RESUMO
Cerebral palsy (CP) affects body posture and movement coordination and is the most common cause of severe disability in the pediatric population. The diagnosis of CP is not a description of a person's functioning or interaction with their environment. Therefore, the diagnosis should be complemented with a description of functioning, using tools based on the biopsychosocial model proposed by the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This report describes the preliminary data from a multicenter study conducted in Argentina with the aim of standardizing the description of the profiles of functioning of children and adolescents with CP. These data showed that the participants had some skills in sleep functions, mental functions of language, seeing functions, and in some environmental factors. They showed significant difficulties in categories such as maintaining body position, walking, and toileting.
La parálisis cerebral (PC) afecta la postura y la coordinación del movimiento, y es la causa más común de discapacidad grave en la población pediátrica. El diagnóstico de PC no describe el funcionamiento ni la interacción de la persona con el contexto en el cual se desarrolla. Por lo tanto, el diagnóstico se debe complementar con una descripción del funcionamiento, utilizando herramientas basadas en el modelo biopsicosocial de la Clasificación del Funcionamiento (CIF) de la Organización Mundial de la Salud (OMS). En esta comunicación, describimos los datos preliminares de un estudio multicéntrico en Argentina destinado a estandarizar la descripción del perfil de funcionamiento en niños y adolescentes con PC. Estos datos mostraron que los participantes tienen algunas habilidades en las funciones del sueño, las funciones mentales del lenguaje y las visuales, así como en algunas relacionadas con el contexto. Presentan dificultades importantes en categorías tales como mantener la posición del cuerpo, el andar y la higiene.
Assuntos
Paralisia Cerebral , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/diagnóstico , Humanos , Argentina , Criança , Masculino , Adolescente , Feminino , Pré-Escolar , Avaliação da DeficiênciaRESUMO
Recently, the large migratory fishes of the family Serrasalmidae (Piaractus brachypomus and P. orinoquensis) were described as restricted to the Orinoco and Amazon basins. Both species provide important ecosystem services. They also are an important fisheries resource, which has caused that their populations have decreased in recent years. National fisheries policies still consider both species as one, which leads to inefficiencies in their management and conservation. The aim of this study was to genetically characterize these two species, using microsatellite and mitochondrial markers, and discuss the implication of these results for conservation and management. We found that both species have moderate genetic diversity and varied patterns of genetic distribution in the fluvial landscape. Piaractus brachypomus presented genetic diversity of A=6.5; He=0.72; Ho=0.67; H=1.000; á´«=0.0092, three management units related to the evolutionary process of the Amazon basin and the effective sizes of local populations were smaller compared to P. orinoquensis, which presented genetic diversity of A=6.1; He=0.66; Ho=0.55; H=0.968; á´«=0.010 and comprises only one management unit. These results demonstrate the need to design management policies that focus on species and geographically restricted populations.
Recientemente, los grandes peces migratorios Serrasalmidae (Piaractus brachypomus y P. orinoquensis) fueron diferenciados en las cuencas del Orinoco y Amazonas. Ambas especies brindan importantes servicios ecosistémicos, entre ellos la pesca para la dieta humana, lo que ha provocado que sus poblaciones hayan disminuido en los últimos años. Las políticas pesqueras nacionales aún consideran a ambas especies como una sola, lo que conduce a ineficiencias en su gestión y conservación. El objetivo de este estudio fue caracterizar genéticamente estas dos especies de Piaractus, usando marcadores microsatélites y mitocondriales, y discutir la implicación de estos resultados para la conservación y el manejo. Encontramos que ambas especies tienen una diversidad genética moderada y patrones variados de distribución genética en el paisaje fluvial. Piaractus brachypomus presentó diversidad genética de A=6.5; He=0.72; Ho=0.67; H=1.000; á´«=0.0092, tres unidades de manejo relacionadas con el proceso evolutivo de la cuenca Amazónica y los tamaños efectivos de las poblaciones locales fueron menores en comparación con P. orinoquensis, que presentó diversidad genética de A=6.1; He=0.66; Ho=0.55; H=0.968; á´«=0,010 y comprende una sola unidad de gestión. Estos resultados demuestran la necesidad de diseñar políticas de manejo que se enfoquen en especies y poblaciones geográficamente restringidas.
