RESUMO
In Argentina, migratory activity in search of floral diversity has become a common approach to maximizing honey production. The Entre Ríos province possesses a floral diversity that allows beekeepers to perform migratory or stationary management. Beyond the impact caused by transhumance, migratory colonies in this province start and end the season in monoculture areas. To study the effect of these practices on viral infection, we assayed for the presence, abundance and genetic characterization of the Deformed Wing Virus (DWV) in honey bees from apiaries with both types of management. In migratory apiaries, DWV was detectable in 86.2% of the colonies at the beginning of the season (September 2018), and 66% at the end of the season (March 2019). On the other hand, DWV was detected in 44.11% and 53.12% of stationary samples, at the beginning and the end of the season, respectively. Sequence analysis from migratory and stationary colonies revealed that all samples belonged to DWV-A type. The highest viral loads were detected in migratory samples collected in September. Higher DWV presence and abundance were associated with migratory management and the sampling time. Based on our findings we propose that the benefit of migration to wild flowering areas can be dissipated when the bee colonies end the season with monoculture.
Assuntos
Vírus de RNA , Animais , Abelhas/virologia , Argentina , Vírus de RNA/genética , Vírus de RNA/isolamento & purificação , Migração Animal , Estações do Ano , Filogenia , Criação de Abelhas , Carga ViralRESUMO
Housing is a pressing problem worldwide and a key determinant of health and wellbeing. The right to adequate housing, as a pillar of the right to an adequate standard of living, means more than a roof to live under. Adequate means the dwelling must fulfill material functions and psychosocial functions, thus contributing to dwellers health and wellbeing. Social housing policies aim to fulfill the right to housing, but frequently fail in fulfilling the right to it being adequate. This study capitalizes on the implementation of a national urban regeneration program in two social housing villas in central Chile (one in Santiago, in the central valley, the other in Viña del Mar, a coastal city) to run a natural experiment assessing the impact of dwelling renovation on several dimensions of perceived habitability and housing satisfaction among the -mostly female-household homemakers. We use 5 waves of survey data collected with a step-wedge design to estimate the association between a time-varying exposure status (the intervention) and 7 binary outcomes for habitability and 5 for housing dissatisfaction, including overall housing satisfaction. We use Poisson regression models with robust variance and a random intercept at the respondent level. At baseline, reports of poor habitability and dissatisfaction across all features were markedly high, the highest levels of dissatisfaction being with acoustic insulation and dwelling size in both villas, and with indoor temperature in Santiago. The intervention resulted in statistically significant and markedly large improvements in reported habitability and dissatisfaction relative to those housing components targeted by the intervention, as well as with overall dwelling satisfaction in both study cases. Implications are, first, that the policy response to quantitative housing deficits must not overlook housing quality; second, that housing renovation appears as a promising intervention for qualitative housing crises; third, that while improvements in habitability and satisfaction are specific to the interventions in place, overall housing satisfaction can improve in more limited, tailored, dwelling renovation interventions. Social housing renovation in Latin America appears as a promising intervention to improve quality of life among the urban poor dwellers and reduce inequalities in health related to housing conditions.
Assuntos
Satisfação Pessoal , Habitação Popular , Humanos , Chile , Feminino , Masculino , Habitação Popular/estatística & dados numéricos , Habitação Popular/normas , Adulto , Pessoa de Meia-Idade , Reforma Urbana , Habitação/estatística & dados numéricos , Habitação/normas , Inquéritos e QuestionáriosRESUMO
Herein, we examined the effect of the type of housing (individual vs group housing) of anestrus female goats on plasma cortisol concentrations and socio-sexual behaviors during first contact with photo-stimulated male goats and determined the impact on sexual and reproductive responses after 15 d of contact with photo-stimulated males. Therefore, after weaning, 10 females each were individually and group-housed, respectively. Ten bucks were rendered sexually active by exposure to artificially long days (16 h of light and 8 h of darkness per day) for 2.5 mo. During the naturally increasing photoperiod, 15-mo-old females were exposed and maintained with males. On day 0, during the first contact with males, individually- and group-housed females exhibited similar plasma cortisol concentrations (22.6 vs 27.4 ng/mL, respectively). Likewise, socio-sexual behaviors did not differ between examined groups on day 0. Moreover, the interval from first contact with males to the first estrus, short and normal ovulatory cycles, ovulation, fertility, and prolificacy rates were similar between differently housed females. Furthermore, mounting attempts did not differ between males in contact with either female group. In conclusion, individually- and group-housed anestrus females displayed elevated and similar plasma cortisol concentrations during first contact with photo-stimulated males and similar socio-sexual behaviors and reproductive responses when exposed to photo-stimulated males.
