 39, mediante parto transpelviano, espontáneo, obteniéndose un recién nacido de 2 850 gramos, buen puntaje de Apgar, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los potenciales riesgos para la madre y el feto, que contribuyen a que los profesionales de la salud que laboran en la atención primaria reconozcan la importancia de esta entidad nosológica para el Programa de Atención Materno Infantil, aún cuando la frecuencia de su aparición no sea elevada(AU)


We present the case of a pregnant woman, aged 27 years old, with neurofibromatosis type 1, diagnosed pre-conceptionally, who was attended at the Family Doctor´s consultation 80, of the Teaching Policlinic Milanes, of Matanzas. Pregnancy finished at the 39 week, in a spontaneous transpelvic birth, bearing a 2 850 grams new born, with good Apgar score, and with a satisfactory evolution of the binomial mother-child. We reviewed the universal literature on the disease, highlighting the potential risks for mother and child, with the objective of allowing the health professionals working at the primary health care level to recognize the importance of this entity for the Infant-Maternal Care Program, even when it is not very frequent(AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/tratamento farmacológico , Complicações na Gravidez/diagnóstico , Relatos de Casos
14.
Rev. medica electron ; 34(3): 381-388, mayo-jun. 2012.
Artigo em Espanhol | LILACS | ID: lil-644761

RESUMO

Se presenta el caso de gestante de 27 años de edad, afecta de neurofibromatosis tipo 1, diagnosticada preconcepcionalmente, la cual fue atendida en el consultorio del médico de familia no. 80, perteneciente al Policlínico Universitario Milanés, de Matanzas. El embarazo concluyó a la semana 39, mediante parto transpelviano, espontáneo, obteniéndose un recién nacido de 2 850 gramos, buen puntaje de Apgar, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los potenciales riesgos para la madre y el feto, que contribuyen a que los profesionales de la salud que laboran en la atención primaria reconozcan la importancia de esta entidad nosológica para el Programa de Atención Materno Infantil, aún cuando la frecuencia de su aparición no sea elevada.


We present the case of a pregnant woman, aged 27 years old, with neurofibromatosis type 1, diagnosed pre-conceptionally, who was attended at the Family Doctor´s consultation 80, of the Teaching Policlinic Milanes, of Matanzas. Pregnancy finished at the 39 week, in a spontaneous transpelvic birth, bearing a 2 850 grams new born, with good Apgar score, and with a satisfactory evolution of the binomial mother-child. We reviewed the universal literature on the disease, highlighting the potential risks for mother and child, with the objective of allowing the health professionals working at the primary health care level to recognize the importance of this entity for the Infant-Maternal Care Program, even when it is not very frequent.


Assuntos
Humanos , Adulto , Feminino , Gravidez , Complicações na Gravidez/diagnóstico , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/tratamento farmacológico , Relatos de Casos
15.
Ginecol Obstet Mex ; 80(12): 777-82, 2012 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-23405509

RESUMO

BACKGROUND: Breast cancer occupies the chief place in incidence after the cervix. This gland sarcomas are rare with less than 1% at this location. Its diagnosis is difficult and its evolution is aggressive. Primary breast osteogenic sarcomas are a subset of lower frequency so that their behavior, evolution, prognosis ytratamiento no much experience and often are diagnosed as benign tumors. CASE REPORT: We report the case of a woman of 59 years which initially arose from a tumor in the right breast was performed with tru-cut biopsy with inconclusive results, using the tumor 7 months after the presence of a multilobulated solid tumor 20 cm, tumor compatible with mammography Phylodes (BIRADS 2). It was decided to perform right total mastectomy and pectoral muscle resection reconstruction with latissimus dorsi more and histochemical review pathology diagnosed with malignant mesenchymal neoplasm, osteosarcoma osteoblast osteoclast type and complemented the treatment with radiotherapy and chemotherapy. The prognosis is poor because the five-year survival is less than 40%. CONCLUSION: In the fast-growing breast tumors and large mammographic calcifications with signs and antecedentesde irradiation, trauma and Phyllodes tumor must be aware of this disease and that early diagnosis improves survival. In the surgical treatment of axillary dissection is not indicated and adjuvant treatment with radiotherapy and chemotherapy.


