RESUMO

BACKGROUND: Accelerations role during the second stage of labor has not been studied and current classification system NICHD downplays its presence. The objective of this study is to determine validity for acidemia detection of the loss of accelerations during the second stage of labor. MATERIAL AND METHOD: This is a one year retrospective case-control study of 102 neonates with acidemia defined as an umbilical cord gas pH≤7.10 compared to 100 non acidemic controls. The last thirty minutes of CTG were evaluated by two obstetricians blind to clinical and outcome data that classified tracings into categories according to NICHD definitions, determining the presence or absence of accelerations. Validity of NICHD categories and absence of accelerations were calculated. RESULTS: 85% of fetuses presented a category II tracing in the last 30 minutes of labor. Absence of accelerations was associated with neonatal acidemia (ORa 4.43). Category II tracings were not associated with acidemia after adjusting for confounding factors.Validity of the absence of accelerations during the second stage of labor was higher in terms of sensitivity (80.3%), specificity (54%) and global value (67%) to that of the presence of a category II tracing (96%, 24% and 60% respectively) in this period. CONCLUSIONS: The absence of accelerations during the second stage of labor shows a bigger validity for neonatal acidemia than the presence of a category II tracing.

Assuntos

RESUMO

INTRODUCTION: Nutritional support (NS) leads complications that must be detected and prompt treated. OBJECTIVE: To estimate the incidence of some complications of nutritional support in critically ill patients. MATERIALS AND METHODS: A multicenter, descriptive, prospective study in patients with NS in intensive care units. Studied variables included medical diagnosis, nutritional status, length of NS, path, type of formula and ten complications. RESULTS: 419 patients evaluated, 380 received enteral nutrition (EN) and 39 parenteral nutrition (PN). The high gastric residue was the most incident complication in the ENS (24.2%), followed by diarrhea (14%) and withdrawal tube (6.6%). The high gastric residue and diarrhea were associated with the duration of the NS (p < 0.05). For the PNS the complication most incidents were hypophosphatemia (38.5%), followed by catheter sepsis (15.4%). The duration of the NS was associated with cholestasis, sepsis and hypophosphatemia (p < 0.05). CONCLUSIONS: complications of highest incidence were the high gastric residue for EN and hypophosphatemia for the PN; the withdrawal of the tube is a complication that claims further monitoring. The duration of the NS was the variable that showed greater association with the complications studied. Is a must to get consensus on complications definitions for comparisons establishment and best international standards target, furthermore propose protocols in order to decrease complications incidence of NS to fulfill the critical ill patient requirements.

Assuntos

RESUMO

Três garanhões foram utilizados para estudar o efeito da adição de trolox e pentoxifilina na motilidade, integridade do acrossoma e DNA de espermatozoides pós-descongelação. Para congelação, utilizou-se Tris-gema com glicerol (5 por cento) em máquina de congelação de sêmen. As amostras foram descongeladas a 37ºC durante 30 segundos e tratadas com: T1= 150µL de sêmen + 150µL de Tris; T2= 150µL de sêmen + 150µL de Tris + 120µM/mL de trolox; T3= 150µL de sêmen + 150µL de Tris + 3,5mM de pentoxifilina e T4= 150µL de sêmen + 150µL de Tris + 3,5mM de pentoxifilina + 120µM/mL de trolox. Após 0, 60 e 120 minutos de incubação (37ºC), as amostras foram analisadas quanto à motilidade, vigor, integridade de acrossoma e DNA. Não houve diferença (P>0,05) entre tratamentos após 0 e 60 minutos de incubação em todos os parâmetros estudados. Após 120 minutos de incubação, verificou-se maior porcentual (P<0,05) de células com motilidade total e progressiva nas amostras do T2. Conclui-se que a adição de trolox após descongelação do sêmen equino preserva a motilidade total e progressiva dos espermatozoides submetidos à incubação a 37ºC durante 120 minutos.

