RESUMO
Background: The assessment of cranial foramina is an important part of the objective diagnostic and therapeutic study relevant to pathologies involving structures of the skull base. The study of the foramen ovale not only holds significance for anatomical development but also bears profound surgical importance, such as in trigeminal neuralgia, and diagnostic importance in tumors and various types of epilepsy. It becomes relevant in fine-needle aspiration techniques in perineural tumor procedures, for electroencephalographic analysis in seizures, and therapeutic procedures such as percutaneous trigeminal rhizotomy for trigeminal neuralgia. Methods: A cross-sectional study at the Department of Neurosurgery, Specialties Hospital, La Raza National Medical Center, Mexico City, involved 70 patients aged >18 years who underwent a single skull computed tomography scan between July 2023 and March 2024. Patients with sufficient scan quality and optimal visualization of skull base foramina were included in the study. Measurements of tomographic images were taken using Inobitec's DICOM file viewer. Data analysis in Microsoft Excel yielded mean, standard deviation, and 95% confidence interval (CI) for morphometric parameters of the foramen ovale. Results: Analysis of tomographies from 70 patients revealed a total of 140 foramen ovale, evenly split between 25 males (35.7%) and 45 females (64.3%). The measurements for the maximum anteroposterior diameter, transverse diameter, and surface area of all foramina were as follows: 6.61 ± 0.25 mm (95% CI), 3.97 ± 0.21 mm (95% CI), and 20.84 ± 1.58 mm2 (95% CI), respectively. Specific measurements for the right and left sides were obtained: for the right side, 6.59 ± 0.26 mm (95% CI) and 3.89 ± 0.21 mm (95% CI) for the maximum anteroposterior and transverse diameters, respectively, and 20.38 ± 1.62 mm2 (95% CI) for the surface area. For the left side, the measurements were 6.63 ± 0.24 mm (95% CI), 4.05 ± 0.21 mm (95% CI), and 21.31 ± 1.55 mm2 (95% CI) for the maximum anteroposterior diameter, transverse diameter, and surface area, respectively. The maximum and minimum dimensions for anteroposterior and transverse diameters were 10.67 mm, 4.41 mm, 7.09 mm and 2.36 mm, respectively, with a corresponding range for the surface area of 10.16 mm2-44.13 mm2. The average minimum distance between the foramen ovale and the foramen spinosum was 2.32 ± 0.24 mm (95% CI). In males, the average size of the foramen ovale was 23.66 ± 1.61, which was 22% larger than the average size in females (19.28 ± 1.45) (P = 0.0001). Conclusion: The foramen ovale is one of the main anatomical structures of the skull base, and besides that, it is complex and not directly accessible for clinical evaluation, useful information can be obtained through morphometric analysis. The present study provides specific anatomical data with morphological patterns to increase the understanding of the characteristics of the foramen ovale in the Mexican population. These are intended to be helpful in the pursuit of acknowledging the morphometrics and thus being able to plan neurosurgical procedures in the middle cranial fossa.
RESUMO
Resumen Introducción: la COVID-19 es una enfermedad aguda del tracto respiratorio causada por el coronavirus SARS-CoV-2. A pesar de que han surgido algunas opciones quimioprofilácticas, aún no existe un tratamiento efectivo contra esta enfermedad. Objetivo: investigar las propiedades antivirales de las nanopartículas de plata sintetizadas contra SARS-CoV-2 usando modelos in vitro. Metodología: en este estudio se sintetizaron AgNPs por medio de un método electroquímico. La caracterización de las AgNPs se realizó mediante técnicas físicoquímicas (ICP-OES, espectroscopía UV-Vis, y microscopía electrónica de transmisión). El efecto citotóxico y la actividad antiviral de las AgNPs contra SARS-CoV-2 se evaluó in vitro en células Vero E6. La viabilidad celular se evaluó en presencia de diluciones seriadas de AgNPs mediante el ensayo de MTT. Adicionalmente, el efecto antiviral contra el SARS-CoV-2 fue evaluado por ensayo de placa en células Vero E6 bajo la estrategia prepostratamiento. El diámetro de las AgNPs estuvo entre 2,6 y 30 nm. El tamaño promedio obtenido por los métodos electroquímicos fue de 6,2 nm. Resultados: el efecto citotóxico fue observado a concentraciones por encima de 0,07 ppm. Cuando se empleó la estrategia pre-postratamiento con las AgNPs se observó una reducción significativa del título de SARS-CoV-2 con porcentajes de inhibición del 96,5 %, 64,13 % y 74,72 % en las concentraciones de 0,03, 0,017 y 0,008 ppm, respectivamente. Conclusión: nuestros resultados sugieren que las AgNPs podrían reducir la replicación del SARS-CoV-2, con un bajo efecto citotóxico. Sin embargo, se requieren estudios adicionales tanto in vitro como in vivo para definir su potencial terapéutico en humanos.