Assuntos
Neoplasias da Mama/diagnóstico , Sarcoma/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade
16.
Rev. medica electron ; 33(4)jul.-ago. 2011. tab
Artigo em Espanhol | CUMED | ID: cum-49470

RESUMO

Introducción: El estado nutricional materno insuficiente acarrea riesgos para el recién nacido, constituyendo un importante parámetro estrechamente relacionado con la morbimortalidad perinatal, condición esta que requiere priorizar la atención a la mujer desnutrida antes del embarazo. Objetivo: Analizar la relación entre desnutrición materna, ganancia de peso transgestacional y peso al nacer. Métodos: Estudio efectuado en el equipo básico número 2, del área de salud Milanés, de Matanzas, a 124 mujeres paridas con bajo peso preconcepcional (desnutridas), entre los años 2000 y 2009, que se compararon con igual número de féminas, también paridas normopeso, y en similar período de tiempo. Las variables contempladas fueron: edad materna, ganancia de peso en el embarazo, hemoglobina en el tercer trimestre de gestación y peso del recién nacido. Resultados: Existió estrecha relación del bajo índice de masa corporal preconcepcional, ganancia insuficiente de peso en el embarazo, anemia en el tercer trimestre de la gestación con el peso deficitario al nacer. Conclusiones: Se puso de manifiesto que la desnutrición materna es un predictor del peso deficitario al nacer, sobre todo, si se acompaña de anemia e insuficiente incremento de peso transgestacional. Se hace necesario revalidar la identificación de las mujeres en edad fértil desnutridas antes de engendrar, propiciar atención nutricional y terapéutica oportuna por parte de los profesionales que atienden la atención primaria de salud(AU)


Introduction: The insufficient maternal nutritional status brings risks for the newborn, and is an important parameter tightly related with perinatal morbidity and mortality, conditions that require the prioritization of the undernourished women attention before pregnancy. Objective: Analyzing the relation between maternal undernourishing, transgestational weight and weight at birth. Methods: A study of the 124 postpartum women with low preconceptional weight in the period from 2000 to 2009, carried out in the basic team nr 2, of the Health Area Milanés, Matanzas. They were compared with the same number of women, who gave birth with normal weight, in the same time period. The variables taken into account were: maternal age, weight gaining during pregnancy, hemoglobin in the third semester of pregnancy and newborn weight. Results: There it was a tight relation of the low index of preconceptional corporal mass, the insufficient weigh gaining in pregnancy, and the anemia in the third month of pregnancy with the deficient weight at birth. Conclusions: It was showed that maternal undernourishing is a predictor of deficient weight at birth, especially if it is accompanied by anemia and the insufficient increase of the transgestational weight. It is necessary to identify the undernourished fertile-aged women before engendering, to propitiate the opportune therapeutic and nutritional attention for professional working at the primary health attention(AU)


Assuntos
Humanos , Feminino , Recém-Nascido , Adulto , Desnutrição/complicações , Estado Nutricional , Nutrição da Gestante , Índice de Massa Corporal , Recém-Nascido de Baixo Peso , Fatores de Risco , Saúde Materno-Infantil
17.
Rev. medica electron ; 33(4): 448-455, jul.-ago. 2011.
Artigo em Espanhol | LILACS | ID: lil-615849

RESUMO

Introducción: El estado nutricional materno insuficiente acarrea riesgos para el recién nacido, constituyendo un importante parámetro estrechamente relacionado con la morbimortalidad perinatal, condición esta que requiere priorizar la atención a la mujer desnutrida antes del embarazo. Objetivo: Analizar la relación entre desnutrición materna, ganancia de peso transgestacional y peso al nacer. Métodos: Estudio efectuado en el equipo básico número 2, del área de salud Milanés, de Matanzas, a 124 mujeres paridas con bajo peso preconcepcional (desnutridas), entre los años 2000 y 2009, que se compararon con igual número de féminas, también paridas normopeso, y en similar período de tiempo. Las variables contempladas fueron: edad materna, ganancia de peso en el embarazo, hemoglobina en el tercer trimestre de gestación y peso del recién nacido. Resultados: Existió estrecha relación del bajo índice de masa corporal preconcepcional, ganancia insuficiente de peso en el embarazo, anemia en el tercer trimestre de la gestación con el peso deficitario al nacer. Conclusiones: Se puso de manifiesto que la desnutrición materna es un predictor del peso deficitario al nacer, sobre todo, si se acompaña de anemia e insuficiente incremento de peso transgestacional. Se hace necesario revalidar la identificación de las mujeres en edad fértil desnutridas antes de engendrar, propiciar atención nutricional y terapéutica oportuna por parte de los profesionales que atienden la atención primaria de salud.