Assuntos
Animais , Caraciformes/genética , Pesqueiros , Brasil , Bacias Hidrográficas , Colômbia , Ecossistema Amazônico , Repetições de MicrossatélitesRESUMO
At "Instituto de Alergias y Autoinmunidad Dr. Maximiliano Ruiz Castañeda, A.C." in Mexico City, a non-traditional health care center focused on the treatment of autoimmune and allergic diseases using personalized medicine, an alternative treatment referred to as an "immune-modulator" has been developed. In this study, we will refer to this treatment substance as the "immune-modulator." In brief, a urine sample is collected from the patient and processed to obtain the peptide fraction, which is conditioned and then administered sublingually to the patient. Sample processing involves multiple steps aimed at the removal of toxic compounds and enrichment for cytokines, growth factors, and other immune peptides that may contribute to the function of the immune-modulator. This treatment has been administered for many years, and patients testify that it is useful and reliable. Despite the benefits of this treatment, the molecular mechanisms underlying its effects have not been thoroughly investigated. Therefore, this study aims to identify immunoregulatory peptides, such as cytokines and growth factors, in the immune-modulator. Urine and immune-modulator concentrations of cytokines and growth factors were assessed using a Luminex assay. Twenty-one cytokines and growth factors were identified in immune-modulator samples. MCP-1 was identified in 100% of the samples; MIP-1ß, IL-8, RANTES, INF-γ, and IP-10 were identified in approximately 65-70% of samples; IL5, IL-1B, and IL-17 in 50-60%; eotaxin, VEGF, IL-6, and FGF in about 40%; MIP-1α, IL-9, GM-CSF, G-CSF, IL-12, and IL-15 in about 20-30%; and IL-13 and PDGF-bb were identified in <6% of samples. Additionally, patients exhibited significant changes in IL-1ß, IFN-γ, and MCP-1 concentrations after treatment with the immune-modulator, whereas healthy individuals showed no significant change in response to the treatment. The immune-modulator is an alternative treatment based on the administration of cytokines and growth factors obtained from the urine of patients. In this study, its composition was characterized. The isolated products could be responsible for the effects of the immune-modulator. Further trials are required to evaluate the effective delivery of these molecules by the administration route described.
Assuntos
Doenças Autoimunes/urina , Citocinas/urina , Hipersensibilidade/urina , Adulto , Idoso , Doenças Autoimunes/terapia , Doença Crônica , Feminino , Humanos , Hipersensibilidade/terapia , Masculino , Pessoa de Meia-IdadeRESUMO
Piaractus orinoquensis, a new species of serrasalmid fish, is described from the Orinoco River basin. The new species differs from congeners by having a slenderer body, relatively smaller head and snout, more compressed mid-body, fewer scales above and below the lateral line and diagnostic molecular characters in the coI mitochondrial gene region. We also provide a re-description of Piaractus brachypomus, restricting its geographic distribution to the Amazon River basin. Both species are economically important in their respective basins and need to be independently managed as distinct species.
Assuntos
Caraciformes/classificação , DNA Mitocondrial/química , Complexo IV da Cadeia de Transporte de Elétrons/genética , Nadadeiras de Animais/anatomia & histologia , Escamas de Animais/anatomia & histologia , Animais , Brasil , Caraciformes/anatomia & histologia , Caraciformes/genética , Colômbia , Pesqueiros/organização & administração , Sistema da Linha Lateral/anatomia & histologia , Funções Verossimilhança , Maxila/anatomia & histologia , Mitocôndrias/genética , Filogenia , Pigmentação , Distribuição de Poisson , Rios , Alinhamento de Sequência , Software , Coluna Vertebral/anatomia & histologia , Terminologia como AssuntoRESUMO
The objective of this study was to evaluate the incidence of bruises and losses due to injuries in bovine carcasses submitted to road transport. A total of 1599 carcasses were evaluated for the number of bruises and 1440 for injuries losses. The study was conducted in the city of Aquidauana/MS, at a slaughterhouse. The number, location, color and size of the bruises were visually assessed. In addition, data regarding types of trucks in which the animals were transported, distance traveled to the slaughterhouse, sexual class and age of the animals were collected. In order to quantify the injury losses, the injuries removed during toilet of the carcasses were collected and weighed. Animals that traveled longer distances to the slaughterhouse showed more bruises in the carcasses, 97.81% of the carcasses evaluated had one or more bruises. In addition, the regions of the carcasses that obtained the highest average percentage of bruises were the sacral and lumbar, being 31.77 and 31.63%, respectively. Bruises