Assuntos
Cabras , Habitação , Feminino , Masculino , Animais , Hidrocortisona , Reprodução , AnestroRESUMO
The objective of this study was to identify the effect of pre and postpartum DCAD on serum levels of calcium, phosphorus, and magnesium in peripartum Holstein cows. Blood samples were collected from 56 cows (18 primiparous and 38 multiparous) on days -7, +7, +14 and +28 relative to parturition, to determine serum levels of total and ionized calcium, phosphorus, magnesium, and albumin; diet samples for determination of calcium, phosphorus, magnesium and DCAD were collected at the same moments and urine samples were collected at day -7 for measurement of urinary pH. Prepartum DCAD was positively correlated with total calcium (p = 0.02) and with corrected total calcium (p = 0.01) at day -7. There was a negative correlation between prepartum DCAD and magnesium levels at day -7 (p = 0.02). No influence of prepartum DCAD on phosphataemia was observed. Postpartum DCAD did not correlate with serum mineral levels at any time point. Our results demonstrate that prepartum DCAD can influence calcium and magnesium homeostasis, but not phosphorus. In addition, parity and time period should be considered when evaluating serum levels of these minerals in Holstein cows during transition period.
Objetivou-se identificar o efeito da DCAD pré e pós-parto nos níveis séricos de cálcio, fósforo e magnésio, em vacas Holandesas em periparto. Foram coletadas amostras de sangue de 56 vacas (18 primiparas e 38 multiparas) nos dias -7, +7, +14 e +28 em relação ao parto, para determinação dos níveis séricos de cálcio total e ionizado, fósforo, magnésio e albumina; amostras de alimento foram coletadas nos mesmos momentos para determinação dos níveis cálcio, fósforo, magnésio e DCAD dietético; e amostras de urina foram coletadas no dia -7, para mensuração do pH urinário. A DCAD pré-parto foi positivamente correlacionada com cálcio total (P = 0,02) e com cálcio total corrigido (P = 0,01) no dia -7. Houve correlação negativa entre a DCAD pré-parto e os níveis de magnésio no momento -7 (P = 0,02). Não houve influência da DCAD pré-parto na fosfatemia. A DCAD pós-parto não se correlacionou com os níveis séricos de minerais em nenhum momento. Os resultados demonstram que a DCAD pré-parto pode influenciar na homeostase do cálcio e do magnésio, mas não do fósforo. Além disso, as variáveis paridade e tempo devem ser consideradas ao se avaliarem os níveis séricos desses minerais em bovinos leiteiros da raça Holandesa em transição.
Assuntos
Animais , Feminino , Bovinos , Cátions/análise , Dieta , Hipocalcemia/veterinária , Ração Animal/análise , Ânions/análise , Valores de ReferênciaRESUMO
Resumen El rabdomiosarcoma laríngeo es un cáncer infrecuente en cabeza y cuello, y aún más en adultos. Describimos el caso de un varón de 55 años con un rabdomiosarcoma del músculo cricoaritenoideo posterior izquierdo tratado mediante laringectomía total y linfadenectomía funcional bilateral.
Abstract Laryngeal rhabdomyosarcoma is an uncommon cancer in head and neck, especially in adults. We report a 55 years old male with a rhabdomyosarcoma from the left posterior cricoarytenoid muscle treated with a total laryngectomy and double functional cervical lymphadenectomy.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/diagnóstico , Rabdomiossarcoma Embrionário/cirurgia , Rabdomiossarcoma Embrionário/diagnóstico , Laringe/cirurgia , Tomografia Computadorizada por Raios X/métodos , Neoplasias Laríngeas/terapia , Rabdomiossarcoma Embrionário/terapia , Tratamento Farmacológico/métodos , Laringectomia/métodosRESUMO
Resumen Los schwannomas son neoplasias derivadas de las células de Schwann de la cubierta de los nervios periféricos. Su desarrollo en la región nasosinusal es poco frecuente, especialmente a nivel septal. Su diagnóstico diferencial es variado y debe establecerse con otras causas más habituales de masa nasal unilateral. Su tratamiento es quirúrgico. Describimos el caso de un varón de 47 años con una masa nasal derecha intervenida mediante cirugía endoscópica nasosinusal y con diagnóstico anatomopatológico de schwannoma septal.
