RESUMO

Objetivo: determinar la huella psicosocial de la pandemia por COVID-19 en enfermeras de 4 países de Sudamérica, año 2021-2022. Métodos: estudio de corte transversal, en una muestra de 279 enfermeras: colombianas (86), paraguayas (68), mexicanas (54) y chilenas (71), que cumplieron los criterios de inclusión.Se aplicaron las escalas de Duke-UNC para evaluar apoyo social recibido y confidencial; El cuestionario Medical Outcomes Study-Social Support Survey (MOS) para evaluar apoyo social y el cuestionario de variables de interacción psicosocial (VIP) Resultados: tanto el buen apoyo confidencial como afectivo, se asoció con las variables de vivir con dos o más personas, ser perteneciente a una religión, y trabajar en una unidad con pacientes. El consumo de medicamentos fue significativamente menor en el grupo con buen apoyo confidencial y afectivo, (p=0.012) Conclusiones:la ejecución del rol profesional de la enfermera es conocido como de alta calidad, y con una destacada responsabilidad, especialmente en pandemia por SAR COVID 19. Sin embargo, se aprecian huellas residuales físicas y emocionales en los profesionales de enfermería.

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Objective: to determine the psychosocial footprint of the COVID-19 pandemic in nurses from 4 South American countries, 2021-2022. Methods: cross-sectional study, in a sample of 279 nurses: Colombian (86), Paraguayan (68), Mexican (54) and Chilean (71), who met the inclusion criteria. Duke-UNC scales were applied to assess received and confidential social support; The Medical Outcomes Study-Social Support Survey (MOS) questionnaire to assess social support and the psychosocial interaction variables (VIP) questionnaire. Results: both good confidential and affective support were associated with the variables of living with two or more people, belonging to a religion, and working in a unit with patients. Medication consumption was significantly lower in the group with good confidential and affective support, (p=0.012). Conclusions: the execution of the professional role of the nurse is known to be of high quality, and with outstanding responsibility, especially in the SAR pandemic. COVID 19. However, residual physical and emotional traces can be seen in nursing professionals.

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Objetivo determinar a pegada psicossocial da pandemia de COVID-19 em enfermeiros de 4 países da América do Sul, 2021-2022. Métodos: estudo transversal, em uma amostra de 279 enfermeiras: colombianas (86), paraguaias (68), mexicanas (54) e chilenas (71), que atenderam aos critérios de inclusão. As escalas de Duke-UNC foram aplicadas para avaliar o suporte social recebido e confidencial; o questionário Medical Outcomes Study-Social Support Survey (MOS) para avaliar o apoio social e o questionário de variáveis de interação psicossocial (VIP). Resultados: tanto o bom apoio confidencial quanto o afetivo estiveram associados às variáveis morar com duas ou mais pessoas, pertencer a uma religião e trabalhar em unidade com pacientes. O consumo de medicamentos foi significativamente menor no grupo com bom apoio confidencial e afetivo, (p=0,012). Conclusões: sabe-se que o desempenho da função profissional do enfermeiro é de alta qualidade, e com destacada responsabilidade, principalmente na pandemia SAR COVID 19. No entanto, traços residuais físicos e emocionais podem ser observados nos profissionais de enfermagem.

Assuntos

Humanos , Apoio Social , Esgotamento Profissional , COVID-19 , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem

RESUMO

Phyllodes tumor (PT) is considered a rare fibroepithelial tumor. Very few series have been reported in children and adolescents. Based on histopathological features, it can be classified as benign, borderline, or malignant, with the latter having a more aggressive clinical behavior. We report the case of a 10-year-old female who began with an asymptomatic mobile right breast mass. An initial fine needle biopsy (FNB) concluded fibroadenoma (FA). Months later, the mass kept growing, with the appearance of pain and nipple discharge. Benign PT was demonstrated in a new biopsy. A total mastectomy was performed. The post-surgical histopathological examination was compatible with a borderline PT. The patient is now symptom-free and with no signs of relapse. Not all breast masses in the pediatric or adolescent age bracket are FA. Attention is warranted when the clinical behavior does not follow the usual outline. PT has to be considered as a possible diagnosis and treated accordingly.

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RESUMEN En situación de obesidad y cuando no se logra cumplir las metas del tratamiento, la cirugía bariátrica puede ser una alternativa prometedora, con efectos, a nivel físico y en el plano psicológico de la calidad de vida (CV). Este estudio tuvo como objetivo determinar el efecto de la cirugía bariátrica sobre la CV en hombres y mujeres obesas entre 20 y 60 años. Se realizó una revisión sistemática (RS) con metanálisis de RS aleatorizadas, que comparan la CV en los pacientes poscirugía bariátrica. Fueron consultadas las bases de datos electrónicas Ebsco, Scopus, Pubmed y Cochrane Library. Las variables de respuesta fueron las dimensiones función física, social, mental y emocional de la CV. Se sometieron a metanálisis con R 4.2.2. Se incluyeron tres RS, de las cuales se combinaron 25 ensayos clínicos con 3-6 y 12 meses de seguimiento poscirugía bariátrica. Se encontraron cambios estadísticamente significativos de los puntajes en función física (1,20; IC 95%: 0,80-1,61), social (0,95; IC 95%: 0,66-1,25), mental (0,35; IC 95%: -0,21- +0,90) y emocional (0,54; IC 95%: 0,03-1,06). Los ámbitos de la CV mejoran poscirugía bariátrica en pacientes obesos.

