RESUMO
OBJECTIVE: To identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. METHODS: Retrospective case-control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n = 258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n = 544 eyes). RESULTS: Age at cataract surgery among cases was lower than in the control group (57 ± 13 vs. 67 ± 14 years old, respectively; p < 0.0001). Age at retinal detachment was 59 ± 13 years old (range 6-88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1-4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR] = 18.03, 95% confidence interval [95%CI] = 5.92-54.87; 50-59 years: aOR = 10.09, 95%CI = 3.37-30.23; and 60-69 years: aOR = 5.48, 95%CI = 1.88-15.93), male sex (aOR = 3.71, 95%CI = 2.54-5.44), anterior vitrectomy (aOR = 3.26, 95%CI = 1.16-9.16), history of retinal detachment in the fellow eye (aOR = 6.95, 95%CI = 3.15-15.31), and intraoperative complications during cataract extraction (aOR = 7.45, 95%CI = 3.54-15.69). CONCLUSIONS: This is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.
Assuntos
Catarata , Descolamento Retiniano , Humanos , Masculino , Lactente , Pré-Escolar , Criança , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Pseudofacia/complicações , Pseudofacia/epidemiologia , Seguimentos , Estudos Retrospectivos , Estudos de Casos e Controles , Colômbia/epidemiologia , Fatores de Risco , Catarata/complicaçõesRESUMO
The objective was to carry out cytotoxicity assays in Vero cells and cytokines analyses in Balb/c mice as safety assessments to evaluate the probiotic mixture (M) Saccharomyces cerevisiae RC016 (Sc) and Lactobacillus rhamnosus RC007 (Lr) for use as feed additive. Vero cells (104 cells per well) were exposed to Sc (2·08 × 107 , 2·08 × 106 ; 2·08 × 105 cells per ml), Lr (8·33 × 107 ; 8·33 × 106 ; 8·33 × 105 cells per ml) and their M (1 : 1). Sc concentrations did not affect the Vero cells viability; in contrast, they were lower when exposed to Lr (P Ë 0·0001). Vero cells showed increasing viability with M decreasing concentrations (91% viability with M2). Control BALB/c mice received only phosphate buffer saline and the others received the M. The IL-10, IL-6 and TNFα concentrations from intestinal fluid were analysed and no significant differences were observed among treatments. The same occurred with the ratio between IL-10/TNF-α. Beneficial effects of probiotics are associated with the regulation of the excessive inflammatory response; it is desirable they can modulate the cytokines production only under pathological conditions. Here, M administration to healthy mice did not induce negative side effects and expands the knowledge about beneficial effects of using probiotic microorganisms in mixture for feed additives development.
Assuntos
Aditivos Alimentares/análise , Lacticaseibacillus rhamnosus/metabolismo , Probióticos/farmacologia , Saccharomyces cerevisiae/metabolismo , Ração Animal/análise , Animais , Sobrevivência Celular/efeitos dos fármacos , Chlorocebus aethiops , Citocinas/genética , Citocinas/imunologia , Aditivos Alimentares/efeitos adversos , Interleucina-10/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Probióticos/efeitos adversos , Probióticos/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/imunologia , Células VeroRESUMO
This study aim to determine the proportion of traffic rule infractions in Cali, Colombia, in places where a road traffic injury (RTI) occurred. Description of videotaping of sites where a person was injured in an RTI in 2009. Counts of road users and infractions were established for each road user group and were compared using a Z-test. They were found 13,491 users, distributed as follow: 8.9% were pedestrians, 4.6% cyclists, 24.6% motorcyclists, and 61.8% were automobile drivers. The most frequent traffic violation among motorcyclists was transiting on lines designated for other vehicles (55.2%). Among cyclists, the most frequent violations were transiting without a helmet (99.2%) and not wearing the designated vest (100%). Among pedestrians, crossing streets at prohibited places (77.3%), even at sites where a pedestrian bridge was present (72.7%), represented two common violations. Vulnerable road users committed more traffic infractions than automobile drivers (p < 0.001). High rates of traffic rule infractions among vulnerable road users were observed. Studies to better understand the occurrence of these behaviours and the promotion of effective interventions are warranted.
