RESUMO
OBJECTIVE: To evaluate work productivity of adult Latin American patients with rheumatoid arthritis (RA) treated with tofacitinib and biological disease-modifying anti-rheumatic drugs (bDMARDs) measured by the Work Productivity and Activity Impairment (WPAI) in RA questionnaire at 0- and 6-month follow-up. METHODS: This non-interventional study was performed in Colombia and Peru. Evaluated the effects of tofacitinib and bDMARDs in patients with RA after failure of conventional DMARDs. The WPAI-RA questionnaire was administered at baseline and at the 6-month (±1 month) follow-up. The results are expressed as least squares means (LSMs), and standard errors (SEs). RESULTS: One hundred patients treated with tofacitinib and 70 patients treated with bDMARDs were recruited. Twenty-eight percent of patients from the tofacitinib group and 40.0% from the bDMARDs group were working for pay at baseline. At month 6, the changes in absenteeism, presenteeism, and work impairment due to health were -18.3% (SE 7.7), -34.8% (SE 5.9), and -11.0% (SE 16.5), respectively, in the tofacitinib group and -19.4% (SE 8.0), -34.8% (SE 6.2), and -15.9% (SE 15.0), for the bDMARD group. CONCLUSION: For patients who reported working, there were improvements in presenteeism, absenteeism, and work impairment due to health in both groups. TRIAL REGISTRATION: NCT03073109.
Assuntos
Antirreumáticos , Artrite Reumatoide , Adulto , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Eficiência , Humanos , América Latina , Piperidinas/uso terapêutico , Pirimidinas/uso terapêutico , Pirróis/efeitos adversos , Resultado do Tratamento , Desempenho ProfissionalRESUMO
En diferentes regiones de Latinoamérica la infección por T. cruzi y Leishmania se superponen, por lo cual se reportan infecciones mixtas circulantes, debido a esto; deben realizarse pruebas diagnósticas específicas para evitar reacciones cruzadas entre estas dos patologías. OBJETIVO: determinar patrones de fluorescencia que permitan la diferenciación entre Leishmaniasis, enfermedad de Chagas e infección mixta empleando epimastigotes de T. cruzi. MÉTODOS: se empleó la técnica de Inmunofluorescencia Indirecta utilizando epimastigotes de T. cruzi (TcV autóctono) como antígeno figurado frente a un panel de muestras de suero codificados como A, B, C y D correspondientes a pacientes con infección por: Leishmaniasis (A), Infección mixta por Leishmania y Chagas(B), Enfermedad de Chagas (C) y sin ninguna de las dos infecciones (D). RESULTADOS: en los cuatro paneles de muestras se observaron diferentes patrones de intensidad de fluorescencia a nivel de membrana y núcleo de los epimastigotes de T. cruzi (TcV autóctono). CONCLUSIONES: la técnica de Inmunofluorescencia (IFI) con antígenos de epimastigotes de T. cruzi a demostrado utilidad en la diferenciación entre enfermedad de Chagas, Leishmaniasis y/o infecciones mixtas por ambos parásitos en aquellas zonas donde la coexistencia de ambas es habitual
In different regions of Latin America, infection by T. cruzi and Leishmania overlap, for which mixed circulating infections are reported, due to this; Specific diagnostic tests must be performed to avoid cross reactions between these two pathologies. OBJECTIVE: to determine fluorescence patterns that allow the differentiation between Leishmaniasis, Chagas disease and mixed infection using T. cruzi epimastigotes. METHODS: the Indirect Immunofluorescence technique was used using epimastigotes of T. cruzi (autochthonous TcV) as figurative antigen against a panel of serum samples coded as A, B, C and D corresponding to patients with infection by: Leishmaniasis (A) , Mixed infection by Leishmania and Chagas (B), Chagas disease (C) and without either of the two infections (D). RESULTS: in the four sample panels, different patterns of fluorescence intensity were observed at the membrane and nucleus level of the epimastigotes of T. cruzi (autochthonous TcV). CCONCLUSIONS: the Immunofluorescence technique (IFI) with T. cruzi epimastigote antigens has proven useful in differentiating between Chagas disease, Leishmaniasis and / or mixed infections by both parasites in areas where the coexistence of both is common.
Assuntos
Humanos , Trypanosoma cruzi , Leishmaniose , Fluorescência , Parasitos , Doença de Chagas , InfecçõesRESUMO
TITLE: Disfunción de barrera y síndrome de Guillain-Barré como exponentes del daño endotelial en la COVID-19.
Assuntos
COVID-19 , Síndrome de Guillain-Barré , Humanos , Pandemias , SARS-CoV-2RESUMO
TITLE: Estrés oxidativo y epigenética en la obesidad, el síndrome metabólico y la percepción olfativa.