Abstract Introduction: COVID-19 is an acute respiratory tract disease caused by the emerging coronavirus SARS-CoV-2. Although several options for chemoprophylaxis are under development, effective treatment for COVID-19 is not yet available. Objective: To investigate the antiviral properties of synthesized silver nanoparticles (AgNPs) against SARS-CoV-2 using in vitro models. Materials and methods: This work synthesized AgNPs using an electrochemical method and characterized them using physico-chemical techniques (ICP-OES, ultraviolet-visible spectroscopy, and transmission electron microscopy). AgNPs with diameter sizes ranging between 2.6 to 30 nm and an average size of 6.2 nm were obtained by the electrochemical method. The cytotoxic effect and the antiviral activity of prepared AgNPs against SARS-CoV-2 were evaluated in vitro using Vero E6 cells. Cell viability was evaluated by MTT assay in the presence of serial dilutions of AgNPs. The antiviral effect of AgNPs was evaluated before and after the infection of Vero E6 cells by plaque assay. Results: Cytotoxic effect was observed at concentrations above 0.07 ppm. AgNPs exhibit a significant reduction of SARS-CoV-2 viral titer after a prepost treatment strategy with inhibition of 96.5%, 64.13%, and 74.72% at 0.03, 0.017, and 0.008 ppm, respectively. Conclusion: Our results suggest that AgNPs could reduce SARS-CoV-2 replication with a low cytotoxic effect. Still, additional in vitro and in vivo studies are required to define its potential therapeutic application in humans.
RESUMO
The pepper weevil Anthonomus eugenii is one of the most damaging pests to the pepper crop. To offer alternative management strategies to insecticides, several studies have identified the semiochemicals that are involved in the pepper weevil's aggregation and mating behavior; however, there is no information on its perireceptor molecular mechanism, to date. In this study, bioinformatics tools were used to functionally annotate and characterize the A. eugenii head transcriptome and their probable coding proteins. We identified twenty-two transcripts belonging to families related to chemosensory processes, seventeen corresponding to odorant-binding proteins (OBP), and six to chemosensory proteins (CSP). All results matched with closely related Coleoptera: Curculionidae homologous proteins. Likewise, twelve OBP and three CSP transcripts were experimentally characterized by RT-PCR in different female and male tissues. The results by sex and tissue display the different expression patterns of the AeugOBPs and AeugCSPs; some are present in both sexes and all tissues, while others show expressions with higher specificity, which suggests diverse physiological functions in addition to chemo-detection. This study provides information to support the understanding of odor perception in the pepper weevil.
Assuntos
Besouros , Inseticidas , Receptores Odorantes , Gorgulhos , Humanos , Animais , Masculino , Feminino , Gorgulhos/genética , Besouros/genética , Odorantes , Transcriptoma , Proteínas de Insetos/genética , Receptores Odorantes/metabolismo , Filogenia , Perfilação da Expressão GênicaRESUMO
Insect chemosensory systems, such as smell and taste, are mediated by chemosensory receptor and non-receptor protein families. In the last decade, many studies have focused on discovering these families in Tephritidae species of agricultural importance. However, to date, there is no information on the Mexican fruit fly Anastrepha ludens Loew, a priority pest of quarantine importance in Mexico and other countries. This work represents the first effort to identify, classify and characterize the six chemosensory gene families by analyzing two head transcriptomes of sexually immature and mature adults of A. ludens from laboratory-reared and wild populations, respectively. We identified 120 chemosensory genes encoding 31 Odorant-Binding Proteins (OBPs), 5 Chemosensory Proteins (CSPs), 2 Sensory Neuron Membrane Proteins (SNMPs), 42 Odorant Receptors (ORs), 17 Ionotropic Receptors (IRs), and 23 Gustatory Receptors (GRs). The 120 described chemosensory proteins of the Mexican fruit fly significantly contribute to the genetic databases of insects, particularly dipterans. Except for some OBPs, this work reports for the first time the repertoire of olfactory proteins for one species of the genus Anastrepha, which provides a further basis for studying the olfactory system in the family Tephritidae, one of the most important for its economic and social impact worldwide.
Assuntos
Receptores Odorantes , Tephritidae , Animais , Perfilação da Expressão Gênica , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Receptores Odorantes/genética , Receptores Odorantes/metabolismo , Olfato , Tephritidae/genética , Tephritidae/metabolismo , TranscriptomaRESUMO
OBJECTIVE: To contribute to the training of specialists by describing in a systematic and detailed way the ten steps to perform a safe and feasible Total Laparoscopic Hysterectomy (HTL). METHOD: The detailed description of the steps of the HTL intends that this procedure can be safely and effectively reproduced. RESULTS: By clearly knowing the steps of HTL, it is possible to favor minimally invasive routes so that patients benefit from its multiple proven benefits. CONCLUSIONS: The benefits of minimally invasive routes for performing a hysterectomy have already been demonstrated in the literature. It is particularly important that specialists are familiar with these techniques and that groups standardize the procedure so that more patients can safely undergo and benefit from the laparoscopic approach.
OBJETIVO: Contribuir a la formación de los especialistas describiendo de manera sistemática y pormenorizada los diez pasos para realizar una histerectomía total por laparoscopia (HTL) segura y reproducible. MÉTODO: La descripción detallada de los pasos de la HTL pretende que este procedimiento pueda ser reproducido de manera segura y efectiva. RESULTADOS: Al conocer claramente los pasos de la HTL es posible favorecer las rutas de mínima invasión para que las pacientes se beneficien de sus múltiples beneficios demostrados. CONCLUSIONES: Los beneficios de las rutas mínimamente invasivas para la realización de una histerectomía ya han sido demostrados en la literatura. En muy importante que los especialistas estén familiarizados con estas técnicas y que los grupos estandaricen el procedimiento para que más pacientes puedan ser intervenidas de manera segura y se beneficien de la vía laparoscópica.