in the posterior area of the carcass may represent greater economic losses because meat cuts of higher market value are located in this area. Females and uncastrated males were the groups with the highest number of carcasses with bruises. The injuries represented an average loss of 0.225 kg per carcass, generating an average economic loss of R$ 2.14, in this context, females showed greater losses due to injuries when compared to uncastrated and castrated males. In conclusion, longer distances increase the risk of bruised carcasses. Transport with inadequate stocking, physical conditions of vehicles and inadequate handling are the main causes of bruising. In addition, factors inherent to the animals may also favor the occurrence of bruises and injuries, such as lower fat cover in females and the more aggressive behavior of uncastrated males when compared to castrated males.(AU)
Objetivou-se avaliar a incidência de hematomas e perdas por lesões em carcaças bovinas de animais submetidos ao transporte rodoviário. Foram avaliadas 1.599 carcaças quanto ao número de hematomas e 1.440 quanto as perdas por lesões. O estudo foi conduzido no município de Aquidauana/MS, em abatedouro frigorífico. Avaliou-se visualmente o número, localização, coloração e tamanho dos hematomas. Além disso, foram coletados dados referentes aos tipos de caminhões em que os animais foram transportados, distância percorrida até o abatedouro frigorífico, classe sexual e idade dos animais. Para quantificar as lesões, realizou-se a coleta e pesagem das lesões retiradas durante a toalete das carcaças. Animais que percorreram maiores distâncias até o frigorífico apresentaram maior número de lesões nas carcaças, sendo que, 97,81% das carcaças avaliadas, apresentaram um ou mais hematomas. Além disso, a região sacral e lombar foram as que obtiveram a maior percentagem média de hematomas, 31,77 e 31,63%, respectivamente. Hematomas na área posterior da carcaça podem representar maiores perdas econômicas pois cortes cárneos de maior valor agregado se localizam nessa área. Fêmeas e machos inteiros foram os grupos com maior número de carcaças com hematomas. As lesões representaram uma perda média de 0,225 kg por carcaça, gerando uma perda econômica média de R$ 2,14, sendo que as fêmeas apresentaram maior perda por lesões quando comparadas a machos inteiros e castrados. Em distâncias mais longas o risco de surgirem animais contundidos aumenta. Transporte com lotação inadequada, condições físicas dos veículos de transporte e manejos inadequados são as principais causas de ocorrência de hematomas. Além destes, fatores inerentes aos animais também podem favorecer a ocorrência de hematomas e lesões como, por exemplo, menor acabamento de gordura na carcaça em fêmeas e o comportamento mais agressivo de machos inteiros quando comparados a machos castrados.(AU)
Assuntos
Animais , Bovinos , Ferimentos e Lesões/veterinária , Meios de Transporte , Abate de Animais/economia , Carne Vermelha/análise , Bem-Estar do Animal , Qualidade dos AlimentosRESUMO
The objective of this study was to evaluate the incidence of bruises and losses due to injuries in bovine carcasses submitted to road transport. A total of 1599 carcasses were evaluated for the number of bruises and 1440 for injuries losses. The study was conducted in the city of Aquidauana/MS, at a slaughterhouse. The number, location, color and size of the bruises were visually assessed. In addition, data regarding types of trucks in which the animals were transported, distance traveled to the slaughterhouse, sexual class and age of the animals were collected. In order to quantify the injury losses, the injuries removed during toilet of the carcasses were collected and weighed. Animals that traveled longer distances to the slaughterhouse showed more bruises in the carcasses, 97.81% of the carcasses evaluated had one or more bruises. In addition, the regions of the carcasses that obtained the highest average percentage of bruises were the sacral and lumbar, being 31.77 and 31.63%, respectively. Bruises in the posterior area of the carcass may represent greater economic losses because meat cuts of higher market value are located in this area. Females and uncastrated males were the groups with the highest number of carcasses with bruises. The injuries represented an average loss of 0.225 kg per carcass, generating an average economic loss of R$ 2.14, in this context, females showed greater losses due to injuries when compared to uncastrated and castrated males. In conclusion, longer distances increase the risk of bruised carcasses. Transport with inadequate stocking, physical conditions of vehicles and inadequate handling are the main causes of bruising. In addition, factors inherent to the animals may also favor the occurrence of bruises and injuries, such as lower fat cover in females and the more aggressive behavior of uncastrated males when compared to castrated males.
