RESUMO
BACKGROUND: Onychoscopy is a technique that uses a dermatoscope for the evaluation of specific features of different skin conditions that are not visible to the naked eye. There are few studies establishing parameters for the diagnosis of onychomycosis based on onychoscopy. Determining the sensitivity and specificity of a potentially new diagnostic test for onychomycosis requires an evaluation study of this new diagnostic test, as there are limited studies reporting onychoscopy results. AIM: To determine the sensitivity, specificity, positive predictive value and negative predictive value of onychoscopy findings in a Colombian population with onychomycosis. METHODS: We assessed outpatients with a diagnosis of toenail onychomycosis confirmed by potassium hydroxide preparation or fungal culture. Onychoscopy was performed using a dermatoscope, and digital images collected using a smartphone. RESULTS: The onychoscopy findings were: longitudinal striae, distal spiked pattern, distal irregular termination, linear edge and ruins aspect, while some patients were confirmed as having traumatic onycholysis. A statistically significant association was found between the clinical symptoms of onychomycosis and both the clinical feature of dyschromia and the onychoscopy feature of longitudinal striae. CONCLUSION: We suggest that this technique is an alternative method that should be used in patients with onychopathies because it has the potential to differentiate onychomycosis from traumatic onycholysis and another nail involvement.
Assuntos
Dermoscopia , Onicomicose/diagnóstico por imagem , Colômbia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unhas/diagnóstico por imagem , Unhas/lesões , Onicomicose/microbiologia , Onicomicose/patologia , Valor Preditivo dos TestesRESUMO
RESUMEN Objetivo : Presentación de un caso, consistente en una lesión tumoral, compatible con hidradenocarcinoma, desarrollado en un paciente joven, y revisión de la literatura referida a la entidad mencionada. Métodos : Se valora en el servicio de dermatología un paciente de 17 años con una lesión de crecimiento progresivo, localizada en tercio medio de la pierna derecha, la cual a la inspección muestra secreción hialina y sangrado, manifestando prurito como síntoma ocasional, al inicio de la lesión. Se decide tomar biopsia de la lesión para confirmar diagnóstico. Resultados : Se hace diagnóstico clínico e histopatológico de hidradenocarcinoma siendo este un tumor raro maligno, originado en glándulas sudoríparas que se localiza cualquier parte del cuerpo, el cual en la mayoría de los casos se ha descrito como de origen ecrino. Conclusiones : Aunque no es una patología frecuente tiene altas tasas de recurrencia y riesgo de metástasis. Por lo tanto, es importante considerarla siempre como uno de los diagnósticos diferenciales, y de esa manera ofrecer un oportuno tratamiento quirúrgico, con márgenes amplios de resección.
SUMMARY Objective : Presentation of a case report, consisting of a tumor lesion, compatible with hydradenocarcinoma, developed in a young patient, and review of the literature referring to the mentioned entity. Methods : A 17-year-old patient with a progressive growth lesion, located in the middle third of the right leg, was evaluated in the dermatology service, which upon inspection showed hyaline secretion and bleeding, manifesting pruritus as an occasional symptom. A skin biopsy was performed to confirm the diagnosis. Results : A clinical and histopathological diagnosis of hydradenocarcinoma is made, this being a rare and malignant tumor originating in sweat glands that is located anywhere in the body, which in most cases has been described as of eccrine origin. Conclusions : Although it is not a frequent pathology, it has high recurrence rates and risk of metastasis. Therefore, it is important to always consider it as one of the differential diagnoses, and thus offer timely surgical treatment, with wide resection margins.
RESUMO
Cryptorchidism is one of the most common congenital disorders in boys, and several genetic, hormonal, and environmental factors have been proposed as possible causes for this genitourinary defect. Genetic factors have been intensively searched, but relatively few pathogenic variants have been described. Cryptorchidism is a frequent finding in patients with RASopathies, a group of syndrome caused by mutations in genes of the Ras/MAPK pathway. Our aim was to determine whether patients with isolated cryptorchidism (IC) exhibit Ras/MAPK pathway gene variants associated with RASopathies. Two hundred thirty-nine patients with IC were recruited after orchidopexy. Determination of Ras/MAPK pathway gene variants was performed by high-resolution melting (HRM) analysis followed by sequencing. Restriction or allele-specific amplification assay was applied to (i) variant confirmation; (ii) search in healthy controls; and (iii) segregation analysis. Controls correspond to 100 healthy Chilean adults without a history of cryptorchidism. Molecular analysis showed one synonymous substitution (BRAF_p.Q456Q) in two patients and four missense substitutions (SOS1_ p.R497Q, BRAF_ p.F595L, NRAS_ p.T50I, and MAP2K2_ p.Y134C) in five patients. Our results suggest that some patients with isolated cryptorchidism, but with no evidence of dysmorphic features suggestive of RASopathies, may harbor Ras/MAPK pathway gene alterations.