Assuntos
Laparoscopia , Feminino , Humanos , Histerectomia , EspecializaçãoRESUMO
Abstract Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.
Resumen Introducción: Las complicaciones postanestésicas, especialmente las respiratorias, siguen siendo causa de preocupación por su alta frecuencia, en particular, en la población pediátrica. Objetivo: Describir la incidencia de complicaciones respiratorias en la unidad de cuidados postanestésicos de una institución de mediana complejidad, en un período de seis meses y explorar las variables relacionadas con las complicaciones respiratorias mayores. Materiales y métodos: Estudio de cohorte retrospectivo, basado en la valoración de historias clínicas. Se revisaron los registros de la unidad de cuidados postanestésicos de una institución pediátrica de mediana complejidad ubicada en Medellín. Esta institución utiliza un modelo de atención -basado en enfermería- que incluye la extubación del paciente en la unidad de cuidados postanestésicos. Resultados: Se analizaron los registros de 1181 pacientes. La incidencia acumulada de complicaciones mayores fue: broncoespasmo 1,44 %, laringoespasmo 0,68 % y depresión respiratoria 0,59 %. No se presentaron casos de paro cardiaco ni de edema agudo de pulmón. El antecedente de infección respiratoria menor a 15 días, rinitis y sexo femenino se asociaron con complicaciones respiratorias mayores. Conclusiones: Durante la atención en la unidad de cuidados postanestésicos por parte del personal de enfermería entrenado en la recuperación de la anestesia y de la vía aérea de los pacientes pediátricos, se encontró una baja frecuencia de complicaciones respiratorias.
Assuntos
Humanos , Masculino , Feminino , Edema Pulmonar , Insuficiência Respiratória , Anestesia , Anestésicos , Espasmo Brônquico , Rinite , Laringismo , Estudos de Coortes , Colômbia , Edema , Parada Cardíaca , Infecções , Recursos Humanos de EnfermagemRESUMO
Introducción. Se desconoce el estado de la investigación en educación médica en cirugía general (IEMC) en Colombia en el siglo XXI. El objetivo de esta revisión bibliométrica de la literatura es realizar un análisis de las publicaciones relacionadas con la IEMC en Colombia a partir del año 2000. Métodos. Se incluyeron artículos originales, escritos en español o inglés, publicados por grupos de investigación que cuentan al menos con un investigador colombiano como autor principal o coautor. Se definieron variables demográficas e indicadores bibliométricos para cada estudio y autor. Resultados. Un total de 63 estudios fueron incluidos. Estas publicaciones se enfocaron predominantemente en investigación sobre bienestar, enseñanza clínica y simulación a nivel de postgrado. El 36 % de los artículos sobre IEMC fueron publicados en revistas sin indexación (ISI/SCOPUS); 13 artículos (20,6 %) fueron publicados en re-vistas en el cuartil 1 (Q1). El promedio de citas por artículo fue 9,3.Discusión. La producción intelectual en educación en cirugía en Colombia tiene bajo impacto a nivel internacional. Los hallazgos encontrados pueden ser utilizados para organizar y priorizar la investigación en educación quirúrgica en el país
Introduction. The state of research in medical education in general surgery (IEMC) in Colombia in the XXI century is unknown. The objective of this bibliometric review of the literature is to conduct an analysis of the publications related to the IEMC in Colombia from the year 2000.Methods. Original articles, written in Spanish or English, published by research groups that have at least one Co-lombian researcher as main author or co-author, were included. Demographic variables and bibliometric indicators were defined for each study and author.Results. A total of 63 studies were included. Publications predominantly focused on wellness research, clinical teaching, and simulation at the graduate level; 36% of the articles on IEMC were published in non-indexed journals (ISI / SCOPUS), 13 articles (20.6%) were published in journals in quartile 1 (Q1). The average number of citations per article was 9.3.Discussion. Intellectual production in Colombian surgery education shows low impact at international level. These findings can be used to prioritize research in surgical education in the country
Assuntos
Humanos , Educação Médica , Programas de Pós-Graduação em Saúde , Pesquisa , Cirurgia Geral , Bibliometria , Fator de ImpactoRESUMO
OBJECTIVE: To describe intra and postoperative complications of total laparoscopic hysterectomy (TLH) for benign uterine pathology and to compare with other hospitals with large volumes of laparoscopic hysterectomies. METHODS: Retrospective cohort study of women who underwent TLH for benign gynecological pathology between 2007 and 2017 in a private high complexity institution that serves populations covered by contributive and state-subsidized insurance in Pereira, Colombia. The procedures were performed by the group of surgeons of the ALGIA training center. Consecutive sampling was used. Sociodemographic and baseline clinical characteristics, intra-operative findings and intra- and post-operative complications are described. Descriptive statistics were used. RESULTS: A total of 1.350 patients were included during the study period. Surgical time was 95 minutes (SD ± 31), blood loss 88 cc (SD ± 66), and average uterine weight was 236 g (SD ± 133); 96.5% of the patients were assessed within the next 30 to 45 days; 3.48% had minor complications and 2.5% had major complications; 3 patients were converted to laparotomy. There were no deaths in the study sample. CONCLUSIONS: TLH is a safe procedure and the rate of complications is similar to the best international standards. Further prospective studies using objective criteria are important in order to compare the performance of different groups and institutions offering surgical procedures and training.