Objetivou-se avaliar a incidência de hematomas e perdas por lesões em carcaças bovinas de animais submetidos ao transporte rodoviário. Foram avaliadas 1.599 carcaças quanto ao número de hematomas e 1.440 quanto as perdas por lesões. O estudo foi conduzido no município de Aquidauana/MS, em abatedouro frigorífico. Avaliou-se visualmente o número, localização, coloração e tamanho dos hematomas. Além disso, foram coletados dados referentes aos tipos de caminhões em que os animais foram transportados, distância percorrida até o abatedouro frigorífico, classe sexual e idade dos animais. Para quantificar as lesões, realizou-se a coleta e pesagem das lesões retiradas durante a toalete das carcaças. Animais que percorreram maiores distâncias até o frigorífico apresentaram maior número de lesões nas carcaças, sendo que, 97,81% das carcaças avaliadas, apresentaram um ou mais hematomas. Além disso, a região sacral e lombar foram as que obtiveram a maior percentagem média de hematomas, 31,77 e 31,63%, respectivamente. Hematomas na área posterior da carcaça podem representar maiores perdas econômicas pois cortes cárneos de maior valor agregado se localizam nessa área. Fêmeas e machos inteiros foram os grupos com maior número de carcaças com hematomas. As lesões representaram uma perda média de 0,225 kg por carcaça, gerando uma perda econômica média de R$ 2,14, sendo que as fêmeas apresentaram maior perda por lesões quando comparadas a machos inteiros e castrados. Em distâncias mais longas o risco de surgirem animais contundidos aumenta. Transporte com lotação inadequada, condições físicas dos veículos de transporte e manejos inadequados são as principais causas de ocorrência de hematomas. Além destes, fatores inerentes aos animais também podem favorecer a ocorrência de hematomas e lesões como, por exemplo, menor acabamento de gordura na carcaça em fêmeas e o comportamento mais agressivo de machos inteiros quando comparados a machos castrados.
Assuntos
Animais , Bovinos , Abate de Animais/economia , Carne Vermelha/análise , Ferimentos e Lesões/veterinária , Meios de Transporte , Bem-Estar do Animal , Qualidade dos AlimentosRESUMO
RESUMEN OBJETIVO: reportar un caso de endometrioma complicado con absceso ovárico, exponer y discutir los factores de riesgo asociados, con la finalidad de difundir esta rara alteración y establecer el diagnóstico oportuno. CASO CLÍNICO: paciente de 34 años de edad, que acudió a consulta al Hospital Santa Rosa de Lima (Ensenada, Baja California Norte), con antecedente de dolor pélvico crónico de 5 meses de evolución y fiebre intermitente. El tratamiento con antibiótico de amplio espectro no mostró reacción satisfactoria. El ultrasonido transvaginal del ovario derecho mostró una imagen compatible con endometrioma. Mediante laparotomía se disecó la cápsula y se drenaron múltiples adherencias tubo-ováricas. El informe histopatológico confirmó el diagnóstico de endometrioma complicado por absceso. CONCLUSIÓN: es importante conocer los factores de riesgo para definir la causa de un absceso en un endometrioma, a través de la historia clínica detallada. La sospecha y diagnóstico oportuno es trascendental para reducir la morbilidad y mortalidad de esta complicación. Cualquier mujer con endometriosis en etapa avanzada es susceptible de complicaciones, como la formación de un absceso ovárico espontáneo.
ABSTRACT OBJETIVE: To report a case of Endometrioma complicated with ovarian abscess, expose and discuss the factors of risk associated with the purpose of disseminating this rare alteration and establishing the appropriate diagnosis. CASE REPORT: A 34 year old, seen at the Santa Rosa de Lima Hospital in Ensenada, Baja California, for a history of 5 months long chronic pelvic pain with intermittent fever, under treatment with broad spectrum antibiotic with no improvement. Transvaginal ultrasound revealed a compatible image with an endometrioma on the right ovary, followed by a laparotomy, capsule dissection and release of multiple tube-ovarian adhesions. The histo-pathological report confirmed that it was an ovarian endometrioma complicated by abscess. CONCLUSION: We emphasized in the study the risk factors and define a cause of an endometrioma and the clinical history details. Prevention and a good diagnoses as a priority to reduce morbi-mortality. It is very important to know that any woman with advanced stage history of endometriosis is susceptible to complications.
RESUMO
Rabies is a viral infectious disease that affects all mammals, including humans. Factors associated with the incidence of rabies include the presence and density of susceptible hosts and potential reservoirs. Currently, Chile is declared free of canine-related rabies, but there is an overpopulation of dogs within the country and an emergence of rabies in bats. Our objectives are to determine potential areas for bat-borne rabies spillover into dog populations expressed as a risk map, and to explore some key features of dog ownership, abundance, and management in Chile. For the risk map, our variables included a dog density surface (dog/km(2)) and a distribution model of bat-borne rabies presence. From literature review, we obtained dog data from 112 municipalities, which represent 33% of the total municipalities (339). At country level, based on previous studies the median human per dog ratio was 4.8, with 64% of houses containing at least one dog, and a median of 0.9 dog per house. We estimate a national median of 5.3 dog/km(2), and a median of 3680 dogs by municipality, from which we estimate a total population of 3.5×10(6) owned dogs. The antirabies vaccination presented a median of 21% of dogs by municipality, and 29% are unrestricted to some degree. Human per dog ratio have a significant (but weak) negative association with human density. Unrestricted dogs have a negative association with human density and income, and a positive association with the number of dogs per house. Considering dog density by municipality, and areas of potential bat-borne rabies occurrence, we found that 163 (â¼48%) of Chilean municipalities are at risk of rabies spillover from bats to dogs. Risk areas are concentrated in urban settlements, including Santiago, Chile's capital. To validate the risk map, we included cases of rabies in dogs from the last 27 years; all fell within high-risk areas of our map, confirming the assertive risk prediction. Our results suggest that the use of dog population parameters may be informative to determine risk areas for bat-rabies spillover events. In addition, we confirm that dog abundance is a neglected and emerging public health concern in Chile, particularly within urban areas, which deserves prompt intervention.
