RESUMO
This study aimed to characterize the population pharmacokinetics of sertraline in Mexican patients with psychiatric and substance use disorders. Fifty-nine patients (13 to 76 years old) treated with doses of sertraline between 12.5 and 100 mg/day were included. Plasma sertraline concentrations were determined in blood samples and five of the main substances of abuse were determined by rapid tests in urine samples. Demographic, clinical, and pharmacogenetic factors were also evaluated. Population pharmacokinetic analysis was performed using NONMEM software with first-order conditional estimation method. A one-compartment model with proportional residual error adequately described the sertraline concentrations versus time. CYP2D6*2 polymorphism and CYP2C19 phenotypes significantly influenced sertraline clearance, which had a population mean value of 66 L/h in the final model. The absorption constant and volume of distribution were fixed at 0.855 1/h and 20.2 L/kg, respectively. The model explained 11.3% of the interindividual variability in sertraline clearance. The presence of the CYP2D6*2 polymorphism caused a 23.1% decrease in sertraline clearance, whereas patients with intermediate and poor phenotype of CYP2C19 showed 19.06% and 48.26% decreases in sertraline clearance, respectively. The model was internally validated by bootstrap and visual predictive check. Finally, stochastic simulations were performed to propose dosing regimens to achieve therapeutic levels that contribute to improving treatment response.
Assuntos
Citocromo P-450 CYP2C19 , Citocromo P-450 CYP2D6 , Sertralina , Transtornos Relacionados ao Uso de Substâncias , Humanos , Sertralina/farmacocinética , Sertralina/uso terapêutico , Sertralina/sangue , Masculino , Pessoa de Meia-Idade , Adulto , Feminino , Idoso , Citocromo P-450 CYP2D6/genética , Citocromo P-450 CYP2D6/metabolismo , Adolescente , Citocromo P-450 CYP2C19/genética , Citocromo P-450 CYP2C19/metabolismo , Transtornos Relacionados ao Uso de Substâncias/sangue , Adulto Jovem , Modelos Biológicos , Transtornos Mentais/tratamento farmacológico , Polimorfismo Genético , Inibidores Seletivos de Recaptação de Serotonina/farmacocinética , Inibidores Seletivos de Recaptação de Serotonina/sangue , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , México , Antidepressivos/farmacocinética , Antidepressivos/uso terapêutico , Antidepressivos/sangueRESUMO
The aim of this study was the molecular imprinting polymers (MIPs) assessment as a controlled release system of ciprofloxacin. The MIPs synthesis was performed by three different methods: emulsion, bulk, and co-precipitation. Lactic acid (LA) and methacrylic acid (MA) were used as functional monomers and ethylene glycol dimethacrylate as crosslinker. Also, nonimprinted polymers (NIPs) were synthesized. MIPs and NIPs were characterized by scanning electron microscopy, Fourier Transform Infrared Reflection, specific surface area, pore size, and release kinetics. Their efficiency against Staphylococcus aureus and Escherichia coli, and their cytotoxicity in dermal fibroblast cells were proven. Results show that MIPs are mesoporous materials with a pore size between 10 and 20 nm. A higher adsorption with the co-precipitation MIP with MA as a monomer was found. The release kinetics proved that a non-Fickian process occurred and that the co-precipitation MIP with LA presented the highest release rate (90.51 mg/L) in 8 h. The minimum inhibitory concentration was found between 0.031 and 0.016 mg/L for Staphylococcus aureus and between 0.004 and 0.031 mg/L for the Escherichia coli. No cytotoxicity in cellular cultures was found; also, cellular growth was favored. This study demonstrated that MIPs present promising properties for drug administration and their application in clinical practice.
Assuntos
Metacrilatos , Impressão Molecular , Polímeros Molecularmente Impressos , Preparações de Ação Retardada , Ciprofloxacina/farmacologia , Polímeros , Impressão Molecular/métodos , Escherichia coli , AdsorçãoRESUMO
Spermatogenesis is a very complex process with an intricate transcriptional regulation. The transition from the diploid to the haploid state requires the involvement of specialized genes in meiosis, among other specific functions for the formation of the spermatozoon. The transcription factor cAMP-response element modulator (CREM) is a key modulator that triggers the differentiation of the germ cell into the spermatozoon through the modification of gene expression. CREM has multiple repressor and activator isoforms whose expression is tissue-cell-type specific and tightly regulated by various factors at the transcriptional, post-transcriptional and post-translational level. The activator isoform CREMτ controls the expression of several relevant genes in post-meiotic stages of spermatogenesis. In addition, exposure to xenobiotics negatively affects CREMτ expression, which is linked to male infertility. On the other hand, antioxidants could have a positive effect on CREMτ expression and improve sperm parameters in idiopathically infertile men. Therefore, CREM expression could be used as a biomarker to detect and even counteract male infertility. This review examines the importance of CREM as a transcription factor for sperm production and its relevance in male fertility, infertility and the response to environmental xenobiotics that may affect CREMτ expression and the downstream regulation that alters male fertility. Also, some health disorders in which CREM expression is altered are discussed.