TITULO: SEGURIDAD DE LA HISTERECTOMÍA TOTAL POR LAPAROSCOPIA ENTRE EL 2007 Y 2017 EN UN HOSPITAL DE ALTA COMPLEJIDAD, PEREIRA, COLOMBIA. ESTUDIO DE COHORTE. OBJETIVO: Describir las complicaciones intra y posoperatorias de la histerectomía total por laparoscopia (HTL) para patología benigna del útero y hacer una comparación con otros hospitales que tienen altos volúmenes de HTL. METODOS: Estudio de cohorte retrospectivo en mujeres que se sometieron a HTL por patología ginecológica benigna entre 2007 y 2017 en una institución privada de alta complejidad, que atiende población perteneciente al régimen contributivo y subsidiado por el Estado en el Sistema General de Seguridad Social, en Pereira, Colombia, por el grupo de cirujanos del centro de entrenamiento ALGIA. Muestreo consecutivo. Se describen la características sociodemográficas y clínicas basales, los hallazgos intraoperatorios y las complicaciones intra y posoperatorias. Se usó estadística descriptiva. RESULTADOS: en el periodo de estudio se incluyeron 1.350 pacientes. El tiempo quirúrgico fue de 95 min (DE ± 31), el sangrado quirúrgico 88 cc (DE ± 66), el peso promedio del útero fue de 236 g (DE ± 133). El 96,5 % de las pacientes fueron evaluadas entre los 30 y 45 días. El 3,48 % de las pacientes tuvieron complicaciones menores y el 2,5 % complicaciones mayores. Tres pacientes requirieron conversión a laparotomía (0,23%). No hubo mortalidad en la muestra estudiada. CONCLUSIONES: la HTL es un procedimiento seguro y la tasa de complicaciones es similar a la de los mejores estándares internacionales. Es importante que se sigan haciendo estudios prospectivos con criterios objetivos de evaluación para comparar el desempeño de los diferentes grupos e instituciones que ofrecen procedimientos quirúrgicos y entrenamiento.
Assuntos
Histerectomia/métodos , Complicações Intraoperatórias/epidemiologia , Laparoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica , Estudos de Coortes , Colômbia , Feminino , Humanos , Histerectomia/efeitos adversos , Laparoscopia/efeitos adversos , Laparotomia/estatística & dados numéricos , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Doenças Uterinas/cirurgia , Adulto JovemRESUMO
OBJECTIVE: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. METHODS: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. RESULTS: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. CONCLUSIONS: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.
OBJETIVO: Establecer recomendaciones para la toma de decisiones de manejo en radioterapia durante la pandemia de COVID-19, adaptadas a un país con recursos de salud limitados. MÉTODOS: A través de una revisión rápida de la literatura se buscaron publicaciones que describieran medidas para reducir el riesgo de infección por COVID-19, así como también pautas de manejo para reducir la carga de trabajo en las unidades de radioterapia. Se incluyeron en el alcance de esta revisión las siguientes patologías: tumores ginecológicos, cáncer de mama, tumores gastrointestinales, tumores genitourinarios, tumores de cabeza y cuello, cáncer de piel, tumores del sistema nervioso central y linfomas. Un grupo de expertos discutió en línea los datos extraídos y redactó las recomendaciones. Mediante un método Delphi modificado, se evaluó el consenso entre 14 radio-oncólogos certificados. Se evaluó la calidad de la evidencia que sustentó las recomendaciones sobre esquemas de tratamiento. RESULTADOS: Se incluyeron un total de 57 documentos. De 25 trabajos se extrajeron las estrategias para reducir el riesgo de infección. De los restantes, se obtuvieron las recomendaciones para cada patología. Las recomendaciones están orientadas a establecer escenarios específicos donde se pueden omitir, diferir, priorizar y acortar los tratamientos. En el ítem de acortar se recomiendan esquemas de tratamiento para cada patología, priorizando los esquemas hipofraccionados cuando fue posible. CONCLUSIÓN: Se plantean estrategias para la gestión de los servicios de radioterapia con el objetivo de garantizar que los tratamientos de alta calidad para pacientes oncológicos sigan entregándose, pese a la crisis sanitaria ocasionada por COVID-19.
Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/estatística & dados numéricos , Carga de Trabalho , COVID-19 , Infecções por Coronavirus/prevenção & controle , Técnica Delphi , Desinfecção/métodos , Física Médica , Humanos , Higiene/normas , Neoplasias/radioterapia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/veterinária , Cuidados Paliativos/organização & administração , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade)/organização & administração , SARS-CoV-2 , Triagem/organização & administraçãoRESUMO
RESUMEN Objetivo: describir las complicaciones intra y posoperatorias de la histerectomía total por laparoscopia (HTL) para patología benigna del útero y hacer una comparación con otros hospitales que tienen altos volúmenes de HTL. Materiales y métodos: estudio de cohorte retrospectivo en mujeres que se sometieron a HTL por patología ginecológica benigna entre 2007 y 2017 en una institución privada de alta complejidad, que atiende población perteneciente al régimen contributivo y subsidiado por el Estado en el Sistema General de Seguridad Social, en Pereira, Colombia, por el grupo de cirujanos del centro de entrenamiento ALGIA. Muestreo consecutivo. Se describen la características sociodemográficas y clínicas basales, los hallazgos intraoperatorios y las complicaciones intra y posoperatorias. Se usó estadística descriptiva. Resultados: en el periodo de estudio se incluyeron 1.350 pacientes. El tiempo quirúrgico fue de 95 min (DE ± 31), el sangrado quirúrgico 88 cc (DE ± 66), el peso promedio del útero fue de 236 g (DE ± 133). El 96,5 % de las pacientes fueron evaluadas entre los 30 y 45 días. El 3,48 % de las pacientes tuvieron complicaciones menores y el 2,5 % complicaciones mayores. Tres pacientes requirieron conversión a laparotomía (0,23%). No hubo mortalidad en la muestra estudiada. Conclusión: la HTL es un procedimiento seguro y la tasa de complicaciones es similar a la de los mejores estándares internacionales. Es importante que se sigan haciendo estudios prospectivos con criterios objetivos de evaluación para comparar el desempeño de los diferentes grupos e instituciones que ofrecen procedimientos quirúrgicos y entrenamiento.
ABSTRACT Objective: To describe intra and postoperative complications of total laparoscopic hysterectomy (TLH) for benign uterine pathology and to compare with other hospitals with large volumes of laparoscopic hysterectomies. Materials and Methods: Retrospective cohort study of women who underwent TLH for benign gynecological pathology between 2007 and 2017 in a private high complexity institution that serves populations covered by contributive and state-subsidized insurance in Pereira, Colombia. The procedures were performed by the group of surgeons of the ALGIA training center. Consecutive sampling was used. Sociodemographic and baseline clinical characteristics, intra-operative findings and intra- and post-operative complications are described. Descriptive statistics were used. Results: A total of 1.350 patients were included during the study period. Surgical time was 95 minutes (SD ± 31), blood loss 88 cc (SD ± 66), and average uterine weight was 236 g (SD ± 133); 96.5% of the patients were assessed within the next 30 to 45 days; 3.48% had minor complications and 2.5% had major complications; 3 patients were converted to laparotomy. There were no deaths in the study sample. Conclusion: TLH is a safe procedure and the rate of complications is similar to the best international standards. Further prospective studies using objective criteria are important in order to compare the performance of different groups and institutions offering surgical procedures and training.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Laparoscopia , Histerectomia , Estudos de Coortes , HospitaisRESUMO
Resumen Objetivo: Describir la percepción que tienen adolescentes escolarizados entre 12 y 16 años, en Piedecuesta (Santander), en 2016, sobre los facilitadores y las barreras que influyen en la práctica de la actividad física. Metodología: Análisis cualitativo desde un enfoque fenomenológico, con la participación de 20 adolescentes escolarizados que, mediante entrevistas semiestructuradas y un grupo focal, conversaron sobre la práctica, los beneficios, los entornos y la influencia y la compañía en relación con la actividad física, para identificar barreras y facilitadores. Resultados: La práctica de la actividad física se limitaba a las clases de educación física en la mayoría de los casos. El compañero principal en la práctica extracurricular era el padre del mismo sexo. La actividad física representaba una oportunidad para el disfrute, mejorar la salud física y mental, así como la contextura corporal, y para romper con la rutina diaria. La falta de tiempo por compromisos académicos fue la razón principal para no realizar actividad física. Los lugares públicos no siempre estaban disponibles, a menudo no se consideraban seguros. En la escuela, el espacio y las instalaciones eran inadecuados, y el uso estaba restringido. Conclusiones: La escuela es un punto de convergencia importante para la práctica de la actividad física, lo que sugiere la necesidad de fortalecer el plan de estudios al respecto; este entorno es un facilitador potencial para aumentar el nivel de actividad física en adolescentes. También se percibe como barrera, dado que la práctica interfiere con las actividades académicas. Las mejoras en la seguridad y el atractivo estético en el entorno comunitario se visibilizan como un facilitador para promover la actividad física.
Abstract Objective: Describe the perception of adolescents aged between 12 and 16 years, in Piedecuesta (Santander), in 2016, about the facilitators and barriers that influence physical activity. Methodology: Qualitative analysis from a phenomenological approach, with the participation of 20 adolescents who talked about the practice, benefits, environments, influence and company in connection with physical activity , to identify barriers and facilitators, through semi-structured interviews and a focus group. Results: Physical activity was limited to physical education classes in most cases. The main companion in extracurricular physical activity was the parent of the same sex. Physical activity represented an opportunity for enjoyment, improvement of physical and mental health, as well as body composition, and to have a break in their daily routine. Lack of time due to academic commitments was the main reason for not doing physical activity. Public places were not always available and they were often not considered to be safe. Space and facilities at school were inadequate, and their use was restricted.. Conclusions: The school is an important point of convergence for doing physical activity, suggesting the need to strengthen the curriculum in this respect; this environment is a potential facilitator to increasing the level of physical activity in adolescents. It can also be seen as a barrier, given that the practice interferes with academic activities. Improvements in safety and aesthetic appeal in the surrounding community are seen as a facilitator to promoting physical activity.