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ABSTRACT In a situation of obesity and when treatment goals are not met, bariatric surgery can be a promising alternative; with effects at the physical level as well as at the psychological level of the quality of life. This study aims to determine the effect of bariatric surgery on the quality of life in obese men and women between 20 and 60 years of age. A systematic review (SR) was carried out with meta-analysis of randomized systematic reviews, which compare the quality of life in patients after bariatric surgery. Electronic databases were consulted: Ebsco, Scopus, Pubmed and Cochrane Library. The response variables were: physical, social, mental and emotional function. They were submitted to meta-analysis, with R 4.2.2. Three SR were included, of which 25 clinical trials were combined with 3-6 and 12-month follow-up after bariatric surgery, finding statistically significant changes in physical function scores (1.20; 95% CI: 0.80-1 .61), social (0.95; 95% CI: 0.66-1.25), mental (0.35; 95% CI: -0.21- +0.90) and emotional (0.54; 95% CI: 0.03-1.06). The surroundings of the quality of life improve post bariatric surgery in obese patients.

RESUMO

BiP (immunoglobulin heavy-chain binding protein) is a Hsp70 monomeric ATPase motor that plays broad and crucial roles in maintaining proteostasis inside the cell. Structurally, BiP is formed by two domains, a nucleotide-binding domain (NBD) with ATPase activity connected by a flexible hydrophobic linker to the substrate-binding domain. While the ATPase and substrate binding activities of BiP are allosterically coupled, the latter is also dependent on nucleotide binding. Recent structural studies have provided new insights into BiP's allostery; however, the influence of temperature on the coupling between substrate and nucleotide binding to BiP remains unexplored. Here, we study BiP's binding to its substrate at the single molecule level using thermo-regulated optical tweezers which allows us to mechanically unfold the client protein and explore the effect of temperature and different nucleotides on BiP binding. Our results confirm that the affinity of BiP for its protein substrate relies on nucleotide binding, by mainly regulating the binding kinetics between BiP and its substrate. Interestingly, our findings also showed that the apparent affinity of BiP for its protein substrate in the presence of nucleotides remains invariable over a wide range of temperatures, suggesting that BiP may interact with its client proteins with similar affinities even when the temperature is not optimal. Thus, BiP could play a role as a "thermal buffer" in proteostasis.

Assuntos

Proteínas de Choque Térmico , Nucleotídeos , Humanos , Nucleotídeos/metabolismo , Temperatura , Proteínas de Choque Térmico/química , Chaperonas Moleculares/química , Chaperona BiP do Retículo Endoplasmático , Proteínas de Choque Térmico HSP70/química , Adenosina Trifosfatases/química , Ligação Proteica

RESUMO

Objetivo: Analizar las conductas alimentarias de riesgo, en relación al estado nutricional y actividad física en jóvenes adultos durante la pandemia COVID-19 en las comunas de Chillán y Chillán Viejo. Método: Diseño observacional y transversal. Se obtuvo una muestra de 184 adultos jóvenes de ambos sexos, que residían en dos comunas de la región de Ñuble (Chile) durante el periodo de confinamiento por la pandemia COVID-19. Se les aplicó un cuestionario de antecedentes personales y la escala SCOFF que evalúa el riesgo de trastornos de la conducta alimentaria (TCA). Resultados: Se encontró un 37,16% de riesgo para TCA (IC 95%: 30,23 - 44,63%). El riesgo de trastornos de la conducta alimentaria tuvo relación con las variables: actividad física (p = 0,01 análisis bivariante) y estado nutricional (p = 0,03, análisis ajustado). Conclusión: Se logró identificar una proporción superior a la registrada en la literatura y los factores asociados a TCA eran los que se esperaban encontrar.

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Objective: To analyze risky eating behaviors in relation to nutritional status and physical activity in young adults during the COVID-19 pandemic in the communes of Chillán and Chillán Viejo. Methods: Observational and cross-sectional design. A sample of 184 young adults of both sexes, who lived in two communes in the Ñuble region (Chile) during the period of confinement due to COVID-19 pandemic, was obtained. A personal history questionnaire and the SCOFF scale that assesses the risk of eating behavior disorders (EDs) were applied. Results: A 37.16% risk for ED was found (95% CI: 30.23 - 44.63%). The risk of eating behavior disorders was related to the variables: physical activity (p=0.01 bivariate analysis) and nutritional status (p=0.03, adjusted analysis). Conclusion: It was possible to identify a higher proportion than that recorded in the literature and the factors associated with eating disorders were those that were expected to be found.

RESUMO

Anaplastic large cell lymphoma (ALCL) is children's most common mature T-cell neoplasm. The majority is positive for anaplastic lymphoma kinase (ALK). Initial presentation as a soft-tissue pelvic mass without nodal involvement is rare and can be easily misdiagnosed. We report a case of a 12-year-old male presenting with pain and movement restriction in the right extremity. Computed tomography (CT) scan revealed a solitary pelvic mass. Initial biopsy examination concluded rhabdomyosarcoma. After developing pediatric multisystemic inflammatory syndrome due to coronavirus disease 2019 (COVID-19), central and peripheral lymph node enlargement appeared. New cervical adenopathy and pelvic mass biopsies were performed. Immunohistochemistry concluded an ALK-positive ALCL with a small-cell pattern. The patient was treated with brentuximab-based chemotherapy and eventually improved. Differential diagnosis of pelvic masses in children and adolescents must include ALCL. An inflammatory trigger may promote the appearance of a typical nodal disease, previously absent. Attention is warranted during histopathological examination to avoid diagnostic errors.