Assuntos
Acidentes de Trânsito , Condução de Veículo , Regulamentação Governamental , Colômbia/epidemiologia , Humanos , Motocicletas , Prevalência , Segurança , Gravação de Videoteipe , Ferimentos e LesõesRESUMO
Chromium (Cr) is a highly toxic metal for microorganisms as well as plants and animal cells. Due to its widespread industrial use, Cr has become a serious pollutant in diverse environmental settings. The hexavalent form of the metal, Cr(VI), is considered a more toxic species than the relatively innocuous and less mobile Cr(III) form. The study of the interactions between microorganisms and Cr has been helpful to unravel the mechanisms allowing organisms to survive in the presence of high concentrations of Cr(VI) and to detoxify and remove the oxyanion. Various mechanisms of interactions with Cr have been identified in diverse species of bacteria and fungi, including biosorption, bioaccumulation, reduction of Cr(VI) to Cr(III), and chromate efflux. Some of these systems have been proposed as potential biotechnological tools for the bioremediation of Cr pollution using bioreactors or by in situ treatments. In this review, the interactions of microorganisms with Cr are summarised, emphasising the importance of new research avenues using advanced methodologies, including proteomic, transcriptomic, and metabolomic analyses, as well as the use of techniques based on X-ray absorption spectroscopy and electron paramagnetic resonance spectroscopy.
Assuntos
Bactérias/crescimento & desenvolvimento , Cromo/metabolismo , Poluentes Ambientais/metabolismo , Fungos/crescimento & desenvolvimento , Bactérias/genética , Bactérias/metabolismo , Biodegradação Ambiental , Espectroscopia de Ressonância de Spin Eletrônica , Fungos/genética , Fungos/metabolismo , Perfilação da Expressão Gênica , Metabolômica , Proteômica , Espectroscopia por Absorção de Raios XRESUMO
Introducción: Los modelos en salud promueven el desarrollo de intervenciones para solucionar diferentes problemáticas poblacionales. Objetivo: El objetivo de este artículo es establecer un diagnóstico de los modelos existentes para la rehabilitación del desorden músculo esquelético (DME) en la población trabajadora, a través de una revisión documental y de la literatura científica disponible. Metodología: Se realizó una revisión sistemática de la literatura en las bases de datos Ovid SP, EBSCO HOST, PROQUEST, MEDLINE, Science Direct, PubMed, y otros motores de búsqueda, siguiendo las etapas de identificación, tamización, elegibilidad e inclusión consignadas en la guía PRISMA. Resultados: Se seleccionaron 72 artículos, de los cuales 60 documentos fueron tenidos en cuenta para el análisis bibliométrico; se identificaron y abordaron doce modelos teóricos del proceso salud enfermedad, los cuales mostraron un enfoque en rehabilitación clínica. Discusión y conclusiones: Se concluyó que los modelos de rehabilitación encontrados contienen diversos elementos que los hacen complementarios y que no generan conflicto entre ellos, por el contrario de acuerdo a las disciplinas que lo definen y la interdisciplinariedad que puedan tener, los hacen aún más sólidos en sus premisas para la rehabilitación de los (DME) en trabajadores. Adicionalmente se observa como los enfoques de los modelos de rehabilitación más recientes están dirigidos a fomentar las condiciones protectoras del trabajador con el fin de prevenir alteraciones en su condición de salud.
Introduction: Health models promote the development of interventions to address various population issues. Objective: The aim of this article is to establish a diagnosis of existing rehabilitation of musculoskeletal disorder in the working population models, through a literature review and the available scientific literature. Methodology: A systematic literature review was made in databases Ovid SP, EBSCO HOST, PROQUEST, MEDLINE, Science Direct, PubMed, among other research engines following the stages of identification, screening, eligibility and inclusion contained in the PRISMA guideline. Results: 72 articles were selected, of which 60 papers were considered for the bibliometric analysis; it they identified and addressed twelve theoretical models of health-disease process, which showed a focus in Clinical Rehabilitation. Discussion and conclusions: It was concluded that models rehabilitation found contain various elements that make them complementary and not create conflict between them, on the contrary according to the disciplines that define and interdisciplinary they may have, make them even stronger in their premises for rehabilitation of DME workers. Additionally it is seen as approaches most recent models are aimed at promoting rehabilitation protective worker conditions in order to prevent changes in their health condition.