Assuntos
Quirópteros/virologia , Doenças do Cão/transmissão , Raiva/transmissão , Animais , Censos , Chile , Doenças do Cão/epidemiologia , Doenças do Cão/prevenção & controle , Cães , Mapas como Assunto , Propriedade , Raiva/epidemiologia , Raiva/prevenção & controle , Vacina Antirrábica/uso terapêutico , Análise de Regressão , Medição de RiscoRESUMO
In Chile, while dog rabies has decreased markedly over the last 30 years, bat rabies is still reported frequently. In order to shed new light on the spatiotemporal trends of these reports, we analysed active and passive data from years 1985 and 2012, which included 61 076 samples from 289 counties of Chile. We found that from 1994 to 2012, more than 15 000 bat samples were submitted for diagnostics through passive surveillance, 9·5% of which tested positive for rabies. By contrast, the prevalence of infection was only ~0·4% among the nearly 12 000 bat samples submitted through active surveillance. We found that the prevalence of dog rabies dropped steadily over the same period, with just a single confirmed case since 1998. None of the 928 samples from wild animals, other than bats, were positive for rabies. Although there has been only one confirmed case of human rabies in Chile since 1985, and a single confirmed case in a dog since 1998, bats remain a reservoir for rabies viruses. While active surveillance indicates that rabies prevalence is low in bat colonies, the high proportion of positive bats submitted through passive surveillance is a concern. To prevent human rabies, local public health agencies should increase research on the basic ecology of bats and the role of stray dogs and cats as potential rabies amplifiers.
Assuntos
Quirópteros , Vírus da Raiva/isolamento & purificação , Raiva/epidemiologia , Animais , Chile/epidemiologia , Prevalência , Saúde Pública/tendências , Raiva/prevenção & controle , Raiva/transmissão , Raiva/virologia , Vírus da Raiva/classificação , Estações do Ano , Especificidade da Espécie , Fatores de TempoRESUMO
In the past, the use of animals for transport and traction has been of economic importance all over the world, and this is still the case in certain areas of the world today, especially in rural and peri-urban areas of developing and transition countries. In Chile, for example, thousands of families rely on draught animal power as a fundamental source of income. This provides an opportunity to generate scientific information to increase understanding of the relationship between human well-being and that of domestic animals. Minimising the risks associated with poor draught animal welfare should be beneficial for this relationship. Given the important role of working equids as a source of wealth, in Chile and similar countries, different strategies have been implemented to address the health and welfare of these animals. For these strategies to be successful it is essential to establish appropriate government policies as well as to consider the cultural, political and geographical situation of the regions in which these equids work.