Three stallions were used to study the effect of trolox and pentoxifylline addition on the motility and integrity of acrossome and DNA equine spermatozoa after thawing. Tris-egg-yolg diluent with glycerol (5 percent) were used to freeze the semen samples in a freezing machine. The samples were thawed at 37ºC during 30 seconds and treated with: T1=150µL of semen + 150µL of Tris; T2= 150µL of semen + 150µL of Tris +150mM/mL of trolox; T3= 150µL of semen + 150µL Tris +3.5mM of pentoxifylline; and T4= 150µL of semen + 150µL of Tris + 3.5mM of pentoxifylline + 150mM of trolox. After 0, 60, and 120 minutes of incubation (37ºC), the samples were analyzed to motility, vigor, and integrity of acrossome and DNA. There was no difference (P>0.05) among treatments considering 0 and 60 minutes of incubation in all studied parameters. After 120 minutes of incubation, it was observed higher percentage (P<0.05) of cells with total and progressive motility in the samples of T2. It can be concluded that the trolox addition after thawing of equine semen preserved total and progressive motility of the sperm incubated at 37ºC during 120 minutes.

Assuntos

RESUMO

Três garanhões foram utilizados para estudar o efeito da adição de trolox e pentoxifilina na motilidade, integridade do acrossoma e DNA de espermatozoides pós-descongelação. Para congelação, utilizou-se Tris-gema com glicerol (5 por cento) em máquina de congelação de sêmen. As amostras foram descongeladas a 37ºC durante 30 segundos e tratadas com: T1= 150µL de sêmen + 150µL de Tris; T2= 150µL de sêmen + 150µL de Tris + 120µM/mL de trolox; T3= 150µL de sêmen + 150µL de Tris + 3,5mM de pentoxifilina e T4= 150µL de sêmen + 150µL de Tris + 3,5mM de pentoxifilina + 120µM/mL de trolox. Após 0, 60 e 120 minutos de incubação (37ºC), as amostras foram analisadas quanto à motilidade, vigor, integridade de acrossoma e DNA. Não houve diferença (P>0,05) entre tratamentos após 0 e 60 minutos de incubação em todos os parâmetros estudados. Após 120 minutos de incubação, verificou-se maior porcentual (P<0,05) de células com motilidade total e progressiva nas amostras do T2. Conclui-se que a adição de trolox após descongelação do sêmen equino preserva a motilidade total e progressiva dos espermatozoides submetidos à incubação a 37ºC durante 120 minutos.(AU)

Three stallions were used to study the effect of trolox and pentoxifylline addition on the motility and integrity of acrossome and DNA equine spermatozoa after thawing. Tris-egg-yolg diluent with glycerol (5 percent) were used to freeze the semen samples in a freezing machine. The samples were thawed at 37ºC during 30 seconds and treated with: T1=150µL of semen + 150µL of Tris; T2= 150µL of semen + 150µL of Tris +150mM/mL of trolox; T3= 150µL of semen + 150µL Tris +3.5mM of pentoxifylline; and T4= 150µL of semen + 150µL of Tris + 3.5mM of pentoxifylline + 150mM of trolox. After 0, 60, and 120 minutes of incubation (37ºC), the samples were analyzed to motility, vigor, and integrity of acrossome and DNA. There was no difference (P>0.05) among treatments considering 0 and 60 minutes of incubation in all studied parameters. After 120 minutes of incubation, it was observed higher percentage (P<0.05) of cells with total and progressive motility in the samples of T2. It can be concluded that the trolox addition after thawing of equine semen preserved total and progressive motility of the sperm incubated at 37ºC during 120 minutes.(AU)

