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1.
Lett Appl Microbiol ; 76(10)2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37740443

RESUMO

Pentaerythritol tetranitrate (PETN) is a nitrate ester explosive that may be persistent with scarce reports on its environmental fate and impacts. Our main objective was to isolate and characterize bacteria that transform PETN under aerobic and anaerobic conditions. Biotransformation of PETN (100 mg L-1) was evaluated using mineral medium with (M + C) and without (M - C) additional carbon sources under aerobic conditions and with additional carbon sources under anaerobic conditions. Here, we report on the isolation of 12 PETN-transforming cultures (4 pure and 8 co-cultures) from environmental samples collected at an explosive manufacturing plant. The highest transformation of PETN was observed for cultures in M + C under aerobic conditions, reaching up to 91% ± 2% in 2 d. Under this condition, PETN biotransformation was observed in conjunction with the release of nitrites and bacterial growth. No substantial transformation of PETN (<45%) was observed during 21 d in M - C under aerobic conditions. Under anaerobic conditions, five cultures could transform PETN (up to 52% ± 13%) as the sole nitrogen source, concurrent with the formation of two unidentified metabolites. PETN-transforming cultures belonged to Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, and Actinobacteria. In conclusion, we isolated 12 PETN-transforming cultures belonging to diverse taxa, suggesting that PETN transformation is phylogenetically widespread.


Assuntos
Substâncias Explosivas , Tetranitrato de Pentaeritritol , Tetranitrato de Pentaeritritol/metabolismo , Anaerobiose , Bactérias/genética , Bactérias/metabolismo , Carbono
2.
Rev. cuba. oftalmol ; 36(2)jun. 2023.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1550913

RESUMO

Objetivo: Comparar la efectividad del tratamiento de atropina versus oclusión ocular en pacientes con ambliopía refractiva moderada unilateral. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de una serie de casos que acudieron a la consulta de Oftalmología Pediátrica del Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el período comprendido de septiembre del 2019 a septiembre de 2021. La muestra quedó conformada por 44 pacientes, los cuales se dividieron de forma aleatoria en dos grupos de estudio, 22 casos al grupo de oclusiones e igual número al grupo de atropina, que cumplían los criterios de inclusión. Se analizaron las variables edad, sexo, defecto refractivo, agudeza visual mejor corregida, sensibilidad al contraste y estereopsis. Resultados: Predominó el astigmatismo hipermetrópico en ambos grupos de estudio. La media de la agudeza visual mejor corregida inicial en ambos grupos fue de 0,4 LogMAR y mejoró a 0,1 LogMAR al finalizar el tratamiento. La media de la sensibilidad al contraste inicial fue de 1,48 (±19,75) para el grupo de oclusiones y de 1,47 (±20,5) para el grupo atropina, al finalizar alcanzaron 1,59 (±10,1) y 1,57 (±10,0) por orden de mención. La estereopsis inicial fue subnormal en ambos grupos, al finalizar el tratamiento fue normal en el 77,3 por ciento grupo oclusión y el 68,2 por ciento grupo atropina. Conclusiones: La efectividad del tratamiento en pacientes con ambliopía refractiva moderada unilateral con atropina es similar a la que se alcanza con la aplicación de la oclusión ocular(AU)


Objective: To compare the effectiveness of atropine treatment versus ocular occlusion in patients with unilateral moderate refractive amblyopia. Methods: A descriptive, longitudinal and prospective study of a series of cases that attended the Pediatric Ophthalmology office of the Ramón Pando Ferrer Cuban Institute of Ophthalmology during the period from September 2019 to September 2021 was carried out. The sample consisted of 44 patients, who were randomly divided into two study groups, 22 cases to the occlusion group and the same number to the atropine group, who met the inclusion criteria. The variables age, gender, refractive defect, best corrected visual acuity, contrast sensitivity and stereopsis were analyzed. Results: Hypermetropic astigmatism predominated in both study groups. Average initial best-corrected visual acuity in both groups was 0.4 LogMAR and improved to 0.1 LogMAR at the end of treatment. Average initial contrast sensitivity was 1.48 (±19.75) for the occlusion group and 1.47 (±20.5) for the atropine group, at completion reaching 1.59 (±10.1) and 1.57 (±10.0) in order of mention. Initial stereopsis was subnormal in both groups, at the end of treatment it was normal in 77.3 percent occlusion group and 68.2 percent atropine group. Conclusions: The effectiveness of treatment in patients with unilateral moderate refractive amblyopia with atropine is similar to that achieved with the application of ocular occlusion(AU)


Assuntos
Humanos , Criança , Atropina/uso terapêutico , Ambliopia/etiologia , Epidemiologia Descritiva , Estudos Longitudinais
3.
JCO Glob Oncol ; 8: e2200104, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35867948

RESUMO

PURPOSE: To report on pathogenic germline variants detected among individuals undergoing genetic testing for hereditary breast and/or ovarian cancer (HBOC) from Latin America and compare them with self-reported Hispanic individuals from the United States. METHODS: In this cross-sectional study, unrelated individuals with a personal/family history suggestive of HBOC who received clinician-ordered germline multigene sequencing were grouped according to the location of the ordering physician: group A, Mexico, Central America, and the Caribbean; group B, South America; and group C, United States with individuals who self-reported Hispanic ethnicity. Relatives who underwent cascade testing were analyzed separately. RESULTS: Among 24,075 unrelated probands across all regions, most were female (94.9%) and reported a personal history suggestive of HBOC (range, 65.0%-80.6%); the mean age at testing was 49.1 ± 13.1 years. The average number of genes analyzed per patient was highest in group A (A 63 ± 28, B 56 ± 29, and C 40 ± 28). Between 9.1% and 18.7% of patients had pathogenic germline variants in HBOC genes (highest yield in group A), with the majority associated with high HBOC risk. Compared with US Hispanics individuals the overall yield was significantly higher in both Latin American regions (A v C P = 1.64×10-9, B v C P < 2.2×10-16). Rates of variants of uncertain significance were similar across all three regions (33.7%-42.6%). Cascade testing uptake was low in all regions (A 6.6%, B 4.5%, and C 1.9%). CONCLUSION: This study highlights the importance of multigene panel testing in Latin American individuals with newly diagnosed or history of HBOC, who can benefit from medical management changes including targeted therapies, eligibility to clinical trials, risk-reducing surgeries, surveillance and prevention of secondary malignancy, and genetic counseling and subsequent cascade testing of at-risk relatives.