Assuntos
Síndrome Metabólica , Percepção Olfatória , Epigênese Genética , Humanos , Obesidade , Estresse OxidativoRESUMO
The effect of dietary aflatoxin B1 (AFB1) and Salmonella Enteritidis infection on intestinal permeability was investigated. Two hundred 1-day-old male Ross 308 broiler chickens were randomly divided into 4 treatments of 5 replicates each (10 birds per replicate), which were fed ad libitum for 3 weeks with the following treatments: control, chickens fed an AFB1-free diet; AF, chickens fed an AFB1-contaminated diet at 470 ng/g; SE, chickens fed an AFB1-free diet and challenged with 108 cfu of S. Enteritidis per bird at 18 days old; AF + SE, chickens fed an AFB1-contaminated diet and challenged with 108 cfu of S. Enteritidis per bird at 18 days old. At day 21 of age, chicks received an oral gavage dose of fluorescein isothiocyanate dextran (FITC-dextran) to evaluate gastrointestinal leakage. Blood and intestinal samples were collected to evaluate serum biochemistry and total intestinal IgA secretion, respectively. Liver tissues were aseptically collected to assess bacterial invasiveness and for histomorphological studies. The results showed that chickens receiving AFB1 presented a significant increment (up to 2.4-fold) in serum FITC-dextran concentration (p < 0.05). Nevertheless, S. Enteritidis infection had no additional effect on gastrointestinal leakage. Furthermore, the ingestion of AFB1 had no impact on the invasive potential of S. Enteritidis. These results suggest that moderate-dose AFB1 adversely affects intestinal barrier function resulting in increased gut permeability in broiler chickens.
Assuntos
Aflatoxina B1 , Intestinos/patologia , Permeabilidade/efeitos dos fármacos , Salmonella enteritidis/patogenicidade , Aflatoxina B1/administração & dosagem , Aflatoxina B1/efeitos adversos , Aflatoxina B1/toxicidade , Ração Animal/análise , Animais , Galinhas , Dieta/veterinária , Fígado/efeitos dos fármacos , Fígado/microbiologia , Fígado/patologia , Doenças das Aves Domésticas , Salmonelose AnimalRESUMO
TITLE: Nuevas evidencias y retos sobre neuropatia optica inflamatoria recurrente cronica.
Assuntos
Doenças do Nervo Óptico , Humanos , Nervo Óptico , RecidivaRESUMO
Objetivos: las Infecciones Hematógenas Asociadas a Catéter Venoso Central (IHACVC) producen mayor morbilidad y mortalidad, se podría disminuir esta tasa con la implementación de guías de buenas prácticas (GBP) y bundles. El estudio pretende determinar la incidencia de IHACVC, después de la aplicación de bundles validados de inserción y mantenimiento de CVC. Métodos: se plantea un estudio de tipo observacional, descriptivo de corte longitudinal realizado en el Hospital del Niño Manuel Ascencio Villarroel, en 94 pacientes portadores de CVC, estratificados en dos grupos: grupo de pacientes con CVC insertados sin aplicación de bundles y los insertados con la aplicación de los bundles. Realizando en ellos seguimiento de la presentación de infecciones y colonizaciones del CVC. Resultados: la incidencia de IHACVC fue 3,9/1000 días de CVC, se detectaron 12 casos de colonización asociadas a CVC. Los gérmenes aislados fueron gramnegativos intrahospitalarios multiresistentes. La adherencia a los bundles durante la inserción del CVC se cumplen 5,8 (DS 0,8) criterios de 6; y durante el mantenimiento se cumplen 4,6 (DS 1,3) de 6. Conclusiones: la tasa de IHACVC es baja debida al uso de CVC de corto plazo, la colonización o formación del biofilm, se pudo evidenciar por encima de los 10 días de exposición y en pacientes en los que no se siguieron los criterios recomendados. La reducción de las IAAS debe ser una tarea permanente del hospital, recomendamos mantener la aplicación de los bundles, enfatizando a la educación permanente del personal y los mecanismos de vigilancia activa.
Objectives: Bloodstream Central Venous Catheter Infections (BCVCI) leads increased morbidity and mortality. This rate could be reduced by the implementation of good practice guidelines (GBP) and bundles. The study aims to determine the incidence of IHACVC, after application of insertion and maintenance CVC validate bundles. Methods: An observational, descriptive longitudinal study was performed at Manuel Ascencio Villarroel Children Hospital, in 94 patients with CVC, stratified into 2 groups: CVCs inserted without application of bundles and those inserted with the application of bundles. Performing following-up on infections and colonizations presentation. Results: The incidence of BCVCI was 3.9 / 1000 days of CVC, 12 cases of colonization associated to CVC were detected. Isolated pathogens were multiresistant Gram-negative. Adherence to bundles during insertion of the CVC met 5.8 (SD 0.8) criteria of 6; And during maintenance, 4.6 (DS 1.3) of 6 are met. Conclusions: The rate of BCVCI is low due to the use of short-term CVC, colonization or biofilm formation could be evidenced after 10 days of exposure and in patients in whom the recommended criteria were not followed. Reduction of IAAS should be a permanent task of the hospital; we recommend to maintain the application of bundles, emphasizing the permanent education of staff and mechanisms of active surveillance.