Resumo Objetivo: Descrever a percepção que os adolescentes entre 12 e 17 anos de Piedecuesta em Santander, tiveram em 2016 sobre os facilitadores e as barreiras que influenciaram na prática da atividade física. Metodologia: Análise qualitativa partindo de um foco fenomenológico, com a participação de 20 adolescentes em idade escolar que, através de entrevistas semiestruturadas e um grupo focal, conversaram sobre a prática, os benefícios, os entornos, a influência e o acompanhamento relacionados com a atividade física, para identificar barreiras e facilitadores. Resultados: Na maioria dos casos, a prática da atividade física limitava-se às aulas de educação física. O companheiro principal na prática extracurricular era o genitor ou genitora do mesmo sexo. A atividade física representava uma oportunidade para disfrutar, melhorar a saúde física e mental, além da estrutura corporal e para sair da rotina diária. A falta de tempo devido às responsabilidades escolares foi a principal razão para não realizarem atividade física. Os lugares públicos nem sempre estavam disponíveis e geralmente não são considerados seguros. Na escola, o espaço e as instalações eram inadequados e o uso estava restrito. Conclusões: A escola é um importante ponto de convergência para a prática da atividade física, o que determina a necessidade de fortalecer o currículo relacionado; esse ambiente é um facilitador potencial para aumentar o nível de atividade física nos adolescentes. Também se percebe como barreira, já que a prática interfere com as atividades escolares. As melhorias na segurança e um espaço comunitário mais atraente do ponto de vista estético são determinantes como facilitadores para a promoção da atividade física.
RESUMO
OBJETIVO: Establecer recomendaciones para la toma de decisiones de manejo en radioterapia durante la pandemia de COVID-19, adaptadas a un país con recursos de salud limitados. MÉTODOS: A través de una revisión rápida de la literatura se buscaron publicaciones que describieran medidas para reducir el riesgo de infección por COVID-19, así como también pautas de manejo para reducir la carga de trabajo en las unidades de radioterapia. Se incluyeron en el alcance de esta revisión las siguientes patologías: tumores ginecológicos, cáncer de mama, tumores gastrointestinales, tumores genitourinarios, tumores de cabeza y cuello, cáncer de piel, tumores del sistema nervioso central y linfomas. Un grupo de expertos discutió en línea los datos extraídos y redactó las recomendaciones. Mediante un método Delphi modificado, se evaluó el consenso entre 14 radio-oncólogos certificados. Se evaluó la calidad de la evidencia que sustentó las recomendaciones sobre esquemas de tratamiento. RESULTADOS: Se incluyeron un total de 57 documentos. De 25 trabajos se extrajeron las estrategias para reducir el riesgo de infección. De los restantes, se obtuvieron las recomendaciones para cada patología. Las recomendaciones están orientadas a establecer escenarios específicos donde se pueden omitir, diferir, priorizar y acortar los tratamientos. En el ítem de acortar se recomiendan esquemas de tratamiento para cada patología, priorizando los esquemas hipofraccionados cuando fue posible. CONCLUSIÓN: Se plantean estrategias para la gestión de los servicios de radioterapia con el objetivo de garantizar que los tratamientos de alta calidad para pacientes oncológicos sigan entregándose, pese a la crisis sanitaria ocasionada por COVID-19.
OBJECTIVE: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. METHODS: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. RESULTS: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. CONCLUSIONS: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.
Assuntos
Humanos , Carga de Trabalho , Radioterapia (Especialidade)/estatística & dados numéricos , Consenso , Países em Desenvolvimento/estatística & dados numéricos , SARS-CoV-2 , COVID-19/epidemiologia , Cuidados Paliativos/organização & administração , Desinfecção/métodos , Higiene/normas , Triagem/organização & administração , Técnica Delphi , Radioterapia (Especialidade)/organização & administração , Pandemias/prevenção & controle , Equipamento de Proteção Individual , COVID-19/prevenção & controle , Física Médica , Neoplasias/radioterapia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/veterináriaRESUMO
Objective: Describe the intraoperative findings, procedures and the safety of laparoscopic surgical management of Deep Infiltration Endometriosis (DIE). Materials and methods: A descriptive historical cohort study of patients with suspected pre-surgical diagnosis of DIE due to clinical findings, pelvic ultrasound or magnetic resonance imaging and histological confirmation of the disease. The patients were taken to minimally invasive surgery between 2007 and 2016 in a reference health institution located in Pereira, Colombia. Sociodemographic, clinical, intraoperative findings, types of procedure performed, intra and postoperative complications and post-surgical pain levels at 6 weeks were evaluated. A descriptive analysis was performed. Results: One hundred and sixty seven patients were included. The most frequent location of the disease was the recto-vaginal septum (85.7 %). A total of 83 patients (49.7 %) had bowel endometriosis. Of these, 86 % had a shaving and 13.2 % segmental bowel resection. Four patients (2.4 %) had intraoperative complications. One was converted to laparotomy and other five (2.9 %) had post-surgical infection. Conclusions: Laparoscopic management of DIE is an option to be considered with a 5% of complication frequency. Randomized studies with a control group are required for a better evaluation of safety and efficacy.
