RESUMO
Previous scientific evidence has shown a relationship between hormones and the onset and relapse of perinatal psychotic disorders (PPD) in women during pregnancy, childbirth, and the postpartum period. In healthy women the interaction between hormones and cognitive changes has been confirmed mainly in memory, attention, and executive function during pregnancy and postpartum, which respond to adaptive demands related to parenting tasks. In women with psychotic episodes there is a significant impairment in several cognitive functions, but studies of the perinatal period are limited. The objective of this mini review is to analyze the main findings to identify whether hormonal changes interact with the onset of PPD and cognitive impairment in perinatal women. The studies included samples of women with psychosis, risk of developing psychosis, bipolar psychosis, schizoaffective psychosis, and psychotic symptoms, during pregnancy and postpartum. Findings contributed to knowledge about five hypotheses regarding the relationship between hormones in the perinatal period and the appearance of PPD. Nevertheless, this review did not find reports of evidence of a relationship between hormonal production and cognitive function among women with clinically diagnosed PPD, suggesting a research gap. Clinical implications of assessing hormonal production and cognitive function in PPD are discussed. Although the evidence identified is scarce and heterogeneous, the findings call for further research with clinical samples on the role of hormones in perinatal psychotic disorders, especially as they relate to the study of cognition. This will promote more consistent evidence and understanding of PPD etiopathology that can guide early and effective multidisciplinary interventions.
RESUMO
Dry eye has two basic subdivisions: aqueous deficient dry eye (ADDE), with SS a major cause; and evaporative dry eye (EDE), due to either intrinsic or extrinsic factors. SS is a chronic inflammatory disorder defined by dysfunction of the exocrine glands leading to dry eye and dry mouth. The objective of this article was to carry out a systematic and critical review of several scientific publications on dry eye disease, with the aim of providing general recommendations to distinguish dry eye and its different variants in patients with SS, during the period 1979 to 2020, using search engines for articles indexed in Scopus, Latindex, Scielo, Clinical Trials, Medline, Embase, and Cochrane, allowing the analysis of 132 articles published in indexed journals on the subject of dry eye disease and SS, evidencing its conceptualization, prevalence, risk factors, etiopathogenesis, clinical manifestations, diagnosis, and treatment.
RESUMO
El propósito de este estudio fue analizar el efecto de la deficiencia de vitamina D sobre la recurrencia de vértigo y la discapacidad auto percibida en pacientes diagnosticados con Vértigo Postural Paroxístico Benigno en un hospital de tercer nivel de la Ciudad de México. Se trata de un estudio retrospectivo y descriptivo. Se revisaron expedientes electrónicos (enero 2017 diciembre 2019), de pacientes previamente diagnosticados, que presentaran valores deficientes de vitamina D sérica. Se contabilizó la cantidad de episodios de vértigo reportados, así como, la puntuación obtenida en el Dizzines Handicap Inventory para determinar el nivel de discapacidad auto percibida al momento del diagnóstico y a los 6 meses de seguimiento. Los niveles de vitamina D sérica de los pacientes seleccionados (n=30), demostraban hipovitaminosis (media de 17.1 ng/mL) al momento del diagnóstico. Seis meses después y habiendo recibido tratamiento con maniobras de reposicionamiento los pacientes reportaron desde ausencia absoluta de recurrencias (7 pacientes, 23.3%) hasta 8 recurrencias (1 paciente, 3.3%) en el mismo periodo. En cuanto al nivel de discapacidad auto percibida en la evaluación inicial predominó la discapacidad moderada (60%), mientras que, en la evaluación final, la preponderante fue la discapacidad leve (73.3%). No se encontró diferencia estadísticamente significativa entre la deficiencia de vitamina D y la recurrencia de episodios de vértigo. Se concluye que los resultados obtenidos posiblemente se deben a que la insuficiencia de vitamina D es muy común en la población mexicana, incluso en individuos sanos
The purpose of this study was to analyze the effect of vitamin D deficiency on vertigo recurrence and self-perceived disability in patients diagnosed with Benign Paroxysmal Postural Vertigo in a tertiary care hospital in Mexico City. This is a retrospective and descriptive study. Electronic records (January 2017 - December 2019) of previously diagnosed patients who presented deficient values of serum vitamin D were reviewed. The number of reported episodes of vertigo was counted, as well as the score obtained in the Dizzines Handicap Inventory to determine the level of self-perceived disability at the time of diagnosis and at 6-month follow-up. The serum vitamin D levels of the selected patients (n=30) showed hypovitaminosis (mean 17.1 ng/mL) at the time of diagnosis. Six months later and having received treatment with repositioning maneuvers, the patients reported from absolute absence of recurrences (7 patients, 23.3%) to 8 recurrences (1 patient, 3.3%) in the same period. Regarding the level of self-perceived disability in the initial evaluation, moderate disability predominated (60%), while, in the final evaluation, the predominant one was mild disability (73.3%). No statistically significant difference was found between vitamin D deficiency and recurrence of vertigo episodes. It is concluded that the results obtained are possibly due to the fact that vitamin D insufficiency is very common in the Mexican population, even in healthy individuals.