Assuntos
Neoplasias Ovarianas , Neoplasias da Mama , Carcinoma Epitelial do Ovário , Estudos Transversais , Feminino , Células Germinativas , Hispânico ou Latino/genética , Humanos , América Latina/epidemiologia , Masculino , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Prevalência , Estados Unidos/epidemiologia
4.
Rev. colomb. cir ; 37(2): 226-236, 20220316. tab
Artigo em Espanhol | LILACS | ID: biblio-1362949

RESUMO

Introducción. La hipocalcemia es la complicación más frecuente de la tiroidectomía. La profilaxis con calcio/calcitriol es una alternativa costo-efectiva, sencilla y expedita para disminuir esta situación, sin alterar la función paratiroidea residual. Lo que no está claro es si hay superioridad de una dosis frente a otra, por lo que el objetivo de este estudio fue evaluar el comportamiento entre diferentes esquemas de profilaxis para hipocalcemia. Métodos. Estudio de cohorte retrospectivo de adultos operados en un hospital de cuarto nivel, entre febrero de 2017 y diciembre de 2020. Se calculó la tasa de síntomas, la hipocalcemia e hipercalcemia bioquímica en el control postquirúrgico durante las siguientes dos semanas. Se hizo análisis bivariado y multivariado entre dosis de calcio/calcitriol, otros factores asociados y los desenlaces mencionados. Resultados. Se incluyeron 967 pacientes. El 10 % presentaron síntomas. No hubo diferencias significativas en el calcio sérico del control posquirúrgico entre los grupos con distintas dosis de calcio. La dosis de carbonato de calcio >3600 mg/día y el calcio en las primeras 24 horas de cirugía se asociaron a la presencia de síntomas. La dosis de calcitriol <1 mcg/día y el bocio aumentaron el riesgo de hipocalcemia bioquímica, mientras que la dosis de 1,5 mcg/día lo disminuyó. Ninguna variable evaluada se asoció a hipercalcemia bioquímica. Conclusiones. Podemos establecer que dosis altas de carbonato de calcio no se asocian con menos hipocalcemia bioquímica, lo cual está a favor de usar dosis intermedias (3600 mg/día). De forma similar, la dosis de calcitriol de 1,5 mcg/día disminuye el riesgo de este desenlace. La identificación de variables que aumentan o disminuyen el riesgo de hipocalcemia posterior a tiroidectomía, como bocio o el nivel de calcio en las primeras 24 horas para este estudio, pueden determinar ajustes individuales en la dosis rutinaria profiláctica de calcio/calcitriol.


Introduction. Hypocalcemia is the most frequent complication of thyroidectomy. Calcium/calcitriol prophylaxis is a cost-effective, simple and expeditious alternative to reduce this situation, without altering residual parathyroid function. It is not clear whether there is superiority of one dose over another, so the objective of this study was to evaluate the behavior between prophylaxis doses for hypocalcemia. Methods. Retrospective cohort study of adults operated in a fourth level hospital, between February 2017 and December 2020. The rate of symptoms, biochemical hypocalcemia and hypercalcemia was calculated in the post-surgical control during the following two weeks. Bivariate and multivariate analyses were performed between calcium/calcitriol dose, other associated factors, and the mentioned outcomes. Results. Out of the 967 patients included, 10% presented symptoms. There were no significant differences in postoperative control serum calcium between the groups with different doses of calcium. The dose of calcium carbonate > 3600 mg/day and calcium in the first 24 hours of surgery were associated with the presence of symptoms. The dose of calcitriol <1 mcg/day and goiter increased the risk of biochemical hypocalcemia, while the dose of 1.5 mcg / day decreased it. No variable evaluated was associated with biochemical hypercalcemia. Conclusion. We can establish that high doses of calcium are not less associated with biochemical hypocalcemia, which is in favor of intermediate doses (i.e. 3600mg/day). In a similar way, the calcitriol dose of 1.5mcg/day decreases the risk of this outcome. The identification of variables that increase or decrease the risk of this complication (goiter or the 24h serum calcium in this study) can decide settings in the rutinary prophylactic dose of calcium/calcitriol.


Assuntos
Humanos , Complicações Pós-Operatórias , Tireoidectomia , Hipocalcemia , Calcitriol , Carbonato de Cálcio , Hipercalcemia
5.
Rev. colomb. gastroenterol ; 36(supl.1): 98-101, abr. 2021. graf
Artigo em Espanhol | LILACS | ID: biblio-1251555

RESUMO

Resumen Se presenta el caso de un paciente con antecedente de consumo crónico de alcohol, que consultó por dolor abdominal inespecífico, fiebre intermitente no cuantificada y pérdida de peso, con posterior aumento del perímetro abdominal. Se encontró ascitis y hallazgos en imágenes que sugerían cirrosis. El estudio del líquido ascítico fue no hipertensivo con predominio de linfocitos y niveles de adenosina-desaminasa (ADA) elevados. La ecografía y tomografía de abdomen mostraron el engrosamiento del peritoneo y la biopsia peritoneal por laparoscopia fue compatible con enfermedad granulomatosa, con reacción en cadena de la polimerasa (PCR) positiva para Mycobacterium tuberculosis en un paciente sin otras causas de inmunosupresión. Este caso muestra la necesidad de mantener una alta sospecha clínica de TB en patologías abdominales con clínica inespecífica, aun en pacientes sin inmunocompromiso claro.


