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INTRODUCTION: Renal cell carcinoma (RCC) is one of the most common types of kidney cancer. While RCC tends to present as a localized tumor, a notable proportion may present with distant metastasis. In some instances, RCC may also present with intravascular tumor extension, often called tumor thrombus (TT). Its presence confers a worse prognosis and has important implications for the tumor's staging and treatment. Despite extensive documentation of RCC TT in the US, limited data exists regarding its presentation, management, and outcomes in Puerto Rico (PR). This study aims to broaden the available information on RCC TT, emphasizing surgical management and outcomes. We also provide descriptive data on patient demographics and clinical presentation to improve decision-making among clinicians caring for Puerto Rican men and women. METHODS: In this single-center, retrospective study, we evaluated patients who underwent partial or total nephrectomy at Saint Luke's Episcopal Medical Center between 2018 and 2022. Data was abstracted from electronic health records (EHR). Patients without documented evidence of TT during the peri-operative period were excluded from the study. A total of 220 patient records were evaluated, of which 12 met the inclusion criteria for the study. Cases were categorized using the latest RCC TT guidelines. Central tendency measurements were used to describe the sample distribution. The mean was considered to make assumptions regarding the prevalent observations, and the median was considered to rule out possible outliers. Categorical data were evaluated using proportion analyses, including TT extension level and BMI variables. Fisher's exact test evaluated the association between the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade and TT extension level. RESULTS: Most patients lacked TT-related symptoms. The most severe presenting symptom was a pulmonary embolism (8.3%). Hypertension (83.3%), BMI greater than 25 at the time of diagnosis (75%), and type 2 diabetes mellitus (66.7%) were the most common comorbid conditions within our cohort. Nearly 75% of patients underwent laparoscopic radical nephrectomy with TT resection. One left-sided level III case was managed by laparoscopic-assisted open radical nephrectomy with a right subcostal incision. There were zero intraoperative complications and two postoperative complications. The histopathological reports of all cases were consistent with clear cell carcinoma, and half of the cases (n=6) were WHO/ISUP G4. All patients are alive and free of disease. CONCLUSION: RCC is a common renal neoplasm in PR that can present with intravascular tumor extension. Our findings do not establish a definitive association between BMI, tumor size, WHO/ISUP grading, and TT extension level. Our study shows that laparoscopic removal of RCC TT is a safe and effective approach. However, the generalizability of our findings is limited by the study's design and sample size. Future research should focus on identifying predictive markers, establishing effective screening protocols, and determining if our hybrid approach has comparable outcomes to the standard open approach.
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We aim to describe and report on a novel graft preservation technique using a human gelatin thrombin matrix with rifampin for the treatment of vascular graft infections. Eight patients with vascular graft infections were included, one with bilateral infections, for a total of nine cases from January 2016 through June 2021. All the patients underwent wound exploration and placement of human gelatin thrombin matrix with rifampin. No deaths or allergic reactions had been reported at the 30-day follow-up, with only one major amputation. The graft and limb salvage rates were 77.8% at the 1-year follow-up. The mean time to a major amputation was 122 days, and the mean time to graft excision was 30 days.
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Romosinuano is a tropically adapted Bos taurus breed, and some Mexican breeders aim to improve it genetically. The aim was to estimate allelic and genotypic frequencies for SNPs associated with meat quality in a Mexican Romosinuano population. Four hundred ninety-six animals were genotyped using the Axiom©BovMDv3 array. Only SNPs related to meat quality in this array were studied in this analysis. The Calpain, Calpastatin, and Melanocortin-4 receptor alleles were considered. Allelic and genotypic frequencies and Hardy-Weinberg equilibrium were estimated with the PLINK software. Alleles associated with meat tenderness and higher marbling scores were found in the Romosinuano cattle population. CAPN1_4751 was not found in Hardy-Weinberg equilibrium. The rest of the markers could not be affected by selection and inbreeding. Romosinuano cattle in Mexico have similar genotypic frequencies in markers related to meat quality to Bos taurus breeds known for their meat tenderness. Breeders can choose a marker-assisted selection to improve meat quality characteristics.
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Carne , Polimorfismo de Nucleotídeo Único , Bovinos/genética , Animais , Alelos , México , Marcadores Genéticos , GenótipoRESUMO
The objective of this study was to evaluate the genetic diversity of the Tropical Milking Criollo cattle (TMC) breed in Mexico through parameters derived from pedigree and genomic information assessment. The pedigree file consisted of 3780 animals. Seventy-nine bovines were genotyped with the medium-density single nucleotide polymorphism chip and considered a reference population for pedigree analysis. The effective population size and the probability of gene origin used to assess the evolution of genetic diversity were calculated with pedigree information. Inbreeding coefficients were evaluated based on pedigree (FPed), the genomic relationship matrix (FGRM), and runs of homozygosity (FROH) of different length classes. The average inbreeding was 2.82 ± 2.66%, −0.7 ± 3.8%, and 10.9 ± 3.0% for FPED, FGRM, and FROH, respectively. Correlation between FPED and FROH was significant only for runs of homozygosity > 4 Mb, indicating the FPED of a population with an average equivalent complete generation of five only recovers the most recent inbreeding. The parameters of the probability of gene origin indicated the existence of genetic bottlenecks and the loss of genetic diversity in the history of the TMC cattle population; however, pedigree and genomic information revealed the existence of current sufficient genetic diversity to design a sustainable breeding program.
