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Abstract: Objective: We tested the effectiveness of the I prefer plain water educational strategy used to increase water consumption in elementary school children. Materials and methods: A community intervention trial was performed in eight public elementary schools in Mexico City. The schools were randomized into an intervention (IG) and a control (CG) group. Each school was provided water dispensers inside the classrooms. The IG received the educational strategy. The strategy was considered effective if the students increased their water consumption by ≥220 ml. Results: Water consumption in the IG increased 167 ml vs. 37 ml in CG (p < 0.001). The goal of the educational strategy for water consumption was achieved in 166/413 children in the IG and 95/364 children in the CG (p < 0.001). Conclusions: I prefer plain water, associated with free access to water inside the classrooms, proved to be effective to increase water consumption.
Resumen: Objetivo: Evaluar la efectividad de la estrategia Prefiero agua simple para incrementar el consumo de agua en niños de escuelas primarias públicas. Material y métodos: Ensayo de intervención comunitaria en ocho escuelas en la Ciudad de México. Las escuelas se aleatorizaron en grupo de intervención (GI) y de control (GC). Se instalaron dispensadores de agua dentro de las aulas. Implementamos la estrategia al GI. Consideramos efectiva la estrategia si los estudiantes incrementaron su consumo de agua en ≥220 ml. Resultados: El incremento global en el consumo de agua del GI fue de 167 ml vs. 37 ml en GC (p <0.001). La efectividad de la estrategia para el consumo de agua se logró en 166/413 niños del GI y en 95/364 niños del GC (p <0.001). Conclusiones: Prefiero agua simple, asociada con libre acceso al agua dentro de las aulas, demostró ser efectiva para incrementar el consumo de agua.
Assuntos
Humanos , Animais , Masculino , Feminino , Pré-Escolar , Criança , Estudantes , Água Potável , Ingestão de Líquidos , Promoção da Saúde/métodos , Bebidas Gaseificadas/estatística & dados numéricos , Leite/estatística & dados numéricos , Bebidas Adoçadas com Açúcar/estatística & dados numéricos , MéxicoRESUMO
OBJECTIVE: We tested the effectiveness of the I prefer plain water educational strategy used to increase water consumption in elementary school children. MATERIALS AND METHODS: A community intervention trial was performed in eight public elementary schools in Mexico City. The schools were randomized into an intervention (IG) and a control (CG) group. Each school was provided water dispensers inside the classrooms. The IG received the educational strategy. The strategy was considered effective if the students increased their water consumption by ≥220 ml. RESULTS: Water consumption in the IG increased 167 ml vs. 37 ml in CG (p < 0.001). The goal of the educational strategy for water consumption was achieved in 166/413 children in the IG and 95/364 children in the CG (p < 0.001). CONCLUSIONS: I prefer plain water, associated with free access to water inside the classrooms, proved to be effective to increase water consumption.
OBJECTIVE: Evaluar la efectividad de la estrategia Prefiero agua simple para incrementar el consumo de agua en niños de escuelas primarias públicas. MATERIALS AND METHODS: Ensayo de intervención comunitaria en ocho escuelas en la Ciudad de México. Las escuelas se aleatorizaron en grupo de intervención (GI) y de control (GC). Se instalaron dispensadores de agua dentro de las aulas. Implementamos la estrategia al GI. Consideramos efectiva la estrategia si los estudiantes incrementaron su consumo de agua en ≥220 ml. RESULTS: El incremento global en el consumo de agua del GI fue de 167 ml vs. 37 ml en GC (p < 0.001). La efectividad de la estrategia para el consumo de agua se logró en 166/413 niños del GI y en 95/364 niños del GC (p < 0.001). CONCLUSIONS: Prefiero agua simple, asociada con libre acceso al agua dentro de las aulas, demostró ser efectiva para incrementar el consumo de agua.
Assuntos
Água Potável , Ingestão de Líquidos , Promoção da Saúde/métodos , Estudantes , Animais , Bebidas Gaseificadas/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , México , Leite/estatística & dados numéricos , Bebidas Adoçadas com Açúcar/estatística & dados numéricosRESUMO
The aim of this study was to describe the tracheal growth pattern and its zoometric relationship in related medium-sized mongrel puppies through adulthood. Fourteen puppies were studied. CT monitoring was performed monthly, starting in the 1st month of life through the 7th month and subsequently at the 9th and 12th months. Additionally, six zoometric measurements were performed. Dorsoventral (DV) and transverse (TV) diameters and the luminal area from C1 to T2 were obtained. The global tracheal growth pattern revealed an increase up to 13 times its initial size, reaching a plateau phase during the last trimester. The relationship between the DV and the TV internal diameters of the tracheal lumen did not change during growth. As previously reported, the cranial tracheal area was wider, while the caudal part gradually decreased towards T1-T2; this consideration is important since the more distal an endotracheal tube is inserted, the greater the risk that injury may occur. The linear correlation between the zoometric measurements and the tracheal ring areas was positive. This study provides evidence for the evaluation of the morphometry of the canine trachea during physiological growth using helicoidal CT as a non-invasive, accurate tool.