RESUMO

Background. Obesity is a problem present in almost all societies, which has led to the search for different methods to combat it. One of them is intermittent fasting (IF), characterized by periods without eating (16 to 24 hours), limited or no caloric intake, combined with normal eating windows. Target. To determine the effectiveness of intermittent fasting on biochemical and anthropometric markers in obese adults. Materials and methods. A systematic review was proposed that postulated to study blinded or open clinical trials of IA interventions, compared with a control group. The response variables were: systolic and diastolic blood pressure, total cholesterol, LDL, HDL and triglycerides, blood glucose, fat mass, weight, waist circumference, BMI and heart rate. The search and identification of studies was masked. The risks of bias for the Cochrane collaboration were assessed. They underwent meta-analysis (random effect), with R 4.0.0. Results. Six studies were included, involving 10-48 weeks of intervention with alternate-day fasting and time-restricted feeding, reporting some statistically significant changes for different variables. Conclusion. Intermittent fasting could intervene in the reduction of cardiovascular risk due to improvement in BMI and biochemical parameters.

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Antecedentes. La obesidad es un problema presente en casi todas las sociedades, lo que ha conllevado a buscar distintos métodos para combatirla. Uno de ellos es el ayuno intermitente (AI), caracterizado por periodos sin ingesta (16 a 24 hr), ingesta calórica limitada o nula, combinada con ventanas de alimentación normal. Objetivo. Determinar la efectividad del ayuno intermitente sobre los marcadores bioquímicos y antropométricos en adultos obesos. Materiales y Métodos. Se planteó una revisión sistemática que postuló estudiar ensayos clínicos enmascarados o abiertos de intervenciones de AI, comparado con grupo control. Las variables de respuesta fueron: presión arterial sistólica y diastólica, colesterol total, LDL, HDL y triglicéridos, glicemia, masa grasa, peso, circunferencia de cintura, IMC y frecuencia cardiaca. La búsqueda e identificación de los estudios fue enmascarada. Se evaluaron los riesgos de sesgo de la colaboración Cochrane. Se sometieron a meta-análisis (efecto aleatorio), con R 4.0.0. Resultados. Se incluyeron 6 estudios, de 10-48 semanas de intervención con ayuno en días alternos y alimentación con restricción de tiempo, reportándose algunos cambios estadísticamente significativos para distintas variables. Los meta-análisis obtenidos muestran diferencias de medias estadísticamente significativas.  Conclusión. Existe evidencia que respalda un beneficio de AI a nivel de indicadores bioquímicos.

RESUMO

Introduction: Introduction: Chile is among the countries with the highest rate of excess malnutrition, for that reason it is important to have effective tools to evaluate the nutritional status; interest in neck circumference (NC) measurement as a potential prognostic tool that is easy to access and low-cost has increased. Objective: to evaluate the diagnostic capacity of neck circumference to predict obesity in the population aged 15-16 years, using data from the third National Health Survey 2009-2010. Materials and methods: Concurrent Criteria of Diagnostic Validation were used for the study. The sample consisted of 536 people of ages from 15 to 26 years, where BMI data where taken in order to classify obesity versus normality (gold standard), as was NC (measured in centimeters). People with hyperthyroidism were excluded. Indicators of diagnostic accuracy were obtained; the SPSS, version 25 was used for calculations. Results: according to age and gender ranks, the NC cut-off points to classify general obesity showed sensitivities and specificities above 0.85, with an area under the curve over 0.90, all with p < 0.001. Conclusion: there is evidence that supports that NC cutoff points are a suitable tool for diagnosing obesity in this age group.

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Introducción: Introducción: Chile está dentro de los países con mayor tasa de malnutrición por exceso, lo que obliga a disponer de herramientas eficaces para evaluar el estado nutricional; así surge nuestro interés por explorar la posibilidad de utilizar la medición de la circunferencia del cuello (CCUE) como herramienta potencial de diagnóstico de fácil obtención y acceso, y bajo costo. Objetivo: evaluar la capacidad diagnóstica de la circunferencia del cuello como predictor de obesidad en la población de 15-26 años de edad. Materiales y métodos: dado que se encuentran disponibles, y son adecuados para nuestra investigación, se utilizarán datos extraídos de la Tercera Encuesta Nacional de Salud 2009-2010. Nuestro estudio se realizó aplicando el Método de Validación Diagnóstica por Criterio Concurrente. La muestra estuvo compuesta por 536 personas cuyas edades fluctuaban entre los 15 y 26 años, de quienes se tomaron los datos de IMC, para clasificarlas en las categorías de obesidad o normalidad (patrón oro), y la CCUE (en centímetros). Se excluyeron las personas con hipertiroidismo. Se obtuvieron indicadores de exactitud diagnóstica y valores predictivos. Se aplicó el SPSS, versión 25. Resultados: según los rangos de edad y el sexo, los puntos de corte de la CCUE para clasificar la obesidad general presentaron sensibilidades y especificidades superiores a 0,85 con una área bajo la curva superior a 0,90, todos con p < 0,001. Conclusión: existe evidencia a favor de que los puntos de corte de la CCUE presentan una adecuada capacidad de diagnosticar la obesidad en este grupo etario.

