RESUMO
El trombohematoma subcoriónico masivo o Mola de Breus, por ser éste el autor que lo describió por primera vez en abortos, es un hematoma subcorial de al menos 1 cm de grosor que ocupa al menos, el 50% de la superficie fetal. Suele asociar una alta morbimortalidad fetal y perinatal, en forma de abortos, retraso del crecimiento intrauterino, muerte intrauterina, desprendimiento de placenta normalmente inserta y recién nacidos de bajo peso, generalmente pretérminos. Esta entidad debe diferenciarse de otros procesos que pueden asentar bajo la placa corial, hacia la superficie fetal como: corioangioma, depósitos de fibrina y trombosis del espacio intervelloso. Se han intentado postular mecanismos que pudieran causar dicha circunstancia, sin que por el momento podamos definir factores de riesgo médicos que claramente predispongan a padecer esta entidad. El objetivo de describir estos dos casos clínicos diagnosticados en 2013 es resaltar que, gracias a la sospecha ecográfica de un trombohematoma subcoriónico masivo, podemos estudiar la pieza de placenta y membranas tras la finalización de la gestación, con lo que obtendríamos así la confirmación anátomo-patológica, de otra manera esta información podría perderse.
The massive subchorionictrombo hematoma or Breus's Mola, this was the author who first described it in miscarriages, is a subchorionic hematoma at least 1 cm in thickness which occupies at least 50% of the fetal surface. Usually associated with high fetal and perinatal morbidity and mortality, as miscarriages, intrau-terine growth retardation, stillbirth, placental abruption and low birth weight, preterm generally. This entity should be distinguished from other processes that can seat under the chorionic plate to the fetal surface as chorioangioma, fibrin deposition and thrombosis intervillous space. They have tried to apply mechanisms that could cause such a circumstance, but for now we don't define medical risk factors that predispose clearly suffer from this entity. In order to describe these two cases diagnosed in 2013 is to emphasize that thanks to the sonographic suspicion of a massive subchorionic trombohematoma, can study the piece of placenta and membranes after the end of pregnancy, so it would provide pathologic confirmation, otherwise this information could be lost.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Doenças Placentárias/diagnóstico por imagem , Trombose/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Trombose/complicações , Aborto Espontâneo , Ultrassonografia Pré-Natal , Retardo do Crescimento Fetal/etiologia , Retardo do Crescimento Fetal/diagnóstico por imagem , Hematoma/complicaçõesRESUMO
RESUMO O objetivo deste estudo foi determinar o potencial de plantas que crecem na região de Coquimbo, no controle de nematódeos gastrintestinais em caprinos. Nós usamos uma abordagem não-experimental para validar a eficácia potencial das plantas medicinais como anti-helmínticos. Esta validação foi realizada com base em uma revisão da extensa literatura consultada a respeito de plantas medicinais. Determinou-se o um potencial de eficácia das plantas, da consistência das informações sobre o uso tradicional, os compostos presentes e farmacologia. Analisamos também os dados dos potenciais efeitos adversos que impedem seu uso em animais. Antecedentes apoiam a um alto potencial da eficácia como anti-helmíntico para se três espécies de plantas que crescem na região de Coquimbo: Allium sativum L., Artemisia absinthium L. e Chenopodium ambrosioides L. Os possíveis efeitos secundários do consumo de plantas medicinais ou seus derivados devem ser avaliadas em testes de campo antes de serem utilizados nas em escala produtiva.
ABSTRACT The aim of this study was to determine the potential of the plants which grow at the Coquimbo region in the control of gastrointestinal nematodes in goats. We used a non-experimental approach to evaluate the potential efficacy of medicinal plants as anthelmintics. This research was conducted with exhaustive bibliography referred to the medicinal use of plants in the international literature. We determined the potential of effectiveness of the plants, the consistency of the information about the traditional use, the present compounds and the pharmacology. We also performed an analysis about the potential adverse effects of the plants" application in animals. The collected data support the efficacy of these three species of plants growing at the Coquimbo region as efficient anthelmintic ones: the Allium sativum L., the Artemisia absinthium L. and the Chenopodium ambrosioides L. The possible side effects of the consumption of medicinal plants or their derivatives must be evaluated in field trials before they start being used in a productive scale.