RESUMO
Both the impact of habitat modification on the food preferences of species and its impact on ecosystem functioning are poorly understood. In this study, we analyzed food selection by dung beetles in 80 tropical forest fragments and their adjacent cattle pastures in the Los Tuxtlas Biosphere Reserve, Mexico. Ten pitfall traps were placed at each site, half baited with human dung and the other half with fish carrion. We assessed dung beetle food selection and classified any specialization in resource use quantitatively using a multinomial classification model. We collected 15,445 beetles belonging to 42 species, 8747 beetles (38 species) in forest fragments and 6698 beetles (29 species) in cattle pastures. Twenty-five species were present in both habitats. Of all the beetles captured, 76% were caught in dung traps (11,727 individuals) and 24% in carrion traps (3718 individuals). We found 21 species of dung specialists, 7 carrion specialists, 8 generalists, and 6 species too rare to classify. The bait most frequently selected by beetles in this study was dung in both forests and pastures. Specialists tended to remain specialists in both habitats, while generalists tended to change their selection of bait type depending on the habitat. In summary, our results show that replacing forests with cattle pastures modifies the patterns of resource selection by dung beetles and this could affect ecosystem functioning.
Assuntos
Biodiversidade , Besouros , Fezes , Animais , Bovinos , Florestas , Humanos , MéxicoRESUMO
The global increase in demand for productive land requires us to increase our knowledge of the value of agricultural landscapes for the management and conservation of biodiversity, particularly in tropical regions. Thus, comparative studies of how different community attributes respond to changes in land use under different levels of deforestation intensity would be useful. We analyzed patterns of dung beetle diversity in an Andean region dominated by sun-grown coffee. Diversity was estimated using two measures of species abundance (the number of individuals and biomass) and was compared among four types of vegetation cover (forest, riparian forest, sun-grown coffee, and pastures) in three landscape plots with different degrees of deforestation intensity (low, intermediate, and high). We found that dung beetle diversity patterns differed between types of vegetation cover and degree of deforestation, depending on whether the number of individuals or biomass was used. Based on biomass, inequality in the dung beetle community was lowest in the forest, and increased in the sun-grown coffee and pastures across all levels of deforestation, particularly for the increasing dominance of large species. The number of beetles and biomass indicate that the spatial dominance of sun-grown coffee does not necessarily imply the drastic impoverishment of dung beetle diversity. In fact, for these beetles, it would seem that the landscape studied has not yet crossed "a point of no return." This system offers a starting point for exploring biodiversity management and conservation options in the sun-grown coffee landscapes of the Colombian Andes.
Assuntos
Agricultura , Biodiversidade , Biomassa , Coffea , Besouros/fisiologia , Florestas , Animais , Coffea/crescimento & desenvolvimento , Colômbia , Densidade DemográficaRESUMO
In this work we extend the toxicological studies of hot aqueous extract of A. satureioides (As-HAE) evaluating cytotoxic and apoptotic effects on human peripheral blood mononuclear cells (PBMCs). We also determine genotoxic action of this extract in vivo. In addition, the extract was chemically characterized. Finally, we established a comparison with previous data of cold aqueous extract. The As-HAE induced cytotoxicity on PBMCs determined by trypan blue dye exclusion (CC50 = 653 µg/mL) and MTT (CC50 = 588 µg/mL) assays being more toxic than cold extract. However, As-HAE as well as cold extract did not induce apoptosis measured by Hoechst 33258 staining, TUNEL assay, and DNA fragmentation analysis. The in vivo micronucleus test showed that As-HAE exerted cytogenotoxic effects on bone marrow of mice, contrary to what was observed with cold extract. The chemical study of As-HAE allowed identifying the flavonoids found in cold extract: luteolin, quercetin, and 3-O-methylquercetin, but at higher concentrations. We suggest that toxic effects induced by As-HAE could be due to high concentrations of these flavonoids. Given that As-HAE is the most used in folkloric medicine, its administration should be controlled in order to prevent potential cell damage.