Assuntos

Análise de Dados , Obesidade , Índice de Massa Corporal , Chile/epidemiologia , Inquéritos Epidemiológicos , Humanos , Pescoço , Obesidade/diagnóstico , Obesidade/epidemiologia , Circunferência da Cintura , Adulto Jovem

RESUMO

El ayuno intermitente se ha popularizado como una estrategia alternativa para el control de peso y disminución de algunos parámetros bioquímicos. El propósito de esta revisión sistemática fue evaluar la efectividad del ayuno intermitente en dos protocolos: ayuno en días intermitentes (ADA) y ayuno restringido en el tiempo (ART), sobre el perfil lipídico, composición corporal y presión arterial en adultos. Método: Revisión sistemática basada en ensayos controlados aleatorios consultados en las bases de datos: Web of Science, Scopus, Cochrane Library, Clinical Trials, Proquest y PubMed. Se estudió a adultos mayores de 18 años con cualquier estado nutricional. La intervención correspondió a ayuno intermitente de al menos 16 horas. Se evaluaron riesgos de sesgos según la colaboración de Cochrane. Resultados: Se analizaron seis ensayos clínicos, encontrándose que el protocolo ADA, presente en cuatro de ellos, generó cambios en las variables: triglicéridos, c-HDL, c-LDL, colesterol total, peso, masa magra, masa grasa y presión arterial sistólica, mientras que el protocolo ART, presente en los dos restantes, provocó cambios en las variables: peso, masa grasa, masa magra, triglicéridos, colesterol total, c-LDL, c-HDL y glicemia. Conclusión: La evidencia disponible con ensayos clínicos nos permite sugerir que los protocolos ADA y ART pueden ser una dieta alternativa para adultos. Sin embargo, el ajuste calórico y una adecuada educación sobre estilos de vida saludable muestran resultados similares. Sin perjuicio a esto, el AI puede ser una alternativa para aquellos a quienes les es difícil seguir un patrón dietético con restricción calórica diaria.

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Intermittent fasting has become popular as an alternative strategy for weight control and the reduction of some biochemical parameters. The purpose of this systematic review (SR) was to evaluate the effectiveness of intermittent fasting in two protocols: intermittent days fasting (ADA) and time-restricted fasting (ART), on lipid profile, body composition and blood pressure among adults. Methods: SR based on randomized controlled trials consulted in the following databases: Web of Science, Scopus, Library Cochrane, Clinical Trials, Proquest and PubMed. Adults over 18 years of age with any nutritional status were studied. The intervention corresponded to intermittent fasting of at least 16 hours. Risk of bias were assessed according to the Cochrane collaboration. Results: Six clinical trials were analyzed, finding that the ADA protocol, present in four of them, generated changes in the variables: triglycerides, c-HDL, c-LDL, total cholesterol, weight, lean mass, fat mass and systolic blood pressure, while the ART protocol, present in the remaining two, caused changes in the variables: weight, fat mass, lean mass, triglycerides, total cholesterol, c-LDL, c-HDL and glycemia. Conclusion: The available evidence with clinical trials allows us to suggest that the ADA and ART protocols can be an alternative diet for adults. However, caloric adjustment and adequate education on healthy lifestyles show similar results. Notwithstanding this, intermittent fasting may be an alternative for those who find it difficult to follow a dietary pattern with daily caloric restriction.

RESUMO

Objetivo: Determinar la frecuencia, las causas y los factores asociados de suspensión de cirugías programadas en un hospital de alta complejidad en un periodo de 5 años. Materiales y Método: Se realizó un estudio descriptivo transversal, en un hospital terciario del sur de Chile durante los años 2014 a 2018. Se describe la frecuencia de suspensión quirúrgica del establecimiento y por especialidad, especificando sus principales causas. Además, se identificaron aquellas suspensiones evitables y sus factores asociados mediante regresión logística. Resultados: La tasa de suspensión en los 5 años de estudio fue de 11,2%. Neurocirugía y Traumatología tuvieron la mayor tasa de suspensión (18,8% y 13,9%, respectivamente), mientras que Ginecología y Obstetricia la menor (4,1%). Las causas más frecuentes fueron la inasistencia del paciente (16,9%), la prolongación de la cirugía anterior (16,4%) y la paralización de actividades por motivos gremiales (7,9%). Un 80,1% de las causas fueron evitables. La especialidad quirúrgica y la edad del paciente fueron los factores asociados más relevantes. Discusión: Se evidenció una alta tasa de suspensiones quirúrgicas y la mayoría por causas evitables. Su disminución puede ser la intervención más costo efectiva para contribuir a reducir las extensas listas de espera quirúrgica posterior a la crisis sanitaria por COVID 19, ya que sólo requiere optimizar los recursos existentes. Conclusiones: La suspensión quirúrgica es un problema frecuente en el proceso quirúrgico. Nuestros resultados permiten identificar a los grupos de mayor riesgo de suspensión, asignar responsabilidades a los equipos quirúrgicos y desarrollar estrategias efectivas para su prevención.

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Aim: To determine the frequency, the causes and the associated factors of the surgical cancellation of scheduled surgeries at the Hospital Base Valdivia between the years 2014 and 2018. Materials and Method: A descriptive cross-sectional study was carried out. Were described the frequency of suspension of scheduled surgeries of the establishment, by specialty and their main causes, identifying those that can be avoided. In addition, the factors associated with suspension were identified by logistic regression. Results: The suspension rate in the 5 years of study was 11.2%. Neurosurgery and Traumatology had the highest frequency of surgical cancellation (18.8% y 13.9%, respectively), Obstetrics, and Gynecology the lowest (4.1%). The most frequent causes of suspension were the absence of the patient (16.9%), the prolongation of the previous surgery (16.4%) and the suspension of activities due to Union reasons (7.9%). 80.1% of the causes were avoidable. The age and surgical specialty were the most relevant associated factorsm Discussion: A high rate of surgical suspensions and most for avoidable reasons were evident. Reducing surgical cancellations can be the most cost effective intervention to help reduce the extensive post-health crisis surgical waiting lists by COVID 19, as it only requires optimizing existing resources. Conclusions: Surgical suspension is a common problem in the surgical process. Our results allow to identify the groups most at risk of suspension, assign responsibilities to surgical teams and develop effective strategies for their prevention.