Introduction: The insufficient maternal nutritional status brings risks for the newborn, and is an important parameter tightly related with perinatal morbidity and mortality, conditions that require the prioritization of the undernourished women attention before pregnancy. Objective: Analyzing the relation between maternal undernourishing, transgestational weight and weight at birth. Methods: A study of the 124 postpartum women with low preconceptional weight in the period from 2000 to 2009, carried out in the basic team nr 2, of the Health Area Milanés, Matanzas. They were compared with the same number of women, who gave birth with normal weight, in the same time period. The variables taken into account were: maternal age, weight gaining during pregnancy, hemoglobin in the third semester of pregnancy and newborn weight. Results: There it was a tight relation of the low index of preconceptional corporal mass, the insufficient weigh gaining in pregnancy, and the anemia in the third month of pregnancy with the deficient weight at birth. Conclusions: It was showed that maternal undernourishing is a predictor of deficient weight at birth, especially if it is accompanied by anemia and the insufficient increase of the transgestational weight. It is necessary to identify the undernourished fertile-aged women before engendering, to propitiate the opportune therapeutic and nutritional attention for professional working at the primary health attention.


Assuntos
Humanos , Adulto , Feminino , Recém-Nascido , Desnutrição/complicações , Estado Nutricional , Fatores de Risco , Nutrição da Gestante , Recém-Nascido de Baixo Peso , Índice de Massa Corporal , Saúde Materno-Infantil
18.
Rev. cuba. obstet. ginecol ; 36(4): 532-543, oct.-dic. 2010. tab
Artigo em Espanhol | CUMED | ID: cum-51989

RESUMO

El bajo peso al nacer aumenta varias veces el riesgo de morbilidad neonatal e infantil, causando trastornos familiares y sobrecarga los presupuestos de cuidados intensivos y neonatales especiales del país. Por ello, la atención a estos pequeños constituye un problema de salud pública mundial. OBJETIVO: Elaborar una propuesta de acción para la reducción de factores maternos relacionados con el bajo peso al nacer. MÉTODOS: Se realizó estudio prospectivo descriptivo para caracterizar el comportamiento del bajo peso al nacer y su relación con causas maternas predisponentes de 123 recién nacidos bajo peso que se compararon con igual número de neonatos con peso igual o superior a 2 500 g, durante los años 2001 al 2007, procedentes del área de salud José Jacinto Milanés de Matanzas. Entre las variables estudiadas se señala edad materna, valoración nutricional, ganancia de peso e intervalo intergenésico, antecedentes obstéricos, enfermedad materna asociada y hábito de fumar. RESULTADOS: Existió estrecha relación del bajo peso al nacer con la desnutrición materna, ganancia insuficiente de peso y embarazos muy próximos, en nulíparas, con abortos inducidos, trastornos hipertensivos y tabaquismo asociados. CONCLUSIONES: Se elaboró una propuesta de acción educativa y médica para actuar sobre los factores maternos relacionados con el bajo peso al nacer. Se recomienda continuar el estudio en otras áreas de salud, divulgación de los resultados y propuesta en eventos y generalizarlos a otras entidades (AU)


The low birth weight several times increases the neonatal and infantile morbidity risk, leading to family disorders and a overload in budgets related to intensive and neonatal special care for the country. Thus, the care of this children is a world public health problem. OBJECTIVE: A descriptive and prospective study was conducted to characterize the low birth weight behavior and its relation to the mother predisposing causes of 123 low birth weight newborns compared with a similar number of neonates with similar or higher weight from 2001to 2007 or the José Jacinto Milanés health area in Matanzas province. Study variable include mother age, nutritional assessment, weight gain and inter-genesis, obstetric backgrounds, associated mother disease and smoking. RESULTS: There was a close relationship between he low birth weight and the mother malnutrition, insufficient weight gain and pregnancy very near each other, in nullipara with induced abortions, associated hypertensive disorders and smoking CONCLUSIONS: An educational and medical action proposal was designed to act on the mother factors related to the low birth weight. It is recommended the study on other health areas, communicate the results and the suggestion in events and a generalization to other entities (AU)


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Recém-Nascido de Baixo Peso , Nutrição da Gestante , Fatores de Risco , Epidemiologia Descritiva , Estudos Prospectivos
19.
Rev. cuba. obstet. ginecol ; 36(4)oct.-dic. 2010. tab
Artigo em Espanhol | CUMED | ID: cum-50511

RESUMO

El bajo peso al nacer aumenta varias veces el riesgo de morbilidad neonatal e infantil, causando trastornos familiares y sobrecarga los presupuestos de cuidados intensivos y neonatales especiales del país. Por ello, la atención a estos pequeños constituye un problema de salud pública mundial. OBJETIVO: Elaborar una propuesta de acción para la reducción de factores maternos relacionados con el bajo peso al nacer. MÉTODOS: Se realizó estudio prospectivo descriptivo para caracterizar el comportamiento del bajo peso al nacer y su relación con causas maternas predisponentes de 123 recién nacidos bajo peso que se compararon con igual número de neonatos con peso igual o superior a 2 500 g, durante los años 2001 al 2007, procedentes del área de salud José Jacinto Milanés de Matanzas. Entre las variables estudiadas se señala edad materna, valoración nutricional, ganancia de peso e intervalo intergenésico, antecedentes obstéricos, enfermedad materna asociada y hábito de fumar. RESULTADOS: Existió estrecha relación del bajo peso al nacer con la desnutrición materna, ganancia insuficiente de peso y embarazos muy próximos, en nulíparas, con abortos inducidos, trastornos hipertensivos y tabaquismo asociados. CONCLUSIONES: Se elaboró una propuesta de acción educativa y médica para actuar sobre los factores maternos relacionados con el bajo peso al nacer. Se recomienda continuar el estudio en otras áreas de salud, divulgación de los resultados y propuesta en eventos y generalizarlos a otras entidades (AU)