Assuntos
Flavonoides/farmacologia , Luteolina/farmacologia , Extratos Vegetais/farmacologia , Quercetina/análogos & derivados , Achyrocline/química , Animais , Apoptose/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Fragmentação do DNA/efeitos dos fármacos , Flavonoides/química , Humanos , Leucócitos Mononucleares/efeitos dos fármacos , Luteolina/isolamento & purificação , Camundongos , Extratos Vegetais/química , Quercetina/isolamento & purificação , Quercetina/farmacologiaRESUMO
Acacia aroma, native plant from San Luis, Argentina, is commonly used as antiseptic and for healing of wounds. The present study was conducted to investigate the in vitro cytotoxicity and genotoxicity of hot aqueous extract (HAE) and ethanolic extract (EE) of A. aroma. The cytotoxic activity was assayed by neutral red uptake assay on Vero cell. Cell treatment with a range from 100 to 5000 µg/mL of HAE and EE showed that 500 µg/mL and 100 µg/mL were the maximum noncytotoxic concentrations, respectively. The CC50 was 658 µg/mL for EE and 1020 µg/mL for HAE. The genotoxicity was tested by the single-cell gel electrophoresis comet assay. The results obtained in the evaluation of DNA cellular damage exposed to varied concentrations of the HAE showed no significant genotoxic effect at range of 1-20 mg/mL. The EE at 20 mg/mL showed moderate genotoxic effect related to the increase of the DNA percentage contained in tail of the comet; DNA was classified in category 2. At concentrations below 5 mg/mL, the results of cytotoxicity and genotoxicity of aqueous and ethanolic extracts of Acacia aroma guarantee the safety at cell and genomic level. However further studies are needed for longer periods including animal models to confirm the findings.
Assuntos
Acacia/química , Mutagênicos/toxicidade , Extratos Vegetais/toxicidade , Folhas de Planta/química , Adulto , Animais , Morte Celular/efeitos dos fármacos , Forma Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Chlorocebus aethiops , Dano ao DNA , Humanos , Células VeroRESUMO
AIMS: To acquire data on the safety-in-use of the probiotic Saccharomyces cerevisiae RC016 and test its ability to reduce genotoxicity caused by dietary aflatoxins (AFs). METHODS AND RESULTS: The probiotic was orally administered to Wistar rats. Six groups (n = 6) were arranged: feed and probiotic controls, two levels of AFs-contaminated feed and two treatments including both the probiotic and the toxin. Genotoxiciy and cytotoxicity were evaluated with the bone marrow micronuclei assay and the comet assay and internal organs were macroscopically and microscopically examined. The tested S. cerevisiae strain did not cause genotoxicity or cytotoxicity in vivo, and it was able to attenuate AFs-caused genotoxicity. Saccharomyces cerevisiae RC016 did not cause any impairment on the rats' health and it showed no negative impact on the weight gain. Moreover, RC016 improved zootechnical parameters in AFs-treated animals. The beneficial effects were likely to be caused by adsorption of AFs to the yeast cell wall in the intestine and the consequent reduction in the toxin's bioavailability. CONCLUSIONS: The dietary administration of RC016 does not induce genotoxicity or cytotoxicity to rats. SIGNIFICANCE AND IMPACT OF THE STUDY: Incorporation of RC016 in the formulation of feed additives increases animal productivity. Similar effects may even occur in human food applications.