Assuntos
Criptorquidismo/genética , GTP Fosfo-Hidrolases/genética , MAP Quinase Quinase 2/genética , Proteínas de Membrana/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteína SOS1/genética , Adolescente , Criança , Pré-Escolar , Chile , Variação Genética , Humanos , Lactente , Masculino , Proteínas Quinases Ativadas por Mitógeno/genética , Transdução de Sinais/fisiologia , Proteínas ras/genéticaRESUMO
Introducción: Los eventos adversos (EA) son un daño no intencionado derivado de la atención sanitaria que se relacionan con los recursos humanos, los factores del sistema o las condiciones clínicas del paciente. Objetivo: Analizar factores relacionados con la calidad y la seguridad del paciente a través de los reportes de EA. Metodología: Diseño transversal, multicéntrico, realizado en 5 institutos nacionales de salud y en un hospital de alta especialidad, se estudiaron los EA ocurridos durante 18 meses, para lo cual se utilizó el instrumento SYREC 2007; análisis descriptivo y evaluación de asociación entre grado de evitabilidad y factores intrínsecos, extrínsecos y del sistema; se observaron los aspectos éticos vigentes. Resultados: Se analizaron un total de 540 EA, ocurrieron 55.5% en hombres, 58.7% estaban en estado de alerta, el 92.6% de los EA ocurrió en el servicio asignado, el 55.9% no se reportó a la familia, se consideró sin duda como evitable en el 70.5%, los factores del sistema estuvieron presentes en 80.6%, hubo asociación significativa entre estos y la evitabilidad del suceso. Discusión: Los principales resultados encontrados son coincidentes con otras investigaciones internacionales tales como: To err is human 1999, el estudio ENEAS de España 2006 y con el de prevalencia IBEAS 2010; en todos ellos se hizo evidente la necesidad de reforzar la cultura de la notificación de los EA y el clima para la seguridad del paciente, además de promover una reflexión interpersonal acerca de la calidad de los servicios asistenciales. Conclusiones: Los factores relacionados con el sistema tienen un mayor peso en la aparición de EA. Es de vital importancia su identificación a fin de poder evitarlos.
Introduction: Adverse events (AE) are unintended harms derived from human health attention, system factors, or clinical conditions in the patients. Objective: To analyze factors influencing the quality of patient healthcare and safety through the review of diverse records on AEs. Methodology: This transversal and multi-centric design study was carried out in five National Institutes of Health and a high specialty hospital. AEs in an 18 month period were studied using the SYREC 2007 instrument. Descriptive analysis, as well as assessments on the association between the preventability degree and the intrinsic, extrinsic, and system factors were all performed. Current ethical issues were observed. Results: A total of 540 AEs were analyzed; 55.5% occurred in men; 58.7% occurred during state of alertness; 92.6% occurred at the assigned service; 55.9% were not reported to the families; 70.5% were considered preventable; and system factors were present in 80.6% of them. A significant association between the AEs and the possibility to prevent them was found. Discussion: The main findings were consistent with those of other international studies including: ''To err is human'', 1999, the ENEAS study in Spain, 2006, and the IBEAS prevalence study, 2010. All of these studies emphasize the need to strengthen the culture of AE-notifying and to improve the patient safety climate, as well as to promote inter-personal reflections on to the quality of care services. Conclusions: System-related factors have the strongest influence on the occurrence of AEs, and thus, their identification becomes critical in order to enhance the quality of healthcare services.