Assuntos
Criação de Animais Domésticos/métodos , Bem-Estar do Animal/normas , Cavalos , Criação de Animais Domésticos/economia , Bem-Estar do Animal/economia , Animais , Chile , PobrezaRESUMO
The arowanas, fishes of Gondwanan origin, are represented in South America by the genus Osteoglossum. All species were initially reported as being exclusive to the Amazon region, with O. ferreirai restricted to the Negro River basin and O. bicirrhosum to the Amazon and Essequibo Rivers basin. Starting in the mid 1970's it was reported that O. ferreirai also occurs in the Orinoco River basin. In all regions the arowanas assumed significant socio-economic importance due to their popularity in the international ornamental fish trade, leading to over-exploitation of both species in some areas. The Orinoco populations are particularly heavily exploited, and thus conservation and management measures are needed. Both depend on the clarification of taxonomic status, and phylogenetic distinctness of the Orinoco populations. With the goal of molecularly characterizing the two species of Osteoglossum, and comparing populations of Osteoglossum from the Orinoco and Amazon basins, we characterized individuals sampled from eight localities, one in the Orinoco River basin and seven in the Amazon River basin. We sampled 39 individuals, obtaining 1004 base pairs, of which 79 were synapomorphies. Genetic distance between the two species calculated using the HKY + G model of molecular evolution was 8.94%. Intraspecific distances ranged from 0.42% in O. bicirrhosum to 0.10% in O. ferreirai. The genetic characterization confirmed the taxonomic status of O. ferreirai in the Orinoco basin, and suggested that its distribution in the Orinoco basin is unlikely to be the result of vicariance or natural dispersal, but rather an anthropic introduction.(AU)
Os aruanãs, peixes de origem Gondwana, são representados na América do Sul pelo gênero Osteoglossum. Todas as espécies foram inicialmente reportadas como sendo exclusivamente da região Amazônica, com O. ferreirai restrito a bacia do Rio Negro e O. bicirrhosum para a bacia Amazônica e rio Essequibo. No meio dos anos 70 foi reportado que O. bicirrhosum também ocorre na bacia do rio Orinoco. Em todas as regiões os aruanãs são de significante importância socio-econômica devido a sua popularidade no comércio internacional de peixes ornamentais, levando a sobre-exploração de ambas as espécies em algumas áreas. As populações no rio Orinoco são particularmente muito exploradas, e assim medidas de conservação e manejo são necessárias. Ambas as medidas dependem de clarificações do estatus taxonômico, e distinções filogenéticas das populações do Orinoco. Com o objetivo de caracterizar molecularmente as duas espécies de Osteoglossum, e comparar as populações de Osteoglossum das bacias do Orinoco e Amazonas, nós caracterizamos indivíduos amostrados de oito localidades, uma da bacia do rio Orinoco e sete da bacia Amazônica. Nós amostramos 39 indivíduos, obtendo 1004 pares de bases, dos quais 97 foram sinapomorfias. A distância genética entre as duas espécies, calculadas usando-se o modelo HKY+G de evolução molecular foi de 8.94%. Distâncias intraespecíficas variaram de 0.42% em O. bicirrhosum a 0.10% em O. ferreirai. A caracterização genética confirmou o estatus taxonômico de O. ferreirai na bacia do rio Orinoco, e sugere que sua distribuição na bacia do rio Orinoco é improvavel de ser o resultado de um evento de vicariância ou dispersão natural, sendo melhor explicada como uma introdução antrópica.(AU)
Assuntos
Animais , Peixes/genética , Peixes/classificação , Classificação/métodos , Filogenia , Especificidade da EspécieRESUMO
OBJECTIVE: To validate the Spanish version of the CAM-ICU. DESIGN: Validation study. The inter-rater reliability and validity were evaluated using a blind comparison with the DSM-IVTR criteria (reference standard) in a group of patients hospitalized in an Intensive Care Unit (ICU). SETTING: Medical-surgical ICU. PATIENTS: 129 adults with RASS >-4 score, within the 24-48 h of ICU admission. Independent application of the CAM-ICU by two intensive care specialists and evaluation by a psychiatrist using the DSM-IVTR criteria for delirium. RESULTS: Prevalence of delirium in the sample was 26.4%, this being and 48.3% in the 29 patients who received mechanical ventilation. Inter-rater reliability in the whole sample according to the Kappa index was 0.792 (95% CI 0.662-0.922, p<0.001) and in those who received mechanical ventilation was 0.726 (95% CI 0.487-0.965, p<0.001). The sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were 79.4% (95% CI 63.2-89.7%); 97.9% (95% CI 92.6-99.4%); 93.1% (95% CI 78.0-98.1%); 93.0% (95% CI 86.3-96.6%); 37.72 (95% CI 9.47-150.20) and 0.21(95% CI 0.11-0.41), respectively, in the whole sample. In mechanically-ventilated patients, sensitivity, specificity, PPV, NPV, +LR and -LR were 92.9% (95% CI 68.5-98.7%); 86.7% (95% CI 62.1-96.3%); 86.7% (95% CI 62.1-96.3%); 92.9% (95% CI 68.5-98.7%); 6.96(95% CI 1.90-25.51) and 0.08 (95% CI 0.01-0.55), respectively. CONCLUSION: The Spanish version of the CAM-ICU is reliable. Its sensitivity, specificity and predictive values should be considered good.
Assuntos
Cuidados Críticos/métodos , Estado Terminal/psicologia , Delírio/diagnóstico , Índice de Gravidade de Doença , Adulto , Idoso , Colômbia/epidemiologia , Coma/diagnóstico , Delírio/epidemiologia , Delírio/psicologia , Demência/diagnóstico , Demência/epidemiologia , Demência/psicologia , Diagnóstico Diferencial , Humanos , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Valor Preditivo dos Testes , Prevalência , Reprodutibilidade dos Testes , Respiração Artificial , Sensibilidade e Especificidade , Método Simples-CegoRESUMO
The congenital cystic adenomatoid malformation (CCAM) of the lungs is a rare congenital abnormality that it is usually discovered during childhood. Late-onset CCAM is extremely uncommon, usually detected as a radiographic finding in adult patients. Timely diagnosis of this condition is important mainly because of the risk of recurrent infections and mainly forits neoplastic potential. The case ofan adult patient is presented.