Assuntos

Salas Cirúrgicas/organização & administração , Centro Cirúrgico Hospitalar/organização & administração , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Administração Hospitalar/estatística & dados numéricos , Agendamento de Consultas , Administração Hospitalar/tendências

RESUMO

The effect of a ketogenic diet (KD) on biochemical parameters and nutritional status has been the subject of debate over the years, as several randomized clinical trials (RCTs) obtained different results. METHOD: A systematic review and random-effects meta-analysis of RCTs comparing KD with a balanced diet was performed by means of a search of PubMed, Cochrane Library, Scopus, and Web of Science. Trials where the method for measuring the response variables was unclear, those that considered pathologies other than chronic non-communicable diseases and those with participants receiving pharmacological treatment for obesity were excluded from the comparison. RESULTS: Of the studies included in the meta-analysis, no statistically significant standardized mean differences were observed for body mass index (BMI) (d = -0.457, p = 0.359), total cholesterol, COL-T (d = 0.230, p = 0.591), high-density lipoprotein, HDL (d = -0.028, p = 0.934), low-density lipoprotein, LDL (d = 0.528, p = 0.173), or triglycerides, TG (d = -0.283, p = 0.222), with high values of heterogeneity. The percentage of women included in the studies is a significant moderating variable in terms of BMI ratio (z = -6.68, p < 0.001) and TG (z = -2.27, p = 0.023). CONCLUSION: A KD shows no more benefits on nutritional parameters than a balanced diet, and adverse effects of being on the diet are sometimes reported.

Assuntos

Índice de Massa Corporal , Dieta Cetogênica/métodos , Lipídeos/sangue , Estado Nutricional , Obesidade/sangue , Obesidade/dietoterapia , Colesterol/sangue , Feminino , Humanos , Lipoproteínas/sangue , Masculino , Triglicerídeos/sangue

RESUMO

High-performance-validated tests are essential for successful epidemiological monitoring, surveillance of parasitic infections, and comparative studies in wildlife populations. The Mini-FLOTAC is a novel flotation-based technique for the sensitive detection and quantification of gastrointestinal parasites that is recently being explored for use in wildlife. A limitation of any flotation-based copromicroscopic method is the selection of the flotation solution (FS), which might influence the performance of the test. However, no study has compared the influence of using different FS in the Mini-FLOTAC technique for parasite detection in wild birds. Here, we evaluated the diagnostic performance of the Mini-FLOTAC in three waterbird host species using two widely used FS: saturated salt (NaCl; specific gravity 1.20) and saturated zinc sulfate (ZnSO4; specific gravity 1.35). One hundred fresh fecal samples were analyzed for parasite fecal egg counts (FEC). Regardless of the host species, fecal samples evaluated with the Mini-FLOTAC method using ZnSO4 resulted in a significantly higher detection rate and higher FEC of strongylid, capillarid, cestode, and trematode parasites, than samples analyzed with the NaCl solution. Our concise study demonstrated the importance of using an appropriate FS for the identification of parasite eggs in wildlife species, especially in hosts with an expected aggregated distribution and low parasite load such as waterbird hosts. The higher analytical sensitivity of the Mini-FLOTAC technique achieved with ZnSO4, and its applicability to fieldwork, highlights this method as a promising tool for the quantitative surveillance of parasite infections in wild bird populations.

Assuntos

Aves/parasitologia , Helmintos , Enteropatias Parasitárias , Animais , Animais Selvagens/parasitologia , Fezes/parasitologia , Helmintos/isolamento & purificação , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/veterinária , Contagem de Ovos de Parasitas , Sensibilidade e Especificidade

RESUMO

INTRODUCTION: During the COVID-19 pandemic, endoscopic procedures are associated with a high risk of SARS-CoV-2 infection. However, in cases of upper gastrointestinal bleeding (UGIB), priority should be given to an early endoscopy. OBJECTIVE: The main objective was to compare the time since arrival at the hospital and the performance of the endoscopy between both groups. MATERIALS AND METHODS: We performed a retrospective study. Data contains information of patients who attended to the hospital with UGIB and underwent an endoscopy between October 19th, 2019 and June 6th, 2020. Patients were divided into 2 phases: pre-pandemic and pandemic. The time between arrival at the hospital and the performance of the endoscopy in both phases were compared as well as other indicators such hospital stay and in-hospital mortality. RESULTS: With information from 219 patients, the median age was 69 years. 154 and 65 endoscopies were performed in pre-pandemic and pandemic phase, respectively. The time between arrival at the hospital and the performance of the endoscopy was significantly longer during the pandemic (10.00 vs. 13.08 hours, p-value = 0.019). Nevertheless, there were no significant differences in hospital stay or mortality. CONCLUSION: The management of patients with UGIB during the COVID-19 pandemic is complex and requires the application of clinical judgment to decide the best timing to perform an endoscopy without affecting patient care.