Assuntos
Infertilidade Masculina , Xenobióticos , Masculino , Humanos , Sêmen , Espermatogênese/genética , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico , Infertilidade Masculina/genética , Meiose , Elementos de Resposta , Fertilidade/genética , Modulador de Elemento de Resposta do AMP Cíclico/genéticaRESUMO
CATSPER2 (Cation channel sperm-associated protein 2) protein, which is part of the calcium CATSPER channel located in the membrane of the flagellar principal piece of the sperm cell, is only expressed in the testis during spermatogenesis. Deletions or mutations in the Catsper2 gene are associated with the deafness-infertility syndrome (DIS) and non-syndromic male infertility. However, the mechanisms by which Catsper2 is regulated are unknown. Here, we report the characterization of the promoter region of murine Catsper2 and the role of CTCF and CREMτ in its transcription. We report that the promoter region has transcriptional activity in both directions, as determined by observing luciferase activity in mouse Sertoli and GC-1 spg transfected cells. WGBS data analysis indicated that a CpG island identified in silico is non-methylated; Chromatin immunoprecipitation (ChIP)-seq data analysis revealed that histone marks H3K4me3 and H3K36me3 are present in the promoter and body of the Catsper2 gene respectively, indicating that Catsper2 is subject to epigenetic regulation. In addition, the murine Catsper2 core promoter was delimited to a region between -54/+189 relative to the transcription start site (TSS), where three CTCF and one CRE binding site were predicted. The functionality of these sites was determined by mutation of the CTCF sites and deletion of the CRE site. Finally, ChIP assays confirmed that CREMτ and CTCF bind to the Catsper2 minimal promoter region. This study represents the first functional analysis of the murine Catsper2 promoter region and the mechanisms that regulate its expression.
Assuntos
Canais de Cálcio , Epigênese Genética , Regiões Promotoras Genéticas , Proteínas de Plasma Seminal , Animais , Masculino , Camundongos , Sítios de Ligação , Canais de Cálcio/genética , Regulação da Expressão Gênica , Proteínas de Plasma Seminal/genéticaRESUMO
Background: In countries with emerging economies, the adequate and efficient management of resources is a priority, through strategies to reduce prolonged stay, increase the availability of beds, maximize profitability and reduce iatrogenic complications. Objective: The purpose of the study was to evaluate the effect of the "Follow up" strategy (FU) on the main indicators of the hospitalization process. Material and methods: A cross-sectional, comparative study was developed to evaluate the impact of the FU strategy on the indicators: hospital admissions and discharges, average days of hospital stay (DEH), percentage of hospital occupancy (OH), bed substitution interval (ISC), bed turnover rate (CRI) and prolonged hospital stay (EHP). Results: The FU was associated with a reduction in DEH [5.7 (5.5-6.1) vs. 6.5 days (6.1-6.9), p = 0.01]; ISC [0.6 (0.4-0.8) vs. 1.2 (0.8-1.3), p = 0.01] and EHP [23.6 (21.6-24.7) vs. 26.3% (24.4-28.7), p = 0.02] compared to the control group, with an increase in existence [1436 (1381-1472) vs. 1347 patient days (1280-1402), p = 0.02], respectively. There was no significant difference in the number of admissions, discharges or in the IRC. Conclusions: The FU reduces the average number of days of hospital stay, the rate of bed substitution and prolonged stay.