Objetivo: describir los hallazgos intraoperatorios, los procedimientos realizados y la seguridad del manejo quirúrgico por vía laparoscópica de la endometriosis infiltrativa profunda (EIP). Materiales y métodos: cohorte histórica descriptiva. Ingresaron pacientes con sospecha diagnóstica prequirúrgica de EIP por hallazgos clínicos, ultrasonido pélvico o imágenes de resonancia magnética y con confirmación histológica de la enfermedad. Las pacientes fueron llevadas a cirugía mínimamente invasiva entre 2007 y 2016, en una institución de salud de referencia ubicada en Pereira, Colombia. Se evaluaron variables sociodemográficas, clínicas, hallazgos intraoperatorios, tipos de procedimientos realizados, complicaciones intra y posoperatorias y control del dolor a las 6 semanas. Se hace un análisis descriptivo. Resultados: se incluyeron 167 pacientes. La localización más frecuente de la enfermedad fue el tabique recto-vaginal (85,7 %). Un total de 83 pacientes (49,7 %) presentaron endometriosis intestinal. De estas, al 86 % se les realizó shaving (afeitado o nodulectomía), y al 13,2 % resección intestinal segmentaria. Un total de 4 pacientes (2,4 %) presentaron complicaciones intraoperatorias, de las cuales una requirió laparoconversión y otras 5 pacientes (2,9 %) desarrollaron complicaciones posoperatorias. Conclusiones: el manejo laparoscópico de la EIP es una alternativa por considerar, con una frecuencia de complicaciones cercana al 5 %. Se requieren estudios aleatorizados con grupo control para una mejor evaluación de la seguridad y eficacia.
Assuntos
Endometriose/cirurgia , Laparoscopia/métodos , Pelve/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Adulto , Estudos de Coortes , Colômbia , Endometriose/diagnóstico por imagem , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Laparoscopia/efeitos adversos , Imageamento por Ressonância Magnética , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Ultrassonografia , Adulto JovemRESUMO
RESUMEN Objetivo: describir los hallazgos intraoperatorios, los procedimientos realizados y la seguridad del manejo quirúrgico por vía laparoscópica de la endometriosis infiltrativa profunda (EIP). Materiales y métodos: cohorte histórica descriptiva. Ingresaron pacientes con sospecha diagnóstica prequirúrgica de EIP por hallazgos clínicos, ultrasonido pélvico o imágenes de resonancia magnética y con confirmación histológica de la enfermedad. Las pacientes fueron llevadas a cirugía mínimamente invasiva entre 2007 y 2016, en una institución de salud de referencia ubicada en Pereira, Colombia. Se evaluaron variables sociodemográficas, clínicas, hallazgos intraoperatorios, tipos de procedimientos realizados, complicaciones intra y posoperatorias y control del dolor a las 6 semanas. Se hace un análisis descriptivo. Resultados: se incluyeron 167 pacientes. La localización más frecuente de la enfermedad fue el tabique recto-vaginal (85,7 %). Un total de 83 pacientes (49,7 %) presentaron endometriosis intestinal. De estas, al 86 % se les realizó shaving (afeitado o nodulectomía), y al 13,2 % resección intestinal segmentaria. Un total de 4 pacientes (2,4 %) presentaron complicaciones intraoperatorias, de las cuales una requirió laparoconversión y otras 5 pacientes (2,9 %) desarrollaron complicaciones posoperatorias. Conclusiones: el manejo laparoscópico de la EIP es una alternativa por considerar, con una frecuencia de complicaciones cercana al 5 %. Se requieren estudios aleatorizados con grupo control para una mejor evaluación de la seguridad y eficacia.
ABSTRACT Objective: Describe the intraoperative findings, procedures and the safety of laparoscopic surgical management of Deep Infiltration Endometriosis (DIE). Materials and methods: A descriptive historical cohort study of patients with suspected pre-surgical diagnosis of DIE due to clinical findings, pelvic ultrasound or magnetic resonance imaging and histological confirmation of the disease. The patients were taken to minimally invasive surgery between 2007 and 2016 in a reference health institution located in Pereira, Colombia. Sociodemographic, clinical, intraoperative findings, types of procedure performed, intra and postoperative complications and post-surgical pain levels at 6 weeks were evaluated. A descriptive analysis was performed. Results: One hundred and sixty seven patients were included. The most frequent location of the disease was the recto-vaginal septum (85.7 %). A total of 83 patients (49.7 %) had bowel endometriosis. Of these, 86 % had a shaving and 13.2 % segmental bowel resection. Four patients (2.4 %) had intraoperative complications. One was con- verted to laparotomy and other five (2.9 %) had post-surgical infection. Conclusions: Laparoscopic management of DIE is an option to be considered with a 5% of complication frequency. Randomized studies with a control group are required for a better evaluation of safety and efficacy.