Assuntos
Humanos , Cateteres Venosos Centrais , Klebsiella pneumoniae , Unidades de Terapia IntensivaRESUMO
PROPÓSITO: Comparar la eficacia y complicaciones de la vía retropúbica (TVT o RP) y la vía transobturadora (TVT-O) en el tratamiento quirúrgico de la incontinencia de orina de esfuerzo (IOE). MÉTODOS: Estudio retrospectivo de pacientes con diagnóstico de IOE operadas entre Julio 2004 y Julio 2014 en el Hospital Clínico de la Universidad de Chile. Se evaluaron los datos demográficos, antecedentes médicos, síntomas y examen físico tanto preoperatorio como post operatorio y seguimiento post quirúrgico. RESULTADOS: De un total de 715, se analizaron los datos de 383 pacientes operada durante la fecha. 59,7% (n= 229) fueron sometidas a TVT-O y 40,3% (n=154) a TVT. Un 4,8% (n=11) de las pacientes en que se realizó cinta transobturadora tenían antecedente de cirugía previa de incontinencia versus un 14,29% (n=22) de las pacientes en que se realizó cinta retropúbica (P 0,006). Los datos post operatorios fueron ajustados según el dato anterior. En el seguimiento post operatorio se presentaron diferencias significativas en la disfunción del vaciamiento vesical [OR 0,28, (95%IC 0,10-0,74), p = 0,011]; y en el dolor inguinal post operatorio [OR 0,19 (95%IC 0,06-0,56), p = 0,003); siendo ambos más frecuentes en el grupo transobturador. No hubo diferencias significativas en el éxito subjetivo de la resolución de la IOE así como en otro tipo de complicaciones postoperatorias. CONCLUSIONES: Si bien ambas técnicas presentan tasas similares de éxito subjetivo en la resolución de la IOE, en nuestra experiencia, la vía transobturadora presenta mayor riesgo de disfunción del vaciamiento vesical y dolor inguinal postoperatorio.
PURPOSE: To compare the efficacy and complications of the retropubic sling (TVT or RP) and the transobturator sling (TVT-O or TOT) for the surgical treatment of stress urinary incontinence (SUI). METHODS: Retrospective study including patients diagnosed with SUI who had surgery between July 2004 and July 2014 at the Clinical Hospital of the University of Chile. Demographics, medical history, symptoms and physical examination (preoperative, postoperative and post-surgical follow-up) were evaluated. RESULTS: From a total of 715 operated during this period, the data from 383 patients was analyzed. 59.7% (n = 229) were submitted to TVT-O and 40.3% (n = 154) to TVT. 4.8% (n = 11) of patients in the transobturator sling group had previously had an incontinence surgery versus 14.29% (n = 22) of patients that had a retropubic sling (P 0.006). The postoperative data was adjusted according to this data. At the postoperative follow-up there were significant differences in bladder emptying dysfunction [OR 0.28 (95% CI 0.10 to 0.74), p = 0.011]; and postoperative groin pain [OR 0.19 (95% CI 0.06 to 0.56), p = 0.003); both being more frequent in the transobturator group. There were no significant differences in subjective success of the resolution of the SUI as well as other postoperative complications. CONCLUSIONS: Although both techniques have similar rates of subjective success in solving the SUI, in our experience, the transobturator approach has increased risk of bladder emptying dysfunction and postoperative groin pain.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Urológicos/métodos , Incontinência Urinária por Estresse/cirurgia , Slings Suburetrais , Complicações Pós-Operatórias , Chile , Estudos Retrospectivos , SeguimentosRESUMO
OBJECTIVE: We investigated the short- and long-term effects of extremely low-frequency electromagnetic fields (EMF) on social recognition behavior and expression of α- and ß-estrogen receptors (ER). METHODS: Rats were exposed to 60-Hz electromagnetic fields for 9 or 30 days and tested for social recognition behavior. Immunohistochemistry and western blot assays were performed to evaluate α- and ß-ER expression in the olfactory bulb of intact, ovariectomized (OVX), and ovariectomized+estradiol (E2) replacement (OVX+E2). RESULTS: Ovariectomization showed impairment of social recognition after 9 days of EMF exposure and a complete recovery after E2 replacement and so did those after 30 days. Short EMF exposure increased expression of ß-ER in intact, but not in the others. Longer exposure produced a decrease in intact but an increase in OVX and OVX+E2. DISCUSSION: Our findings suggest a significant role for ß-estrogen receptors and a lack of effect for α-estrogen receptors on a social recognition task. ABBREVIATIONS: EMF: extremely low frequency electromagnetic fields; ERs: estrogen receptors; OB: olfactory bulb; OVX: ovariectomized; OVX + E2: ovariectomized + estradiol replacement; IEI: interexposure interval; ß-ER: beta estrogen receptor; E2: replacement of estradiol; GAPDH: glyceraldehyde-3-phosphate dehydrogenase; WB: Western blot; PBS: phosphate-buffer saline; PB: phosphate-buffer.