Abstract This is the case of a patient with a history of chronic alcohol consumption, who consulted for nonspecific abdominal pain, intermittent fever, and weight loss, with subsequent increase in the abdominal perimeter. Ascites and imaging findings suggestive of cirrhosis were found. The study of ascitic fluid was non-hypertensive with a predominance of lymphocytes and elevated adenosine deaminase (ADA) levels. Ultrasound and abdominal tomography showed peritoneal thickening. Laparoscopic peritoneal biopsy was compatible with granulomatous disease, with positive PCR for Mycobacterium tuberculosis in a patient with no other causes of immunosuppression. This report shows the importance of keeping a high index of suspicion for TB in patients with abdominal pathology, even in those without evident inmunocompromise.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Peritônio , Ascite , Tuberculose , Consumo de Bebidas Alcoólicas , Etanol
6.
Plast Reconstr Surg Glob Open ; 8(8): e3013, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32983773

RESUMO

An estimated 43,390 breast augmentation surgeries (86,780 implants) and 1486 breast implant reconstructions are performed annually in Colombia, representing the second-most breast surgery destination in South America, the fourth in the western hemisphere, and the fifth country worldwide. No previous reports have evaluated the incidence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) epidemiology or outcomes in a Hispanic population. Published data on the incidence of this disease in Colombia are unknown; therefore, a National Joint Multidisciplinary Committee was developed between the Colombian scientific societies of Mastology, Plastic Surgery, Hemato-Oncology, and the Invima (The National Food and Drug Surveillance Institute) to track national cases of BIA-ALCL. MATERIALS AND METHODS: We performed a retrospective review (survey-based study) of historical cases since 2011-2019, and a prospective collection of all patients with a confirmed World Health Organization diagnosis of BIA-ALCL identified in a newly established National Registry of BIA-ALCL. The trial was approved by Institutional Review Board (IRB). RESULTS: Eighteen cases of BIA-ALCL were identified in Colombia between 2011 and 2019. Hundred percent developed as sequelae of textured implants. Six patients (33.3%) presented either a peri-implant capsule mass or axillary lymph node involvement. Seven (38.9%) required adjuvant chemotherapy most commonly with CHOP regimen. Different brands of implants were associated with our cases. One death (5.6%) was attributed to BIA-ALCL, and one (5.6%) case displayed with relapsed with bone marrow involvement requiring a bone marrow transplantation. Six cases (33.3%) were identified with advanced stage (IIB-IV). Disease-free survival of 92.3% was achieved at 30.8-month follow-up. CONCLUSIONS: Colombia has one of the highest volumes of breast surgery and use of textured surface breast implants in the world. This study is the initial report of an implant registry in South America. A high proportion of advanced disease may be a consequence of delayed presentation, lack of disease awareness, and timely access to tertiary cancer centers for diagnosis and treatment. Brands other than Allergan and Mentor were found to be associated with BIA-ALCL in our study.

7.
Rev Colomb Obstet Ginecol ; 71(2): 87-102, 2020 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-32770869

RESUMO

OBJECTIVE: To determine the association between delayed diagnosis and advanced clinical stage breast cancer, and to explore the factors that influence this delay. METHODS: Cross-sectional study of women over 18 years of age with breast cancer who attended 4 oncology centers in Medellín, Colombia, in 2017. The "Breast Cancer Delay Questionnaire" which includes sociodemographic and clinical variables as well as time intervals was used. Crude and adjusted odds ratio (OR) were estimated, using advanced clinical stage as outcome and delayed diagnosis as exposure. RESULTS: 42 patients were included. The median time interval between the identification of the problem and the diagnostic biopsy was 104.5 days; between the identification of the problem and the first medical visit, 20 days; and between the first visit and the diagnostic biopsy, 53 days. Of all the cases, 52.1 % were diagnosed at an advanced stage. An association was found between delayed diagnosis and advanced clinical stage (OR = 2.15 95 % CI 1.21-3.79). Age above 40 was found to be a protective factor against having an advanced-stage lesion (OR = 0.35; 95 % CI: 0.14-0.83). Delayed diagnosis was associated with affiliation to the government subsidized health system (OR = 9.67; 95 % CI 2.76- 33.9) and age over 40 years (OR = 2.75; 95 % CI1.16-6.53). CONCLUSIONS: Patient education is required in order to ensure adherence to early screening programs or timely consultation whenever a sign or symptom is identified, thus allowing diagnosis at an early stage of the disease. Moreover, prospective studies are needed in order to identify factors associated with delays in treatment after the diagnosis of breast cancer, and to assess interventions designed to reduce delays in the care of this form of cancer.


TITULO: ASOCIACIÓN ENTRE RETRASO EN EL DIAGNÓSTICO Y ESTADIO CLÍNICO AVANZADO DE CÁNCER DE MAMA AL MOMENTO DE LA CONSULTA EN CUATRO CENTROS ONCOLÓGICOS DE MEDELLÍN, COLOMBIA, 2017. ESTUDIO DE CORTE TRANSVERSAL. OBJETIVO: Establecer la asociación entre el retraso en el diagnóstico de cáncer de mama con un estadio clínico avanzado y explorar factores que influyen en dicho retraso. METODOS: Estudio de corte transversal con mujeres mayores de 18 años con cáncer de mama que consultaron en cuatro centros oncológicos de Medellín, Colombia, en 2017. Se usó el Breast Cancer Delay Questionnaire que incluye variables sociodemográficas, clínicas y de tiempos de atención. Se estimó el odds ratio (OR) crudo y ajustado por medio de una regresión logística con el estadio clínico avanzado como desenlace y el retraso diagnóstico como exposición. RESULTADOS: Se incluyeron 242 pacientes. La mediana del tiempo entre identificar el problema y la biopsia diagnóstica fue 104,5 días; entre identificar el problema y la primera consulta médica, 20 días, y de la primera consulta a la biopsia diagnóstica fue de 53 días. El 52,1 % se diagnosticó en estadio avanzado. Hubo asociación del retraso diagnóstico con estadio clínico avanzado (OR = 2,15; IC 95 %: 1,21-3,79). Se encontró que la edad mayor a 40 años es un factor protector contra una lesión avanzada (OR = 0,35; IC 95 %: 0,14-0,83). El retraso diagnóstico se asoció con estar afiliada al régimen subsidiado por el Estado (OR = 9,67; IC 95 %: 2,76-33,9) y tener edad mayor a 40 años (OR = 2,75; IC 95 %: 1,16-6,53). CONCLUSIONES: Se requieren intervenciones educativas en las pacientes para adherir a los programas de tamización temprana o la consulta oportuna al identificar un signo o síntoma, para lograr un diagnóstico en estadios tempranos de la enfermedad. Además, se requieren estudios prospectivos para determinar los factores relacionados con la demora en recibir el tratamiento una vez diagnosticado el cáncer de seno y evaluar las intervenciones destinadas a disminuir las dilaciones en la atención de este cáncer.