Assuntos
Probióticos/toxicidade , Saccharomyces cerevisiae , Administração Oral , Aflatoxinas/toxicidade , Ração Animal , Animais , Dano ao DNA , Masculino , Ratos , Ratos Wistar , Testes de Toxicidade SubcrônicaRESUMO
Objetivo: Describir los resultados de la histerectomía laparoscópica total ambulatoria. Método: Se analizan 297 pacientes sometidas a histerectomía laparoscópica total y que fueron dadas de alta luego de la recuperación anestésica, entre mayo de 2007 y marzo de 2008. Se requería una puntuación de menos de 5 en la escala visual análoga del dolor para el alta. Resultados: El promedio de edad fue de 42 años, el tiempo quirúrgico de 79,1 minutos, el sangrado estimado fue de 37,1 ml, el tiempo promedio de estancia total fue de 9,4 horas con un tiempo promedio de estancia postoperatoria de 5,4 horas. La tasa de complicaciones postoperatorias fue de 11,8 por ciento y la de readmisiones del 3,3 por ciento. El promedio de Escala Visual Análoga del dolor para la primera noche fue de 4,2 puntos. El 6 por ciento de las pacientes presentaron vómitos en su domicilio. El 99 por ciento de las pacientes recomendarían este tipo de manejo. Conclusiones: El manejo ambulatorio después de histerectomía laparoscópica total es posible, seguro y bien evaluado por las pacientes. Este manejo no conlleva un mayor riesgo de complicaciones y la tasa de readmisiones es baja.
Objective: To describe the results of a group of patients in which total laparoscopic hysterectomy was done as an outpatient procedure. Methods: We included 297 patients who were undergone to laparoscopic total hysterectomy, and were discharge to their home after recovery of anesthesia from may 2007 to march 2008. It was necessary to have a punctuation less than 5 in the analogue visual scale to be sent at home. Results: Mean age was 42 years, surgical time 79.1 minutes, estimated blood loss 37.1 ml, overall length of stay 9.4 hours, postoperative length of stay 5.4 hours. Postoperative complication rate was 11.8 percent, readmission rate was 3.3 percent. Mean VAS Score for pain during the first night was 4.2 points; 6 percent of patients vomited at home. Mean VAS Score for satisfaction with ambulatory management was 9.5, and 99 percent of the patients would recommend this type of management. Conclusions: Ambulatory management after total laparoscopic hysterectomy is possible, safe and well evaluated by patients. It does not impose a higher risk of complications and readmission rate is low.
Assuntos
Humanos , Adulto , Feminino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Ambulatórios , Histerectomia/métodos , Laparoscopia/métodos , Perda Sanguínea Cirúrgica , Estudos de Viabilidade , Tempo de Internação , Medição da Dor , Satisfação do Paciente , Complicações Pós-OperatóriasRESUMO
This study documents differences in fish assemblages for 32 freshwater streams located between 258 and 2242 m a.s.l. on the eastern slopes of the central range of the Colombian Andes. A total of 2049 fishes belonging to 62 species, 34 genera and 16 families were collected. Species richness declined rapidly with altitude; nearly 90% of the species were recorded between 250 and 1250 m a.s.l. Three of the four physico-chemical variables, of the water, temperature, dissolved oxygen and pH, explained 53.5% of the variation in species richness along the altitudinal gradient, with temperature the most important (37.6%). An analysis of species composition showed that the distinctiveness of the fish fauna increased with elevation, with the greatest turnover observed between 1000 and 1750 m a.s.l. On this altitudinal gradient, turnover was dominated by the loss of species rather than gain, and dominance by just a few species was greater at higher elevations. Turnover was also observed along the altitudinal gradient in the structure of the three functional groups (torrential, pool and pelagic species). The study focused on understanding the pattern of diversity of fish communities inhabiting the Andes in Colombia. Anthropogenic effects on the altitudinal distribution of fish species in the region, however, are largely unknown and would require further investigations.
Assuntos
Altitude , Biodiversidade , Peixes/classificação , Rios , Animais , Colômbia , Modelos Lineares , Modelos BiológicosRESUMO
The vacA and cagA genotypes of Helicobacter pylori exhibited distinct geographic distribution and correlation with severity of disease. In the above genotypes (obtained from 150 H. pylori-positive patients--139 with gastritis, 10 with ulcer and 1 patient with gastric cancer) combinations vacA s1/m1 and s2/m2 were detected using PCR in 75 and 25% of isolates, respectively, in patients with chronic gastritis. The of s1/m1 and s2/m2 combinations were also detected from ulcers (60 and 40%, respectively). The cagA was detected in 30% of isolates. Concentrated culture supernatants of 7 (64%) out of 11 H. pylori strains induced vacuolization in Vero cells in titers ranging from 1:5 to 1:40. The vacA s1 genotype was significantly associated with, but not predictive of the presence of vacuolating cytotoxin activity and the cagA gene.