Introducción: en los países con economías emergentes es prioritaria la gestión adecuada y eficiente de los recursos hospitalarios. Las estrategias de gestión pueden reducir la estancia prolongada, aumentar la disponibilidad de camas, maximizar la rentabilidad y reducir las complicaciones iatrogénicas. Objetivo: el propósito del estudio fue evaluar el efecto de la estrategia de Follow up (FU) en los principales indicadores del proceso de hospitalización. Material y métodos: se desarrolló un estudio transversal, comparativo, para evaluar el impacto de la estrategia de FU en los indicadores: ingresos y egresos hospitalarios, promedio de días de estancia hospitalaria (DEH), porcentaje de ocupación hospitalaria (OH), intervalo de sustitución de camas (ISC), índice de rotación de camas (IRC) y estancia hospitalaria prolongada (EHP). Resultados: la estrategia de FU se asoció con una reducción de los DEH [5.7 (5.5-6.1) frente a 6.5 días (6.1-6.9), p = 0.01]; ISC [0.6 (0.4-0.8) frente a 1.2 (0.8-1.3), p = 0.01] y EHP [23.6 (21.6-24.7) frente a 26.3% (24.4-28.7), p = 0.02] respecto al grupo control, con incremento de la existencia [1436 (1381-1472) frente a 1347 días paciente (1280-1402), p = 0.02], respectivamente. No hubo diferencia significativa en el número de ingresos, egresos ni en el IRC. Conclusiones: la estrategia de FU disminuyó el promedio de días de estancia hospitalaria, el índice de sustitución de camas y la estancia prolongada.
Assuntos
Ocupação de Leitos , Hospitalização , Estudos Transversais , Humanos , Tempo de InternaçãoRESUMO
(1) Solar ultraviolet radiation (UVR) poses a major risk factor for developing skin cancer after years of chronic exposure. The irradiation is strongly dependent upon the activity or occupation carried out, but also on the climate conditions at the workplace. Knowledge of both has been tested within the occupational group of road construction workers in Colombia and Germany. (2) The GENESIS-UV measurement system has been used at both locations for consistency. A number of workers in both countries wore an electronic data logging dosimeter for several months to deliver detailed information on UVR exposure. (3) It was found that in a tropical climate, UVR exposure remains constant throughout the year, while in a temperate climate seasonal effects are visible, superimposed by behavioural aspects e.g., in springtime. The daily distribution of the radiation shows a distinct dip, especially in the Colombian data. Derived data show the high fraction of working days exceeding a threshold set by the skin type. (4) Road construction work involves high UVR exposure. In both countries, preventive measures are required to reduce the personal exposure to a minimum. Exceedance of the minimal erythema dose (MED) suggests a possible enhancing effect, especially in fair skinned people. Intercomparison of UVR exposure at workplaces is possible between countries and climate zones, emphasizing efforts for global action against skin cancer.
Assuntos
Indústria da Construção , Exposição Ocupacional , Neoplasias Cutâneas , Colômbia , Alemanha , Humanos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Clima Tropical , Raios Ultravioleta/efeitos adversosRESUMO
Residential use of natural gas (NG) for heating and cooking purposes may contribute significantly to CH emissions to the atmosphere. To analyze whether the NG demand in the city of Tandil, Argentina, contributes to the increase in atmospheric CH concentration, we conducted systematic collections of time-integrated air samples for a year in six city sites with different population and built-up density. Some meteorological parameters and NG consumption were registered. Atmospheric CH concentration ranged from 1.12 to 1.95 mg m (1.72 to 2.84 ppm) with significant seasonal and spatial variations. In all the sites, with the exception of a peri-urban site bordering rural areas, the maximum CH concentrations were measured during the coldest months, with a statistically significant correlation between residential and commercial NG consumption with respect to air temperature ( < 0.001, = -0.84 to -0.69) and atmospheric CH concentration ( < 0.05, = 0.58 to 0.94). In Argentina, the most popular home heating system is the balanced-draft heater, which has a thermal efficiency of 39 to 63%. This low efficiency allows us to attribute the highest atmospheric CH concentration found during the coldest months mainly to the leaks of the heating systems and the greater residential use of NG. Repairing the gas leaks by increasing thermal efficiency or replacing heating systems with more efficient ones will bring economic, environmental, and health benefits. This study is important for our country where the dependence on the use of NG from heating systems is significant.
Assuntos
Poluentes Atmosféricos , Gás Natural , Argentina , Cidades , Monitoramento Ambiental , Calefação , Metano , Estações do AnoRESUMO
Múltiples series de pieloplastia laparoscópica han demostrado altos niveles de éxito y escasas complicaciones para población adulta. El uso de robótica facilita la reconstrucción pieloureteral debido a la superioridad en cuanto a visión estereoscópica, precisión de movimientos y filtros anti temblor . Lo que permite además del éxito quirúrgico, una ventaja en términos de técnica mínimamente invasiva y consecuentemente menor estadía hospitalaria. El objetivo del presente video es demostrar la técnica utilizada en nuestro centro para pieloplastia robótica y mostrar una sistematización que simplifica el procedimiento.AU
Multiple series of laparoscopic pyeloplasty have demonstrated high success levels and few complications in the adult population. The use of robotics facilitates pyeloureteral reconstruction due to the superiority in stereoscopic vision, movement precision and anti-tremor filters. The previous provides not only surgical success but also an advantage in terms of minimally invasive technique and consequently less hospital stay. The objective of this video is to demonstrate the technique used in our facilities in robotic pyeloplasty and to show a systematization that simplifies the procedure.