Assuntos

Infecções por Coronavirus , Endoscopia Gastrointestinal/tendências , Hemorragia Gastrointestinal/diagnóstico por imagem , Pandemias , Pneumonia Viral , Padrões de Prática Médica/tendências , Tempo para o Tratamento/tendências , Trato Gastrointestinal Superior/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Tomada de Decisão Clínica , Infecções por Coronavirus/prevenção & controle , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/terapia , Mortalidade Hospitalar/tendências , Humanos , Controle de Infecções/métodos , Tempo de Internação/tendências , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Peru , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos

RESUMO

ABSTRACT Introduction : During the COVID-19 pandemic, endoscopic procedures are associated with a high risk of SARS-CoV-2 infection. However, in cases of upper gastrointestinal bleeding (UGIB), priority should be given to an early endoscopy. Objective : The main objective was to compare the time since arrival at the hospital and the performance of the endoscopy between both groups. Materials and methods : We performed a retrospective study. Data contains information of patients who attended to the hospital with UGIB and underwent an endoscopy between October 19th, 2019 and June 6th, 2020. Patients were divided into 2 phases: pre-pandemic and pandemic. The time between arrival at the hospital and the performance of the endoscopy in both phases were compared as well as other indicators such hospital stay and in-hospital mortality. Results : With information from 219 patients, the median age was 69 years. 154 and 65 endoscopies were performed in pre-pandemic and pandemic phase, respectively. The time between arrival at the hospital and the performance of the endoscopy was significantly longer during the pandemic (10.00 vs. 13.08 hours, p-value = 0.019). Nevertheless, there were no significant differences in hospital stay or mortality. Conclusion : The management of patients with UGIB during the COVID-19 pandemic is complex and requires the application of clinical judgment to decide the best timing to perform an endoscopy without affecting patient care.

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RESUMEN Introducción : Durante la pandemia de COVID-19, los procedimientos endoscópicos se asocian con un alto riesgo de infección por SARS-CoV-2. Sin embargo, en casos de hemorragia digestiva alta (HDA), se debe dar prioridad a una endoscopia precoz. Objetivo : El objetivo principal fue comparar el tiempo transcurrido desde la llegada al hospital y la realización de la endoscopia entre ambos grupos. Materiales y métodos : Realizamos un estudio retrospectivo. Los datos contienen información de pacientes que acudieron al hospital con HDA y fueron sometidos a endoscopia entre el 19 de octubre de 2019 y el 6 de junio de 2020. Los pacientes se dividieron en 2 fases: prepandémica y pandémica. Se comparó el tiempo transcurrido entre la llegada al hospital y la realización de la endoscopia en ambas fases, así como otros indicadores como la estancia hospitalaria y la mortalidad intrahospitalaria. Resultados : Con información de 219 pacientes, la mediana de edad fue de 69 años. Se realizaron 154 y 65 endoscopias en fase prepandémica y pandémica, respectivamente. El tiempo entre la llegada al hospital y la realización de la endoscopia fue significativamente mayor durante la pandemia (10,00 frente a 13,08 horas, valor de p = 0,019). Sin embargo, no hubo diferencias significativas en la estancia hospitalaria ni en la mortalidad. Conclusión : El manejo de pacientes con HDA durante la pandemia de COVID-19 es complejo y requiere la aplicación del juicio clínico para decidir el mejor momento para realizar una endoscopia sin afectar la atención del paciente.

Assuntos

Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral , Padrões de Prática Médica/tendências , Endoscopia Gastrointestinal/tendências , Infecções por Coronavirus , Trato Gastrointestinal Superior/diagnóstico por imagem , Pandemias , Tempo para o Tratamento/tendências , Hemorragia Gastrointestinal/diagnóstico por imagem , Peru , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos , Controle de Infecções/métodos , Mortalidade Hospitalar/tendências , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Tomada de Decisão Clínica , COVID-19 , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/terapia , Tempo de Internação/tendências

RESUMO

This study was conducted to determine the monthly composition of the minerals Ca, P, K, Mg, Cu, Fe, Mn and Zn in five shrub species that are consumed by small ruminants in the semi-arid regions of northeastern Mexico. Leaves samples of shrub species; Celtis pallida, Croton suaveolens, Forestiera angustifolia, Guaiacum angustifolium and Parkinsonia aculeata were randomly collected during twelve consecutive months from July 2018 to June 2019 in two sites, located in Linares and Los Ramones counties, in the state of Nuevo Leon, Mexico. Mineral content was analyzed using an atomic absorption spectrophotometer, while phosphorus was measured by the colorimetry method. The Linares county showed the highest content of macro- and micro-minerals. Among species, C. pallida showed the highest values of macro-minerals and P. aculeata content of micro-minerals was highest. Ca (total mean = 40.0 g kg-1 DM), K (15.4 g kg-1), Mg (3.7 g kg-1), Fe (87.2 mg kg-1), Mn (35.5 mg kg-1) were available in adequate quantities, while P (1.3 g kg-1 DM), Cu (6.4 mg kg-1) and Zn (17.7 mg kg-1) were found deficient. Shrub species in this study can be considered as a good source of Ca, K, Mg, Fe and Mn except in C. suaveolens. However, P, Cu and Zn must be supplemented.(AU)