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Genômica , Endogamia , Bovinos/genética , Animais , Linhagem , Homozigoto , Polimorfismo de Nucleotídeo ÚnicoRESUMO
A genome-wide association study (GWAS) was performed to elucidate genetic architecture of growth traits in Braunvieh cattle. Methods: The study included 300 genotyped animals by the GeneSeek® Genomic Profiler Bovine LDv.4 panel; after quality control, 22,734 SNP and 276 animals were maintained in the analysis. The examined phenotypic data considered birth (BW), weaning (WW), and yearling weights. The association analysis was performed using the principal components method via the egscore function of the GenABEL version 1.8-0 package in the R environment. The marker rs133262280 located in BTA 22 was associated with BW, and two SNPs were associated with WW, rs43668789 (BTA 11) and rs136155567 (BTA 27). New QTL associated with these liveweight traits and four positional and functional candidate genes potentially involved in variations of the analyzed traits were identified. The most important genes in these genomic regions were MCM2 (minichromosome maintenance complex component 2), TPRA1 (transmembrane protein adipocyte associated 1), GALM (galactose mutarotase), and NRG1 (neuregulin 1), related to embryonic cleavage, bone and tissue growth, cell adhesion, and organic development. This study is the first to present a GWAS conducted in Braunvieh cattle in Mexico providing evidence for genetic architecture of assessed growth traits. Further specific analysis of found associated genes and regions will clarify its contribution to the genetic basis of growth-related traits.
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Bovinos/crescimento & desenvolvimento , Bovinos/genética , Variação Genética , Animais , Animais Recém-Nascidos , Peso ao Nascer/genética , Feminino , Genética Populacional , Estudo de Associação Genômica Ampla/veterinária , Genótipo , Masculino , México , Fenótipo , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , DesmameRESUMO
Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem neurocutaneous genetic condition. It is characterized by TSC-associated neuropsychiatric disorders, epilepsy, tumors, and angiomyolipoma in multiple organs, such as the skin, lungs, and kidneys. TSC is also associated with the development of aneurysms of the medium and large arteries, including the renal arteries. This condition will usually be diagnosed early in life, and active surveillance is required of tumor and aneurysm growth to prevent life-threatening events. We have presented the case of a 41-year-old patient with TSC that had not been previously diagnosed. The patient had presented with retroperitoneal hematoma secondary to the rupture of two left renal artery branch aneurysms that had likely developed within the angiomyolipoma.
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The antibody immobilization compatible with low-cost materials and label-free strategies is a challenge for biosensor device fabrication. In this study, ZnO thin film deposition was carried out on corning glass substrates by ultrasonic spray pyrolysis at 200 °C. The thin films were analyzed as platforms for enteropathogenic Escherichia coli (E. coli EPEC) antibody immobilization. The modification of thin films from the functionalization and antibody immobilization steps was visualized using Fourier transform infrared spectroscopy (FTIR) spectroscopy, and surface changes were observed by atomic force microscopy. The obtained FTIR spectra after functionalization showed a contribution of the amino group (NH2) derived from silane (3-aminopropyltrimethoxysilane). The antibody immobilization showed an amide I conserved signal corresponding to the C=O stretching vibrations and the amide II signal related to the N-H scissor vibration mode. In this way, the signals observed are correlated with the presence of antibody immobilized on the film. The ZnO film morphology changes after every stage of the process and allows observing the antibody distribution on the immobilized surface. In order to validate the antibody recognition capability as well as the E. coli EPEC detection in situ, polymerase chain reaction was used.
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Abstract The prevalence of pregnancy in adolescent women is high in Mexico and represents a public health problem. The pregnant teenager with heart disease has a high probability of complications during pregnancy and the delivery, which carries a risk of death of both the mother and the product. In many cases the pregnancy should have been avoided, planned or interrupted, however the majority at this age is vulnerable and although certain cases must be interrupted by their high risk of maternal-fetal death, prevention and legal aspects should be considered. In some cases the woman wants a pregnancy although her health condition does not allow it, but there are options of adoption or recourse to a surrogate belly. In response to this growing social problem, the National Cardiology Institute Ignacio Chávez and National Institute of Perinatology, with the coordination of Ministry of Health in Mexico, started a pregnancy prevention module within a clinic of follow-up of cardiopathy and pregnancy. This review raises the global problem in our country that occupies the first place in pregnancies in adolescents, with more than 400,000 pregnancies a year and the form of immediate response in a multidisciplinary way.