La malformación adenomatoídea quística pulmonar es una extraña anomalía congénita que frecuentemente se detecta durante la infancia. La presentación tardía es poco frecuente y más comúnmente se detecta como un hallazgo radiológico en adultos. El diagnóstico de esta patología es importante, principalmente por el riesgo de infecciones recurrentes y transformación neoplásica.
Assuntos
Humanos , Masculino , Adolescente , Malformação Adenomatoide Cística Congênita do Pulmão , Malformação Adenomatoide Cística Congênita do Pulmão/classificação , Malformação Adenomatoide Cística Congênita do Pulmão/patologia , Prognóstico , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
Antecedentes: En Chile aproximadamente 475.297 mujeres se encuentran expuestas al riesgo de embarazos no deseados y abortos provocados, ya sea porque usan anticonceptivos de baja eficacia o no los usan. Objetivos: Conocer el perfil biosocial de las usuarias que demandan la píldora de anticoncepción de emergencia, una vez que ésta estuvo disponible para las beneficiarías de los Consultorios de Atención Primaria del Servicio de Salud. Métodos: Se analizó las características sociodemográficas y antecedentes gineco-obstétricos de la totalidad de las 93 fichas de las mujeres que solicitaron anticoncepción de emergencia entre el segundo semestre de 2006 y el primer semestre de 2007, en un Consultorio de Atención Primaria de Salud del Servicio de Salud Metropolitano de Santiago. Resultados: El perfil obtenido es de una mujer joven de promedio de 23,6 años, soltera, estudiante, beneficiaría exenta de pago del sistema de salud público, con edad promedio de inicio de relaciones sexuales de 16,2 años, que ha tenido entre una y dos parejas sexuales, sin hijos, que no utiliza un método anticonceptivo habitual, que consulta por haber tenido una relación sexual no protegida en las últimas 24 horas. Conclusiones: El perfil identificado corresponde a una población de conducta sexual desprotegida, de alto riesgo de embarazo no deseado y de aborto inseguro, que deben ser incorporadas a los programas regulares de control de la fecundidad.
Background: In Chile approximately 475,297 women are in risk of unwanted pregnancies and induced abortions, either because of low effectiveness contraceptive use or not use at all. Objective: To determine the biosocial profile of users who demand the pill of emergency contraception once they were available to the beneficiaries of a primary care health service. Method: This investigation analyzed sociodemographic characteristics and background obstetric-gynecological of 93 medical files of women who requested emergency contraception in a Primary Care Health of the Central Region Metropolitan Santiago, between the second semester of 2006 at first semester of 2007. Results: The profile obtained was a young woman of 23.6 years, single, student, benefician/ exempt of paying in the public health system, with an age of onset sexual intercourse of 16.2 years, who has had between one and two sexual partners, without children, who are not using a regular contraceptive method, and who consults mainly by having unprotected sexual intercourse in the last 24 hours. Conclusions: The profile identified corresponds to a population of unprotected sexual conduct, with a high risk of unwanted pregnancy and unsafe abortion, which should be incorporated into regular programmes of fertility control.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepção Pós-Coito/psicologia , Anticoncepção Pós-Coito , Atenção Primária à Saúde , Comportamento Contraceptivo , Anticoncepcionais Orais , Chile/epidemiologia , Demografia , Necessidades e Demandas de Serviços de Saúde , Comportamento Sexual , Fatores SocioeconômicosRESUMO
The effect of Maitotoxin (MTX) on the calcium-activated chloride current (ICl-Ca) from Xenopus oocytes was studied, applying the two-electrode voltage clamp technique. MTX increased the current amplitude at all the voltages explored and reduced the time to reach the maximum current level (time to peak). At low toxin concentrations (15 pM), both effects were fully reversible. Activation of ICl-Ca by MTX was secondary to the increment in the intracellular Ca2+ concentration induced by this toxin, since incubation of the oocytes with the cell-permeant Ca2+ chelator BAPTA-AM, greatly reduced the effect of MTX on ICl-Ca. Furthermore, external chloride ions removal also diminished the MTX effect on the current, strongly suggesting that the main current activated by MTX is ICl-Ca. Subsequent applications of a fixed toxin concentration after toxin washout resulted in enhanced ICl-Ca, suggesting that the toxin effect potentiates.