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O presente estudo foi realizado com o intuito de determinar os teores dos minerais Ca, P, K, Mg, Cu, Fe, Mn e Zn, ao longo do ano, em cinco espécies de arbustos consumidas por pequenos ruminantes nas regiões semiáridas do nordeste do México. Amostras de folhas de espécies arbustivas; Celtis pallida, Croton suaveolens, Forestiera angustifolia, Guaiacum angustifolium e Parkinsonia aculeata foram coletadas aleatoriamente durante doze meses consecutivos, de Julho de 2018 a Junho de 2019, em dois locais, nos municípios de Linares e Los Ramones, no estado de Nuevo Leon, México. O conteúdo mineral foi analisado através de um espectrofotômetro de absorção atômica, enquanto o fósforo foi medido pelo método da colorimetria. O município de Linares apresentou o maior conteúdo de macro e microminerais. Entre as espécies, C. pallida apresentou os maiores valores de macrominerais, enquanto o teor de microminerais foi maior na P. aculeata. Ca (média = 40.0 g kg-1 MS), K (15.4 g kg-1), Mg (3.7 g kg-1), Fe (87.2 mg kg-1), Mn (35.5 mg kg-1) estavam disponíveis em quantidades adequadas, enquanto P (1.3 g kg-1 MS), Cu (6.4 mg kg-1) e Zn (17.7 mg kg-1) foram encontrados deficientes. As espécies arbustivas deste estudo podem ser consideradas uma boa fonte de Ca, K, Mg, Fe e Mn, exceto na espécie C. suaveolens. No entanto, P, Cu e Zn devem ser suplementados.(AU)

Assuntos

Animais , Árvores , Ruminantes , Minerais , Dieta/veterinária , México

RESUMO

ABSTRACT: This study was conducted to determine the monthly composition of the minerals Ca, P, K, Mg, Cu, Fe, Mn and Zn in five shrub species that are consumed by small ruminants in the semi-arid regions of northeastern Mexico. Leaves samples of shrub species; Celtis pallida, Croton suaveolens, Forestiera angustifolia, Guaiacum angustifolium and Parkinsonia aculeata were randomly collected during twelve consecutive months from July 2018 to June 2019 in two sites, located in Linares and Los Ramones counties, in the state of Nuevo Leon, Mexico. Mineral content was analyzed using an atomic absorption spectrophotometer, while phosphorus was measured by the colorimetry method. The Linares county showed the highest content of macro- and micro-minerals. Among species, C. pallida showed the highest values of macro-minerals and P. aculeata content of micro-minerals was highest. Ca (total mean = 40.0 g kg-1 DM), K (15.4 g kg-1), Mg (3.7 g kg-1), Fe (87.2 mg kg-1), Mn (35.5 mg kg-1) were available in adequate quantities, while P (1.3 g kg-1 DM), Cu (6.4 mg kg-1) and Zn (17.7 mg kg-1) were found deficient. Shrub species in this study can be considered as a good source of Ca, K, Mg, Fe and Mn except in C. suaveolens. However, P, Cu and Zn must be supplemented.

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RESUMO: O presente estudo foi realizado com o intuito de determinar os teores dos minerais Ca, P, K, Mg, Cu, Fe, Mn e Zn, ao longo do ano, em cinco espécies de arbustos consumidas por pequenos ruminantes nas regiões semiáridas do nordeste do México. Amostras de folhas de espécies arbustivas; Celtis pallida, Croton suaveolens, Forestiera angustifolia, Guaiacum angustifolium e Parkinsonia aculeata foram coletadas aleatoriamente durante doze meses consecutivos, de Julho de 2018 a Junho de 2019, em dois locais, nos municípios de Linares e Los Ramones, no estado de Nuevo Leon, México. O conteúdo mineral foi analisado através de um espectrofotômetro de absorção atômica, enquanto o fósforo foi medido pelo método da colorimetria. O município de Linares apresentou o maior conteúdo de macro e microminerais. Entre as espécies, C. pallida apresentou os maiores valores de macrominerais, enquanto o teor de microminerais foi maior na P. aculeata. Ca (média = 40.0 g kg-1 MS), K (15.4 g kg-1), Mg (3.7 g kg-1), Fe (87.2 mg kg-1), Mn (35.5 mg kg-1) estavam disponíveis em quantidades adequadas, enquanto P (1.3 g kg-1 MS), Cu (6.4 mg kg-1) e Zn (17.7 mg kg-1) foram encontrados deficientes. As espécies arbustivas deste estudo podem ser consideradas uma boa fonte de Ca, K, Mg, Fe e Mn, exceto na espécie C. suaveolens. No entanto, P, Cu e Zn devem ser suplementados.

RESUMO

Pathogenic trypanosomatids (Trypanosoma cruzi, Trypanosoma brucei, and Leishmania spp.) are protozoan parasites that cause neglected diseases affecting millions of people in Africa, Asia, and the Americas. In the process of infection, trypanosomatids evade and survive the immune system attack, which can lead to a chronic inflammatory state that induces cumulative damage, often killing the host in the long term. The immune mediators involved in this process are not entirely understood. Most of the research on the immunologic control of protozoan infections has been focused on acute inflammation. Nevertheless, when this process is not terminated adequately, permanent damage to the inflamed tissue may ensue. Recently, a second process, called resolution of inflammation, has been proposed to be a pivotal process in the control of parasite burden and establishment of chronic infection. Resolution of inflammation is an active process that promotes the normal function of injured or infected tissues. Several mediators are involved in this process, including eicosanoid-derived lipids, cytokines such as transforming growth factor (TGF)-ß and interleukin (IL)-10, and other proteins such as Annexin-V. For example, during T. cruzi infection, pro-resolving lipids such as 15-epi-lipoxin-A4 and Resolvin D1 have been associated with a decrease in the inflammatory changes observed in experimental chronic heart disease, reducing inflammation and fibrosis, and increasing host survival. Furthermore, Resolvin D1 modulates the immune response in cells of patients with Chagas disease. In Leishmania spp. infections, pro-resolving mediators such as Annexin-V, lipoxins, and Resolvin D1 are related to the modulation of cutaneous manifestation of the disease. However, these mediators seem to have different roles in visceral or cutaneous leishmaniasis. Finally, although T. brucei infections are less well studied in terms of their relationship with inflammation, it has been found that arachidonic acid-derived lipids act as key regulators of the host immune response and parasite burden. Also, cytokines such as IL-10 and TGF-ß may be related to increased infection. Knowledge about the inflammation resolution process is necessary to understand the host-parasite interplay, but it also offers an interesting opportunity to improve the current therapies, aiming to reduce the detrimental state induced by chronic protozoan infections.