Assuntos
Neoplasias da Mama/diagnóstico , Diagnóstico Tardio , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Idoso , Biópsia , Neoplasias da Mama/patologia , Institutos de Câncer/estatística & dados numéricos , Colômbia/epidemiologia , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tamanho da Amostra , Fatores Socioeconômicos , Avaliação de Sintomas
8.
Polymers (Basel) ; 12(5)2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32438664

RESUMO

Polyaniline (PANI) has recently gained great attention due to its outstanding electrical properties and ease of processability; these characteristics make it ideal for the manufacturing of polymer blends. In this study, the processing and piezoresistive characterization of polymer composites resulting from the blend of PANI with ultra-high molecular weight polyethylene (UHMWPE) in different weight percentages (wt %) is reported. The PANI/UHMWPE composites were uniformly homogenized by mechanical mixing and the pellets were manufactured by compression molding. A total of four pellets were manufactured, with PANI percentages of 20, 25, 30 and 35 wt %. Fourier-transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), differential thermal analysis (DTA), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to confirm the effective distribution of PANI and UHMWPE particles in the pellets. A piezoresistive characterization was performed on the basis of compressive forces at different voltages; it was found that the error metrics of hysteresis and drift were influenced by the operating voltage. In general, larger voltages lowered the error metrics, but a reduction in sensor sensitivity came along with voltage increments. In an attempt to explain such a phenomenon, the authors developed a microscopic model for the piezoresistive response of PANI composites, aiming towards a broader usage of PANI composites in strain/stress sensing applications as an alternative to carbonaceous materials.

9.
Rev. colomb. obstet. ginecol ; 71(2): 87-102, abr.-jun. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1126321

RESUMO

RESUMEN Objetivo: establecer la asociación entre el retraso en el diagnóstico de cáncer de mama con un estadio clínico avanzado y explorar factores que influyen en dicho retraso. Materiales y métodos: estudio de corte transversal con mujeres mayores de 18 años con cáncer de mama que consultaron en cuatro centros oncológicos de Medellín, Colombia, en 2017. Se usó el Breast Cancer Delay Questionnaire que incluye variables sociodemográficas, clínicas y de tiempos de atención. Se estimó el odds ratio (OR) crudo y ajustado por medio de una regresión logística con el estadio clínico avanzado como desenlace y el retraso diagnóstico como exposición. Resultados: se incluyeron 242 pacientes. La mediana del tiempo entre identificar el problema y la biopsia diagnóstica fue 104,5 días; entre identificar el problema y la primera consulta médica, 20 días, y de la primera consulta a la biopsia diagnóstica fue de 53 días. El 52,1 % se diagnosticó en estadio avanzado. Hubo asociación del retraso diagnóstico con estadio clínico avanzado (OR = 2,15; IC 95 %: 1,21-3,79). Se encontró que la edad mayor a 40 años es un factor protector contra una lesión avanzada (OR = 0,35; IC 95 %: 0,14-0,83). El retraso diagnóstico se asoció con estar afiliada al régimen subsidiado por el Estado (OR = 9,67; IC 95 %: 2,76-33,9) y tener edad mayor a 40 años (OR = 2,75; IC 95 %: 1,16-6,53). Conclusión: se requieren intervenciones educativas en las pacientes para adherir a los programas de tamización temprana o la consulta oportuna al identificar un signo o síntoma, para lograr un diagnóstico en estadios tempranos de la enfermedad. Además, se requieren estudios prospectivos para determinar los factores relacionados con la demora en recibir el tratamiento una vez diagnosticado el cáncer de seno y evaluar las intervenciones destinadas a disminuir las dilaciones en la atención de este cáncer.


ABSTRACT Objective: To determine the association between delayed diagnosis and advanced clinical stage breast cancer, and to explore the factors that influence this delay. Materials and methods: Cross-sectional study of women over 18 years of age with breast cancer who attended 4 oncology centers in Medellín, Colombia, in 2017. The "Breast Cancer Delay Questionnaire" which includes sociodemographic and clinical variables as well as time intervals was used. Crude and adjusted odds ratio (OR) were estimated, using advanced clinical stage as outcome and delayed diagnosis as exposure. Results: 242 patients were included. The median time interval between the identification of the problem and the diagnostic biopsy was 104.5 days; between the identification of the problem and the first medical visit, 20 days; and between the first visit and the diagnostic biopsy, 53 days. Of all the cases, 52.1 % were diagnosed at an advanced stage. An association was found between delayed diagnosis and advanced clinical stage (OR = 2.15 95 % CI 1.21-3.79). Age above 40 was found to be a protective factor against having an advanced-stage lesion (OR = 0.35; 95 % CI: 0.14-0.83). Delayed diagnosis was associated with affiliation to the government subsidized health system (OR = 9.67; 95 % CI 2.76- 33.9) and age over 40 years (OR = 2.75; 95 % CI: 1.16-6.53). Conclusion: Patient education is required in order to ensure adherence to early screening programs or timely consultation whenever a sign or symptom is identified, thus allowing diagnosis at an early stage of the disease. Moreover, prospective studies are needed in order to identify factors associated with delays in treatment after the diagnosis of breast cancer, and to assess interventions designed to reduce delays in the care of this form of cancer.