Assuntos
HumanosRESUMO
Descemet's membrane detachment (DMD) is a complication fundamentally associated with cataract surgery, the subclinical presentation being higher than expected. There are many varied treatments, from simple observation to penetrating keratoplasty. We present a case report of a 78-year-old male patient, without comorbidities, who underwent cataract surgery with phacoemulsification plus intraocular lens implantation in the capsular bag of the left eye. During the intraoperative procedure, he presented a DMD (height of 350 um and length of 3 mm in Zone 1 according to the HELP algorithm), managed with adaptive viscoelastic under the soft-shell technique in the same operative act, injection of iso-expansile SF6 (20%) intracameral plus postural positioning for 2 hours carried out 48 hours after surgery plus intensive topical treatment with hypertonic sodium chloride and steroidal anti-inflammatory drugs. At 72 hours after the operation of the application of the gas bubble, he presented with a transparent cornea and a best-corrected visual acuity of 20/80, which finally for his ophthalmological control at 8 weeks presented definitive resolution of the case in the AS-OCT and with a BCVA of 20/30.
RESUMO
Wasp stings are considered an ophthalmological emergency as they can be complicated when they occur near the eyelids or especially on the cornea. Due to type I hypersensitivity response, such as epithelial defect, corneal edema, loss of endothelial cells, anterior uveitis, optic neuritis and, therefore, permanent loss of vision due to anterior segment ischemia. It warns that the wasp stinger has a saw-shaped texture, contains toxins that inflame the area where it stings. Due to the immunological and toxic effects of the stinger and its venom infiltrates the cornea. We present the case of a 32-year-old man who presented keratouveitis secondary to a wasp sting in a region of the jungle of Peru. He was treated emergency with intensive steroid therapy to reduce the toxic effects. His follow-up up to 2 months was successful, leaving only a 1 mm central leukoma where the bite occurred, which did not impair his vision.
RESUMO
BACKGROUND: Population-based studies on the clinical course and prognosis of autoimmune hepatitis (AIH) from Caribbean countries are limited. OBJECTIVE: The aim of this study was to provide information regarding the clinical and laboratory findings, histological profile, treatments, and outcomes of patients with AIH with long-term follow-up in a tertiary referral center. METHODS: A retrospective study was performed at the National Institute of Gastroenterology in Havana, Cuba, by enrolling 82 patients with a well-documented, long-term clinical course of AIH. Clinical and laboratory findings, histological profiles, treatments, and outcomes were analyzed. RESULTS: At diagnosis, 73 (89%) patients had AIH type 1, 84.1% were women, and their median age was 46.5 years (range, 17-79 years). The median follow-up period was 84 months (interquartile range, 12-276 months). Clinical onset was mild or subclinical in 72% of patients and asymptomatic in 12.2%. At diagnosis, the Hennes's median score was 6 (range, 3-8). Complications were seen in 44 (53.6%) patients, 42 (51.2%) with liver-related complications and 9 (10.9%) without liver-related complications. Cirrhosis was present at diagnosis in 32 (39%) patients. Cirrhosis was subsequently diagnosed in the other 28 patients who were not cirrhotic at diagnosis, over a median follow-up of 12 (IQR, 2-84) months. During follow-up, 6 patients died (7.3%). Cumulative survival at 5 and 10 years was 98.4% and 89%, respectively. A complete biochemical response was achieved in 79% of patients in a mean (SD) of 11.7 (11.6) months. Side effects due to treatment were reported in 76 (92.7%) patients, and no pretreatment factors were found to predict treatment response. CONCLUSIONS: These Cuban patients with AIH had acceptable disease remission rate and a prompt treatment response. Although most patients had advanced-stage liver disease at diagnosis or developed during follow-up, the cumulative survival rate was high when patients were receiving and complying with treatment.