Assuntos
Campos Eletromagnéticos , Bulbo Olfatório/metabolismo , Receptores de Estrogênio/metabolismo , Reconhecimento Psicológico/efeitos da radiação , Comportamento Social , Análise de Variância , Animais , Modelos Animais de Doenças , Relação Dose-Resposta à Radiação , Estradiol/farmacologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos da radiação , Locomoção/efeitos dos fármacos , Locomoção/efeitos da radiação , Bulbo Olfatório/efeitos dos fármacos , Bulbo Olfatório/efeitos da radiação , Ovariectomia , Ratos , Ratos Wistar , Reconhecimento Psicológico/efeitos dos fármacos , Fatores de TempoRESUMO
The olive ridley sea turtle ( Lepidochelys olivacea), considered the most abundant sea turtle species, is listed as vulnerable on the International Union for Conservation of Nature Red List. The most important nesting areas are located in the Eastern Pacific, and congenital malformations have been previously reported in this species. The present study was conducted in a single population at El Verde beach, one of the most important nesting beaches for the species in the northwestern Mexican Pacific. The study was based on embryos that had been incubated in a controlled environment. Schistosomus reflexus syndrome (SRS) was observed in 124 of 20 257 olive ridley embryos (0.6%), comprising 124 of 400 (31%) cases of congenital malformations over a 7-month period. Affected embryos had malformations of the carapace, bridge, or plastron, resulting in exposure of the abdominal or thoracic viscera, as well as spinal malformation and abnormal positioning of limbs adjacent to the head with subsequent ankylosis. SRS phenotypes (although lethal) varied from mild to severe, although most cases were severe. SRS was mostly associated with congenital malformations in the neck (short neck, 80%), tail (anury, 38%), and flippers (different types of dysmelias, 53%). In most cases of severe SRS, ankyloses were present. Documenting these findings could be important to identify the cause of the developmental defects, and identification of the cause of the defects may be of significance to the population and to our efforts to manage this and other populations at risk.
Assuntos
Tartarugas/anormalidades , Anormalidades Múltiplas/patologia , Anormalidades Múltiplas/veterinária , Animais , Feminino , México , Oceano Pacífico , Síndrome , Tartarugas/embriologiaRESUMO
Resumen: La frecuencia del tumor de células gigantes reportada en la literatura es muy variable. Tomando en cuenta que nuestra población presenta características propias, diferentes a las poblaciones anglosajona y asiática, consideramos que tanto la frecuencia como las cualidades clínicas del tumor de células gigantes en nuestro país son distintas. El objetivo principal de este trabajo fue determinar la frecuencia y las características clínico-patológicas del tumor de células gigantes de hueso. Se realizó un estudio transversal y descriptivo de los casos diagnosticados en el servicio como tumor de células gigantes de hueso durante el período comprendido de Enero a Diciembre de 2013. En cada caso seleccionado, se revisó el expediente clínico electrónico, el expediente radiológico, así como también las laminillas. Los tumores de células gigantes comprendieron 17% de los tumores óseos en general y 28% de los tumores óseos benignos. Hubo 13 mujeres y 18 hombres. Los lugares de presentación más frecuentes del tumor de células gigantes fueron: tibia proximal, nueve casos (29%) y fémur distal, seis casos (19%). Cuarenta y cinco por ciento de los tumores de células gigantes se encontraron asociados con quiste óseo aneurismático (14 casos) y un caso (3%) fue maligno. En esta serie, el tumor de células gigantes presentó una frecuencia intermedia; es decir, una frecuencia mayor a la reportada en países anglosajones (con frecuencia baja), aunque sin llegar a ser igual a la de los países asiáticos (frecuencia alta).
Abstract: The frequency of giant cell tumors reported in the literature is very variable. Considering that our population has its own features, which distinguish it from the Anglo-Saxon and Asian populations, we think that both the frequency and the clinical characteristics of giant cell tumors in our population are different. The major aim of this paper was to determine the frequency and clinicopathological characteristics of giant cell tumors of the bone. A cross-sectional descriptive study was conducted of the cases diagnosed at our service as giant cell tumors of the bone from January to December 2013. The electronic clinical records, radiologic records and histologic slides from each case were reviewed. Giant cell tumors represented 17% of total bone tumors and 28% of benign tumors. Patients included 13 females and 18 males. The most frequent locations of giant cell tumors were: the proximal tibia, 9 cases (29%), and the distal femur, 6 cases (19%). Forty-five percent of giant cell tumors were associated with aneurysmal bone cyst (ABC) (14 cases) and one case (3%) was malignant. The frequency of giant cell tumors in this case series was intermediate, that is, higher than the one reported in Anglo-Saxon countries (usually low), but without reaching the frequency rates reported in Asian countries (high).