Assuntos
Neoplasias da Mama , Diagnóstico Tardio , Tempo para o Tratamento
10.
Cad Saude Publica ; 34(12): e00114117, 2018 12 20.
Artigo em Espanhol | MEDLINE | ID: mdl-30570037

RESUMO

The study aimed to estimate the effect of health insurance on overall survival and disease-free survival in breast cancer patients undergoing surgery at the Las Américas Oncology Institute in Medellín, Colombia, with data from the institutional registry. The variables were compared between subsidized coverage and contributive coverage with chi-squared test (χ2) or Student t test, Kaplan-Meier, and log-rank test. The target variable was adjusted with Cox regression. There were 2,732 patients with a median follow-up of 36 months. Ten percent of the women with contributive coverage died, compared to 23% of the subsidized coverage group. There were differences in time-to-treatment (contributive group with 52 days versus subsidized group with 112 days, p < 0.05). Disease-free survival and overall survival were better in women with contributive coverage compared to those with subsidized coverage (p < 0.05), and overall survival varied according to tumor and treatment variables. Overall survival and disease-free survival and early time-to-diagnosis and treatment were better in patients with contributive coverage compared to those with subsidized coverage.


El objetivo fue estimar el efecto del aseguramiento en salud sobre la supervivencia global y libre de enfermedad en pacientes con cáncer de mama. La muestra se compuso de mujeres operadas en el Instituto de Cancerología, Medellín, Colombia, con datos del registro institucional. Las variables se compararon entre régimen subsidiado y contributivo com chi cuadrado test (χ2) o test t de Student, método de Kaplan-Meier y prueba de rangos logarítmicos (log-rank test). La variable de interés se ajustó con una regresión de Cox. Se incluyeron 2.732 pacientes con mediana de seguimiento de 36 meses. Del régimen contributivo murieron el 10% y del régimen subsidiado murieron 23%. Hubo diferencias en tiempos de acceso a tratamiento (régimen contributivo: 52 vs. régimen subsidiado: 112 días, p < 0,05). Supervivencia libre de enfermedad y supervivencia global fueron mejores en régimen contributivo que en régimen subsidiado (p < 0,05); supervivencia global depende de variables del tumor y del tratamiento. Supervivencia global y supervivencia libre de enfermedad y tiempos de acceso para atención y diagnóstico en etapa temprana fueron mejores en régimen contributivo que en régimen subsidiado.


O objetivo deste trabalho foi estimar o efeito do seguro de saúde sobre a sobrevivência global e livre de doença em pacientes com câncer de mama. A amostra foi composta por mulheres operadas no Instituto de Cancerologia Las Américas em Medellín, Colombia, com dados do registro institucional. As variáveis foram comparadas entre o regime subsidiado e contributivo com teste do qui-quadrado (χ2) ou teste t de Student, método de Kaplan-Meier e log-rank test. A variável de interesse foi ajustada por meio de uma regressão de Cox. Foram incluídas 2.732 pacientes durante um período médio de acompanhamento de 36 meses. Do regime contributivo morreram 10% das mulheres e do regime subsidiado morreram 23%. Houve diferenças nos tempos de acesso ao tratamento (regime contributivo: 52 vs. regime subsidiado: 112 dias; p < 0,05). Sobrevivência livre de doença e sobrevivência global foram melhores em regime contributivo do que em regime subsidiado (p < 0,05); sobrevivência global depende de variáveis do tumor e do tratamento. Sobrevivência global e sobrevivência livre de doença e os tempos de acesso para atenção e diagnóstico no estágio inicial foram melhores em regime contributivo do que em regime subsidiado.


Assuntos
Neoplasias da Mama/terapia , Seguro Saúde , Adolescente , Estudos de Coortes , Colômbia , Intervalo Livre de Doença , Feminino , Disparidades nos Níveis de Saúde , Humanos , Estimativa de Kaplan-Meier , Expectativa de Vida , Pessoa de Meia-Idade
11.
Agora USB ; 18(2): 374-383, jul.-dic. 2018.
Artigo em Espanhol | LILACS | ID: biblio-989221

RESUMO

Resumen Al analizar las acciones que emprenden las mujeres víctimas por desaparición forzada en Granada, (Antioquia) y las incidencias que dichas acciones tienen en sus sentidos de vida, nace la necesidad de indagar por las formas cómo han resignificado las mujeres víctimas el hecho por desaparición, debido a la falta de significación entre el estado y la ciudadanía. En este sentido, el proyecto investigativo cobra relevancia en el estudio fenomenológico como forma de analizar cada uno de los fenómenos representados en la desaparición forzada, el cual permita narrar y describir cada una de las afectaciones, acciones e incidencias de cada una de las mujeres víctimas de la Asociación De Víctimas De Granada (Asovida). Por tal motivo, se hace necesario el enfoque logo terapéutico como propuesta metodológica de resignificación de los sentidos de vida para encaminar cada una de las experiencias como guía para el restablecimiento de cada uno de sus derechos, en la construcción de paz.


Abstract In analyzing the actions undertaken by victimized women forced disappearance in Granada, (Antioquia) and the incidents that these actions have on their senses of life, it is necessary to investigate the ways that victimized women have given a new meaning to the fact related to disappearance, due to the lack of significance between the state and the citizenry. In this sense, the research project becomes relevant in the phenomenological study as a way of analyzing each one of the phenomena represented in the forced disappearance, which allows to narrate and to describe each one of the affections, actions and incidents of each of the victimized women of the Association of Victims of Granada (Asovida). For this reason, the logotherapeutic approach is necessary as a methodological proposal for the resignification of the senses of life in order to channel each of the experiences as a guideline for the restoration of each one of their rights, in the construction of peace.