Resumen La prevalencia de embarazo en mujeres adolescentes es muy alta en México, y representa un problema de salud pública. La adolescente embarazada con cardiopatía tiene altas posibilidades de complicaciones durante el embarazo y su resolución, lo que pone en riesgo la vida tanto de la madre como del producto. En muchos casos el embarazo debió ser evitado, planeado o interrumpido, sin embargo la mayoría a esta edad es vulnerable y si bien ciertos casos deben ser interrumpidos por su alto riesgo de muerte materno-fetal, es fundamental considerar la prevención y los aspectos legales. En algunos casos la mujer desea un embarazo aunque su condición de salud no se lo permite, pero existen opciones de adopción o recurrir a un vientre subrogado. Atendiendo este problema social cada vez más creciente, el Instituto Nacional de Cardiología Ignacio Chávez, en coordinación con la Comisión Coordinadora de la Secretaría de Salud y el Instituto Nacional de Perinatología, echaron a andar un módulo de prevención de embarazo dentro de una clínica de seguimiento de cardiopatía y embarazo. Esta revisión plantea el problema global en nuestro país, que ocupa el primer lugar en embarazos en adolescentes, con más de 400 mil embarazos al año y la forma de dar respuesta inmediata de manera multidisciplinaria.
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Humanos , Feminino , Gravidez , Adolescente , Complicações Cardiovasculares na Gravidez/fisiopatologia , Gravidez na Adolescência , Cardiopatias/fisiopatologia , Prevalência , MéxicoRESUMO
Abstract Background: Romosinuano cattle breed in Mexico has endured isolation and it is necessary to characterize it in order to facilitate sustainable genetic management. Objective: To assess the evolution of the structure and genetic diversity of the Romosinuano breed in Mexico, through pedigree analysis. Methods: Pedigree data was obtained from Asociación Mexicana de Criadores de Ganado Romosinuano y Lechero Tropical (AMCROLET). The ENDOG program (4.8 version) was used to analyze two datasets, one that includes upgrading from F1 animals (UP) and the other with only straight-bred cattle (SP). For both datasets, three reference populations were defined: 1998-2003 (RP1), 2004-2009 (RP2), and 2010-2017 (RP3). The pedigree included 3,432 animals in UP and 1,518 in SP. Demographic parameters were: Generation interval (GI), equivalent number of generations (EG), pedigree completeness index (PCI), and gene flow among herds. Genetic parameters were: Inbreeding (F) and average relatedness (AR) coefficients, effective population size (Nec), effective number of founders and ancestors, and number of founder genome equivalents. Results: The GI varied from 6.10 to 6.54 for UP, and from 6.47 to 7.16 yr for SP. The EG of the UP and SP improved >63% from RP1 to RP3. The PCI increased over time. No nucleus or isolated herds were found. For RP3, F and AR reached 2.08 and 5.12% in the UP, and 2.55 and 5.94% in the SP. For RP3, Nec was 57 in the UP and 45 in the SP. Genetic diversity losses were attributed mainly (>66%) to genetic drift, except for RP3 in the SP (44%). Conclusions: A reduction of the genetic diversity has been occurring after the Romosinuano breed association was established in Mexico, and this is mainly due to random loss of genes.
Resumen Antecedentes: La raza bovina Romosinuano ha estado prácticamente aislada en México y requiere ser caracterizada para un manejo genético sostenible. Objetivo: Evaluar la evolución de la estructura y diversidad genética de la raza Romosinuano en México, mediante el análisis del pedigrí. Métodos: Los datos genealógicos provinieron de la Asociación Mexicana de Criadores de Ganado Romosinuano y Lechero Tropical (AMCROLET). Los análisis se realizaron con el programa ENDOG (versión 4.8) para dos bases de datos, una que incluyó animales en cruzamiento absorbente (UP) a partir de F1 y la otra con sólo animales puros (SP). Para ambas bases de datos se definieron tres poblaciones de referencia: 1998-2003 (RP1), 2004- 2009 (RP2), y 2010-2017 (RP3). El pedigrí incluyó 3.432 animales en la UP y 1.518 en la SP. Los parámetros demográficos fueron: intervalo generacional (GI), número de generaciones equivalentes (EG), índice de completitud del pedigrí (PCI), y flujo de genes entre hatos. Los parámetros genéticos fueron: coeficientes de consanguinidad (F) y de relación genética aditiva (AR), tamaño efectivo de la población (Nec), número efectivo de fundadores y ancestros, y número equivalente de genomas fundadores. Resultados: El GI varió de 6,10 a 6,54 para la UP, y de 6,47 a 7,16 años para la SP. El EG de la UP y la SP mejoró >63%, de RP1 a RP3. El PCI aumentó a través de los años, pero más para la SP que para la UP. No se encontraron hatos núcleo o aislados. Para RP3, F y AR alcanzaron 2,08 y 5,12% en la UP, y 2,55 y 5,94% en la SP. Para RP3, Nec fue 57 en la UP y 45 en la SP. Más de 66% de las pérdidas en diversidad genética se debieron a deriva genética, excepto para RP3 en la UP (44%). Conclusiones: una reducción de la diversidad genética ha estado ocurriendo después de que se formó la asociación de criadores de ganado Romosinuano en México, y es debida principalmente a pérdidas aleatorias de genes.