Assuntos
Animais , Feminino , Plantas Medicinais/metabolismo , Ruminantes/classificação , Nematoides/patogenicidade , Parasitos/classificação , Anti-Helmínticos/análiseRESUMO
OBJECTIVE: To describe sedation with continuous perfusion of propofol in critically ill children. DESIGN: A retrospective, descriptive observational study was carried out. SETTING: A pediatric intensive care unit. PATIENTS: Pediatric patients requiring sedoanalgesia between October 1, 2009 and September 30, 2010. INTERVENTIONS: None. DATA COLLECTED: Demographic, clinical and laboratory test variables, diagnosis, treatment, complications and evolution in each patient. In addition, the potential adverse effects associated with propofol administration were analyzed. RESULTS: Midazolam, fentanyl and propofol were the most commonly used sedative and analgesic drugs. Seventy-one out of 222 patients (32%) received propofol in continuous infusion. The average dose was 2.1 mg/kg/h (SD 1.3, range: 0.5 to 6), and the average duration of treatment was of 6.7 days (SD 8.5 range 0.5-40). Fifty-two percent were males, and the mean patient age was 45.8 months (median: 24; interquartile range: 7-65). No patient developed propofol infusion syndrome or other serious drug-related adverse effects. Patients treated with propofol showed more abnormal laboratory test findings, although no relationship to drug administration could be demonstrated. There were no significant differences in lactate level or in the incidence of infection in either group. CONCLUSIONS: Propofol at a dose of 1 to 4 mg/kg/h is a safe alternative for sustained sedation in critically ill children. However, further studies are needed to assess its effects and safety profile.
Assuntos
Cuidados Críticos/métodos , Estado Terminal , Hipnóticos e Sedativos/administração & dosagem , Unidades de Terapia Intensiva Pediátrica , Propofol/administração & dosagem , Analgesia Epidural/estatística & dados numéricos , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Criança , Pré-Escolar , Dipirona/administração & dosagem , Dipirona/uso terapêutico , Interações Medicamentosas , Quimioterapia Combinada , Feminino , Fentanila/administração & dosagem , Fentanila/uso terapêutico , Humanos , Hipnóticos e Sedativos/efeitos adversos , Hipnóticos e Sedativos/uso terapêutico , Lactente , Infusões Intravenosas , Masculino , Midazolam/administração & dosagem , Midazolam/uso terapêutico , Nutrição Parenteral Total , Piperidinas/administração & dosagem , Piperidinas/uso terapêutico , Propofol/efeitos adversos , Propofol/uso terapêutico , Remifentanil , Estudos Retrospectivos , Espanha , Vasoconstritores/administração & dosagem , Vasoconstritores/uso terapêuticoRESUMO
Objective: To explore associations of sociodemographic and gestational factors with blood hemoglobin concentration. Methodology: Randomized sample of 336 pregnant women medical records from the Public Hospital Network in Medellín. Hemoglobin concentration, sociodemographic, and pregnancy data analyzed by Student T test, ANOVA and Pearsons correlation. Results: Average age of pregnant women was 24±6; 3.3%; 67.6% of them were high school graduates; 62.2% had permanent partners. Number of attendance to prenatal appointments was 6+1. Pregestacional weight was 54.4+8.2 kg; average hemoglobin concentration on the first trimester was 13.0±1.0 g/dl, 11.9±1.1 g/dl on the second, and 12.2±1.1 g/dl on the third. There was a significant difference in hemoglobin concentration based on pregestacional body mass index (BMI) (p=0,035), a significant correlation between first trimester hemoglobin concentration and pregestacional BMI (r=0.178, p=0.028), and also with third trimester hemoglobin concentration (r=0.356 andp=0.000). Conclusion: Pregestacional BMI was associated with hemoglobin concentration at the beginning and at the end of pregnancy.
Objetivo: Explorar la asociación de factores socio-demográficos y gestacionales con la concentración de hemoglobina. Metodología: Estudio descriptivo transversal en 336 embarazadas de la Red Hospitalaria Pública de Medellín, 2007; se obtuvieron datos socio-demográficos, gestacionales y hemoglobina. Para el análisis se utilizó T de Student, ANOVA y correlación de Pearson. Resultados: el promedio de edad fue 24±6 años, 67,6% había cursado secundaria, 62,2% tenía un compañero estable, la asistencia a los controles prenatales fue 6±1, peso pre-gestational: 54,4±8,2kg, hemoglobina: 13,0±1,0g/dL en el primer trimestre, 11,9±1,1 g/dL en segundo y 12,2±1,1 g/dL en tercero. Se encontró una diferencia significativa entre la hemoglobina por IMC pregestacional (p=0,035). La hemoglobina del primer trimestre correlacionó con el IMC pregestacional (r=0,178 y p=0,028) y con la hemoglobina del tercer trimestre (r=0,356 y p=0,000). Conclusión: El IMC pregestacional, se asoció con la concentración de hemoglobina del primer trimestre y correlacionó con la hemoglobina final de la gestación.