12.
Cad. Saúde Pública (Online) ; 34(12): e00114117, 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-974616

RESUMO

Resumen: El objetivo fue estimar el efecto del aseguramiento en salud sobre la supervivencia global y libre de enfermedad en pacientes con cáncer de mama. La muestra se compuso de mujeres operadas en el Instituto de Cancerología, Medellín, Colombia, con datos del registro institucional. Las variables se compararon entre régimen subsidiado y contributivo com chi cuadrado test (χ2) o test t de Student, método de Kaplan-Meier y prueba de rangos logarítmicos (log-rank test). La variable de interés se ajustó con una regresión de Cox. Se incluyeron 2.732 pacientes con mediana de seguimiento de 36 meses. Del régimen contributivo murieron el 10% y del régimen subsidiado murieron 23%. Hubo diferencias en tiempos de acceso a tratamiento (régimen contributivo: 52 vs. régimen subsidiado: 112 días, p < 0,05). Supervivencia libre de enfermedad y supervivencia global fueron mejores en régimen contributivo que en régimen subsidiado (p < 0,05); supervivencia global depende de variables del tumor y del tratamiento. Supervivencia global y supervivencia libre de enfermedad y tiempos de acceso para atención y diagnóstico en etapa temprana fueron mejores en régimen contributivo que en régimen subsidiado.


Abstract: The study aimed to estimate the effect of health insurance on overall survival and disease-free survival in breast cancer patients undergoing surgery at the Las Américas Oncology Institute in Medellín, Colombia, with data from the institutional registry. The variables were compared between subsidized coverage and contributive coverage with chi-squared test (χ2) or Student t test, Kaplan-Meier, and log-rank test. The target variable was adjusted with Cox regression. There were 2,732 patients with a median follow-up of 36 months. Ten percent of the women with contributive coverage died, compared to 23% of the subsidized coverage group. There were differences in time-to-treatment (contributive group with 52 days versus subsidized group with 112 days, p < 0.05). Disease-free survival and overall survival were better in women with contributive coverage compared to those with subsidized coverage (p < 0.05), and overall survival varied according to tumor and treatment variables. Overall survival and disease-free survival and early time-to-diagnosis and treatment were better in patients with contributive coverage compared to those with subsidized coverage.


Resumo: O objetivo deste trabalho foi estimar o efeito do seguro de saúde sobre a sobrevivência global e livre de doença em pacientes com câncer de mama. A amostra foi composta por mulheres operadas no Instituto de Cancerologia Las Américas em Medellín, Colombia, com dados do registro institucional. As variáveis foram comparadas entre o regime subsidiado e contributivo com teste do qui-quadrado (χ2) ou teste t de Student, método de Kaplan-Meier e log-rank test. A variável de interesse foi ajustada por meio de uma regressão de Cox. Foram incluídas 2.732 pacientes durante um período médio de acompanhamento de 36 meses. Do regime contributivo morreram 10% das mulheres e do regime subsidiado morreram 23%. Houve diferenças nos tempos de acesso ao tratamento (regime contributivo: 52 vs. regime subsidiado: 112 dias; p < 0,05). Sobrevivência livre de doença e sobrevivência global foram melhores em regime contributivo do que em regime subsidiado (p < 0,05); sobrevivência global depende de variáveis do tumor e do tratamento. Sobrevivência global e sobrevivência livre de doença e os tempos de acesso para atenção e diagnóstico no estágio inicial foram melhores em regime contributivo do que em regime subsidiado.


Assuntos
Humanos , Feminino , Adolescente , Pessoa de Meia-Idade , Neoplasias da Mama/terapia , Seguro Saúde , Estudos de Coortes , Expectativa de Vida , Colômbia , Intervalo Livre de Doença , Disparidades nos Níveis de Saúde , Estimativa de Kaplan-Meier
13.
Rev. colomb. cir ; 32(4): 269-276, 2017. fig, tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-905222

RESUMO

Introducción. La falla anastomótica es una de las principales complicaciones de las cirugías gastrointestinales, que se presenta en 3,4 a 15 % de los pacientes, aproximadamente. En Colombia, no se conoce con exactitud la incidencia de falla anastomótica. Objetivo. Determinar la incidencia de falla anastomótica en cirugías intestinales en dos hospitales de IV nivel de Bogotá. Métodos. Se llevó a cabo un estudio prospectivo de cohorte que incluyó pacientes sometidos a anastamosis y a quienes se les hizo seguimiento hasta de 30 días. Se realizó un análisis descriptivo de la información, asociaciones entre variables mediante la prueba de ji al cuadrado y, además, se emplearon gráficas de KaplanMeier para determinar el tiempo hasta el evento. Los datos se analizaron en Stata 13®. Resultados. Se incluyeron 195 pacientes. El 47,1 % era de sexo masculino y la mediana de la edad fue de 60 años (rango intercuartílico, RIC: 48 a 70). La incidencia de falla anastomótica fue de 10,8 % y la tasa de incidencia fue de 10,2 por 1.000 personas/año. El 29,7 % de los pacientes presentaron complicaciones posoperatorias y se presentó una mortalidad de 9,7 %. La mediana de la estancia hospitalaria fue de 8 días (RIC: 5 a 16). Conclusiones. La incidencia de fístula de la anastomosis que se presentó estuvo acorde con lo reportado en la literatura científica a nivel mundial. El antecedente de cirugía abdominal así como la cirugía de urgencia fueron los factores frecuentes entre los pacientes que presentaron falla anastomótica