The low birth weight several times increases the neonatal and infantile morbidity risk, leading to family disorders and a overload in budgets related to intensive and neonatal special care for the country. Thus, the care of this children is a world public health problem. OBJECTIVE: A descriptive and prospective study was conducted to characterize the low birth weight behavior and its relation to the mother predisposing causes of 123 low birth weight newborns compared with a similar number of neonates with similar or higher weight from 2001to 2007 or the José Jacinto Milanés health area in Matanzas province. Study variable include mother age, nutritional assessment, weight gain and inter-genesis, obstetric backgrounds, associated mother disease and smoking. RESULTS: There was a close relationship between he low birth weight and the mother malnutrition, insufficient weight gain and pregnancy very near each other, in nullipara with induced abortions, associated hypertensive disorders and smoking CONCLUSIONS: An educational and medical action proposal was designed to act on the mother factors related to the low birth weight. It is recommended the study on other health areas, communicate the results and the suggestion in events and a generalization to other entities (AU)


Assuntos
Humanos , Feminino , Recém-Nascido , Recém-Nascido de Baixo Peso , Fatores de Risco , Complicações na Gravidez/etiologia , Epidemiologia Descritiva , Estudos Prospectivos
20.
Rev. cuba. obstet. ginecol ; 36(4): 532-543, oct.-dic. 2010.
Artigo em Espanhol | LILACS | ID: lil-584659

RESUMO

El bajo peso al nacer aumenta varias veces el riesgo de morbilidad neonatal e infantil, causando trastornos familiares y sobrecarga los presupuestos de cuidados intensivos y neonatales especiales del país. Por ello, la atención a estos pequeños constituye un problema de salud pública mundial. OBJETIVO: Elaborar una propuesta de acción para la reducción de factores maternos relacionados con el bajo peso al nacer. MÉTODOS: Se realizó estudio prospectivo descriptivo para caracterizar el comportamiento del bajo peso al nacer y su relación con causas maternas predisponentes de 123 recién nacidos bajo peso que se compararon con igual número de neonatos con peso igual o superior a 2 500 g, durante los años 2001 al 2007, procedentes del área de salud José Jacinto Milanés de Matanzas. Entre las variables estudiadas se señala edad materna, valoración nutricional, ganancia de peso e intervalo intergenésico, antecedentes obstéricos, enfermedad materna asociada y hábito de fumar. RESULTADOS: Existió estrecha relación del bajo peso al nacer con la desnutrición materna, ganancia insuficiente de peso y embarazos muy próximos, en nulíparas, con abortos inducidos, trastornos hipertensivos y tabaquismo asociados. CONCLUSIONES: Se elaboró una propuesta de acción educativa y médica para actuar sobre los factores maternos relacionados con el bajo peso al nacer. Se recomienda continuar el estudio en otras áreas de salud, divulgación de los resultados y propuesta en eventos y generalizarlos a otras entidades


The low birth weight several times increases the neonatal and infantile morbidity risk, leading to family disorders and a overload in budgets related to intensive and neonatal special care for the country. Thus, the care of this children is a world public health problem. OBJECTIVE: A descriptive and prospective study was conducted to characterize the low birth weight behavior and its relation to the mother predisposing causes of 123 low birth weight newborns compared with a similar number of neonates with similar or higher weight from 2001to 2007 or the José Jacinto Milanés health area in Matanzas province. Study variable include mother age, nutritional assessment, weight gain and inter-genesis, obstetric backgrounds, associated mother disease and smoking. RESULTS: There was a close relationship between he low birth weight and the mother malnutrition, insufficient weight gain and pregnancy very near each other, in nullipara with induced abortions, associated hypertensive disorders and smoking CONCLUSIONS: An educational and medical action proposal was designed to act on the mother factors related to the low birth weight. It is recommended the study on other health areas, communicate the results and the suggestion in events and a generalization to other entities


Assuntos
Humanos , Feminino , Recém-Nascido , Complicações na Gravidez/etiologia , Recém-Nascido de Baixo Peso , Fatores de Risco , Epidemiologia Descritiva , Estudos Prospectivos
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