Assuntos
Humanos , Estreitamento Uretral , Filme e Vídeo Educativo , Cirurgia Assistida por ComputadorRESUMO
Resumen Introducción: Los alimentos de origen animal frecuentemente están implicados en brotes de salmonelosis. Objetivo: Evaluar la frecuencia de Salmonella enterica en carnes molidas de pollo, res y cerdo (un total de 2.592 muestras) obtenidas de mercados sobre ruedas y supermercados de la Delegación Iztapalapa en la Ciudad de México, determinar la susceptibilidad antimicrobiana y efectuar ensayos de adherencia en las cepas aisladas. Métodos: El aislamiento de S. enterica se hizo de acuerdo a la BAM-FDA, la susceptibilidad antimicrobiana de acuerdo con CLSI y el ensayo de adherencia en células HEp-2 conforme a Baffone y cols., 2001. Resultados: Salmonella enterica fue aislada en 511 del total de muestras analizadas (19,7%), de las cuales 244 (47,7%), 152 (29,7%) y 115 (22,5%) correspondieron a carne molida de pollo, res y cerdo, respectivamente. La mayor frecuencia de resistencia de S. enterica a antimicrobianos fue a ampicilina y cloranfenicol en pollo, perfloxacina y ampicilina en res y carbenicilina, ampicilina, cloranfenicol, cefotaxima y perfloxacina en cerdo. Noventa por ciento de las cepas mostraron un patrón de adherencia agregativo. Conclusión: La frecuencia de S. enterica en productos cárnicos es alta, por lo que es importante la adecuada cocción de la carne para disminuir el riesgo de una salmonelosis.
Background: Food of animal origin is often involved in salmonellosis outbreaks. Aim: To evaluate the frequency of Salmonella enterica in chicken, beef and pork ground meat (a total of 2,592 samples) obtained from travelling markets and supermarkets at the Iztapalapa area of Mexico City, in order to determine the antimicrobial susceptibility and adherence capacity of isolated strains. Methods: Isolation of S. enterica was carried out according to the BAM-FDA, the microbial susceptibility according with CLSI and adherence assay on HEp-2 cell line according with Baffone et al., 2001. Results: S. enterica was isolated from 511 of all the analyzed samples (19.7%), from which 244 (47.7%), 152 (29.7%) and 115 (22.5%) corresponded to chicken, beef and pork ground meat, respectively. The highest frequency of resistance of S. enterica to antimicrobials was to ampicillin and chloramphenicol in chicken, perfloxacin and ampicillin in beef and carbenicillin, ampicillin, chloramphenicol, cefotaxime and perfloxacin in pork. Ninety percent of the strains showed an aggregative adherence pattern on HEp-2 cells. Conclusion: The frequency of S. enterica on meat products is high, which is the reason why a proper cooking of these ground meats is important in order to reduce the risk of acquiring salmonellosis.
Assuntos
Animais , Aves Domésticas/microbiologia , Aderência Bacteriana/fisiologia , Salmonella enterica/isolamento & purificação , Salmonella enterica/efeitos dos fármacos , Carne Vermelha/microbiologia , Antibacterianos/farmacologia , Suínos , Fatores de Tempo , Resistência Microbiana a Medicamentos , Bovinos , Testes de Sensibilidade Microbiana , Galinhas , Linhagem Celular Tumoral/microbiologia , Sorogrupo , Microbiologia de Alimentos , MéxicoRESUMO
BACKGROUND: Food of animal origin is often involved in salmonellosis outbreaks. AIM: To evaluate the frequency of Salmonella enterica in chicken, beef and pork ground meat (a total of 2,592 samples) obtained from travelling markets and supermarkets at the Iztapalapa area of Mexico City, in order to determine the antimicrobial susceptibility and adherence capacity of isolated strains. METHODS: Isolation of S. enterica was carried out according to the BAM-FDA, the microbial susceptibility according with CLSI and adherence assay on HEp-2 cell line according with Baffone et al., 2001. RESULTS: S. enterica was isolated from 511 of all the analyzed samples (19.7%), from which 244 (47.7%), 152 (29.7%) and 115 (22.5%) corresponded to chicken, beef and pork ground meat, respectively. The highest frequency of resistance of S. enterica to antimicrobials was to ampicillin and chloramphenicol in chicken, perfloxacin and ampicillin in beef and carbenicillin, ampicillin, chloramphenicol, cefotaxime and perfloxacin in pork. Ninety percent of the strains showed an aggregative adherence pattern on HEp-2 cells. CONCLUSION: The frequency of S. enterica on meat products is high, which is the reason why a proper cooking of these ground meats is important in order to reduce the risk of acquiring salmonellosis.