Resumo Antecedentes: A raça bovina Romosinuano tem estado praticamente isolada no México e precisa ser caracterizada para um manejo genético sustentável. Objetivo: Avaliar a evolução da estrutura e diversidade genética da raça Romosinuano no México, através da análise de pedigree. Métodos: Os dados genealógicos vieram da Asociación Mexicana de Criadores de Ganado Romosinuano y Lechero Tropical (AMCROLET). As análises foram feitas com o programa ENDOG (versão 4.8) para duas bases de dados, uma que incluiu animais em cruzamento absorvente (UP) a partir da F1 e a outra base de dados somente com animais puros (SP). Para ambas bases de dados foram definidas três populações de referência: 1998-2003 (RP1), 2004-2009 (RP2) e 2010-2017 (RP3). O pedigree incluiu 3.432 animais na UP e 1.518 na SP. Os parâmetros demográficos foram: intervalo entre gerações (GI), número de gerações equivalentes (EG), índice de completude do pedigree (PCI), e fluxo de genes entre rebanhos. Os parâmetros genéticos foram: coeficiente de consanguinidade (F) e da relação genética aditiva (AR), tamanho efetivo da população (Nec), número efetivo de fundadores e ancestrais, e número equivalente de genomas fundadores. Resultados: O GI variou de 6,10 a 6,54 para a UP, e de 6,47 a 7,16 anos para a SP. EG da UP e a SP melhorou >63%, de RP1 a RP3. O PCI aumentou ao longo dos anos, mas mais para a SP do que para o UP. Não se encontraram rebanhos núcleo ou isolados. Para RP3, F e AR alcançaram 2,08 e 5,12% na UP, e 2,55 e 5,94% na SP. Para RP3, Nec foi 57 na UP e 45 na SP. Mais de 66% das perdas em diversidade genética foram ocasionadas pela deriva genética, exceto para RP3 no UP (44%). Conclusões: Depois que a associação da raça Romosinuano foi estabelecida no México, tem ocorrido uma redução da diversidade genética, principalmente devido a perdas aleatórias de genes.
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The prevalence of pregnancy in adolescent women is high in Mexico and represents a public health problem. The pregnant teenager with heart disease has a high probability of complications during pregnancy and the delivery, which carries a risk of death of both the mother and the product. In many cases the pregnancy should have been avoided, planned or interrupted, however the majority at this age is vulnerable and although certain cases must be interrupted by their high risk of maternal-fetal death, prevention and legal aspects should be considered. In some cases the woman wants a pregnancy although her health condition does not allow it, but there are options of adoption or recourse to a surrogate belly. In response to this growing social problem, the National Cardiology Institute Ignacio Chávez and National Institute of Perinatology, with the coordination of Ministry of Health in Mexico, started a pregnancy prevention module within a clinic of follow-up of cardiopathy and pregnancy. This review raises the global problem in our country that occupies the first place in pregnancies in adolescents, with more than 400,000 pregnancies a year and the form of immediate response in a multidisciplinary way.
La prevalencia de embarazo en mujeres adolescentes es muy alta en México, y representa un problema de salud pública. La adolescente embarazada con cardiopatía tiene altas posibilidades de complicaciones durante el embarazo y su resolución, lo que pone en riesgo la vida tanto de la madre como del producto. En muchos casos el embarazo debió ser evitado, planeado o interrumpido, sin embargo la mayoría a esta edad es vulnerable y si bien ciertos casos deben ser interrumpidos por su alto riesgo de muerte materno-fetal, es fundamental considerar la prevención y los aspectos legales. En algunos casos la mujer desea un embarazo aunque su condición de salud no se lo permite, pero existen opciones de adopción o recurrir a un vientre subrogado. Atendiendo este problema social cada vez más creciente, el Instituto Nacional de Cardiología Ignacio Chávez, en coordinación con la Comisión Coordinadora de la Secretaría de Salud y el Instituto Nacional de Perinatología, echaron a andar un módulo de prevención de embarazo dentro de una clínica de seguimiento de cardiopatía y embarazo. Esta revisión plantea el problema global en nuestro país, que ocupa el primer lugar en embarazos en adolescentes, con más de 400 mil embarazos al año y la forma de dar respuesta inmediata de manera multidisciplinaria.