Introdução: Os Eventos Adversos (EA) são um dano não intencionado derivado da atenção sanitária que se relaciona com os recursos humanos, os fatores do sistema ou as condições clínicas do paciente. Objetivo: Analisar fatores relacionados com a qualidade e a segurança do paciente a través dos relatórios de EA. Metodologia: Desenho transversal, multicéntrico, realizado em cinco Institutos Nacionais de Saúde e um hospital de alta especialidade, estudaram-se os EA ocorridos durante 18 meses, para o qual se utilizou o instrumento SYREC 2007; análise descritiva e avaliação de associação entre grau de evitabilidade e fatores intrínsecos, extrínsecos e do sistema; observaram-se os aspectos éticos vigentes. Resultados: Analisaram-se um total de 540 EA, ocorreram 55.5% em homens, 58.7% estavam em estado de alerta, o 92.6% o EA aconteceu no serviço assignado, o 55.9% não se informou à família, considerou-se sem dúvida como evitável no 70.5%, os fatores do sistema estiveram presentes em 80.6%, houve associação significativa entre estes e a evitabilidade do evento. Discussão: Os principais resultados encontrados são coincidentes com outras pesquisas internacionais tais como: ''To err is human'' 1999, o estudo ENEAS da Espanha 2006 e com o de prevalência IBEAS 2010; em todos eles se fez evidente a necessidade de reforçar a cultura da notificação dos EA e o clima para a segurança do paciente, além de promover una reflexão interpessoal acerca da qualidade dos serviços assistenciais. Conclusões: Os fatores relacionados com o sistema têm um maior peso na aparição de EA. É de vital importância sua identificação a fim de poder evitá-los.
Assuntos
Humanos , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Idoso , Pacientes , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , HospitalizaçãoRESUMO
Cryptorchidism is the most common congenital disorder in boys, but the cause for most cases remains unknown. Patients with Noonan Syndrome are characterized by a typical face, growth retardation, congenital heart defects, learning disabilities and cryptorchidism. Copy number variations of Ras/MAPK pathway genes are unusual in patients with several clinical features of Noonan Syndrome; however, they have not been studied in patients with only one feature of this condition, such as cryptorchidism. Our aim was to determine whether patients with isolated cryptorchidism exhibit Ras/MAPK pathway gene copy number variations (CNVs). Fifty-nine patients with isolated cryptorchidism and negative for mutations in genes associated with Noonan Syndrome were recruited. Determination of Ras/MAPK pathway gene CNVs was performed by Comparative Genome Hybridization array. A CNV was identified in two individuals, a ~175 kb microduplication at 3p25.2, partially including RAF1. A similar RAF1 microduplication has been observed in a patient with testicular aplasia. This suggests that some patients with isolated cryptorchidism may harbor Ras/MAPK pathway gene CNVs.
Assuntos
Criptorquidismo/genética , Dosagem de Genes , Sistema de Sinalização das MAP Quinases/genética , Adolescente , Criança , Pré-Escolar , Hibridização Genômica Comparativa , Duplicação Gênica , Genes ras , Humanos , Lactente , Masculino , Linhagem , Testosterona/sangueRESUMO
BACKGROUND: Induction therapy reduces the frequency of acute rejection and delayed graft function in renal transplantation. Basiliximab and Thymoglobulin are most commonly used agents for induction. METHODS: A retrospective study of two transplant centers in Veracruz, Mexico compared induction therapy in deceased donor renal transplantation from 2003 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes and hospitalizations during first year, and patient and graft survival. P < .05 was considered statistically significant. RESULTS: Seventy deceased kidney donors (40 male) were studied. Mean donor age was 32.9 ± 14.3 years, mean donor BMI 25.6 ± 4.3 kg/m(2), and mean donor creatinine 1.13 ± 0.58 mg/dL. Main cause of death was trauma (62.9%). In total, 125 kidney transplantations were performed, with female predominance (53.6%) and mean age 33.8 ± 11.8 years. Of these, 66.4% used basiliximab and 33.6% Thymoglobulin. Thymoglobulin patients were significantly older, with lower weight and BMI, and were on dialysis longer than basiliximab patients. DGF was present in 19.3% of basiliximab patients vs 16.7% in Thymoglobulin patients, acute rejection occurred in 16.9% of basiliximab patients vs 19% Thymoglobulin patients. A total of 33.7% basiliximab patients were hospitalized during the first year vs 47.6% Thymoglobulin-induced patients (P > .05). Mean graft survival was 84.2 ± 5.3 months (73.8-94.7) basiliximab vs 32.4 ± 28.7 months (28.7-36.1) Thymoglobulin, Kaplan-Meier survival did not show statistically significant differences between groups (P = .276; CI 95%). CONCLUSION: Similar transplant outcomes were obtained using basiliximab or Thymoglobulin induction in our population.