Introduction: Anastomotic leak is one of the main complications of patients submitted to gastrointestinal surgery. It occurs in approximately in 3.4% to 15% of cases. In Colombia the overall incidence of anastomotic leak is not known. Material and methods: A prospective cohort study that included patients undergoing anastamosis and who were followed up for up to 30 days. A descriptive analysis of the information was performed. The variables were analyzed with the chi-square test and the Kaplan-Meller graphs were used to determine the time to the event. Data analyses was performed on STATA 13. Results: 195 patients were admitted. 47.1% were male, and the median age of the study group was 60 years (ICR: 48-70). The incidence of anastomotic failure was 10.8% and the incidence rate was 10.2 per 1000 person-years; 29.7% of the patients presented postoperative complications and a mortality rate of 9.7%. The median hospital stay was 8 days (ICR: 5 - 16). Conclusion: The incidence of anastomotic leak observed appears in accordance with reports published in the world literature. The history of abdominal surgery as well as emergency surgery were the most frequent factors among the patients who developed anastomosis leak


Assuntos
Humanos , Anastomose Cirúrgica , Fístula Intestinal , Desnutrição Proteico-Calórica , Deiscência da Ferida Operatória
14.
Med. lab ; 19(11-12): 549-566, 2013. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-834737

RESUMO

El uso de las imágenes diágnósticas en mama se ha convertido en una hemorramienta imprescindible para el especialista que maneja la patología mamaria. En la actualidad, las tres herramientas que se utilizan son: mamografía, ecografía o ultrasonido mamario y resonancia nuclear magnética; sin embargo, se encuentran en fase de estudio nuevas tecnologías como la elastografía y tomosíntesis (mamografía digital 3D). En el presente artículo se presentan los elementos más relevantes en estas ayudas diagnósticas, el léxico usado en los reportes y las indicaciones para cada una de las técnicas con el objetivo de actualizar los conocimientos y dar un uso adecuado de las herramientas diagnósticas.


Abstract: Breast imaging diagnostic have become an indispensable tool for the specialist in breast disease.Currently, the diagnostic tools are: mammography, breast ultrasound and magnetic resonance; but they are under study new technologies such as elastography and tomosynthesis (3D digital mammography). This article presented the most important elements in these diagnostic tools, terminology used in reports and indications for each of these techniques.


Assuntos
Humanos , Doenças Mamárias , Neoplasias da Mama , Mamografia , Ultrassonografia Mamária
15.
Med. lab ; 17(3-4): 127-144, 2011. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-834695

RESUMO

El descubrimiento de biomarcadores específicosde una enfermedad brinda la única oportunidad de adelantarseal diagnóstico clínico de la entidad. Esto aporta ventajas enel tratamiento de los pacientes que se verán reflejadas en los desenlaces...


The discovery of specific biomarkers of disease provides the unique opportunity to anticipate the clinical dioagnosis of the disease. This provides advantages in the treatment of patients that will be reflected in the outcomes....


Assuntos
Humanos , Peptídeo Natriurético Encefálico
16.
Rev. colomb. gastroenterol ; 25(3): 240-251, jul.-sept. 2010. ilus, tab
Artigo em Inglês, Espanhol | LILACS | ID: lil-589409

RESUMO

La frecuencia de enfermedad infl amatoria intestinal, tanto de colitis ulcerativa como enfermedad de Crohn seha incrementado a nivel mundial y es necesario establecer la epidemiología y determinar el comportamientoclínico y endoscópico de estas entidades en nuestro medio. Metodología: Este es un estudio observacional descriptivo, en el que se evaluaron sistemáticamentepacientes con diagnóstico de enfermedad infl amatoria intestinal que consultaron al Hospital Pablo TobónUribe, entre agosto de 2001 y julio de 2009. Resultados: Un total de 202 pacientes presentaba diagnóstico de enfermedad infl amatoria intestinal, conuna relación de colitis ulcerativa (80,7%) y enfermedad de Crohn (15,8%) de 4.9:1, con una distribuciónsimilar por géneros. En cuanto a las manifestaciones clínicas, la colitis ulcerativa presenta más diarrea ysangrado, pero menos dolor abdominal y pérdida de peso, comparados con sujetos con enfermedad deCrohn; esta diferencia fue signifi cativa (p < 0,001). El porcentaje de nuestros pacientes con manifestacionesextraintestinales (27,7%) fue similar al de otras poblaciones, con predominio del compromiso articular. Seencontró asociación signifi cativa entre tabaquismo y enfermedad de Crohn. La distribución de la extensión de colitis ulcerativa en nuestros pacientes es 19,5% proctitis, 45% colitis izquierda y 35,5% colitis extensa. En enfermedad de Crohn, la localización más frecuente fue ileocolónica 50%, íleon terminal 18,8%, colónica 28,1% y solo 3,1% tenía compromiso del tracto digestivo superior. En cuanto a severidad, 17,2% de individuos con colitis ulcerativa son asintomáticos (S0) al ingreso al estudio, 27,8% presentan actividad leve (S1), 32,0% moderada (S2) y 23,1% severa (S4). En enfermedad de Crohn, 34,4% de los pacientes presentan comportamiento infl amatorio, 31,3% estenótico, 21,9% perianal, 6,3% penetrante, y 6,3% tienen comportamiento estenótico y perianal...


Worldwide the frequencies of infl ammatory bowel disease, ulcerative colitis and Crohn’s disease have allincreased. In our own environment it has become necessary to establish the epidemiology of these entitiesand to determine their clinical and endoscopic behavior. Methodology: This is a descriptive observational study which systematically evaluated patients with infl ammatory bowel disease at the Pablo Tobon Uribe Hospital between August 2001 and July 2009. Results: Of 202 patients with diagnoses of infl ammatory bowel disease 80.7% had ulcerative colitis and 15.8% had Crohn’s disease. The ratio was 4.9 to 1 with similar distributions among male and female patients.Patients with ulcerative colitis presented more diarrhea and bleeding, but less abdominal pain and weightloss, than those with Crohn’s disease. This difference was signifi cant (p <0.001). The percentage of ourpatients with extraintestinal manifestations (27.7%) was similar to other populations in which compromisedarticulation predominates. A signifi cant association between smoking and Crohn’s disease was found. 19.5%of our patients had proctitis, 45% had left sided colitis, and 35.5% had extensive colitis. The most commonlocation of Crohn’s disease was in the ileocolonic region (50%), while 18.8% were located in the terminal ileum, and 28.1% were in the colonic region. Only 3.1% had upper gastrointestinal tract involvement...