Abstract Schwannomas are tumors that proceed from Schwann cells in the cover of peripheral nerves. It is uncommon in the sinonasal area, especially in the nasal septum. The differential diagnosis is extensive and requires contemplating other more frequent causes of unilateral nasal mass. The current treatment of septal schwannoma is surgical. We report a 47-year-old male with a right nasal mass operated by endoscopic sinonasal surgery with an anatomopathological diagnosis of a nasal septal schwannoma.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/patologia , Septo Nasal/patologia , Neurilemoma/patologia , Células de Schwann/patologia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/diagnóstico por imagem , Diagnóstico Diferencial , Septo Nasal/cirurgia , Septo Nasal/diagnóstico por imagem , Neurilemoma/cirurgia , Neurilemoma/diagnóstico por imagemRESUMO
The interactions between calving season, the occurrence of retained placenta, intrauterine infections (IUI), and early mastitis, and their effects on the reproductive performance and milk yield of Holstein-Friesian cows in a tropical environment were studied using data from 3320 calvings (1948 cows) from two farms in El Salvador. Based on environmental conditions, season of calving was categorized into: quadrimester 1 (November-February), quadrimester 2 (March-June), and quadrimester 3 (July-October) where quadrimester 2 and 3 had the highest ambient temperature and relative humidity, respectively. Cows were classified into 1, 2, and 3 + parities. The effects of quadrimester and of diseases on days to first service, services per conception, days open, interval between services and 305-day milk yield were studied in separated multivariate regressions. The likelihood of experiencing a disease contingent on the calving season and the likelihood of a cow being culled due to poor fertility associated with experiencing a disease were evaluated using logistic regression. Cows calving in quadrimester 2 and 3 were more likely to suffer from IUI and showed poorer reproduction than cows calving in quadrimester 1. Reproduction was more strongly affected by IUI. Mastitis increased the days to first service, days open, and interval between services. Mastitis and IUI also caused a lower 305-day milk yield. Overall, hotter and more humid conditions lead to higher incidence of disease and poorer reproductive performance. The physiological responses that lead to these phenomena should be further studied to understand the interactions between diseases, environmental conditions and reproduction.
Assuntos
Lactação , Leite , Animais , Bovinos , Feminino , Fertilidade , Lactação/fisiologia , Gravidez , Reprodução , Estações do AnoRESUMO
Introducción: el síndrome de Hurler es la forma más grave de la mucopolisacaridosis I. El depósito de heparán y dermatán sulfato en las meninges favorece el desarrollo de hidrocefalia y, a su vez, de meningoencefaloceles. Caso clínico: se describe el caso de una paciente de 23 años con este síndrome y un encefalocele nasosinusal intervenido mediante cirugía endoscópica nasosinusal y posterior refuerzo mediante un colgajo pericraneal. Discusión: el abordaje endoscópico de los meningoencefaloceles nasales ha crecido notablemente en los últimos años debido a una tasa de éxito elevada tanto para la eliminación de dicha lesión, como para el adecuado control de la fístula de líquido cefalorraquídeo consecuente. Conclusiones: actualmente, la cirugía endoscópica nasosinusal es una herramienta muy útil para el tratamiento de patologías de base de cráneo y reduce la morbilidad causada por el abordaje transcraneal.
Introduction: Hurler syndrome is the most severe version of mucopolysaccharidosis I. The storage of dermatan and heparin sulfate in meninges allows the development of hydrocephalus and meningoencephaloceles. Case report: We report a 23-year-old female with this syndrome and a sinonasal encephalocele operated by endoscopic sinonasal surgery and subsequent pericranial flap as support. Discussion: Endoscopic sinonasal surgery has grown in last years in relation with treatment of sinonasal meningoencephaloceles due to a high rate of success removing the lesion and closing the subsequent cerebrospinal fluid fistula. Conclusion: Currently, the endoscopic sinonasal surgery has become a useful tool in the management of skull base pathologies, and reduces the morbidity due to a transcranial approach.