Assuntos
Imunossupressores/uso terapêutico , Transplante de Rim/métodos , Adolescente , Adulto , Idoso , Anticorpos Monoclonais/uso terapêutico , Soro Antilinfocitário/uso terapêutico , Basiliximab , Inibidores de Calcineurina/uso terapêutico , Criança , Pré-Escolar , Creatinina , Ciclosporina/uso terapêutico , Função Retardada do Enxerto/mortalidade , Feminino , Rejeição de Enxerto/mortalidade , Sobrevivência de Enxerto/efeitos dos fármacos , Humanos , Terapia de Imunossupressão/métodos , Terapia de Imunossupressão/mortalidade , Estimativa de Kaplan-Meier , Transplante de Rim/mortalidade , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Proteínas Recombinantes de Fusão/uso terapêutico , Estudos Retrospectivos , Doadores de Tecidos/estatística & dados numéricos , Adulto JovemRESUMO
La atención a la salud a veces puede representar un riesgo para los pacientes, que puede derivar en daño físico, psicológico, social, económico, e incluso la muerte. Estos incidentes se denominan eventos adversos (EA) y se presentan durante el proceso de atención. Objetivo: Determinar la ocurrencia de los EA en las áreas de cuidados intensivos y conocer los factores intrínsecos, extrínsecos y del sistema que están presentes en la aparición de un EA, así como su evitabilidad y gravedad. Métodos: Estudio multicéntrico, analítico, transversal y observacional, en siete instituciones de salud de carácter público y de alta especialidad en México. La muestra estuvo compuesta por 137 personas durante el periodo comprendido del 1-04-2012 al 31-01-2013. Los datos se recolectaron con la ficha de notificación de EA tomada y adaptada del proyecto SYREC 2007. Se utilizó el programa estadístico SPSS versión 17. Se realizaron pruebas de correlación de Spearman y phi, U de Mann-Witney, Kruskal-Wallis y Chi2. Resultados: El 58% de los EA se presentaron en pacientes masculinos, el 60% en edad pediátrica. Los EA relacionados con el cuidado fueron los más frecuentes con un 29.9%. En el 51% estuvieron relacionados con invalidez temporal. En un 75% de los casos se pudieron evitar. Sobresalen los factores del sistema con un 98%.Conclusiones: La población más vulnerable son los niños y los adultos mayores, los EA están relacionados directamente con el cuidado de enfermería y su mayoría son evitables. Es necesario implementar estrategias para la gestión de la seguridad del paciente para detectar, registrar, prevenir y minimizar su frecuencia.
Health treatment can sometimes involve risk for patients, which can result in physical, psychological, social, or financial damage, and even death. These incidents are called adverse events (AE) and occur during the treatment process.ObjectiveTo determine the occurrence of AE in intensive care areas, and identify the intrinsic, extrinsic, and systemic factors involved in an AE, and to assess their severity and how to avoid them. Methods Multi-centric, analytic, transversal, and observational study conducted on 7 public and high specialty health institutions in Mexico with a sample of 137 individuals. The study was carried out from 04/01/2012 to 01/31/2013. Data were collected through SYREC 2007 project adapted AE notification charts. SPSS version 17 was used. Spearman, Phi, Mann-Whitney U, Kruskal-Wallis and Chi2 tests were performed. Results:58% of AE occurred among male patients, 60% among the pediatric population. The most frequent AE were those related to care (29.9%). 51% were related to temporal disability. 75% of the cases could not be avoided. Systemic factors were the prevalent ones with 98%. Conclusions: The most vulnerable populations are children and the elderly. AE are directly related to nursing care and most are avoidable. It is necessary to implement strategies to manage patient safety in order to detect, register, prevent, and minimize the frequency of AE.