RESUMO
BACKGROUND: Cleft lip and palate (CLP) is the most common craniofacial anomaly. CLP affects resonance, voice and speech. Besides the most frequently reported resonance and speech disorders, several reports have addressed acoustic abnormalities in the voice of patients with CLP. However, there are just a few reports focusing on vocal treatment in this population. OBJECTIVE: To study whether a Speech and Language Pathology (SLP) intervention including vocal rehabilitation for children with CLP and velopharyngeal insufficiency (VPI) provides significant improvement of abnormal acoustic parameters of voice. MATERIAL AND METHODS: Fifteen children with cleft lip and palate (CLP) and velopharyngeal insufficiency (VPI) were studied. Age ranged 4-5 years. A matched control group of children without craniofacial anomalies and adequate speech, resonance and voice was assembled. All children underwent acoustic analysis of voice at the onset and at the end of SLP intervention including vocal rehabilitation. RESULTS: Hypernasality persisted unchanged following SLP intervention. Mean Fundamental Frequency (F0) did not demonstrate a significant difference between the control and the active groups. At the onset of the intervention mean shimmer and jitter were significantly higher in all patients with CLP as compared to controls. At the end of the intervention shimmer and jitter significantly decreased in patients with CLP showing no differences as compared to controls. CONCLUSION: SLP intervention including vocal rehabilitation improves abnormal acoustic parameters of voice. Besides surgical treatment for VPI the SLP intervention in children with CLP should also address vocal rehabilitation.
Assuntos
Fenda Labial/complicações , Fissura Palatina/complicações , Acústica da Fala , Distúrbios da Voz/reabilitação , Qualidade da Voz , Pré-Escolar , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino , Insuficiência Velofaríngea/complicações , Insuficiência Velofaríngea/cirurgia , Distúrbios da Voz/etiologiaRESUMO
Resumen: Las herramientas de evaluación de la gravedad en el enfermo grave proporcionan información objetiva intra e interobservador relacionada con la gravedad de la enfermedad, su evolución en relación al tiempo y la estratificación de riesgo son parte fundamental en la toma de decisiones. El objetivo de este trabajo es presentar una nueva propuesta de la evaluación del APACHE II basada en un modelo matemático de cambio en el tiempo/velocidad, velocidad instantánea y aceleración.
Abstract: The illness severity scoring systems provide objetive measures for inter and intra comparisons with time, provide useful information for comparing the severity of illness are an essencial part of the improvment in clinical decisions and in stratifying patients. Appropiated application of these models helps in decision making at the right time. The aim of this paper is to submit a proposal for the evaluation of the APACHE II score based on a vectorial mathematical model of chance in time/velocity, instant velocity and aceleration.
Resumo: Os instrumentos de avaliação da gravidade do paciente grave fornecem informações objetivas intra e interobservadores relacionadas à gravidade da doença, sua evolução em relação ao tempo, estratificação de risco são fundamentais para tomada de decisão. O objetivo deste trabalho é apresentar uma nova proposta para a avaliação do APACHE II baseada em um modelo matemático de mudança de tempo/velocidade, velocidade instantânea e aceleração.