Assuntos
Humanos , Mucopolissacaridose I , Retalhos Cirúrgicos , EncefaloceleRESUMO
INTRODUCTION: The medial collateral ligament (MCL) is one of the main stabilizers of the knee, but its injury occurs in conjunction with other ligaments. OBJECTIVE: To determine the prevalence of MCL lesions by magnetic resonance imaging, their degrees and associated lesions in our institution. MATERIAL AND METHODS: Retrospective study from January to April 2018 where KNEE MRIs were evaluated where the MCL lesion was presented to evaluate the degree and type of associated injuries. RESULTS: We included 368 studies, prevalence of isolated MCL lesion of 3.07%, grade I and grade II, prevalence of concomitant MCL lesions was 17.66% grade I (75%), grade II (15%) and grade III (3%). Associated injuries were medial meniscus injury (46.15%), anterior cruciate ligament injury (30.7%), isolated bone contusion (18.46%), chodral injuries (37.58%), medial vastus injury (14.51%), patellar medial retinacular injury (14.51%), vastus lateral injury (9.23%), posterior cruciate ligament injury (6.15%), lateral meniscus injury (4.61%), iliotibial band tenosynovitis (4.61%), medial facet avulsion fracture (3.07%), Pes Anserine tenosynovitis (3.07%). CONCLUSION: Prevalence of 17.66% of the MCL injuries in our hospital by magnetic resonance, the first 2 degrees predominate, with a wide spectrum of associated knee injuries.
INTRODUCCIÓN: El ligamento colateral medial (LCM) es uno de los principales estabilizadores de la rodilla, pero su lesión se presenta en conjunto con otras lesiones ligamentarias. OBJETIVO: Determinar la prevalencia de lesiones del LCM por resonancia magnética, sus grados y lesiones asociadas en nuestra institución. MATERIAL Y MÉTODOS: Estudio retrospectivo de Enero a Abril de 2018, se evaluaron resonancias magnéticas de rodilla donde se presentó lesión del LCM para evaluar grado y tipo de lesiones asociadas. RESULTADOS: Se incluyeron 368 estudios, prevalencia de lesión aislada del LCM de 3.07%, una grado I y una grado II, la prevalencia de lesiones de LCM concomitantes fue de 17.66%, grado I (75%), grado II (15%) y grado III (3%). Las lesiones asociadas fueron lesión del menisco medial (46.15%), lesión del ligamento cruzado anterior (30.7%), contusión ósea aislada (18.46%), lesiones condrales (37.58%), lesión de vasto medial (14.51%), lesión del retináculo medial patelar (14.51%), lesión del vasto lateral (9.23%), lesión del ligamento cruzado posterior (6.15%), lesión del menisco lateral (4.61%), tenosinovitis banda iliotibial (4.61%), fractura de avulsión de la faceta medial (3.07%), tenosinovitis de la Pes Anserinus (3.07%). CONCLUSIÓN: Prevalencia de 17.66% de lesiones del LCM en nuestro hospital por resonancia magnética, predominan los dos primeros grados con un espectro amplio de lesiones asociadas de la rodilla.
Assuntos
Ligamentos Colaterais , Imageamento por Ressonância Magnética , Ligamentos Colaterais/diagnóstico por imagem , Humanos , Espectroscopia de Ressonância Magnética , Prevalência , Estudos RetrospectivosRESUMO
Los queratoquistes maxilares son frecuentes en pacientes con síndrome de Gorlin. Su tratamiento es debatido por su alta tendencia a la recidiva. En los últimos años la cirugía endoscópica nasosinusal ha adquirido importancia en el manejo de esta patología. Exponemos en caso de un varón de 16 años afecto de este síndrome con queratoquistes maxilares donde se realiza un abordaje combinado, endonasal y transoral.
Maxillary keratocysts are frequent in Gorlin Syndrome patients. Its treatment is discussed due to the high tendency to recurrence. In the last years the sinonasal endoscopic surgery has become an important tool in the management of this pathology. We report a 16 years old boy with Gorlin Syndrome and maxillary keratocysts treated with a trans-nasal endoscopic and intra-oral combined approach.
Assuntos
Humanos , Masculino , Adolescente , Síndrome do Nevo Basocelular/cirurgia , Doenças Maxilares/cirurgia , Cistos Odontogênicos/cirurgia , Síndrome do Nevo Basocelular/diagnóstico por imagem , Doenças Maxilares/diagnóstico por imagem , Cistos Odontogênicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Endoscopia/métodosRESUMO
Resumen Los condrosarcomas son cánceres realmente infrecuentes en cabeza y cuello, y más aún en el hueso hioides. Por lo general, son neoplasias que debutan como una masa cervical sin otra sintomatología. Su diagnóstico requiere de estudios de imagen y su tratamiento es fundamentalmente quirúrgico. Comentamos el caso de un paciente de 57 años, desde el diagnóstico de la lesión hasta su tratamiento y seguimiento, y una revisión bibliográfica de esta patología.