A atenção à saúde representa em vários momentos um risco para os pacientes, que pode derivar em dano físico, psicológico, social, económico, inclusivé a morte. Estes incidentes denominam-se eventos adversos (EA), apresentam-se durante o processo de atenção. Objetivo Determinar a ocorrência dos EA nas áreas de cuidados intensivos e conhecer fatores intrínsecos, extrínsecos e do sistema que estão presentes no aparecimento de um EA, bem como a possibilidade de evita-los e a sua gravidade. Métodos: Estudo multicêntrico, analítico, transversal e observacional, em 7 instituições de saúde pública e de alta especialidade no México. A amostra foi de (n = 137) durante o periodo compreendido entre 01-04-2012 e 31-01-2013. Os dados foram recolhidos com a ficha de notificação de EA tomada e adaptada do projeto SYREC 2007. Utilizou-se o programa estatístico SPSS versão 17. Realizaram-se testes de correlação de Spearman e Phi, U de Mann-Witney, Kruskal-Wallis e Chi2. Resultados: Os 58% dos EA apresentaram-se nos pacientes masculinos, os 60% na idade pediátrica. Os EA mais frequentes foram relacionados com o cuidado, com 29.9%. 51% estiveram relacionados com incapacidade temporária. Em 75% dos casos pôde-se evitar. Sobressaem os fatores do sistema com 98%. Conclusões: A população mais vulnerável são as crianças e os idosos, os EA relacionam-se diretamente com o cuidado da enfermagem e a sua maioria são evitáveis. É necessário implementar estratégias para a gestão da segurança do paciente para detectar, registrar, prevenir e minimizar a sua frequência.
Assuntos
Humanos , Masculino , FemininoRESUMO
Long-term graft function and survival are of particular importance in children assuming that they have a longer transplantation life span than most adults. Because acute rejection episodes (ARE) continue to have a serious impact on graft loss, we analyzed the effects of ARE on 5-year survival and function in our population. Fifty-seven living donor kidney transplant recipients (34 males) younger than 18 years of age (13.5 ± 2.6 years; range, 5-17) were follow up for at feast 12 months using cyclosporine, mycophenolate mofetil, and steroid therapy with or without induction treatment between February 2003 and December 2010. ARE incidence during the first 12 months following transplantation was 14%. One-, 3- and 5-year serum creatinine values were 1.24 ± 0.39, 2.16 ± 2.39, and 1.76 ± 0.9 mg/dL, respectively. Mean calculated creatinine clearances (Schwartz) at 1, 3, and 5 years were 82.5 ± 24.8, 64.7 ± 24.1, and 67 ± 27.5 mL/min*1.73 m(2), respectively. Patient/graft survival rates were 96/85%, 90/72%, and 88/65% at 1, 3, and 5 years, respectively. Patients who experienced an ARE within 12 months following transplantation displayed a reduced 5-year graft survival rate (37.5%) versus those who did not (78%; P = .005). Patients who did not have an ARE during 60 months had a higher graft survival rate (76%) than those who had ARE (33%; P = .001). Patient without basiliximab induction showed a lower 5-year graft survival rate (61% vs 100%; P = not significant [NS]). ARE is an important risk factor for graft loss in the pediatric kidney transplant population.
Assuntos
Ciclosporina/administração & dosagem , Rejeição de Enxerto , Sobrevivência de Enxerto , Imunossupressores/administração & dosagem , Transplante de Rim , Doadores Vivos , Ácido Micofenólico/análogos & derivados , Esteroides/administração & dosagem , Adolescente , Criança , Feminino , Humanos , Masculino , México , Ácido Micofenólico/administração & dosagemAssuntos
Colecistectomia/métodos , Colelitíase/cirurgia , Falência Renal Crônica/complicações , Adulto , Idoso , Colecistectomia/mortalidade , Colecistectomia Laparoscópica , Colelitíase/complicações , Colelitíase/mortalidade , Serviços Médicos de Emergência , Feminino , Humanos , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Se ha relacionado la satisfacción laboral con el desempeño y en los servicios de salud además, con la calidad del cuidado que se brinda. Objetivos. Establecer el grado de satisfacción laboral e identificar los factores asociados a ésta en personal de enfermería de cuatro Instituciones públicas de salud del tercer nivel de atención. Metodología: Estudio transversal, observacional y descriptivo. La muestra comprendió 594 profesionales de enfermería. Se aplicó una encuesta integrada por dos apartados, uno de datos socio-demográficos y otro para medir los factores intrínsecos y extrínsecos relacionados con la satisfacción laboral de acuerdo al instrumento de Font Roja ampliado (9 factores con 26 ítems en total). Resultados: Se obtuvo una confiabilidad del instrumento de 0.8 de alfa de Cronbach, 35% de los encuestados es personal especializado, la calificación de Satisfacción Laboral tuvo un promedio global de 101±10. Los factores identificados con insatisfacción fueron la promoción y competencia profesional, los mejor calificados la relación interpersonal con los jefes y con los compañeros. Los factores extrínsecos no mostraron diferencias estadísticamente significativas. Discusión: Los resultados concuerdan con la literatura, la promoción profesional y la competencia laboral son los que más se observan afectados. La institución "C" es la que tiene mayor nivel de satisfacción, también se resalta que el profesional que labora en áreas críticas se encuentra más satisfecho. Conclusiones: El personal de enfermería en estas instituciones tiene una calificación de nivel medio a alto de SL, la identificación de factores de insatisfacción así como de satisfacción son importantes para fundamentar mejoras e incidir en la calidad de los cuidados.