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Colite Ulcerativa , Doença de Crohn
17.
Rev Salud Publica (Bogota) ; 9(3): 448-54, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-18026609

RESUMO

OBJECTIVE: Determining the prevalence of methicillin-resistant Staphylococcus aureus (CA-MRSA) and susceptibility to erythromycin and clindamycin (resistance profile suggestive of being CA-MRSA) in community isolates from de GREBO's database from 2001-2005. MATERIALS AND METHODS: GREBO's database has been complied since 2001, using more than 22 hospitals in Bogota. S. aureus resistance profiles were determined from community isolates. Whonet 5.3 software and CLSI breakpoints (2003) were used. RESULTS: 2,308 S. aureus community isolates were identified. 618 (26,8 %) were methicillin-resistant Staphylococcus aureus (MRSA). 74 (3,2 %) MRSA exhibited susceptibility to all other antibiotics (erythromycin, clindamycin), suggesting that S. aureus belonged to CA-MRSA. CONCLUSIONS: CA-MRSA might have emerged in Bogotá thereby having a profound implication for public health due to possible dissemination in the community and because antibiotic protocols for emergency settings should be changed. The results of our study suggested that CA-MRSA could be more common in Bogotá than currently expected.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Área Programática de Saúde , Colômbia/epidemiologia , Humanos , Prevalência
18.
Rev. salud pública ; Rev. salud pública;9(3): 448-454, jul.-sep. 2007. graf, tab
Artigo em Espanhol | LILACS | ID: lil-467389

RESUMO

Objetivo: Determinar la prevalencia de Staphylococcus aureus resistente a meticilina y sensible a eritromicina y clindamicina (perfil de resistencia sugestivo de ser adquirido en la comunidad) (SARM-AC), de aislamientos ambulatorios de la base de datos de Grebo durante el periodo 2001-2005. Materiales y Métodos: La base de datos del grupo Grebo se integró desde 2001 con más de 22 hospitales participantes en Bogotá. A partir de esta base de datos y con la ayuda del programa Whonet 5.3, se determinaron los perfiles de resistencia de los aislamientos ambulatorios de S.aureus. Se tomaron los puntos de corte establecidos por la CLSI (2003). Resultados: Se identificaron 2 308 aislamientos de S. aureus provenientes de aislamientos ambulatorios, de los cuales 618 (26,8 por ciento) eran Staphylococcus aureus meticilino resistente (SARM). Setenta y cuatro (3,2 por ciento) de éstos, presentaban sensibilidad a todos los otros antibióticos (eritromicina, clindamicina), sugestivos de corresponder al fenotipo SARM-AC. Conclusiones: La presencia en Bogotá de aislamiento de S. aureus sugestivos de tener el perfil de SARM -AC, implica un gran problema de salud pública debido a su posibilidad de diseminación en la comunidad y cambios en el empleo de antibióticos en los servicios de urgencias. Los datos de nuestro estudio sugieren que los aislamientos de SARM-AC en nuestro medio, pueden ser más comúnes de lo que pensamos.


Objective: Determining the prevalence of methicillin-resistant Staphylococcus aureus (CA-MRSA) and susceptibility to erythromycin and clindamycin (resistance profile suggestive of being CA-MRSA) in community isolates from de GREBO's database from 2001-2005. Materials and Methods: GREBO's database has been complied since 2001, using more than 22 hospitals in Bogota. S. aureus resistance profiles were determined from community isolates. Whonet 5.3 software and CLSI breakpoints (2003) were used. Results: 2 308 S. aureus community isolates were identified. 618 (26,8 percent) were methicillin-resistant Staphylococcus aureus (MRSA). 74 (3,2 percent) MRSA exhibited susceptibility to all other antibiotics (erythromycin, clindamycin), suggesting that S. aureus belonged to CA-MRSA. Conclusions: CA-MRSA might have emerged in Bogotá thereby having a profound implication for public health due to possible dissemination in the community and because antibiotic protocols for emergency settings should be changed. The results of our study suggested that CA-MRSA could be more common in Bogotá than currently expected.


Assuntos
Humanos , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Área Programática de Saúde , Colômbia/epidemiologia , Prevalência
19.
Infectio ; 9(2): 91-99, jun. 2005. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-421383

RESUMO

Staphylococcus aureus resistente a la vancomicina (Vancomycin resistant Staphylococcus aureus, VRSA) es una causa emergente de infección en el ambiente hospitalario. Para una adecuada detección, los laboratorios deben utilizar métodos especiales de evaluación y de susceptibilidad. Algunos de estos métodos son altamente específicos, mientras que otros necesitan pruebas adicionales para definir un resultado. Actualmente, existen tres casos de VRSA descritos en los Estados Unidos; en Suramérica, 5 casos de aislamientos de Staphylococcus aureus con resistencia intermedia a la vancomicina (Vancomycin intermediate Staphylococcus aureus, VISA), y en Colombia no se han presentado los primeros reportes de VISA/VRSA.Entre los factores de riesgo para la adquisición de VISA/ VRSA está la alta prevalencia de Staphylococcus aureus resistente a la meticilina (Methicillin resistant Staphylococcus aureus, MRSA) y el alto consumo de vancomicina. Sin una vigilancia epidemiológica, un control de infecciones, el adecuado uso de los antibióticos y una coordinación entre las autoridades de salud pública y los hospitales, los niveles de VRSA probablemente irán en incremento. El objetivo de este artículo es revisar los aspectos epidemiológicos, los mecanismos de resistencia, el proceso diagnóstico, las opciones terapéuticas y las medidas de control de infecciones para detener el desarrollo del VRSA


Assuntos
Resistência a Meticilina , Staphylococcus aureus
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