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Intratumoral expression of genes encoding Cytochrome P450 enzymes (CYP) might play a critical role not only in cancer development but also in the metabolism of anticancer drugs. The purpose of this study was to compare the mRNA expression patterns of seven representative CYPs in paired tumor and normal tissue of child patients with rabdomyosarcoma (RMS). Using real time quantitative RT-PCR, the gene expression pattern of CYP1A1, CYP1A2, CYP1B1, CYP2E1, CYP2W1, CYP3A4, and CYP3A5 were analyzed in tumor and adjacent non-tumor tissues from 13 child RMS patients. Protein concentration of CYPs was determined using Western blot. The expression levels were tested for correlation with the clinical and pathological data of the patients. Our data showed that the expression levels of CYP1A1 and CYP1A2 were negligible. Elevated expression of CYP1B1 mRNA and protein was detected in most RMS tumors and adjacent normal tissues. Most cancerous samples exhibit higher levels of both CYP3A4 and CYP3A5 compared with normal tissue samples. Expression of CYP2E1 mRNA was found to be significantly higher in tumor tissue, however no relation was found with protein levels. CYP2W1 mRNA and/or protein are mainly expressed in tumors. In conclusion, we defined the CYP gene expression profile in tumor and paired normal tissue of child patients with RMS. The overexpression of CYP2W1, CYP3A4 and CYP3A5 in tumor tissues suggests that they may be involved in RMS chemoresistance; furthermore, they may be exploited for the localized activation of anticancer prodrugs.
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Sistema Enzimático do Citocromo P-450/genética , Sistema Enzimático do Citocromo P-450/metabolismo , Músculo Esquelético/metabolismo , Rabdomiossarcoma/genética , Rabdomiossarcoma/metabolismo , Adolescente , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Western Blotting , Criança , Pré-Escolar , Citocromo P-450 CYP1A1/genética , Citocromo P-450 CYP1A1/metabolismo , Citocromo P-450 CYP1A2/genética , Citocromo P-450 CYP1A2/metabolismo , Citocromo P-450 CYP1B1/genética , Citocromo P-450 CYP1B1/metabolismo , Citocromo P-450 CYP2E1/genética , Citocromo P-450 CYP2E1/metabolismo , Citocromo P-450 CYP3A/genética , Citocromo P-450 CYP3A/metabolismo , Família 2 do Citocromo P450 , Feminino , Seguimentos , Perfilação da Expressão Gênica , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Lactente , Masculino , Estudos Prospectivos , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
OBJECTIVES: A longitudinal, randomized, single blind study was done to evaluate the efficacy of an antibacterial hybrid molecule (beta-lactamic-fluoroquinolone) named cephalone after biliary-enteric-bypass (BEB). MATERIAL AND METHODS: Four groups of mongrel dogs were operated on three consecutive periods. Cultures of bile and liver were obtained and assessed, followed by obliteration of common bile duct and BEB to groups A, B and C. Group D served as a control. Ten days later the group A received conventional treatment based on ampicillin/gentamicin and groups B and C, cephalone in two different concentration schemes during 10 consecutive days. Further samples were processed for bacteria and additional liver biopsies were obtained for histopathological analysis. RESULTS: All three treatments reverted bacterial contamination in the liver and most of the bile samples were negative or showed a significant decrease in the number of colony forming units (p = 0.002). Histopathological analysis proved no lesions. CONCLUSIONS: Comparison of efficacy among antibacterial treatments revealed undistinguishable efficacy in this short-term assessment of bacterial contamination after BEB in dogs. The use of cephalone could be considered as a viable treatment or prophylaxis in bacterial infections occurring after BEB. Further studies are needed to assess long-term impact of the cephalone in this setting.
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Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Bile/microbiologia , Cefalosporinas/uso terapêutico , Fluoroquinolonas/uso terapêutico , Fígado/microbiologia , Animais , Modelos Animais de Doenças , Cães , Combinação de Medicamentos , Feminino , MasculinoRESUMO
BACKGROUND: Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. We undertook this study to identify the surgical/medical competencies (SMC) acquired by a group of students after graduating from the Faculty of Medicine, National Autonomous University of Mexico. METHODS: This was a cross-sectional, comparative, observational, and prospective study. Students from the class (1999-2003) who accepted to participate were included in the study. Thirty SMC were evaluated as well as demographic and academic background data from the graduates. Data were analyzed using Mann-Whitney, Kruskal-Wallis andX2tests. RESULTS: Of 341 interviewees, 310 subjects participated in the study; 61% of all participants were females. Mean age at graduation was 25 years; 66% of all participants concluded their medical training in 6 years; 30% of the interviewees had a < or = 8.0-point grade average score; 62% concluded their 6th school year in a Mexican Institute of Social Security (IMSS) and/or in a Ministry of Health (SSa) facility. Subjects reported having little or no command over 21/30 listed SMCs. Female participants rated themselves as less proficient than their male counterparts (p < or = 0.05). The presence of three other concomitant factors among several participants negatively influenced their self-perception of whether or not they possessed certain skills. CONCLUSIONS: A group of recently graduated physicians subjectively perceived themselves as possessing partial or no command over the SMCs included in the Surgery Department syllabus. These results must be completed through an objective assessment.