Abstract Chondrosarcomas are a rare type of head and neck cancer, especially in the hyoid bone. They usually make their debut through a cervical mass, without other symptoms. The diagnosis requires image studies, and the treatment is fundamentally surgical. We report the case of a 57 years old patient, from the lesion diagnosis, its treatment and follow up, and a bibliographic review of this pathology.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/diagnóstico por imagem , Condrossarcoma/cirurgia , Condrossarcoma/diagnóstico por imagem , Osso Hioide/cirurgia , Osso Hioide/diagnóstico por imagem , Neoplasias Ósseas/patologia , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Condrossarcoma/patologia , Osso Hioide/patologiaRESUMO
This study aimed to determine the impact of different post-partum disorders on milk yield and composition. One hundred and fifteen Holstein cows from a commercial dairy farm located in the state of Rio Grande do Sul in southern Brazil were monitored up to 62 days post-partum. During this period, body condition score evaluation and animal clinical examination were conducted. Percentages of fat, protein, and lactose, as well as somatic cells score, were determined in milk samples. The AST activity and concentrations of NEFA, calcium, and BHBA, were analyzed in blood samples. The occurrence of clinical disorders was identified in 30 (26%) cows. Subclinical disorders were identified in 64 (56%) cows. Only 21 (18%) cows did not suffer any kind of disorder within the studied period. In this study, no significant differences were found in milk production, protein, and somatic cell count in clinical, subclinical, and healthy cows. Milk fat and the fat: protein quotient (F:P) were higher in cows with clinical disorders and the 6 to 21 days in milk, and lactose were lower in cows with clinical disorders and the 22 to 42 days in milk (P<0.05).(AU)
O objetivo deste estudo foi determinar o impacto de diferentes distúrbios após o parto na produção de leite e em sua composição. Cento e quinze vacas Holandesas de uma fazenda de gado leiteiro, localizada em estado da região Sul do Brasil, foram monitoradas até 62 dias após o parto. Durante esse período, foram realizadas avaliações do escore de condição corporal e exame clínico nos animais. As porcentagens de gordura, proteína e lactose, bem como o escore de células somáticas, foram determinadas nas amostras de leite. A atividade do AST e as concentrações de NEFA, cálcio e BHBA foram analisadas em amostras de sangue. A ocorrência de distúrbios clínicos foi identificada em 30 (26%) vacas, os distúrbios subclínicos foram identificados em 64 (56%) vacas. Apenas 21 (18%) vacas não sofreram nenhum tipo de distúrbio ao longo do período estudado. Neste estudo, não foram encontradas diferenças significativas na produção do leite, proteína e na contagem de células somáticas em vacas com doenças clínicas, subclínicas e saudáveis. No leite, a gordura e o quociente gordura e proteína (G:P) foram maiores em vacas com doença clínica no período de seis a 21 dias de lactação, e a lactose foi menor em vacas com doença clínica no período de 22 a 42 dias de lactação (P<0,05).(AU)
Assuntos
Animais , Feminino , Bovinos , Leite/química , Período Pós-Parto , Doenças Metabólicas/veterinária , MetabolismoRESUMO
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic is a major worldwide health disorder. There is an increasing number of neurological complications recognized with COVID-19 including patients with GBS and its variants. DEVELOPMENT: A review of the clinical cases of GBS associated to COVID-19 infection published in the last months has been developed. We included 48 patients (31 men, mean age 56.4 years). The most common COVID-19 symptoms were cough (60.4%) and fever (56.3%). Mean time from COVID-19 symptoms to neurologic manifestations was 12.1 days, but in nine patients (18.8%) developed GBS within seven days. Eleven patients (22.9%) presented cranial nerve involvement in the absence of muscle weakness; 36 presented the classic sensory motor variant (75%) and one had a pure motor variant (2.1%). The electrodiagnostic pattern was considered demyelinating in 82.4% of the generalized variants. The presence of hyposmia/dysgeusia was associated with a latency shorter than seven days to GBS onset of symptoms (30% vs 15.6%), and cranial nerve involvement in the absence of weakness (30.8% vs 17.1%). Most patients (87.5%) were treated with intravenous immunoglobulin. Neurological outcome was favorable in 64.6%; 29.2% had respiratory failure and 4.2% died shortly after being admitted. CONCLUSIONS: GBS in patients with SARS-CoV-2 infection resembles clinically and electrophysiology the classical forms. Further studies are necessary to understand whether GBS frequency is actually increased due to SARS-CoV-2 infection and explore pathogenic mechanisms.