Assuntos
Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Gastropatias/microbiologia , Adulto , Idoso , Antígenos de Bactérias/genética , Argentina/epidemiologia , Proteínas de Bactérias/genética , Citotoxinas/biossíntese , Gastroscopia , Genótipo , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Fenótipo , Reação em Cadeia da Polimerase , Gastropatias/epidemiologiaRESUMO
La tuberculosis sigue siendo un importante problema y un tópico de la salud pública de magnitud considerable. La tuberculosis que compromete al sistema nervioso central es un importante y serio compromiso extrapulmonar. El infarto y la hidrocefalia cerebral son complicaciones graves de la meningitis tuberculosa y son de mal pronóstico. Presentamos a un paciente con tuberculosis miliar y compromiso meníngeo que cursa con infartos cerebrales múltiples e hidrocefalia. Él presentó una mala evolución y falleció.
Tuberculosis remains a major global problem and a public health issue of considerable magnitude.Tuberculosis involvement of the central nervous system is an important and serious type of extra pulmonary involvement.Cerebral infarction and hydrocephalus are serious complications of tuberculous meningitis and may worsen the prognosis.We present a patient of milliar tuberculosis and meningeal compromise that course with multiple cerebral infarcts and hydrocephalus. He had a poor outcome.
Assuntos
Humanos , Masculino , Adulto , Hidrocefalia/etiologia , Tuberculose Meníngea/complicações , Tuberculose Meníngea/diagnóstico , Tuberculose Meníngea/terapia , Evolução Fatal , Infarto Cerebral/etiologiaRESUMO
BACKGROUND: Tomato has a high antioxidant capacity due to its high content of vitamin C, vitamin E and lycopene that is a powerful free radical scavenger. However, the effects of tomato on plasma lipoproteins is not well known, and there is little evidence about the relationship between tomato consumption and oxidative state changes in humans. AIM: To assess in vivo the effects of dietary supplementation with pure concentrated tomato juice on short term changes in oxidative state and plasma lipoproteins in healthy volunteers. SUBJECTS AND METHODS: Seventeen healthy volunteers were studied. They received a supplement of pure tomato juice during 7 days. At baseline, at the end of the supplementarion period and eight days after the end of the supplementation, a blood sample was drawn to measure total antioxidant capacity (TRAP), enzymatic antioxidants (catalase and superoxide dismutase), non-enzimatic antioxidants (lycopene and a-tocopherol) and plasma lipoproteins. RESULTS: Lycopene level increased early and significantly in comparison with basal levels (48%; p < 0.05). TRAP, catalase and superoxide dismutase did not change significantly. HDL cholesterol increased significantly in 5.6+/-4.3 mg/dL (p < 0.002) on the second sampling period, improving the ratio cholesterol/HDL. It returned to baseline in the third period. CONCLUSIONS: Dietary supplementation of concentrated tomato juice significantly increases lycopene levels and HDL cholesterol. Non significant changes observed in TRAP, catalase and superoxide dismutase were observed during the supplementation period.