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Competência Clínica , Cirurgia Geral/educação , Autoimagem , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
Introducción: La principal complicación del uso de los expansores titulares (ET) son las infecciones. Una alternativa para evitarla, es agregar antibióticos que se difundan a través de la pared de un ET y eviten la colonización bacteriana. El objetivo de este trabajo fue evaluar la eficacia de una presentación nacional de cotrimoxazol, para difundirse a través de un ET en diferentes volúmenes de expansión. Material y método: Se realizó un experimento longitudinal con 12 ET, llenados a 50,100, 150 o 200% de su capacidad nominal, con solución fisiológica y cotrimoxazol a una concentración de 800/4000 ug/mL de trimetoprin/sulfametoxazol (TMX/SMX), sumergidos posteriormente en un sistema cerrado. Se midió la presión en el interior del ET, al inicio y al final del experimento. En los cuatro grupos se cuantificó la concentración de cotrimoxazol en la solución del contenedor, durante nueve días consecutivos. Los resultados se compararon mediante ANOVA de dos vías. Resultados: El SMX se precipitó dentro del ET. Las concentraciones de TMX en la solución del contenedor fueron diferentes en función del tiempo y el porcentaje de expansión. No hubo correlación entre el porcentaje de expansión y la presión dentro del ET. Conclusiones: La sinergia de cotrimoxazol de uso endovenoso disponible en nuestro país, no es una buena opción a emplearse en un ET a las dosis utilizadas, ya que el coeficiente de solubilidad de SMX se saturó y se formaron cristales. El incremento de difusión de TMX estuvo asociado con un mayor porcentaje de expansión, lo que es una ventaja, considerando que las infecciones son más frecuentes al final del proceso de expansión.
Introduction: Infection associated with tissue expansion is one of the main complications and force to take away the tissue expander. An alternative to avoid this action is to dilute antibiotics inside it. The aim of this experiment was to quantify the concentration of cotrimoxazole diffused through a tissue expander at different expansion and pressure volumes. Material and methods: A test was performed with 12 tissue expanders immersed in a closed system. These were divided in 4 sets according to the introduced expansion rate. Three independent variables were considered: percentage of lumen volume introduced into the expander, pressure inside the expander, and experiment duration. The concentration of the drug diffused through the expander was taken as dependent variable. The solution in which the expander was immersed was continuously sampled and drug concentration was determined by High Performance Liquid Chromatography (HPLC). ANOVA was used to determine differences between concentrations measured of every variable applied. Results: Only trimethoprim (TMX) diffused. No lineal correlation was observed between expansion rate and pressure inside the expander. The difference with respect to time and concentration of the drug outside the expander was statistically significant among the 4 sets of expanders (p = 0.0000). Conclusion: Sulfametoxazole (SMX) did not diffuse and crystallized inside the expander because of the different pk of the two drugs (SMX-TMX) respect to pH of dilution which was similar to pK of trimethoprim. The expansion rate had a proportional effect on TMX concentration outside the expander: an over-expansion of the system greater than 200% increases diffusion highly.
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Las malformaciones arteriovenosas pulmonares (MA VP) son comunicaciones anormales entre las arterias y las venas pulmonares. Las MAVP, están caracterizadas por cortocircuitos de derecha a izquierda de grado variable y el efecto de estas comunicaciones depende del tamaño de los vasos involucrados. Puede presentarse hipoxemia, hipocratismo digital y poliglobulia secundario al cortocircuito intrapulmonar. Presentamos el caso de un paciente femenino de 14 años de edad con MA VP pulmonar, cuyos hallazgos a la exploración física fueron hipocratismo digital y cianosis.
Pulmonary arteriovenous malformations (PVAM) are abnormal communications between pulmonary arteries and pulmonary veins, which are more commonly congenital in nature. Pulmonary arteriovenous fistulae are characterized by right-to-left shunts of variable magnitude; the effect of these communications depends on the size of the vessels involved. Arterial oxygen desaturation, cyanosis, clubbing of the fingers, and polycythemia may occur, secondary to the intrapulmonary shunt. We report the case of a 14-year-old female patient with PA VM; the findings on physical examination were clubbing of her fingers and cyanosis.