TITLE: Síndrome de Guillain-Barré asociado a infección por COVID-19: revisión de casos publicados.Introducción. La pandemia por la enfermedad por coronavirus 2019 (COVID-19) es un importante problema para la salud mundial. Hay un incremento en las complicaciones neurológicas reconocidas por la COVID-19, incluyendo el síndrome de Guillain-Barré (SGB) y sus variantes. Desarrollo. Se realizó una revisión de los casos publicados en los últimos meses de SGB asociado a infección por COVID-19. Incluimos a 48 pacientes (31 hombres; edad media: 56,4 años). Los síntomas de COVID-19 más comunes fueron tos (60,4%) y fiebre (56,3%). El tiempo promedio entre los síntomas de COVID-19 y el SGB fue de 12,1 días, pero nueve pacientes (18,8%) desarrollaron SGB en menos de siete días. Once pacientes (22,9%) presentaron afectación de los nervios craneales en ausencia de debilidad muscular, 36 presentaron la variante clásica sensitivomotora (75%) y uno tuvo una variante motora pura (2,1%). El patrón electrofisiológico se consideró desmielinizante en el 82,4% de las variantes generalizadas. La presencia de hiposmia/disgeusia estuvo asociada con una latencia menor a los siete días hasta el inicio de los síntomas del SGB (30 frente a 15,6%) y a la afectación de los nervios craneales en ausencia de debilidad (30,8 frente a 17,1%). La mayoría de los pacientes (87,5%) fueron tratados con inmunoglobulina endovenosa. La evolución neurológica fue favorable en el 64,6%, el 29,2% tuvo insuficiencia respiratoria y hubo un 4,2% de muertes. Conclusiones. El SGB en pacientes con infección por SARS-CoV-2 es similar clínica y electrofisiológicamente a las formas clásicas. Se requieren más estudios para comprender si la frecuencia del SGB realmente aumentó debido a la pandemia por COVID-19 y explorar los mecanismos patógenos involucrados.
Assuntos
COVID-19/complicações , Síndrome de Guillain-Barré/etiologia , Pandemias , SARS-CoV-2 , Adolescente , Adulto , Idoso , Anosmia/etiologia , Autoanticorpos/sangue , Autoanticorpos/imunologia , Autoantígenos/imunologia , Doenças dos Nervos Cranianos/etiologia , Disgeusia/etiologia , Feminino , Gangliosídeos/imunologia , Síndrome de Guillain-Barré/líquido cefalorraquidiano , Síndrome de Guillain-Barré/imunologia , Síndrome de Guillain-Barré/terapia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Pessoa de Meia-Idade , Plasmaferese , Insuficiência Respiratória/etiologia , Estudos Retrospectivos , Avaliação de Sintomas , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: To end the tuberculosis (TB) epidemic, efficient diagnostic tools are needed. In a previous calibration study, a portable 'point of care' electronic nose device (AeonoseTM ) proved to be a promising tool in a hospital setting. We evaluated this technology to detect TB in an indigenous population in Paraguay. METHODS: A total of 131 participants were enrolled. eNose results were compared with anamnesis, physical examinations, chest radiography and mycobacterial cultures in individuals with signs and symptoms compatible with TB. The eNose analysis was performed in two stages: first, the training with a combination of a previous study population plus 47 participants from the new cohort (total n = 153), and second, the 'blind prediction' of 84 participants. RESULTS: 21% of all participants (n = 131) showed symptoms and/or chest radiography abnormalities suspicious of TB. No sputum samples resulted culture positive for Mycobacterium tuberculosis complex. Only one patient had a positive smell print analysis. In the training model, the specificity was 92% (95% confidence interval (CI): 85%-96%) and the negative predictive value (NPV) was 95%. In the blind prediction model, the specificity and the NPV were 99% (95% CI: 93%-99%) and 100%, respectively. Although the sensitivity and positive predictive value of the eNose could not be assessed in this cohort due to the small sample size, no active TB cases were found during a one year of follow-up period. CONCLUSION: The eNose showed promising specificity and negative predictive value and might therefore be developed as a rule-out test for TB in vulnerable populations.