Job satisfaction has been linked to performance and, in the health services, to the quality of the care being given. Objectives.To establish the job satisfaction grade and to identify the factors associated to it in nursing staff of four tertiary care public health institutions. Methodology. Cross-sectional, observational, and descriptive study. The sample comprised 594 nursing professionals. A survey was applied, it consisted of two sections, one of socio-demographic data and the other to measure the intrinsic and extrinsic factor relate to job satisfaction in accordance to the extended Font Roja questionnaire (9 factors with 26 total items). Results. Instrument reliability with a cron bach's alpha value of 0.8 was obtained. 35% of the respondents are specialized personnel; the job satisfaction score had a. global mean of 101±10. Factor associated with dissatisfaction were job promotion and professional competence, factors with highest marks were interpersonal relationship with boss and workmates. Extrinsic factors did not show statistically significant differences. Discussion. Results are consistent with the literature; professional promotion and job competence are the most affected factors. Institution "C" has the highest ranks in job satisfaction, the fact that a professional working in critical areas is more satisfied is highlighted too. Conclusions. Nursing staff in the surveyed institutions have a medium to high level of job satisfaction, the identification of dissatisfaction and satisfaction factors is important to establish improvements in the health care quality.
Assuntos
Humanos , Masculino , FemininoRESUMO
In regenerative medicine, the generation of biocompatible substitutes of tissues by in vitro tissue engineering must fulfil certain requirements. In the case of human oral mucosa, the rheological properties of tissues deserve special attention because of their influence in the acoustics and biomechanics of voice production. This work is devoted to the rheological characterization of substitutes of the connective tissue of the human oral mucosa. Two substitutes, composed of fibrin and fibrin-agarose, were prepared in cell culture for periods in the range 1-21 days. The time evolution of the rheological properties of both substitutes was studied by two different experimental procedures: steady-state and oscillatory measurements. The former allows the plastic behaviour of the substitutes to be characterized by estimating their yield stress; the latter is employed to quantify their viscoelastic responses by obtaining the elastic (G') and viscous (G'') moduli. The results demonstrate that both substitutes are characterized by a predominant elastic response, in which G' (order 100 Pa) is roughly one order of magnitude larger than G'' (order 10 Pa). But the most relevant insight is the stability, throughout the 21 days of culture time, of the rheological quantities in the case of fibrin-agarose, whereas the fibrin substitute shows a significant hardening. This result provides evidence that the addition to fibrin of a small amount of agarose allows the rheological stability of the oral mucosa substitute to be maintained. This feature, together with its viscoelastic similitude with native tissues, makes this biomaterial appropriate for potential use as a scaffold in regenerative therapies of human oral mucosa.
Assuntos
Fibrina/química , Teste de Materiais , Mucosa Bucal/fisiologia , Reologia , Sefarose/química , Engenharia Tecidual/métodos , Separação Celular , Células Cultivadas , Módulo de Elasticidade , Humanos , Oscilometria , Estresse Mecânico , Fatores de Tempo , ViscosidadeRESUMO
El INER es una institución normativa en las afecciones respiratorias, quien a lo largo de su historia ha enfrentado desafíos ante situaciones emergentes de salud, como lo son la tuberculosis y el VIH. Actualmente afronta un nuevo reto de salud respiratoria, la epidemia de influenza A H1N1, la cual se presentó de forma inesperada en México en la primavera del 2009, provocando la implementación de medidas sanitarias urgentes, al rebasarse la capacidad de atención médica en el Instituto. Por ello, fue necesario organizar todos sus recursos humanos, físicos y materiales. Instaurar el Comité de Influenza Institucional y en apoyo y coordinación con el Comité de Control de Infecciones, tomar decisiones urgentes enfocadas a la prevención, manejo y control de la enfermedad. Se implementó el Triage en los servicios de concentración para la atención integral del paciente con sospecha y/o confirmación de influenza (Consulta Urgencias, Urgencias Observación, Unidades de Terapia Intensiva e Intermedia y clínico 5). Con todo ello y gracias a la intervención y el trabajo en equipo que realizó el profesional de enfermería del Instituto, se logró controlar la propagación de la epidemia y una vez más lograr conciencia en el personal de salud (médicos y enfermeras), para afrontar manera exitosa, nuevos retos en la salud respiratoria.