RESUMO

Increasing drug resistance in gastrointestinal (GI) parasites of livestock and concerns about chemical residues in animal products and the environment are driving the development of alternative control strategies that are less reliant on the use of synthetic drugs. An increasingly investigated approach is the use of bioactive forages with antiparasitic properties as part of the animal's diet (nutraceuticals) or as potential sources of novel, natural parasiticides. Chicory (Cichorium intybus) is a multi-purpose crop and one of the most promising bioactive forages in temperate regions, and numerous in vivo trials have explored its potential against parasitic nematodes in livestock. However, it is unclear whether chicory can induce a direct and broad activity against various GI parasites in different livestock species, and the levels of chicory in the diet that are required to exert an efficient antiparasitic effect. Moreover, the mechanisms leading to the reported parasiticidal activity of chicory are still largely unknown, and its bioactive phytochemicals have only recently been investigated. In this review, we summarise the progress in the study of the antiparasitic activity of chicory and its natural bioactive compounds against GI parasites in livestock, through examination of the published literature. The available evidence indicates that feeding chicory can reduce faecal egg counts and/or worm burdens of abomasal nematodes, but not infections with intestinal worms, in ruminants. Highly chicory-rich diets (≥ 70% of chicory dry matter in the diet) may be necessary to directly affect abomasal parasitism. Chicory is known to synthesise several bioactive compounds with potential antiparasitic activity, but most research has been devoted to the role of sesquiterpene lactones (SL). Recent in vitro studies have confirmed direct and potent activity of SL-rich extracts from chicory against different GI helminths of livestock. Chicory SL have also been reported to exhibit antimalarial properties and its potential antiprotozoal activity in livestock remains to be evaluated. Furthermore, the detailed identification of the main antiparasitic metabolites of chicory and their pharmacokinetics need further confirmation. Research gaps and perspectives on the potential use of chicory as a nutraceutical forage and a source of bioactive compounds for parasite control in livestock are discussed.

Assuntos

Ração Animal/análise , Antiparasitários/administração & dosagem , Cichorium intybus/química , Suplementos Nutricionais , Nematoides/efeitos dos fármacos , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/química , Antiparasitários/química , Bovinos , Fezes/parasitologia , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/parasitologia , Helmintíase/tratamento farmacológico , Humanos , Enteropatias Parasitárias/tratamento farmacológico , Gado/anatomia & histologia , Gado/parasitologia , Contagem de Ovos de Parasitas , Ovinos

RESUMO

Resumen ANTECEDENTES La administración de vitamina K se restringe a situaciones, como antídoto de los antagonistas de vitamina K y enfermedad hemorrágica del recién nacido, pero debido a su papel en la hemostasia, su administración se ha extendido al tratamiento de otras enfermedades, como la enfermedad hepática crónica. OBJETIVO Identificar la eficacia de adicionar vitamina K al tratamiento de los pacientes con insuficiencia hepática terminal con algún estado de descompensación. MATERIAL Y MÉTODO Estudio de casos y controles retrospectivo realizado en el periodo 2016-2017 en pacientes con enfermedad hepática crónica estadio Child-Pugh C durante un episodio de descompensación. La vitamina K (bisulfito sódico de menadiona) se administró a dosis de 10 mg vía intramuscular cada 12 h durante tres días. RESULTADOS Se estudiaron 60 pacientes, 30 recibieron vitamina K, en caso de un evento hemorrágico se administró en conjunto terapia de sustitución con plasma fresco congelado y crioprecipitados. La media de edad fue de 60 (25-86) años, todos los casos eran del género masculino. La principal causa de complicación fue la hemorragia (85%). Cinco casos (8.3%) fallecieron por reactivación de la hemorragia. Administrar vitamina K no acortó las pruebas de coagulación (TP, TTPa, INR) ni mostró beneficio en la mortalidad. Sólo la trombosis como la encefalopatía mostró asociación con la mortalidad. CONCLUSIÓN La adición de vitamina K no influye en las complicaciones en pacientes con enfermedad hepática terminal.

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Abstract BACKGROUND The administration of vitamin K are restricted to situations such as an antidote for vitamin K antagonists and hemorrhagic disease of the newborn, but due to its role in hemostasis, its use has been extended to other diseases, such as terminal chronic liver disease. OBJECTIVE To identify the efficacy of adding vitamin K to the management of patients with terminal hepatic insufficiency with some state of decompensation. MATERIAL AND METHOD A retrospective case-control study was done between 2016-2017 in patients with Child-Pugh C chronic liver disease during an episode of decompensation. Vitamin K (menadione sodium bisulfite) was administered at a dose of 10 mg intramuscular every 12 h for three days. RESULTS A total of 60 patients were studied, 30 received vitamin K, in the case of a hemorrhagic event, replacement therapy with fresh frozen plasma and cryoprecipitates were administered together. The mean age was 60 (25-86) years; all were male. Hemorrhage (85%) was the main cause of complication. Five cases (8.3%) died due to reactivation of the hemorrhage. The administration of vitamin K did not shorten the coagulation tests (TP, aPTT, INR) nor showed a mortality benefit. Only thrombosis such as encephalopathy showed an association on mortality. CONCLUSION The addition of vitamin K does not influence the complications in patients with terminal liver disease.