Assuntos
Antibacterianos/farmacologia , Aderência Bacteriana/fisiologia , Aves Domésticas/microbiologia , Carne Vermelha/microbiologia , Salmonella enterica/efeitos dos fármacos , Salmonella enterica/isolamento & purificação , Animais , Bovinos , Linhagem Celular Tumoral/microbiologia , Galinhas , Resistência Microbiana a Medicamentos , Microbiologia de Alimentos , México , Testes de Sensibilidade Microbiana , Sorogrupo , Suínos , Fatores de TempoRESUMO
INTRODUCCIÓN: El constante avance de la tecnología y el desarrollo de las técnicas mínimamente invasivas en cirugía robótica han dado mayores opciones de tratamiento quirúrgico a pacientes con Cáncer de Próstata. Debido a la complejidad anatómica y reducido espacio de la pelvis la cirugía robótica facilita realizar la prostatectomía . La superioridad técnica del sistema con robot en cuanto a visión, libertad de movimiento y precisión, permite una cirugía más segura además de mejorar resultados quirúrgicos, oncológicos y funcionales. El objetivo del presente video es demostrar la técnica utilizada en nuestro centro para prostatectomía radical robótica y mostrar una sistematización que simplifica el procedimiento. DESARROLLO: Se exponen las características del instrumento Madajet, así como su carga y armado. Se realiza el aislamiento y superficialización del conducto deferente derecho mediante técnica de tres dedos, en la cual el cirujano coloca sus dedos índice y medio en la cara posterior del escroto, fijando el deferente con el dedo pulgar en la cara anterior de la pared escrotal. Una vez aislado el deferente se realiza la anestesia local mediante del disparo del dispositivo sobre la pared anterior del escroto, repitiendo el proceso sobre el deferente izquierdo. Se realiza vasectomía sin bisturí mediante aislamiento del deferente en el rafe medio escrotal con clamp de anillo Li Brand®, con posterior punción y divulsión de la piel con pinza aguzada Li Brand® . Se efectúa la exteriorización del conducto deferente y posterior separación de éste de los vasos deferenciales, finalizando con la oclusión y sección del deferente. CONCLUSIONES: La vasectomía con técnica sin bisturí sin aguja con dispositivo Madajet es una cirugía sencilla y reproducible que simplifica y disminuye los costos del procedimiento, lo que podría producir una mayor masificación de la vasectomía como método de control de fertilidad.(AU)
Assuntos
Masculino , Prostatectomia , Filme e Vídeo Educativo , Procedimentos Cirúrgicos RobóticosRESUMO
The global methane (CH4) emission of lakes is estimated at between 6 and 16 % of total natural CH4 emissions. However, these values have a high uncertainty due to the wide variety of lakes with important differences in their morphological, biological, and physicochemical parameters and the relatively scarse data from southern mid-latitude lakes. For these reasons, we studied CH4 fluxes and CH4 dissolved in water in a typical shallow lake in the Pampean Wetland, Argentina, during four periods of consecutive years (April 2011-March 2015) preceded by different rainfall conditions. Other water physicochemical parameters were measured and meteorological data were reported. We identified three different states of the lake throughout the study as the result of the irregular alternation between high and low rainfall periods, with similar water temperature values but with important variations in dissolved oxygen, chemical oxygen demand, water turbidity, electric conductivity, and water level. As a consequence, marked seasonal and interannual variations occurred in CH4 dissolved in water and CH4 fluxes from the lake. These temporal variations were best reflected by water temperature and depth of the Secchi disk, as a water turbidity estimation, which had a significant double correlation with CH4 dissolved in water. The mean CH4 fluxes values were 0.22 and 4.09 mg/m2/h for periods with low and high water turbidity, respectively. This work suggests that water temperature and turbidity measurements could serve as indicator parameters of the state of the lake and, therefore, of its behavior as either a CH4 source or sink.
Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Lagos/química , Metano/análise , Chuva , Estações do Ano , Água , Argentina , Clima , Efeito Estufa , Soluções , Temperatura , Áreas AlagadasRESUMO
Health care organizations are unsafe. Numerous centers have incorporated the WHO Surgical Safety Checklist in their processes with good results; however, only limited information is available about its effectiveness in Latin America. We aimed to evaluate the impact of the checklist implementation on the in-hospital morbidity and mortality rate in a tertiary health care center. After Institutional review board approval, and using data from our hospital administrative records, we conducted a retrospective analysis of all surgical encounters (n = 70,639) over the period from January 2005 to December 2012. Propensity scoring (PS) methods (matching and inverse weighting) were used to compare the pre and postintervention period, after controlling for selection bias. After PS matching (n = 29,250 matched pairs), the in-hospital mortality rate was 0.82% [95% confidence interval (CI), 0.73-0.92] before and 0.65% (95% CI, 0.57-0.74) after checklist implementation [odds ratio (OR) 0.73; 95% CI, 0.61-0.89]. The median length of stay was 3 days [interquartile range (IQR), 1-5] and 2 days (IQR, 1-4) for the pre and postchecklist period, respectively (Pâ<â0.01).This is the first Latin American study reporting a decrease in mortality after the implementation of the WHO Surgical Checklist in adult surgical patients. This is a strong and simple tool to make health care safer, especially in developing countries.
Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Lista de Checagem/normas , Previsões , Fidelidade a Diretrizes , Complicações Pós-Operatórias/epidemiologia , Melhoria de Qualidade , Organização Mundial da Saúde , Chile/epidemiologia , Feminino , Mortalidade Hospitalar/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Razão de Chances , Complicações Pós-Operatórias/prevenção & controle , Pontuação de Propensão , Estudos RetrospectivosRESUMO
Introducción La pérdida de dientes se ha convertido en un problema de salud pública bucal. Objetivo Determinar la prevalencia y distribución del edentulismo, así como las variables sociodemográficas y socioeconómicas asociadas en individuos de 35 años y más. Materiales y métodos Se realizó un estudio transversal en 656 sujetos seleccionados de forma aleatoria. En el estudio se incluyeron hombres y mujeres de 35 años y más, asistentes a las clínicas de atención dental de la Universidad Autónoma del Estado de Hidalgo (UAEH), una universidad pública de México. Para la realización de este estudio los examinadores fueron capacitados en la cumplimentación de los cuestionarios y estandarizados en el criterio diagnóstico de la pérdida de dientes. La variable dependiente fue el edentulismo. Los datos fueron analizados en Stata 11. Resultados El promedio de edad fue de 49,06 ± 10,33. Los individuos fueron principalmente mujeres (63,3%). La prevalencia general de edentulismo fue de 15,7% (IC 95%: 12,9-18,5); entre las mujeres fue de 17,6% y en los hombres de 12,5% (p = 0,081). La prevalencia de edentulismo fue mayor entre los sujetos de más edad (p < 0,001). Se observó que a mayor escolaridad (p < 0,001), a mejor nivel socioeconómico (p < 0,001) y en quienes tuvieron automóvil en el hogar (p < 0,05), la prevalencia de edentulismo fue menor. Conclusiones La prevalencia de edentulismo en adultos mayores de 35 años que acuden a las clínicas de esta universidad fue del 15,7%. Se observó diferencia de la prevalencia de edentulismo por edad, pero no por sexo. Se observaron diferencias socioeconómicas, sugiriendo ciertas desigualdades en salud bucal.