INER is a respiratory-illness treating institution which has faced diverse health challenges including tuberculosis and VIH; yet, at present, it is facing a new one: the unexpected 2009 A H1N1 influenza outbreak in Mexico. This massive incident provoked the implementation of urgent sanitary measurements including: the organization of human, physical and material resources; the establishment of-Infection Committee coordinated measurement towards illness prevention, control and management; and the establishment of the TRIAGE on concentration services towards patients with confirmed or dubious influenza (Urgencies, Consult, Urgencies Observation, Intensive Therapy Unit, Intermediate Therapy Unit and Clinical 5). Thanks to these measurements and the INER's nursing personnel team work, we were able to control the outbreak propagation, but also to create consciousness among doctors and nurses to successfully face the new respiratory-illnesses challenges.
Assuntos
Humanos , Masculino , Feminino , Cuidados de Enfermagem , Influenza Humana , Vírus da Influenza A Subtipo H1N1RESUMO
In a randomized, controlled study, the efficacy and safety of two different schemes of albendazole therapy for treatment of porcine cysticercosis were tested. Seventeen naturally infected pigs were divided into three groups and treated per os with albendazole (50 mg/kg single dose), albendazole (30 mg/kg every day for three days), or given no treatment, respectively. Serologic responses were monitored with the enzyme-linked electroimmunotransfer blot assay. Pigs were humanely killed 12 weeks after treatment, necropsied, and the number of parasites was recorded. Scolex evagination was used to assess viability of the cysts. Both albendazole-treated groups had significant side effects (anorexia, lethargy). Only a single viable cyst was recovered from the brain of one animal after therapy in the multiple-dose group, and the single-dose therapy left 11% of the cysts viable. In contrast, more than 90% of muscle cysts were found to be viable in the untreated group. Although albendazole therapy for three days was found to be highly effective, side effects and the need for multiple doses would still prevent its widespread use.
Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Cisticercose/veterinária , Doenças dos Suínos/tratamento farmacológico , Albendazol/efeitos adversos , Albendazol/farmacologia , Animais , Anti-Helmínticos/efeitos adversos , Anti-Helmínticos/farmacologia , Encéfalo/parasitologia , Cisticercose/tratamento farmacológico , Cisticercose/transmissão , Cysticercus/efeitos dos fármacos , Coração/parasitologia , Carne/parasitologia , Músculo Esquelético/parasitologia , Método Simples-Cego , Suínos , Doenças dos Suínos/transmissão , Língua/parasitologiaRESUMO
Tetrahydroisoquinolines (TIQs) are alkaloids originated as natural catabolic derivatives of catecholamines (CAT). Dopamine, under special circumstances, condenses with aldehydes to produce tetrahydropapaveroline (THP), salsolinol (SOL) and salsoline (SAL). We investigated the inotropic activity of THP, SOL and SAL on the isometric contractility of papillary muscles isolated from guinea pigs hearts and compared their actions to those corresponding to adrenaline (A) and isopropylarterenol (ISO). In order to analyze their combined effects, TIQs and A were applied simultaneously. THP, SOL and SAL produced positive inotropic effects as beta receptor agonists; their actions were antagonized with propranolol. The inotropic efficacy of TIQs compared to that of catecholamines, is: CAT = 1; SAL = 0.32; THP = 0.47 and SOL = 0.32. Their middle effective dose (DE50), indicates an order of potency of: ISO = SAL greater than A = THP greater than SOL. Combination of THP or ISO with A produces an additive effect; however, SAL behaves as a partial agonist, meaning that it produces an antagonistic, non-competitive type effect on the inotropic action of adrenaline. Chemical structure of TIQs shows significant relationship with their pharmacological activity on ventricular myocardium, similar to that of catecholamines. The influence of the methoxyl group attached to C-7 in SAL, as the only difference with SOL which instead has a hydroxyl group in that position, deserves special mention; such structural difference provides to SAL bigger inotropic efficacy and potency, as well as beta adrenergic antagonistic activity. The results of the present paper emphasize the biological significance of active catabolites from catecholamines as are the tetrahydroisoquinoline compounds.