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Cardiopatias/fisiopatologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Gravidez na Adolescência , Adolescente , Feminino , Humanos , México , Gravidez , PrevalênciaRESUMO
Nitrogen plays an important role in the metabolism of living organisms due to the variety of physiological functions that involve molecules that contain it. This study aimed to estimate genetic parameters for milk nitrogen fractions and the casein:protein ratio in Mexican Brown Swiss population. Milk samples from 317 cows were used to determine total (TN), non-protein (NPN), and non-casein (NCN) nitrogen. Then, crude (CP), true (TP), and whey (WP) proteins, and casein (Cas) percentages were obtained. In addition, the ratios (%) Cas:CP (CCP) and Cas:TP (CTP) were calculated. (Co)variance components and genetic parameters were estimated using an animal model. The pedigree included 2616 animals. Heritabilities were obtained from single-trait and genetic correlations from bivariate analyses. The variation among cows was large for the studied traits. Heritability estimates could be regarded as high (> 0.7) for NCN, WP, CCP, and CTP, while for the rest of the traits, the estimates were from moderate to low magnitude. Genetic correlations estimates differed in magnitude, ranging from - 0.9 to 0.9. There is enough additive genetic variability to achieve genetic improvement for the traits studied; therefore, they could be considered in a breeding program for the studied population.
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Leite/química , Nitrogênio/química , Animais , Caseínas/metabolismo , Bovinos , Feminino , Lactação/genética , México , Proteínas do Leite/análise , Nitrogênio/metabolismo , LinhagemRESUMO
Heritable abnormalities can cause a reduction in productive performance, structural defects, or death of the animal. There are reports of hereditary abnormalities in Braunvieh cattle from several countries, but no evidence was found on their existence in Mexico. In this study, 28 genes associated with hereditary diseases were screened with the GGP-LD 30K array (GeneSeek®) in 300 Mexican registered Braunvieh animals. Allelic frequencies of the markers associated with illness were obtained for the following: citrullinaemia, spinal dysmyelination, spinal muscular atrophy, Brows Swiss fertility haplotype 2, congenital muscular dystonia, epidermolysis bullosa, Pompes, maple syrup urine, syndactyly, Weaver syndrome, crooked tail, deficiency of uridine monophosphate synthase, hypotrichosis, Marfan syndrome, and weak calf syndrome. The allelic frequency values were low for all the analysed loci (from 0.0015 to 0.0110), with exception of syndactyly (0.4145). Although homozygous animals for these genetic conditions were detected, no physical or physiological abnormalities associated with the clinical form of the diseases were observed in the sampled animals. Markers associated with a crooked tail, deficiency of uridine monophosphate synthase, hypotrichosis, Marfan syndrome, and weak calf syndrome were absent. The studied Mexican Braunvieh population does not present clinical or subclinical effects for ten diseases in homozygous animals. However, since the assessed animals are considered as breeding stock, the monitoring of carrier animals might be periodically necessary.
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Doenças dos Bovinos/genética , Predisposição Genética para Doença , Animais , Bovinos , Feminino , Fertilidade , Marcadores Genéticos , Haplótipos , México , PrevalênciaRESUMO
El Perú es un país de ingreso mediano, con un sistema de salud fragmentado. Para fortalecer el sistema de salud basado en atención primaria de salud, existen dimensiones claves que deben ser analizadas: gobernanza, financiamiento, recursos humanos, accesibilidad, longitudinalidad, integralidad, coordinación, equidad, eficiencia y calidad. El logro del desarrollo de estas dimensiones puede llevar a garantizar una atención primaria de salud fuerte, con mejoras en la salud de las personas.
Peru is a middle-income country, with a fragmented health system. To strengthen the health system based on primary health care there, are key dimensions that must be analyzed: governance, financing, human resources, accessibility, longitudinality, comprehensiveness, coordination, equity, efficiency and quality. The achievement of the development of these dimensions can lead to guarantee a strong primary health care, with improvements in the health of people.