Assuntos
Nariz Eletrônico , Sistemas Automatizados de Assistência Junto ao Leito , Grupos Populacionais , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/etnologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paraguai , Projetos Piloto , Sensibilidade e Especificidade , Adulto JovemRESUMO
OBJECTIVE: To describe a bone preservation technique commonly used in neurosurgery in an orthopedic procedure. MATERIAL AND METHODS: We describe the case of a patient who undergoes primary hip arthroplasty with an initial unsatisfactory result, the need for a revision with acetabular reconstruction is considered before the wound closure. Keeping the patient's femoral head in soft tissues for second-time reconstruction. RESULTS: After six months of follow-up, complete osseointegration of the femoral head graft was found, with a good clinical and radiological evolution of the patient. Bone conservation techniques in bone flaps have shown good results in the grafts osseointegration in other areas such as neurosurgery. CONCLUSIONS: The conservation of bone flaps in subcutaneous tissue for later use as a graft is a viable treatment option also in orthopedic surgery.
OBJETIVO: Describir una técnica de conservación ósea de uso común en neurocirugía en un procedimiento ortopédico. MATERIAL Y MÉTODOS: Se describe el caso de una paciente que se somete a artroplastía primaria de cadera con un resultado no satisfactorio inicial, planteándose previo al cierre la necesidad de una revisión con reconstrucción acetabular. Conservando cabeza femoral de paciente en tejidos blandos para realizar reconstrucción en segundo tiempo. RESULTADOS: Tras seguimiento por seis meses se encuentra completa osteointegración de injerto de cabeza femoral, con buena evolución clínica y radiológica de la paciente. Las técnicas de conservación ósea en colgajos óseos han demostrado buenos resultados en la osteointegración de los injertos en otras áreas como neurocirugía. CONCLUSIONES: La conservación de colgajos óseos en tejido celular subcutáneo para posterior uso como injerto es una opción viable de tratamiento también en la cirugía ortopédica.
Assuntos
Artroplastia de Quadril , Prótese de Quadril , Acetábulo/cirurgia , Artroplastia de Quadril/métodos , Transplante Ósseo , Cabeça do Fêmur/transplante , Humanos , Falha de Prótese , Reoperação , Resultado do TratamentoRESUMO
BACKGROUND: B-lines have been associated with adverse clinical outcomes in patients with heart failure (HF) when found at hospital discharge or during outpatient visits. Whether lung ultrasound (LUS) assessed B-lines may predict in-hospital mortality in patients with acute HF is still undetermined. AIM: To evaluate the association between B-lines on admission and in-hospital mortality among patients admitted with acute HF. METHODS: Hand-held LUS was used to examine patients with acute HF. LUS was performed in eight chest zones with a pocket ultrasound device and analyzed offline. The association between B-lines and in-hospital mortality was assessed using Cox regression models. RESULTS: We included 62 patients with median age 56 years, 69.4% men, and median left ventricle ejection fraction 25%. The sum of B-lines ranged from 0 to 53 (median 6.5). An optimal receiver operating characteristic-determined cut-off of ≥19 B-lines demonstrated a sensitivity of 57% and a specificity of 86% (area under the curve 0.788) for in-hospital mortality. The incremental prognostic value of LUS when compared with lung crackles or peripheral edema by integrated discrimination improvement was 12.96% (95% CI: 7.0-18.8, P = 0.02). Patients with ≥19 B-lines had a 4-fold higher risk of in-hospital mortality (HR 4.38; 95% CI: 1.37-13.95, P < 0.01). CONCLUSION: In patients admitted with acute HF, point-of-care LUS measurements of pulmonary congestion (B-lines) are associated with in-hospital mortality.