RESUMO
La lesión del ligamento cruzado anterior (LCA) tiene un alta prevalencia en jugadores de fútbol. En esta disciplina, las carreras con cambios de dirección son frecuentes y pueden ser un factor de riesgo para el desarrollo de lesiones del LCA sin contacto. Objetivo: Describir en futbolistas jóvenes los rangos cinemáticos fisiológicos de rodilla sometida a tareas funcionales con cambios bruscos de dirección. Método: En una muestra de ocho futbolistas con rodillas clínicamente sanas, se evaluó, mediante un sistema de análisis de movimiento 3D, la cinemática de la rodilla de apoyo durante la ejecución de tres tareas funcionales, dos de estas implicaron cambios de dirección en 90° (CD90°) y 180° (CD180°), la tercera golpear un balón (GB). Los rangos fisiológicos de movimiento (ROM) fueron registrados y comparados en la misma rodilla en tres planos diferentes (T-Transversal; F-Frontal; S-Sagital). Resultados: Los rangos fisiológicos obtenidos fueron para las tareas funcionales CD90°: T 11°(13-8), F 5.6° (11-4) y S 22°(30-17); para CD180°: T 9°(12-8), F 6.3°(8-5) y S 17.6°(21-14); y para GB: T 9°(10-5), F 3.8°(10-2), y S 9.6°(15-6). El ROM fue significativamente mayor en el plano transversal para la tarea CD90°. El el plano sagital el ROM fue mayor para CD90° comparado con GB (p<.05), sin embargo no hubo diferencias respecto a la tarea CD180°. No existen diferencias del ROM en el plano frontal. Conclusión: Se logró describir los rangos cinemáticos fisiológicos de la rodilla durante la ejecución de tres tareas funcionales que implicaron cambios bruscos de dirección en futbolistas amateur. En la muestra evaluada, la prueba que produjo una mayor exigencia de los rangos articulares de rodilla en los planos transversal y sagital fue la prueba con cambio de dirección en 90°...
Anterior cruciate ligament (ACL) lesions are frequent among soccer players. In this sport cutting movements are usually made while running and may be a risk factor in developing non-contact ACL injuries. Purpose: To describe the physiological kinematics of the knee during sudden change of direction movements in amateur soccer players. Methods:Eight amateur soccer players without previous injuries were analysed. The kinematics of the support knee were evaluated using 3D motion analysis while executing 3 common manoeuvres: two of them involved a change of direction at 90° and 180° (CD90° and CD180°), and the third while kicking a ball (GB). Physiological articular ranges of motion (ROM) were recorded and compared for the same knee in three different planes (T-Transversal; F-Frontal; S-Sagittal). Results: The physiological ranges obtained were, for manouvre CD90°: T 11°(13-8), F 5.6° (11-4) and S 22°(30-17); for CD180°: T 9°(12-8), F 6.3°(8-5) and S 17.6°(21-14); and for GB: T 9°(10-5), F 3.8°(10-2), and S 9.6°(15-6). ROM was significantly greater in the transversal plane for the CD90° manoeuvre (P<.05). In the sagittal plane, ROM was greater for the CD90° when compared to the GB (P<.05), but no differences were seen when compared to the CD180° manoeuvre (P>.05). There were no differences in ROM in the frontal plane. Conclusion: A description of the physiological kinematic ranges of the knee during three sudden changes of direction manoeuvres in amateur soccer players was presented. According to our results, change of direction in 90° demands a higher range of motion in both the transversal and sagittal planes...
Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Fenômenos Biomecânicos , Imageamento Tridimensional , Ligamento Cruzado Anterior/lesões , Joelho/fisiologia , Futebol , Ligamento Cruzado Anterior/fisiopatologia , Estudo Observacional , Amplitude de Movimento Articular/fisiologiaRESUMO
La luxación de codo en niños es un evento traumático muy poco frecuente descrito por primera vez por Stimson en 1900 y por Tachdjian en 1990, con una incidencia estimada que va de 3 a 6% de todas las lesiones en codo, con un pico de incidencia entre los 13 y 14 años, el trauma de codo se clasifica basándose en la dirección que toma el desplazamiento de la articulación radio ulnar proximal con el húmero, dividiéndolas en luxaciones posteriores y anteriores, siendo la primera más frecuente, ocurriendo en 95% de los casos, por otra parte las luxofracturas del codo son eventos aún más raros presentándose fractura por avulsión del epicóndilo medial con una incidencia de 25 a 36%; cóndilo lateral 4%, olécranon 1.7%, cabeza radial 8%, apófisis coronoides 3.5%, y otras 3.5%, hasta el momento no existe en la literatura un consenso sobre cómo manejar este tipo de lesiones, en especial porque hay autores que respaldan el manejo no quirúrgico, y otros que proponen el manejo quirúrgico como método definitivo; sin embargo, lo que sí se tiene claro es que un diagnóstico tardío o un manejo inoportuno puede repercutir en el crecimiento del niño llevando a serias complicaciones, de esta manera con el presente estudio pretendemos dar a reconocer nuestra experiencia en el manejo quirúrgico de estos casos tan poco frecuentes obteniendo buenos resultados.
Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child's growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.
Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Luxações Articulares/patologia , Cotovelo/lesões , Fraturas Ósseas/patologia , Luxações Articulares/diagnóstico , Luxações Articulares/cirurgia , Cotovelo/patologia , Cotovelo/cirurgia , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/cirurgiaRESUMO
The frequency of giant cell tumors reported in the literature is very variable. Considering that our population has its own features, which distinguish it from the Anglo-Saxon and Asian populations, we think that both the frequency and the clinical characteristics of giant cell tumors in our population are different. The major aim of this paper was to determine the frequency and clinicopathological characteristics of giant cell tumors of the bone. A cross-sectional descriptive study was conducted of the cases diagnosed at our service as giant cell tumors of the bone from January to December 2013. The electronic clinical records, radiologic records and histologic slides from each case were reviewed. Giant cell tumors represented 17% of total bone tumors and 28% of benign tumors. Patients included 13 females and 18 males. The most frequent locations of giant cell tumors were: the proximal tibia, 9 cases (29%), and the distal femur, 6 cases (19%). Forty-five percent of giant cell tumors were associated with aneurysmal bone cyst (ABC) (14 cases) and one case (3%) was malignant. The frequency of giant cell tumors in this case series was intermediate, that is, higher than the one reported in Anglo-Saxon countries (usually low), but without reaching the frequency rates reported in Asian countries (high).
La frecuencia del tumor de células gigantes reportada en la literatura es muy variable. Tomando en cuenta que nuestra población presenta características propias, diferentes a las poblaciones anglosajona y asiática, consideramos que tanto la frecuencia como las cualidades clínicas del tumor de células gigantes en nuestro país son distintas. El objetivo principal de este trabajo fue determinar la frecuencia y las características clínico-patológicas del tumor de células gigantes de hueso. Se realizó un estudio transversal y descriptivo de los casos diagnosticados en el servicio como tumor de células gigantes de hueso durante el período comprendido de Enero a Diciembre de 2013. En cada caso seleccionado, se revisó el expediente clínico electrónico, el expediente radiológico, así como también las laminillas. Los tumores de células gigantes comprendieron 17% de los tumores óseos en general y 28% de los tumores óseos benignos. Hubo 13 mujeres y 18 hombres. Los lugares de presentación más frecuentes del tumor de células gigantes fueron: tibia proximal, nueve casos (29%) y fémur distal, seis casos (19%). Cuarenta y cinco por ciento de los tumores de células gigantes se encontraron asociados con quiste óseo aneurismático (14 casos) y un caso (3%) fue maligno. En esta serie, el tumor de células gigantes presentó una frecuencia intermedia; es decir, una frecuencia mayor a la reportada en países anglosajones (con frecuencia baja), aunque sin llegar a ser igual a la de los países asiáticos (frecuencia alta).
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Pelvic floor dysfunctions are highly prevalent in our population significantly affecting the quality of life of women. Pregnancy and childbirth are well recognized risk factors. It has recently become clear that pelvic floor trauma encompass more than perineal trauma or what one could see in the delivery room. The levator ani muscle may be affected at birth with the loss of the integral structure of the pelvic floor support, secondarily triggering the descent of the pelvic organs. The overdistension of the urogenital hiatus and anal sphincter injuries can also be consequences of a vaginal birth. An episiotomy is an intervention that seeks to facilitate the expulsion of the fetus expanding the perineum preventing tissue distension and perineal tear. However, this claim raised by its developer has no scientific basis. Today the restrictive practice of this procedure is recommended, given the potential complications that may arise when it is systematically performe. Despite this recommendation, there are no conclusive studies that explore the role that episiotomy has in obstetric pelvic floor trauma...
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Humanos , Feminino , Diafragma da Pelve/cirurgia , Diafragma da Pelve/fisiopatologia , Diafragma da Pelve/lesões , EpisiotomiaRESUMO
Antecedentes: La percepción de la enfermedad es una representación cognitiva que influye directamente en la respuesta emocional del paciente a su enfermedad y su comportamiento para hacer frente a esta, haciendo referencia a las percepciones cognitivas (identidad, las consecuencias de la enfermedad, la duración de esta, control personal y la eficacia del tratamiento), y a las percepciones emocionales (la conciencia sobre la enfermedad, las emociones generadas y la comprensión de esta).Objetivo: Determinar la percepción de la enfermedad en los pacientes con lupus eritematoso sistémico (LES) a través del cuestionario de percepción de enfermedad revisado (IPQ-R).Pacientes y métodos: Se realizó la aplicación del IPQ-R en 72 pacientes con LES para la estimación de la percepción de la enfermedad. Análisis estadístico: pruebas de hipótesis, estadístico chi-cuadrado, t de Student y estadística de Pearson.Resultados: IPQ-R puntuaciones: identidad 10,2 ± 4,3, duración (aguda / crónica) 18,1 ± 2,9, consecuencias 19,2 ± 3,7, control personal 19,8 ± 2,9, control de tratamiento 15, 5 ± 1,9, coherencia 14,7 ± 3,1, tiempo cíclico 14,2 ± 2,9, representaciones emocionales 18,3 ± 4,2. Teniendo en cuenta las variables sociodemográficas evidenciamos que los pacientes de mayor nivel educativo tienen menos confianza en que el tratamiento va a controlar la enfermedad y no lo entienden, de igual forma, los pacientes que entienden su enfermedad creen que el tratamiento es eficaz en el control del lupus. El estar desempleado se correlaciona con más síntomas de ansiedad y depresión a causa del LES; a medida que progresa la enfermedad, los pacientes más crónicos sienten mejor control personal sobre su enfermedad y a mayor número de recaídas sienten que tienen consecuencias más negativas en su vida, esto hace que atribuyan al LES más síntomas somáticos...