Assuntos
Humanos , Feminino , Endometriose , Cuidados Pós-Operatórios , Qualidade de Vida , Laparoscopia , Dor PélvicaRESUMO
The burden of cardiovascular diseases (CVD) is increasing, particularly in low-middle-income countries such as most of Latin America. This region presents specific socioeconomic characteristics, generating a high incidence of CVD despite efforts to control the problem. A consensus statement has been developed by Inter-American Society of Cardiology with the aim of answering some important questions related to CVD in this region and the role of the polypill in cardiovascular (CV) prevention as an intervention to address these issues. A multidisciplinary team composed of Latin American experts in the prevention of CVD was convened by the Inter-American Society of Cardiology and participated in the process and the formulation of statements. To characterize the prevailing situation in Latin American countries, we describe the most significant CV risk factors in the region. The barriers that impair the use of CV essential medications are also reviewed. The role of therapeutic adherence in CV prevention and how the polypill emerges as an effective strategy for optimizing adherence, accessibility, and affordability in the treatment of CVDs are discussed in detail. Clinical scenarios in which the polypill could represent an effective intervention in primary and secondary CV prevention are described. This initiative is expected to help professionals involved in the management of CVD and public health policymakers develop optimal strategies for the management of CVDs. (AU)
Assuntos
Doenças Cardiovasculares/tratamento farmacológicoRESUMO
PURPOSE: To determine the prevalence of refractive errors in Colombia and its relations with demographic and socioeconomic variables. METHODS: A cross-sectional study performed in 10 Colombian administrative districts (MIOPUR study), including children and adolescents from 8 to 17 years old and adults from 35 to 55 years old. RESULTS: 3608 individuals (100% of whom agreed to participate) were included. Prevalence estimates of refractive errors were: hyperopia 32.3% (95% CI 30.7 to 33.8), myopia 12.9% (95% CI 11.8 to 14.0), mixed astigmatism 2.8% (95% CI 2.2 to 3.3) and anisometropia 1.9% (95% CI 1.4 to 2.3). Prevalence of myopia in 15-year-old adolescents was 14.7%. In children and adolescents, the hyperopia prevalence decreased while myopia prevalence increased with age. In the adults group, the tendency was the contrary. Myopia prevalence reached 15.7% in urban and 9.2% in rural areas, and for hyperopia, the rates were 29.4% in urban and 36.1% in rural areas. In the multivariate analysis, living in an urban area significantly increased the risk of having myopia (OR: 1.45 (1.12 to 1.89); p<0.01). There were significant regional differences among diverse zones of the country. CONCLUSIONS: Prevalence estimates of myopia and hyperopia in Colombia were found to be at an intermediate point compared with global data. In adults, myopia frequency was lower than in European and Asian studies. The prevalence of myopia increased during childhood and adolescence and was higher in middle-aged adults (35-39 years) than in older adults. On the other hand, hyperopia rates increased with age, findings that suggest a cohort effect. In the multivariate analysis, residence in urban areas and living in a medium-high socioeconomic status were linked to myopia.
Assuntos
Refração Ocular , Erros de Refração/epidemiologia , População Rural , População Urbana , Acuidade Visual , Adolescente , Adulto , Distribuição por Idade , Criança , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Erros de Refração/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Adulto JovemRESUMO
ABSTRACT: The burden of cardiovascular diseases (CVD) is increasing, particularly in low-middle-income countries such as most of Latin America. This region presents specific socioeconomic characteristics, generating a high incidence of CVD despite efforts to control the problem. A consensus statement has been developed by Inter-American Society of Cardiology with the aim of answering some important questions related to CVD in this region and the role of the polypill in cardiovascular (CV) prevention as an intervention to address these issues. A multidisciplinary team composed of Latin American experts in the prevention of CVD was convened by the Inter-American Society of Cardiology and participated in the process and the formulation of statements. To characterize the prevailing situation in Latin American countries, we describe the most significant CV risk factors in the region. The barriers that impair the use of CV essential medications are also reviewed. The role of therapeutic adherence in CV prevention and how the polypill emerges as an effective strategy for optimizing adherence, accessibility, and affordability in the treatment of CVDs are discussed in detail. Clinical scenarios in which the polypill could represent an effective intervention in primary and secondary CV prevention are described. This initiative is expected to help professionals involved in the management of CVD and public health policymakers develop optimal strategies for the management of CVDs.
Assuntos
Terapêutica , Doenças Cardiovasculares , Cooperação e Adesão ao TratamentoRESUMO
Background Pelvic congestion syndrome is among the causes of pelvic pain. One of the diagnostic tools is pelvic venography using Beard's criteria, which are 91% sensitive and 80% specific for this syndrome. Objective To assess the diagnostic performance of the clinical findings in women diagnosed with pelvic congestion syndrome coming to a Level III institution. Methods Descriptive retrospective study in women with chronic pelvic pain taken to transuterine pelvic venography at the Advanced Gynecological Laparoscopy and Pelvic Pain Unit of Clinica Comfamiliar, between August 2008 and December 2011, analyzing social, demographic, and clinical variables. Results A total of 132 patients with a mean age of 33.9 years. Dysmenorrhea, ovarian points, and vulvar varices have a sensitivity greater than 80%, and the presence of leukorrhea, vaginal mass sensation, the finding of an abdominal mass, abdominal trigger points, and positive pinprick test have a specificity greater than 80% when compared with venography. Conclusion This study may be considered as the first to evaluate the diagnostic performance of the clinical findings associated with pelvic congestion syndrome in a sample of the Colombian population. In the future, these findings may be used to create a clinical score for the diagnosis of this condition.