Assuntos
Perda Auditiva Provocada por Ruído/etiologia , Recreação , Adolescente , Criança , Diagnóstico Precoce , Feminino , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/epidemiologia , Humanos , Masculino , México/epidemiologia , Prevalência , População Urbana , Adulto JovemAssuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Recreação , Perda Auditiva Provocada por Ruído/etiologia , População Urbana , Prevalência , Diagnóstico Precoce , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/epidemiologia , México/epidemiologiaAssuntos
Programas Governamentais/estatística & dados numéricos , Transtornos da Audição/diagnóstico , Triagem Neonatal , Diagnóstico Precoce , Reações Falso-Negativas , Transtornos da Audição/epidemiologia , Testes Auditivos/estatística & dados numéricos , Humanos , Recém-Nascido , México/epidemiologia , Triagem Neonatal/estatística & dados numéricos , Avaliação de Programas e Projetos de SaúdeAssuntos
Feminino , Humanos , Temas Bioéticos , Pesquisa Biomédica , Ensaios Clínicos como Assunto , Recidiva Local de Neoplasia/tratamento farmacológico , Testosterona/análogos & derivados , Neoplasias do Colo do Útero/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Bevacizumab , Ética Médica , Testosterona/uso terapêuticoRESUMO
INTRODUCCIÓN: el medio caldo Nitrato es utilizado en los laboratorios de microbiología clínica como prueba bioquímica para la identificación de enterobacterias por la capacidad que tienen estos microorganismos para reducir los nitratos a nitrito. OBJETIVO: evaluar diferentes combinaciones de bases nutritivas destinadas al desarrollo del medio de cultivo. MÉTODOS: se seleccionó como material biológico un conjunto de cepas certificadas y aisladas pertenecientes a especies representativas de varios géneros de la familia de Enterobacteriaeceae. Se diseñaron cinco variantes y se utilizó como bases nutritivas la peptona de gelatina y el extracto de carne, en diferentes combinaciones y concentraciones, para determinar el incremento de absorbancia en el tiempo como indicador de la densidad microbiana y se calculó la velocidad de crecimiento. Se evaluó la capacidad funcional del medio de cultivo por la habilidad de las especies de reducir o no el nitrato a nitrito. RESULTADOS: la mejor combinación de bases nutritivas correspondió a la de mayor concentración de peptona de gelatina (10 g/L) y extracto de carne (3 g/L). La evaluación organoléptica y fisicoquímica del medio de cultivo mostró características satisfactorias para este tipo de producto. Se comprobó la reducción satisfactoria del nitrato a nitrito, por los microorganismos empleados como control positivo. CONCLUSIONES: el medio de cultivo caldo nitrato desarrollado, cumple con los requisitos de calidad y su funcionalidad microbiológica y permite la caracterización de especies bacterianas que poseen la capacidad de reducir los nitratos a nitritos.
INTRODUCTION: the nitrate broth culture medium is used in clinical microbiology laboratories as a biochemical test for the identification of Enterobacteriaceae by the ability of these microorganisms to reduce nitrate to nitrite. OBJECTIVE: to evaluate different combinations of nutritive bases for the development of the culture medium. METHODS: certificed strains were selected as biological test material. The strains belong to different generu of the Enterobactericiae family. Five variants were designed with gelatin peptone and meat extract as nutrient bases at different concentrations and combinations, the growth rate was calculated by measuring the increase in absorbance over time as an indicator of microbial density. The functionality of the culture medium was evaluated by the ability of tested bacteria or reduce nitrate to nitrite RESULTS: the best combination of nutritive bases contained the highest concentration of gelatin peptone (10 g/L) and beef extract (3 g/L). Physicochemical and sensory evaluation of the culture medium showed results characteristic for this type of product. Reductions of nitrate to nitrite were observed for all tested microorganisms choosed as the positive control. CONCLUSIONS: the nitrate broth culture medium developed complies the quality requiment and its microbiological functionality allows the characterization of bacterial species by the ir ability to reduce nitrate to nitrite
Assuntos
Humanos , Peptonas , Técnicas Microbiológicas/métodos , Reações Bioquímicas/métodos , Meios de Cultura , NitratosRESUMO
This paper aims to discuss and analyze the role of mathematics in neurodevelopment, for which discusses the historical, ontogenetic and physiological bases involved. The methodology of this paper is a deductive analysis, describing the use of mathematics in ancient cultures to the specialization of brain regions. Sensory perceptions are useful for the acquisition and development of cortical functions thus sensory stimulations is essential for the maturation of specialized neurologic functions.
Assuntos
Encéfalo/crescimento & desenvolvimento , Aprendizagem , Matemática , Humanos , IdiomaRESUMO
The different diseases that affect the upper respiratory tract, like allergic rhinitis, rhinoconjunctivitis, and rhinosinusitis have inflammation as their main pathophysiological component. Affects approximately 25% of the adults and 40% of the children. Intranasal corticosteroids (INSs) are considered the most effective treatment for the management of allergic rhinoconjunctivitis. Unlike antihistamines or antileukotrienes, INSs have a more profound effect on nasal congestion and the related sleep disturbance and daytime somnolence resulting from nasal congestion that affect their everyday quality of life. We review INSs mechanism of action, pharmacological properties of the different INSs, their therapeutic use and give our suggestions for their proper use.