Background: Illness perception is a cognitive representation that directly influences the patient's emotional response to their disease and their behavior to cope with this. Illness perception focuses on cognitive perceptions (identity, consequences of the disease, duration of this, personal control, and treatment effectiveness) and emotional (awareness of the illness, emotions generated, and understanding of them).Objective: To determine illness perceptions in systemic lupus erythematosus (SLE) patients through the revised Illness Perception Questionnaire (IPQ-R). Patients and methods: A total of 72 patients participated. IPQR was used for the estimation of the illness perception. Statistical analysis: hypothesis tests, chi-square statistic, Student's t-test, Pearson statistic.Results: IPQ-R scores: Identity 10.2±4.3, Timeline (acute/chronic) 18.1±2.9, Consequences 19.2±3.7, Personal Control 19.8±2.9, Treatment control 15.5±1.9, Illness coherence 14.7±3.1, Cylcic timeline 14.2±2.9, Emotional representations 18.3±4,2. Considering sociodemographic variables, higher educational level patients are less confident that the treatment will control the disease and understand it less. Patients who understand their illness think that the treatment is effective in controlling the disease. Unemployment correlated with more symptoms of anxiety and depression due to the SLE. As the disease gets more chronic, patients feel they have better personal control over their illness, and a much higher number of flares bring more negative consequences to their lives, and leads to them having more somatic symptoms than those caused by SLE...
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Humanos , Pacientes , Percepção , ReumatologiaRESUMO
Lead-free ferroelectric ceramics based on the Na(0.5)Bi(0.5)TiO3 system, in solid solution with Pr(3+) and La(3+), are synthesized by the Pechini method at low temperature. The powders calcined at 700 °C are found to be below 200 nm in mean crystal size. The dielectric properties reveal a diffuse phase transition. In Na(0.5)Bi(0.5)TiO3 ceramics the rhombohedral to tetragonal transition temperature (T(R-T)) appears near 190 °C, and the Curie temperature (T(C)) at 280 °C. These transitions are shifted when Pr(3+) and La(3+) cations are introduced into the lattice. The ferroelectric properties are also affected, causing the remnant polarization and coercive field to diminish with the increase in La(3+) content. In addition, the piezoelectric properties decrease in the same way with La(3+) concentration. Finally, the red luminescence of Pr(3+) is improved when lanthanum concentration is increased.
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BACKGROUND: Neuroendocrine tumors (NETs) present all along the length of the gastrointestinal (GI) tract, from the esophagus to the anus, and they also present in the pancreas. AIMS: To classify NETs according to the WHO 2010 criteria and to evaluate their anatomic distribution and clinicopathologic characteristics. MATERIAL AND METHODS: A search was carried out in the hospital pathology archives of all the cases diagnosed with carcinoid tumor and neuroendocrine carcinoma of the GI tract and pancreas studied over a period of 11 years (1999-2010). The cases were reclassified according to the WHO 2010 criteria. The clinical case records of each patient were reviewed. RESULTS: The study group was made up of 127 cases (68 men; 59 women). Age ranged from 24 to 85 years with a median of 52 years. A total of 113 (89.00%) tumors occurred in the GI tract and 14 (11.00%) in the pancreas. Tumor size varied from 0.4cm to 9cm (median: 2.5cm). GI tumor histologic grades were: 54.00% grade 1; 31.00% grade 2; and 15.00% grade 3. Pancreatic tumor histologic grades were: 43.00% grade 1; 36.00% grade 2; and 21.00% grade 3. Ki-67 overexpression was correlated with tumor grade (22.00% grade 3 vs 2.50% grade 1). CONCLUSIONS: Histologic grade of the gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is one of the most important prognostic factors. The term carcinoid should be eliminated because it does not reflect the biological behavior of these tumors.