Introduction Tooth loss has become a problem of oral health. Objective To determine the prevalence and distribution of edentulism, as well as the associated sociodemographic and socioeconomic variables in subjects aged 35 and older. Materials and methods A cross-sectional study was conducted on 656 randomly selected subjects. The study included men and women aged 35 years and older attending dental care clinics at a public university in Mexico. Examiners were trained in filling out questionnaires and receiving training in order to standardise the criteria of tooth loss. The dependent variable was the presence of edentulism. The data were analysed using Stata 11. Results The mean age of the population was 49.06 ± 10.33 years, and the majority (63.3%) were women. The overall prevalence of edentulism was 15.7% (95% CI: 12.9-18.5%); the prevalence among women was 17.6% and the prevalence among men was 12.5% (P = .081). The prevalence of edentulism was higher among older subjects (P < .001). The prevalence of edentulism was lower among individuals with higher levels of education (P < .001), those with higher socioeconomic status (P < .001), and those who had a car at home (P < 0.05) Conclusions The prevalence of edentulism in adults over 35 years of age attending dental care clinics at this public university was 15.7%. Differences were observed in the prevalence of edentulism by age, but not by gender. Socioeconomic differences were observed, suggesting certain oral health inequalities.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Perda de Dente/epidemiologia , Boca Edêntula/epidemiologia , Classe Social , Fatores Socioeconômicos , Prevalência , Estudos Transversais , Análise Multivariada , Distribuição por Idade e Sexo , México/epidemiologiaRESUMO
La estenosis pieloureteral (EPU) puede predisponer al desarrollo de nefrolitiasis debido a estasis urinaria. Inicialmente la endopielotomía percutánea fue la alternativa mínimamente invasiva de elección frente a la cirugía abierta para la resolución de los casos de EPU con nefrolitiasis concomitante. Sin embargo, el bajo éxito de la endopielotomía percutánea ha favorecido el uso de la laparoscopía convencional o asistida por robot para el tratamiento de las EPU. Se han reportado casos de pieloplastías laparoscópicas en los cuales se ha introducido un nefroscopio flexible a través de un trócar para resolver la nefrolitiasis por vía transpiélica. Acá reportamos nuestra experiencia en un caso.(AU)
The pelvi-ureter stenosis may predispose to the development of nephrolithiasis due to urinary stasis. Initially, a percutaneous endopyelotomy was minimally invasive alternative of choice versus open surgery for resolving cases of EPU with concomitant nephrolithiasis. However, the low success of percutaneous endopyelotomy has favored the use of conventional laparoscopy or robot-assisted treatment of the pelvi-ureter stenosis. There have been reports of laparoscopic pyeloplasty in which a flexible nephroscope is inserted through a trocar to solve nephrolithiasis by a transpielic via. Here we report our experience in one case.(AU)
Assuntos
Feminino , Nefrolitíase , Laparoscopia , Constrição Patológica , Filme e Vídeo EducativoRESUMO
BACKGROUND: Endoscopic submucosal dissection (ESD) is a minimally invasive procedure that allows curative treatment of early gastric cancer (EGC) in selected patients. AIM: To report our initial experience with ESD. MATERIAL AND METHODS: Analysis of prospective data from 16 patients aged 61 to 84 years, who underwent ESD between December 2011 and June 2014. Tumor type, operative time, hospitalization length, oncologic outcomes, complications and short-term follow up were registered. RESULTS: En-block resection was achieved in all cases. The median operative time was 135 min (range: 50-320 min). Specimens' median size was 3.5 cm (range: 3-10). All the resections were R0. In 14 patients ESD was considered curative. In two patients, ESD was considered potentially non-curative due to the presence pathological risk factors for lymph-node metastases in the biopsy specimen. Both patients underwent laparoscopic gastrectomy with lymph-node dissection. There was one case of gastric wall perforation that was repaired by laparoscopic suture. There was no mortality. The median follow-up time was 15 months (range: 2-30 months). CONCLUSIONS: ESD is a feasible and safe procedure in our institution with good results in this initial experience.
Assuntos
Adenocarcinoma/cirurgia , Dissecação/métodos , Gastrectomia/métodos , Mucosa Gástrica/cirurgia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Idoso , Intervalo Livre de Doença , Detecção Precoce de Câncer , Feminino , Seguimentos , Mucosa Gástrica/patologia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Duração da Cirurgia , Estudos Prospectivos , Neoplasias Gástricas/patologia , Resultado do TratamentoRESUMO