Assuntos
Conjuntivite Alérgica/tratamento farmacológico , Glucocorticoides/administração & dosagem , Rinite Alérgica Perene/tratamento farmacológico , Administração Oral , Criança , HumanosRESUMO
Proposito: Estudiar si la música clásica influye favorablemente en el tratamiento de un grupo de niños de cuatro años con retraso del lenguaje de patogenia afásica anártrica. Material y Métodos: Se estudiaron prospectivamente seis pacientes con retraso del lenguaje de patogenia afásica anártrica, de julio a diciembre de 1999, los cuales se comprometieron a cumplir con las sesiones de terapia, dos horas por semana durante seis meses. Las sesiones constaban de una hora de psico motricidad y una hora de terapia de lenguaje. Se formaron dos grupos de tres niños cada uno, donde ambos grupos estaban expuestos a la misma metodología, con excepción de la música clásica, la cual solo se utilizó con el grupo experimental. En todos se aplicó la prueba BELE (1) para determinar el nivel de comprensión y lenguaje y la exploración psico motriz que propone Durivage (2) al principio y al final de la investigación. Resultados: El grupo experimental obtuvo mejores resultados en los aspectos evaluados: comprensión, lenguaje y psico motricidad.Conclusiones: Los resultados de ésta investigación sugieren que si se incluye la música clásica en el tratamiento de trastornos de lenguaje de patogenia afásica anártrica, los pacientes podrían tener mejores resultados en las áreas de lenguaje, comprensión y psico motriz.
Assuntos
Humanos , Masculino , Pré-Escolar , Transtornos do Desenvolvimento da Linguagem , Musicoterapia , Afasia , DisartriaRESUMO
Se ofrecen conceptos y conocimientos sobre psicomotricidad y se hace énfasis en su importancia en la rehabilitación de niños con trastornos en comunicación humana (lenguaje, audición, habla, voz y aprendizaje) y dificultades o torpezas motoras. Contenido: Presentación. 1) Psicomotricidad. 2) Elementos de la psicomotricidad. 3) Evaluación psicomotriz. 4) Ejercicios psicomotores. 5) Conclusiones. Bibliografía
Assuntos
NeuropsicologiaRESUMO
Propósito: Estudiar un programa de actividades que faciliten la rehabilitación del paciente disártrico. Material y métodos: Estudio prospectivo de cuatro pacientes de los departamentos de Foniatría y Neurología del I.N.C.H. con diagnóstico de síndrome disártrico, de febrero a octubre de 1995, que se comprometieron a cumplir con las sesiones de terapia, dos horas por semana durante ocho meses. En todos los pacientes se hizo evaluación general y examen de articulación con estudio naso-laringo-endoscópico al principio y al final del periodo de terapia. Resultados: Los pacientes presentaron alteraciones en el mecanismo respiratorio, manifestadas por una inversión del patrón respiratorio, incoordinación e insuficiencia. El tono muscular y la postura presentaron hipotonía, hipertonía o ambas en cabeza, cuello y cintura escapular. Existió deficiencia en el funcionamiento de estructuras inervadas por los pares craneales que intervienen en el proceso de la comunicación y alteraciones en actividades prefonatorias como succión, masticación y deglución. La voz se modificó en timbre, tono e intensidad. El habla era ininteligible como consecuencia de los trastornos mencionados anteriormente. Después del periodo de terapia de 8 meses, los 4 pacientes mejoraron los aspectos involucrados en el proceso de terapia incluyendo respiración, tono muscular y movimiento de estructuras orofaciales, articulación y voz. Conclusiones: Los resultados de esta investigación sugieren que si se incluyen ejercicios de respiración, orofaciales, masoterapia, actividades prefonatorias, voz y por ultimo articulación, en el orden antes mencionado, los pacientes disártricos podrían tener mejores oportunidades de recuperar las habilidades que permiten una comunicación oral de adecuada calidad