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Atenção Primária à Saúde , Serviços Básicos de Saúde , Atenção à SaúdeRESUMO
Heart failure is a health problem associated with disability and mortality. Physicians may stratify the risk of adult patients with heart failure using a cardiopulmonary exercise testing. Until now, in childhood this evaluation has been poorly used. The purpose of this study is to compare the peak oxygen uptake and minute ventilation/carbon dioxide production slope among children with heart failure versus children without heart disease (control). METHODS: Thirty-eight children with heart failure were compared with 194 children without heart disease. All of them performed cardiopulmonary exercise testing using a symptom-limited ramp protocol. Differences between groups were compared using Chi-squared test, Student's t test, or ANOVA. Any value of p < 0.05 was considered significant. RESULTS: Children with heart failure were older, taller, and with a higher prevalence of male gender. This group had also a lower peak oxygen uptake (27 ± 10 ml O2/kg/min) compared to the control group (37 ± 10 ml O2/kg/min); p < 0.001. The minute ventilation/carbon dioxide production was higher in the heart failure group (31 ± 4) than in controls (28 ± 6); p < 0.001. CONCLUSION: Children with heart failure showed lower peak oxygen uptake and higher minute ventilation/carbon dioxide production slope than the control group.
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Dióxido de Carbono/metabolismo , Insuficiência Cardíaca/metabolismo , Consumo de Oxigênio , Respiração , Adolescente , Estatura , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Teste de Esforço , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Prognóstico , Fatores SexuaisRESUMO
Se realizó un estudio observacional y analítico, de casos y controles, de 77 pacientes con peritonitis agudas secundarias, ingresados en la Unidad de Cuidados Intensivos del Hospital Clinicoquirúrgico Universitario "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba, en el período de enero del 2014 a igual mes del 2016, para identificar los factores pronósticos de mortalidad en ellos. Entre los principales resultados se obtuvo un predominio de las perforaciones como causa de muerte y del sexo femenino entre los fallecidos. Se encontró una elevada especificidad para el índice de Mannheim y no existió asociación entre la edad, la necesidad de repetir la laparotomía, la presencia de sepsis y las enfermedades metabólicas y las inmunosupresoras con la probabilidad de morir. Los factores pronósticos con significación estadística relacionados con la probabilidad de morir por una peritonitis secundaria, fueron el estado físico, el tiempo preoperatorio y la disfunción múltiple de órganos.
An observational and analytic cases and controls study of 77 patients with acute secondary peritonitis, admitted in the Intensive Care Unit of "Dr. Ambrosio Grillo Portuondo" University Clinical Surgical Hospital in Santiago de Cuba was carried out, in the period of January, 2014 to same month of 2016, to identify the prognosis factors of mortality in them. A prevalence of perforations as cause of death and prevalence of the female sex in the dead patients were obtained among the main results. A high specificity for the Mannheim index was found and association didn't exist between the age, the necessity to repeat laparotomy, the sepsis presence and the metabolic and immunosuppressive diseases with the probability of dying. The prognosis factors with statistical significance related to the probability of dying due to a secondary peritonitis were the physical status, the preoperative time and the multiple organs dysfunction.
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Peritonite/mortalidade , Escores de Disfunção Orgânica , Prognóstico , Unidades de Terapia IntensivaRESUMO
Background: a concern for breeders is whether an animal ranking based on genetic evaluations is similar to that obtained from show-ring judging. Objective: to determine the association between rankings for Braunvieh (BR) and Brown Swiss (BS) cattle of Mexico based on show-ring judging and their respective expected progeny differences (EPDs) or predicted transmitted abilities (PTAs). Methods: ranking values from judging were transformed using the rankit transformation. For each breed, Pearson correlation analyses were performed between the transformed rank values of the animals obtained from judging at the show-ring and their EPD or PTA values. Results: using the complete databases, in both breeds the correlation coefficient estimates were low (<0.18) but different from zero (p<0.05). The correlation coefficient considering PTAs for milk yield in BS was slightly higher than those obtained for any EPD for growth traits in BR. Correlations in adult animals (0.18 to 0.23) were different from zero (p<0.05) and higher than those of young animals or calves, while those within males or females were similar. Correlations within years of judging in the show-ring were variable and did not indicate any specific trend. Conclusions: show-ring rank results are associated with genetic evaluation of animals, although the magnitude is low. Selection of breeding animals based on show-ring judgment could be used as a complementary tool to genetic evaluation.
Antecedentes: una preocupación de los criadores es si la jerarquización de los animales basada en evaluaciones genéticas es similar a la del juzgamiento en la pista. Objetivo: determinar la asociación entre la jerarquización de animales con base en el juzgamiento en pista y sus respectivas diferencias esperadas en la progenie (EPDs) o habilidades de transmisión predicha (PTAs), para animales Pardo Suizo Europeo (BR) y Americano (BS) de México. Métodos: los valores jerárquicos del juzgamiento fueron transformados usando la transformación rankit. Para cada raza, análisis de correlación de Pearson fueron realizados entre los valores jerárquicos transformados de los animales obtenidos del juzgamiento en la pista y sus valores de EPD o PTA. Resultados: usando las bases de datos completas, en ambas razas los coeficientes de correlación estimados fueron bajos (<0,18) y diferentes de cero (p<0,05). El coeficiente de correlación considerando las PTAs para producción de leche en BS fue ligeramente mayor que los obtenidos con cualquier EPD de las características de crecimiento en BR. Las correlaciones en animales adultos (0,18 a 0,23) fueron diferentes de cero (p<0,05) y mayores que las de animales jóvenes o becerros; mientras que para hembras y machos fueron similares. Correlaciones por año de juzgamiento en pista fueron variables y sin tendencia específica. Conclusiones: la jerarquización de animales usando los resultados de juzgamiento en la pista y las evaluaciones genéticas están asociadas pero en baja magnitud. La selección de animales con base en su juzgamiento en pista puede usarse como herramienta complementaria a la evaluación genética.