Assuntos

RESUMO

Para el año 2002 LA World Health Organization (WHO), estimó que aproximadamente unos 250 millones de personas sufrifrían de trastornos auditivos incapacitantes; que dos terceras partes de estas pesonas vivirían en países en vías de desarrollo, y que la mitad de estas pérdidas auditivas podrían ser evitables. Los programas de WHO, (Healthy People 200) iniciados en 1.990, tenían como objetivo fundamental lograr la identificación de pérdidas auditivas severas en niños antes del primer año de edad, sin embargo, los programas de Joint Comittee of Infant Hearing (1.994) fueron mas ambiciosos y redujeron la identificación del problema a los 6 meses de nacido. El propósito de este trabajo es mostrar los resultados de una encuesta epidemiológica aplicada en las Unidades de Educación Especial (UEE) del estado Sucre: Cumaná (UEE Cumaná), Carúpano (UEE Libertador) y Cumanocoa (UEE Cumanacoa y taller de educación especial Cumanacoa). El objetivo funadmental de esta encuesta era el de establecer las posibles causas que originaron el problema en la población de 3 a 25 años de edad que asisten a estos centros educativos, la edad a la cual se realizó el diagnóstico, el grado de perdida auditiva de los mismos, así como las características de su amplificación aural y escolaridad

Assuntos

RESUMO

OBJECTIVE: To report the experience, obstacles, and strategies of screening for congenital hypothyroidism. SETTING: Newborns in Mexico. METHODS: Thyroid stimulating hormone (TSH) was measured by enzyme immunoassay using commercial kits in 1,140,364 newborns. RESULTS: There were 464 positive cases, of whom 299 (64.4%) were girls. 236 (50.9% showed ectopic nodules, 202 (43.5%) thyroid agenesis, 21 (4.5%) dyshormonogenesis, and 5 (1.1%) an unclassified goitre. The false positive rate was 0.024% and there were 11 false negative results. Currently, 600,000 (26%) of the 2,300,000 newborns are screened. This percentage has been increased in recent years by taking samples from cord blood and will be increased further by starting congenital hypothyroidism screening at social security units and by midwives screening infants born at home. CONCLUSIONS: Mental retardation in infants in developing countries can be reduced by neonatal screening, and carefully planned strategies can steadily extend the benefits of screening.

Assuntos

RESUMO

A newborn screening program for congenital hypothyroidism (CH) and phenylketonuria (PKU) was conducted in 140 163 infants from the Federal District and the states of Mexico and Tlaxcala. These children were born mainly in hospitals for the non-insured population, although some were social security beneficiaries. Their filter-paper blood TSH and phenylalanine concentrations were determined 48 hours after birth. The frequency of CH was 1:1 797, with a 95 per cent confidence interval of 1:1 470 to 1:2 315, and was quite similar in the different types of hospitals. Only two PKU cases were found, for a frequency of 1:70 082, with a 95 per cent confidence interval of 0 to 1:4 762. This work demonstrates the feasibility of newborn screening programs in Mexico, identifies the problems to be solved in order to achieve a wide coverage and establishes the high frequency of CH in the Mexican population.

Assuntos

RESUMO

To determine the transitions of sea urchin sperm specific non-histone chromosomal proteins (Sp NHCP) following fertilization, their presence in zygotes during and after male pronuclear formation was investigated by comparing the electrophoretic patterns of NHCP obtained from gametes with those isolated from zygotes. Polyclonal antibodies directed against whole Sp NHCP were used to detect, by Western immunoblots, the Sp NHCP among the NHCP present in zygotes at different times post-insemination. The results obtained from immunological and electrophoretic studies indicate that shortly after fertilization the majority of Sp NHCP are lost. The electrophoretic patterns of NHCP obtained from unfertilized eggs were almost identical with those observed for NHCP isolated from zygotes. This similarity strongly suggests that the NHCP of unfertilized eggs are conserved after fertilization.

Assuntos

RESUMO

El síndrome del respirador bucal tiene origen funacional y orgánico. El de origen orgánico si no es bien estudiado puede confunadirse con una respirador bucal funcional. Es por eso entonces que se plantea la necesidad de realizar una rinomanometría anterior a todo paciente que presente este síndrome. Se seleccionaron 37 pacientes que no respondieron satisfactoriamente al tratamiento foniátrico, todos ellos con el diagnóstico de respirador bucal funacional. Los resultados indicaron que 27 de ellos presentaban alteraciones orgánicas, que no fueron pesquisadas en el examen clínico previo

Assuntos