Assuntos
Antioxidantes/metabolismo , Bebidas , Carotenoides/metabolismo , Lipoproteínas HDL/sangue , Estresse Oxidativo/efeitos dos fármacos , Solanum lycopersicum , Adulto , Análise de Variância , Antioxidantes/administração & dosagem , Antioxidantes/química , Doenças Cardiovasculares/prevenção & controle , Carotenoides/sangue , Catalase/sangue , Suplementos Nutricionais , Feminino , Humanos , Lipoproteínas LDL/sangue , Estudos Longitudinais , Licopeno , Solanum lycopersicum/química , Masculino , Estatísticas não Paramétricas , Superóxido Dismutase/sangue , Tocoferóis/sangueRESUMO
Small bowel carcinoid tumors are more common in the distal ileum and they are multiple in 30 percent of cases. The most common clinical manifestation is abdominal pain and the treatment of choice is surgical excision. We report a 63 years old female consulting for abdominal pain. An intestinal transit by computed axial tomography revealed multiple images compatible with small bowel carcinoid tumors. She had a surgical excision of the involved intestinal segment and the pathological study confirmed the imaging diagnosis. In the follow up, this patients has been asymptomatic.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Tumor Carcinoide/patologia , Neoplasias Intestinais/patologia , Intestino Delgado/patologia , Dor Abdominal/patologia , Tumor Carcinoide , Neoplasias Intestinais , Intestino Delgado , Tomografia Computadorizada por Raios XRESUMO
Background: Tomato has a high antioxidant capacity due to its high content of vitamin C, vitamin E and lycopene that is a powerful free radical scavenger. However, the effects of tomato on plasma lipoproteins is not well known, and there is little evidence about the relationship between tomato consumption and oxidative state changes in humans. Aim: To assess in vivo the effects of dietary supplementation with pure concentrated tomato juice on short term changes in oxidative state and plasma lipoproteins in healthy volunteers. Subjects and methods: Seventeen healthy volunteers were studied. They received a supplement of pure tomato juice during 7 days. At baseline, at the end of the supplementarion period and eight days after the end of the supplementation, a blood sample was drawn to measure total antioxidant capacity (TRAP), enzymatic antioxidants (catalase and superoxide dismutase), non-enzimatic antioxidants (lycopene and a-tocopherol) and plasma lipoproteins. Results: Lycopene level increased early and significantly in comparison with basal levels (48%; p <0.05). TRAP, catalase and superoxide dismutase did not change significantly. HDL cholesterol increased significantly in 5.6±4.3 mg/dL (p <0.002) on the second sampling period, improving the ratio cholesterol/HDL. It returned to baseline in the third period. Conclusions: Dietary supplementation of concentrated tomato juice significantly increases lycopene levels and HDL cholesterol. Non significant changes observed in TRAP, catalase and superoxide dismutase were observed during the supplementation period.
Assuntos
Adulto , Feminino , Humanos , Masculino , Antioxidantes/metabolismo , Bebidas , Carotenoides/metabolismo , Lipoproteínas HDL/sangue , Solanum lycopersicum , Estresse Oxidativo/efeitos dos fármacos , Análise de Variância , Antioxidantes/administração & dosagem , Antioxidantes/química , Doenças Cardiovasculares/prevenção & controle , Carotenoides/sangue , Catalase/sangue , Suplementos Nutricionais , Lipoproteínas LDL/sangue , Estudos Longitudinais , Solanum lycopersicum/química , Estatísticas não Paramétricas , Superóxido Dismutase/sangue , Tocoferóis/sangueRESUMO
Upper airway obstruction (UAO) can be a severe medical condition with a high mortality in children. We report a 10 year-old girl with UAO due to papillary thyroid carcinoma. The study confirmed a thyroid cancer. The patient was referred to our centre for the evaluation of dyspnea and hoarseness. She was admitted in severe respiratory distress. Her chest X-ray revealed a critical narrowing of the cervical trachea and extensive infiltration of the lung with a miliary pattern; CT scan revealed a thyroid mass with bilateral pulmonary dissemination. An early surgical approach with total thyroidectomy and tracheotomy was performed. The study revealed a thyroid carcinoma. The patient was then referred to a specialized centre to receive radioiodine treatment. Recognition of thyroid carcinoma in children requires a high suspicion index. An early CT scan and fiberoptic assessment could show UAO in many unsuspected lesions.