Background: Endoscopic submucosal dissection (ESD) is a minimally invasive procedure that allows curative treatment of early gastric cancer (EGC) in selected patients. Aim: To report our initial experience with ESD. Material and Methods: Analysis of prospective data from 16 patients aged 61 to 84 years, who underwent ESD between December 2011 and June 2014. Tumor type, operative time, hospitalization length, oncologic outcomes, complications and short-term follow up were registered. Results: En-block resection was achieved in all cases. The median operative time was 135 min (range: 50-320 min). Specimens' median size was 3.5 cm (range: 3-10). All the resections were R0. In 14 patients ESD was considered curative. In two patients, ESD was considered potentially non-curative due to the presence pathological risk factors for lymph-node metastases in the biopsy specimen. Both patients underwent laparoscopic gastrectomy with lymph-node dissection. There was one case of gastric wall perforation that was repaired by laparoscopic suture. There was no mortality. The median follow-up time was 15 months (range: 2-30 months). Conclusions: ESD is a feasible and safe procedure in our institution with good results in this initial experience.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma/cirurgia , Dissecação/métodos , Gastrectomia/métodos , Mucosa Gástrica/cirurgia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Intervalo Livre de Doença , Detecção Precoce de Câncer , Seguimentos , Mucosa Gástrica/patologia , Metástase Linfática , Estadiamento de Neoplasias , Duração da Cirurgia , Estudos Prospectivos , Neoplasias Gástricas/patologia , Resultado do TratamentoRESUMO
Objetivo: Determinar la gravedad de caries (tamaño de la lesión) y las variables asociadas en niños escolares mexicanos. Materiales y Métodos: Se realizó un estudio transversal en 1373 escolares de 6 a 12 años de edad inscritos en escuelas públicas de Campeche, México. Se distribuyeron cuestionarios para determinar una serie de variables sociodemográficas, socioeconómicas y conductuales. Se realizó un examen bucal a cada niño para establecer el tamaño de las lesiones de caries de acuerdo al índice llamado "criterio de magnitud de la lesión cariosa" y asignarlo de acuerdo al número de lesiones presentes a uno de 4 grupos de riesgo para desarrollar caries, en donde el primer grupo representa a los menos afectados. Se generó un modelo multivariado de regresión logística multinomial. Resultados: Los grupos de riesgo a caries quedaron distribuidos de la siguiente manera: 598 (43.6%) fueron del grupo 1; 261 (19.0%) se asignaron al grupo 2; 316 (23.0%) estuvieron en el grupo 3; y 198 (14.4%) en el grupo 4. Comparando con el grupo menos afectado por lesiones cariosas, las variables asociadas en los diferentes grupos de gravedad en el modelo multivariado fueron: grupo de riesgo 2: edad, sexo y defectos de desarrollo del esmalte; grupo de riesgo 3: atención dental en el último año, actitud de la madre hacia la salud bucal y defectos de desarrollo del esmalte; grupo de riesgo 4: edad, atención dental en el último año, actitud de la madre hacia la salud bucal y defectos de desarrollo del esmalte. Conclusión: La gravedad de caries está influenciada por variables demográficas, conductuales y clínicas.
Objective: To determine the severity of caries (lesion size) and associated variables in Mexican schoolchildren. Material and Methods: A cross-sectional study was conducted in 1373 schoolchildren 6-12 years old enrolled in public schools in Campeche, Mexico. Questionnaires were distributed to determine demographic, socioeconomic and behavioral variables. Dental examination was performed to each child to establish the size of caries lesions according "Criterion of carious lesion magnitude" index and to allocate according to the number of lesions present to one of four risk groups for developing cavities wherein the first group represents the least affected. A multivariate multinomial logistic regression model was generated. Results: Caries risk groups were distributed as follows: 598 (43.6%) were in group 1; 261 (19.0%) were assigned to group 2; 316 (23.0%) were in group 3; and 198 (14.4%) in group 4. Comparing with the least affected group by carious lesions, associated variables for severity in the multivariate model were "Risk Group 2": age, sex and developmental enamel defects; "Risk Group 3": dental care in the past year, mother's attitude toward oral health and developmental enamel defects; "Risk Group 4": age, dental care in the past year, mother's attitude toward oral health and developmental enamel defects. Conclusion: Severity of decay is influenced by demographic, behavioral and clinical variables.
Assuntos
Humanos , Criança , Saúde Bucal , Cárie Dentária , México , Saúde do Estudante , Esmalte Dentário , Gravidade do PacienteRESUMO
BACKGROUND: Bariatric surgery is the gold-standard treatment for morbid obesity because it has low morbidity rates in high-volume centers and generates long term sustained weight loss. AIM: To describe our experience in bariatric surgery since the creation of our bariatric program in 1992. MATERIAL AND METHODS: Retrospective analysis of all patients subjected to bariatric surgery from 1992 to December 2010. Data was obtained from the electronic institutional registry. The Procedures per-formed were open and laparoscopic Roux-en-Y gastric bypass (BPGA and BPGL, respectively), laparoscopic adjustable gastric band (BGAL) and laparoscopic sleeve gastrectomy (GML). RESULTS: A total of 4943 procedures were performed, 768 (16%) BPGA, 2558 (52%) BPGL, 199 (4%) BGAL and 1418 (29%) GML. The number of procedures progressively increased, from 100 cases in 2000 to over 700 cases in 2008. Proportion of femóles and preoperative mean body mass Índex fluctuated between 69 and 79% and 35 and 43 kg/m², respectively, among the different procedures. Early and late complications fluctuated between Oto 1% (higher on BPGA) and 3 to 32.7% (higher on BGAL), respectively. The excess weight lost at five years was 76.1% in BPGA, 92.5% in BPGL and 53.7% in BGAL. The figure for GML at three years was 73.7%. CONCLUSIONS: The complication rates of this series of patients are similar to those reported in large series abroad. BPGL is still the most effective procedure; however GML is an attractive alternative for less obese patients.