Antecedentes: uma preocupação dos criadores é se a classificação dos animais baseada em avaliações genéticas é similar na pista de julgamento. Objetivo: determinar a associação entre a classificação de animais baseada no julgamento em pista e suas respectivas diferenças esperadas na progênie (EDPs) o habilidades de transmissão preditas (PTAs), para as animais Braunvieh (BR) e Brown Swiss (BS) do México. Métodos: os valores de classificação dos animais durante o julgamento foram transformados por meio da metodologia rankit. Para cada raça, análises de correlação de Pearson foram realizadas entre os valores de classificação transformados obtidos pela avaliação na pista de julgamento e seus valores de EPD o PTA. Resultados: usando a base de dados completa, em ambas as raças os coeficientes de correlação foram baixos (<0,18) e diferentes de zero (p<0,05). O coeficiente de correlação considerando as PTAs para produção de leite na BS foi ligeiramente maior que os obtidos com qualquer EPD das características de crescimento na BR. Correlações em animais adultos (0,18 a 0,23) foram diferentes de zero (p<0,05) e mais elevadas do que aquelas de animais jovens ou bezerros; enquanto que para as fêmeas e os machos foram semelhantes. Correlações por anos na pista de julgamento foram variáveis e sem tendência específica. Conclusões: a classificação de animais usando os resultados na pista de julgamento e as avaliações genéticas estão associadas, mas em baixa magnitude. A seleção de animais baseada nos resultados na pista de julgamento pode usar-se apenas como ferramenta complementar à avaliação genética.
RESUMO
Fundamento: la instrumentación del enfoque interdisciplinario implica una forma de trabajo metodológico diferente de las utilizadas tradicionalmente, encaminada a lograr aprendizajes significativos en los estudiantes. Objetivo: diseñar una metodología para la implementación de la Medicina Natural y Tradicional en los contenidos de la asignatura Química, en Tecnología de la Salud. Métodos: se realizó una investigación de desarrollo desde septiembre 2012 a julio 2013 en la Facultad de Tecnología de la Salud "Juan Manuel Páez Inchausti" de Santiago de Cuba. El universo de estudio estuvo conformado por la totalidad de estudiantes (215) que recibieron la asignatura Química y 12 profesores con vasta experiencia en la docencia, másteres en Medicina Natural y Tradicional y categoría docente principal. Se utilizaron métodos teóricos, empíricos y estadísticos que permitieron conformar la metodología propuesta. Resultados: se constató que existen algunas insuficiencias para relacionar los contenidos entre MNT y Química: la mayoría de los alumnos refieren que en las clases solo reciben conocimientos de la mencionada asignatura, existen deficiencias en la preparación metodológica de los docentes para integrar ambas ciencias y desconocimiento acerca de las diferentes modalidades de la MNT; por lo que se elaboró una metodología que permite la integración y consolidación de ambos contenidos en el proceso enseñanza aprendizaje. Conclusiones: la implementación de la metodología fue valorada como adecuada por criterio de especialistas por su pertinencia, asequibilidad y tratamiento científico y metodológico. Cumple con una estructura apropiada según las exigencias del modelo de formación del tecnólogo y dinamiza el proceso enseñanza aprendizaje de la Química.
Background: the instrumentation of the interdisciplinary approach implies a form of methodological work that requires to differ from those traditionally used, guided to achieve a meaningful learning in the students. Objective: to design a methodology for the implementation of the Herbal and Folk Medicine (HFM) in the contents of the Chemistry subject, in Health Technology. Methods: it was carried out a development investigation from September 2012 to July 2013 in "Juan Manuel Páez Inchausti" Health Technology faculty of Santiago de Cuba. The study universe comprised all the students who received the Chemistry subject (215) and 12 professors with vast teaching experience, masters in Herbal and Folk Medicine and high teaching ranks. Theoretical, empiric and statistical methods were used which allowed to conform the proposed methodology. Results: it was verified that there are some deficiencies to relate the contents between Herbal and Folk Medicine and Chemistry: most of the students refer that in the classes they only receive knowledge of the mentioned subject, deficiencies exist in the methodological preparation of the professors to integrate both sciences and lack of knowledge about the different modalities of (HFM); That is why a methodology was elaborated that allows the integration and consolidation of both contents in the teaching-learning process. Conclusions: the implementation of the methodology was valued as pertinent by the specialists' criteria for its relevancy, accessibility and scientific and methodological treatment. It fulfills an appropriate structure according to the demands of the model of the technologist's formation and it revitalizes the Chemistry subject teaching-learning process.