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Neoplasias Intestinais/patologia , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Feminino , Hospitais , Humanos , Neoplasias Intestinais/complicações , Neoplasias Intestinais/terapia , Antígeno Ki-67/análise , Masculino , Oncologia , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/terapia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/terapia , Prognóstico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/terapia , Terminologia como Assunto , Resultado do Tratamento , Adulto JovemRESUMO
The objective of this study was to analyze television advertisements from different TV channels which are part of the Chilean National Television Association. During one week in January and one week in February of 2010 the advertisements were screened. The analysis selected and classified food's advertising as healthy, moderately healthy and unhealthy based on food's critic nutritional components: total fat, saturated fat, carbohydrates and sodium using as reference a classification chart called "Traffic Light System" and created by the UK Food Standard Agency. Sixty thousand four hundred and twenty five (6.425) advertisements were registered and analyzed accounting for 56 hours and 36 minutes in total. One thousand forty five (1.045) advertisements were identified as food advertisements (16 percent) accounting for 7 hours and 42 minutes (14 percent) of the total. Nutritional labels of the products were studied in order to classify and select them as described above. From the total offood advertisements it was observed that 64 percent were related to unhealthy food; 27 percent to moderately healthy and 9 percent to healthy food; accounting for respectively 62 percent, 30 percent and 8 percent, respectively, of the total time reported on food advertisement. Food advertisements are mostly unhealthy, promoting food consumption with high levels of fat, sugar and sodium. The broadcasting of this type of advertisements by television promotes the population to follow unhealthy life styles which result in a deterioration of their health.
El objetivo de este estudio, fue describir la Publicidad Alimentaria emitida por los canales pertenecientes a la Asociación Nacional de Televisión. En una semana de enero y una de febrero del año 2010 se seleccionó y clasificó la publicidad alimentaria emitida como saludable, medianamente saludable y no saludable, en base al contenido de nutrientes críticos; grasa total, grasa saturada, hidratos de carbono simples y sodio. Se utilizó como criterio de referencia, la tabla de clasificación de la Agencia Nacional de Alimentos de Inglaterra, denominada "semáforo nutricional". Se registraron y analizaron 6425 anuncios correspondientes a 56 horas 36 minutos continuas de tiempo, de ellos, se identificaron 1045 anuncios alimentarios (16 por ciento), equivalente en tiempo a 7 horas 42 minutos (14 por ciento) del total. Se examinaron las etiquetas nutricionales de los productos para la selección y calificación en saludable, medianamente saludable y no saludable. Se observó, que del total de la publicidad alimentaria, el 64 por ciento correspondió a publicidad alimentaria no saludable; el 27 por ciento, a publicidad alimentaria medianamente saludable y, el 9 por ciento publicidad alimentaria saludable, con un tiempo de emisión de un 62 por ciento, 30 por ciento y 8 por ciento, respectivamente. La publicidad alimentaria emitida es principalmente no saludable, promueve el consumo de alimentos altos en grasa, azúcar y sodio. La televisión al emitir esta publicidad promueve e incentiva a la población a llevar estilos de vida no saludables, en desmedro de la salud de la población.
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Humanos , Sódio , Televisão , Açúcares , Publicidade de Alimentos , Gorduras , ChileRESUMO
Los cambios producidos durante el envejecimiento predisponen al adulto mayor a las caídas frecuentes, en el ambiente clínico el riesgo de caída es valorado mediante pruebas clínicas que muchas veces carecen de poder analítico, por lo cual es necesario describir cual de dichas pruebas puede tener mayor relación con parámetros biomecánicos analíticos con la finalidad de conferirle a dichas pruebas funcionales tales características. El objetivo de este trabajo fue describir la existencia de correlación entre los puntajes obtenidos en la prueba funcional "Timed up and go" (TUG) y momentos articulares del miembro inferior obtenidos durante la ejecución de la transferencia de sedente a bípedo (TSB) en sujetos adultos mayores con antecedentes de caídas frecuentes. Se obtuvo una muestra de 30 voluntarios, todos adultos mayores con antecedentes de caídas frecuentes, los que fueron evaluados con la prueba funcional de TUG. También se evaluó mediante un sistema de análisis de movimiento la TSB donde se registraron los parámetros biomecánicos necesarios para determinar los momentos articulares del miembro inferior. Existió una correlación significativa (r=-0,39; p=0,03) entre el puntaje obtenido en el TUG y el momento articular máximo de rodilla. Para la muestra evaluada, el tiempo de ejecución de la prueba "Timed up and go" fue indicador de la capacidad de generar momento articular por parte de los músculos flexo-extensores de rodilla en sujetos con antecedentes de caídas frecuentes.
The changes that take place during aging predispose the elder adult to frequent falls. In clinical practice fall risk is assessed by clinical tests that many times lack analytical power, therefore making it necessary to describe which of the clinical tests are related to the analytical biomechanical parameters in order to assign such characteristics to these functional tests. The objective of this work was to describe the existence of a correlation between the score of the functional test "Timed up and go" (TUG) and the joint moments of lower limb obtained during the execution of the sit to stand (STS) transfer in elderly subjects with a history of frequent falls. A sample of 30 volunteers was obtained; all were elders with a history of frequent falls. They were assessed with the functional test of TUG. Also assessed were the joint moments of the lower limb with motion analysis system. There is significant correlation (r=0.39; p=0.03) between the score obtained in the TUG and the maximum joint moment of the knee. For the sample assessed, the time of execution of the test "Timed up and go" was indicative of the capacity to generate a joint moment by the flexion-extensor muscles of the knee in subjects with a history of frequent falls.