Assuntos
Criança , Feminino , Humanos , Obstrução das Vias Respiratórias/etiologia , Carcinoma Papilar/complicações , Neoplasias da Glândula Tireoide/complicações , Obstrução das Vias Respiratórias , Obstrução das Vias Respiratórias/cirurgia , Carcinoma Papilar , Carcinoma Papilar/cirurgia , Diagnóstico Diferencial , Neoplasias da Glândula Tireoide , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tomografia Computadorizada por Raios X , TraqueotomiaRESUMO
La administración eficiente de los recursos de salud, requiere de una adecuada gestión clínica y económica. A partir de la identificación de las prestaciones médicas más frecuentes, es posible confeccionar programas de prestación de servicios concordantes con las necesidades de la población. Ha sido el desarrollo de la medicina basada en evidencia, el que ha permitido sistematizar la información y construir guías de atención, que aseguren una atención de calidad acorde a la disponibilidad de recursos económicos. La implementación de programas de intervención, permitirá el uso más racional de los recursos médicos, ajustar la indicación de césareas, mejorar los estándares de atención y ofrecer mejores paquetes de prestaciones a las intituciones demandantes de servicios de salud, aumentando así la rentabilidad de la gestión (1). Se estudió restrospectivamente, los 2126 nacimientos atendidos en el Servicio de Maternidad del Hospital Clínico de la Universidad de Chile durante el año 2001. De un total de 861 casos correspondientes a cesáreas (40,49 por coiento) 282 (32,75 por ciento) fueron primigestas, 268 (52,6 por ciento) presentaban antecedentes de cesáreas y 526 (61.09 por ciento) fueron cesáreas electivas. El tiempo promedio de hospitalización fue de 3,81 días. Las causas más frecuentes fueron cicatriz de cesárea (52,6 por ciento), RPM (11,6 por ciento), DCP (11 por ciento), Podálica (10 por ciento) y falta de progreso del trabajo de parto (10 por ciento). Desde el punto de vista económico, el 93 por ciento del costo del paquete estuvo conformado por: honorarios médicos (47 por ciento), día cama (28 por ciento) y derecho a pabellón (16 por ciento), lo que implica que la reducción de costos debe fundamentarse en modificación de estos factores. Se observó una dismunución significativa en el costo del paquete a reducir a los 2 días de hospitalización materna, así como al considerar sólo el uso de la nestesia espinal. En conclusión, es imperativo establecer guías de atención que aseguren un número de cesáreas ajustado a las necesidades clínicas, optimizando los estándares de servicio. Además, debido a que un 61 por ciento de nuestra cesáreas fueron electivas, la implementación de estos cambios no representaría un menoscabo en la calidad de atención, por el contrario, significaría un importante ahorro de recursos destinados a esta intervención
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Cesárea/economia , Recursos em Saúde , Atenção à Saúde/economia , Chile , Medicina Baseada em Evidências , Necessidades e Demandas de Serviços de Saúde , Maternidades , Hospitais de Ensino , Atenção à Saúde/estatística & dados numéricos , Procedimentos Cirúrgicos Eletivos/economia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Alocação de Recursos , Estudos Retrospectivos , Tempo de Internação/economiaRESUMO
Los trastornos del sueño son una patología frecuente. Cerca del 35 por ciento de los colombianos presentara en cualquier momento de su vida una alteración del sueño. El insomnio es la queja principal en adultos y ancianos. La prevalencia del insomnio en mujeres es del 40 por ciento, se presenta en 30 por ciento de los hombres y en 50 por ciento de personas mayores de 65 años. Los factores asociados con mayor prevalencia son género femenino, presencia de trastornos mentales, condiciones médicas generales, abuso de sustancias y edad avanzada. Una adecuada intervención exige el diagnóstico cuidadoso y el tratamiento según la causa. Existe relación directa entre insomnio y alteraciones médicas, neurológicas, neumológicas y psiquiátricas. El omnólogo descarta estas patologías cuando examina un paciente mediante la anamnesis, heteroanamnesis, examen físico, agenda de sueño, exámenes somáticos y psicológicos y en ocasiones la polisomnografía. Para su manejo se evalúan factores predisponentes, precipitantes y perpetuadores que afectan el curso del insomnio. El tratamiento actual considera un abordaje integral y edológico. Se usa higiene del sueño, hipnóticos, CPAP-BiPAP-AutoCPAP, luminoterapia, cronoterapia y en ocasiones la melatonina. En este artículo se presenta el manejo no psicofarmacológico del insomnio crónico. Se describen las principales técnicas comportamentales y su aplicación en el tratamiento de estos pacientes