Assuntos
Inclusão Escolar , Educação Médica , Metodologia como Assunto , Medicina TradicionalRESUMO
La tuberculosis cardiovascular constituye entre 1-3% de los casos de tuberculosis extrapulmonar. En países en vías de desarrollo es causante de 38-83% de los casos de pericarditis constrictiva crónica, mientras que en los países desarrollados, el porcentaje es del 1%. Es más frecuente en hombres entre 30-50 años de edad. Caso: paciente masculino de 36 años de edad quien 2 meses previos a su ingreso, refiere tos con expectoración verdosa y disnea de 15 días de evolución. Se asocia proptosis indolora, limitación para la motilidad ocular, artritis simétrica, aditiva, ascendente desde tobillos hasta rodillas, luego muñecas y codos. Durante hospitalización requiere múltiples pericardiocentesis, por lo cual, se realiza pericardiectomía anterior con hallazgo en biopsia de aorta ascendente: inflamación crónica granulomatosa, BAAR positiva. Se plantea diagnóstico de TBC extrapulmonar: TBC de aorta ascendente complicada con derrame pericárdico, TBC ocular derecha y artritis reactiva por tuberculosis (Enfermedad de Poncet). La tuberculosis cardiovascular constituye una enfermedad poco común, de difícil diagnóstico que conlleva a consecuencias graves si no se trata oportunamente(AU)
Cardiovascular tuberculosis occurs in 1-3% of cases of extrapulmonary tuberculosis. In developing countries causes 38-83% of cases of chronic constrictive pericarditis, while in developed countries it represents 1%. It is more common in men between 30-50 years of age. We present a 36 year old male patient, who two months prior admission, referred productive cough and dyspnea during 15 days. Painless proptosis, limitation of ocular motility, symmetric, additive, ascending arthritis from ankles to knees, wrists and elbows were then associated. During his hospitalization multiple pericardiocentesis were performed, requiring pericardiectomy. The findings in ascending aorta biopsy were: anulomatous chronic inflammation, positive for alcohol resistant bacillus. Final diagnosis: tuberculosis of ascending aorta complicated with pericardial effusion, right eye tuberculosis and ceactive arthritis tuberculosis (Poncet´s disease) .Cardiovascular tuberculosis is a rare disease difficult to diagnose which leads to serious consequences without timely treatment(AU)
Assuntos
Humanos , Masculino , Adulto , Tuberculose Cardiovascular/fisiopatologia , Tuberculose Cardiovascular/epidemiologia , Tuberculose Pulmonar/complicações , Infecções Bacterianas e Micoses , Medicina InternaRESUMO
Se realizó un estudio observacional, descriptivo y transversal de los 98 pacientes con enfermedad pulmonar obstructiva crónica agudizada, ventilados de forma no invasiva, en las unidades de cuidados intensivos del Hospital Provincial Docente Clinicoquirúgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero de 2011 hasta igual mes de 2015, a fin de caracterizarles según variables sociodemográficas, clínicas, ventilatorias y hemogasométricas. En la serie se obtuvo un porcentaje de fracaso superior a las estadísticas mundiales. Predominaron con evolución desfavorable los pacientes mayores de 65 años y con estadía hospitalaria de más de 7 días; asimismo, la duración, la frecuencia, la modalidad empleada en la ventilación no invasiva y los factores desencadenantes, no tuvieron significación en el resultado de la técnica. El Ph, la PaCO2, las frecuencias respiratoria y cardíaca, así como la escala de coma de Glasgow, evidenciaron mejoría en los pacientes con evolución favorable. El fracaso de esta técnica tuvo relación con el incremento de la mortalidad (83%).
An observational, descriptive and cross sectional study of the 98 patients with lung obstructive worsened chronic disease, ventilated in a non invasive way in the intensive care unit of "Saturnino Lora Torres" Teaching Provincial Clinical Surgical Hospital in Santiago de Cuba was carried out from January of 2011 to the same month of 2015, in order to characterize them according to social demographic, clinical, ventilatory and hemogasometric variables. In the series a higher percentage failure was obtained compared to the world statistics. The patients with unfavorable clinical course and older than 65 years and with hospital stay longer than 7 days prevailed ; also, the duration, frequency, the modality used in the non invasive ventilation and the triggering factors, had no significance in the result of the technique. The Ph, PaCO2, respiratory and heart frequencies, as well as the Glasgow coma scale, evidenced improvement in the patients with favourable clinical course. The failure of this technique was related to an increase in mortality (83%).