Assuntos
Cálcio/metabolismo , Cálcio/farmacologia , Cloretos/química , Toxinas Marinhas/farmacologia , Potenciais da Membrana/efeitos dos fármacos , Oxocinas , Animais , Quelantes/farmacologia , Interações Medicamentosas , Sinergismo Farmacológico , Ácido Egtázico/análogos & derivados , Ácido Egtázico/farmacologia , Técnicas de Patch-Clamp , Fatores de Tempo , Xenopus/fisiologiaRESUMO
OBJECTIVE: To analyze primary health care service (PHCS) utilization by febrile patients in a malarial area of Mexico. MATERIAL AND METHODS: A cross-sectional study was carried out in September, 1993, in 32 communities of Tabasco (decentralized health services) and Campeche (non-decentralized) states. Predictors of utilization were analyzed using descriptive statistics and logistic regression analysis. RESULTS: 817 febrile patients received care at home 55% of all febrile patients received care at home (SELF), 16.5% by PHCS and 17% by volunteer collaborators, with no significant differences in health services utilization between states. Febrile patients living in communities where PHCS was available used these facilities 11 times more than those without PHCS (C.I. 95%: 7.0-18.2%). Severely febrile patients used PHCS 2.8 times more than mild-moderate cases (C.I. 95%: 1.7-4.6%). Febrile patients under 13 years of age used PHCS 1.9 times more than older patients. Two per cent of febrile patients consisted of malaria cases. CONCLUSIONS: There was no difference between decentralized and non-decentralized health services regarding the utilization of PHCS. Fever symptoms must be evaluated as a single screening indicator of malarial disease.
Assuntos
Serviços de Saúde/estatística & dados numéricos , Malária Vivax/terapia , Atenção Primária à Saúde , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Feminino , Febre/terapia , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , México , Pessoa de Meia-Idade , Fatores SocioeconômicosRESUMO
Four antigenic polypeptides present in excretion-secretion antigens which were common to Fasciola hepatica somatic and tegumentary antigens, were identified by Western blotting and purified by affinity chromatography. Monoclonal antibody ES78 was used to that purpose. Molecular weights calculated for these polypeptides ranged from 37 to 13 kd; they proved to be highly reactive with sera from animals experimentally infected by Fasciola hepatica in periods as early as the second week of infection, with maximal values in weeks 6 and 10.
Assuntos
Antígenos de Helmintos/isolamento & purificação , Fasciola hepatica/imunologia , Animais , Feminino , Ratos , Ratos WistarRESUMO
La detección sistemática de casos de SIDA se ha dirigido hacia grupos de riesgo: homosexuales, drogadictos endovenosos y promiscuos sexuales. La alta frecuencia de morbilidad por tuberculosis que presentan los pacientes con SIDA hace elegibles a los enfermos de tuberculosis para buscar seropositividad al VIH. La prevalencia de tuberculosis activa en la Región Metropolitana es de más de 1000 casos los que fueron estudiados con estudio serológico para el VIH. Para ello se les tomó una muestra de sangre en las Centrales de Tratamiento de tuberculosis de los 6 Servicios de Salud de la Región Metropolitana entre los días 16 de agosto y 1 de septiembre de 1989. Se examinaron 1159 muestras de sangre provenientes de igual número de pacientes con tuberculosis activa en tratamiento. Se obtuvieron 4 muestras positivas y 1 indeterminada. Además, otras 5 muestras dieron el resultado del test de ELISA que estaba repetidamente en el límite de la negatividad. Estos pacientes fueron seguidos con nuevas muestras. Los casos detectados se incorporaron a los programas de enfermedades de transmisión sexual de los Servicios de Salud
Assuntos
Adulto , Humanos , Masculino , Soropositividade para HIV/epidemiologia , Mycobacterium tuberculosis/patogenicidade , Tuberculose/epidemiologia , Ensaio de Imunoadsorção Enzimática , Infecções por HIV/diagnósticoRESUMO
Results of HLA-A, B and C typing as well as haplotype frequencies in the Nahuas, who are the predominant Indian group in Mexico are presented. ABO and Rh blood groups show the genetic homogeneity of this population, since all of them were group O and Rh+. The most frequent antigens and haplotype are in general, the same as in some, but not all Amerindian tribes (Papago, Pimas, Zuñi from North America and Ixils from Guatemala). When compared to other Mongoloids, the HLA pattern is very close to the Japanese population. Antigens Bw39 and Cw4 look like markers of Nahuas and because Bw16 cells from four individuals could not be assigned either as Bw38 or Bw39, and 6 subjects did not type for any of the Bw22 splits, new subtypes of these antigens are probable.