Assuntos
Insuficiência Cardíaca , Sistemas Automatizados de Assistência Junto ao Leito , Feminino , Mortalidade Hospitalar , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico , UltrassonografiaRESUMO
The aim of this study was to evaluate the effect of grazing methods and intensities on the metabolic profile of lambs grazing ryegrass. This study was performed in Eldorado do Sul (RS). The treatments consisted of two grazing intensities with rotational and continuous stocking methods: moderate and low. The experimental design was a randomized block arranged in a factorial scheme with four replicates. To evaluate the metabolic and nutritional conditions of the lambs, blood samples were collected to evaluate phosphorus, albumin, glucose, magnesium, globulin, cortisol, urea and total proteins. The highest blood urea value was observed in the month of September in lambs kept in continuous method grazing. There was no statistical difference between the grazing intensities and grazing methods for albumin, glucose, magnesium, globulin, cortisol and total protein levels in profile lambs. The cortisol values suggested that the animals were not subjected to high stress levels. In conclusion, rearing female lambs on ryegrass, irrespective of grazing methods or intensities, allowed the maintenance of body homeostasis and did not cause any metabolic unbalances, nutritional unbalances or stress.(AU)
O objetivo deste estudo foi avaliar o efeito dos métodos e das intensidades de pastejo no perfil metabólico de cordeiros. Este estudo foi realizado em Eldorado do Sul (RS). Os tratamentos consistiram em duas intensidades de pastejo (moderada e baixa), com métodos lotação rotativa e lotação contínua. O delineamento experimental foi em blocos ao acaso, em esquema fatorial com quatro repetições. Para avaliar as condições metabólicas e nutricionais dos cordeiros, foram coletadas amostras de sangue para avaliar fósforo, albumina, glicose, magnésio, globulina, cortisol, ureia e proteínas totais. O maior valor de ureia no sangue foi observado no mês de setembro nos cordeiros mantidos em pastejo contínuo. Não houve diferença estatística entre as intensidades de pastejo e os métodos de pastejo para albumina, glicose, magnésio, globulina, cortisol e níveis de proteína total nos cordeiros perfilados. Os valores de cortisol sugeriram que os animais não foram submetidos a altos níveis de estresse. Concluindo, a criação de cordeiros em azevém, independentemente dos métodos ou das intensidades de pastejo, permitiu a manutenção da homeostase corporal e não causou desequilíbrios metabólicos, desequilíbrios nutricionais ou estresse.(AU)
Assuntos
Animais , Feminino , Lolium , Bem-Estar do Animal , Ovinos/metabolismo , Ovinos/sangue , Pastagens/análise , Regulação da Temperatura CorporalRESUMO
Severe Hypertriglyceridemia (HTG) is associated with complications such as acute pancreatitis (AP) with high morbidity and mortality rates. We report a 42 years-old man with refractory HTG diagnosed at 19 years of age, and multiple episodes of AP, admitted with the suspicion of a new AP episode. Serum triglycerides were over 2000 mg/dl. His body mass index was 18 kg/m2, there was no evidence of xanthomas or xanthelasmas, but lipemia retinalis was found. Management included heparin and insulin, added to his usual treatment with fibrates, statins, omega-3 fatty acids, and orlistat. Due to lack of response, apheresis was started. After five sessions, triglycerides decreased to 588 mg/dl (82% reduction) and levels remained below 1000 mg/dl with daily apheresis. The patient continued with weekly sessions as outpatient with a sustained good response.
Assuntos
Adulto , Humanos , Masculino , Pancreatite , Remoção de Componentes Sanguíneos , Hipertrigliceridemia , Hiperlipidemias , Pancreatite/terapia , Triglicerídeos , Hipertrigliceridemia/terapia , Doença AgudaRESUMO
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death. The mainly risks factors for CVD are diabetes, hypertension and high levels of homocysteine (Hcys), among others. Paraoxonase 1 (PON1) has been proposed as an antiatherogenic target for its ability to hydrolyzing oxi-Low-Density-Lipoproteins (LDL) and Hcys-thiolactone. Thus, the aim of the present study was to evaluate the association of Hcys levels, and the activities and concentration of PON1, as well as vitamin B from the diet with a risk for CVD. METHODS: A case-control study was carry out in patients with cardiovascular diseases (CVD), Arterial hypertension, but not CVD (AH), and in healthy controls (control group) from the Mexican Institute of Social Security. Lipid profile, intake of vitamin B, Hcys, serum amyloid A (SAA), PON1 concentration, and PON1 activities (Arylesterase activity (ARE), Lactonase activity (LAC), and CMPA activity (CMPA)) were evaluated. RESULTS: The CVD group had the highest concentration of Hcys and SAA than in the AH and control groups (p < 0.01). ARE, LAC, and CMPA activities and PON1 concentration were lowest in the CVD group. A positive-independent association between Hcys levels and CVD was found (OR = 2.09; 95% CI: 1.69-2.56) and this increase when it was adjusted by age, BMI, ApoA1, vitamin B intake, SAA, and PON1 (OR = 14.41; 95% CI: 1.75-118.71). LAC and CMPA, as well as PON1 concentration, were inversely associated with CVD. CONCLUSION: LAC activity, PON1 concentration, and Hcys levels might be good biomarkers for CVD and their association could be modified by the intake of vitamin B.