RESUMO
PURPOSE: To describe the dosing patterns of regorafenib in a real-world population of patients with metastatic colorectal cancer (mCRC) in a routine clinical practice setting in Spain, focusing on the starting dose of regorafenib. METHODS: An observational, retrospective, multicenter study that included patients ≥ 18 years old who had histologically documented mCRC and who had initiated treatment with regorafenib since January 2017. Post hoc categorization of dosing patterns revealed the following: initial dose < 160 mg and dose escalation, initial dose < 160 mg and maintenance, initial dose equal to 160 mg and maintenance, and initial dose equal to 160 mg and dose reduction. RESULTS: Most patients (152/241, 63.8%) initiated treatment with regorafenib at doses < 160 mg. There was large variation in the starting dose of regorafenib over time: in 2017, most patients (59%) initiated regorafenib at a dose of 160 mg, this proportion decreased to 6% in 2021. There were no significant differences in the median progression-free survival according to the regorafenib dose patterns during the first two cycles. The proportion of patients who reported at least one adverse event (AE), had a grade 3-4 AE or had an AE leading to dose reduction was greater in the group of patients who received an initial dose equal to 160 and reduction. CONCLUSIONS: Our results indicate that physicians in Spain have gradually adopted a dose-escalation approach during cycle 1, which is a common practice for starting treatment with a reduced dose (< 160 mg/day), a strategy that seems to improve tolerability while maintaining efficacy. TRIAL REGISTRATION: Not applicable.
RESUMO
Specific learning disorder (SLD) is a neurodevelopmental disorder that affects 5-15% of school-aged children worldwide. Often, difficulties in reading (SLD-RD) and mathematics (SLD-MD) occur together. Deficits in phonological awareness (PA) have been identified as the common factor between the two difficulties. Intervention in PA has been shown to be effective in SLD-RD; however, it is not clear whether it is also effective in SLD-MD. Neuropsychological intervention is usually conducted face-to-face, but when the patient is in a remote location or during extraordinary situations such as the COVID-19 pandemic, tele neuropsychology (TeleNP) may be a suitable alternative. The objective of this study was to evaluate the efficacy of a telerehabilitation program for PA to improve math skills in children with SLD-RD/SLD-MD. The study had an N-of-1 SCED design, and included six children aged 10-12 years with SLD-RD/SLD-MD. After four baseline measurements with an arithmetic verification paradigm, they were treated with TeleNP-PA. The effect on each participant was evaluated using visual analysis and the reliable change index. After the intervention, all participants showed improvement in arithmetic tasks, suggesting that the PA intervention had a positive influence on these skills.
RESUMO
Objective: To identify the factors associated with the interference of gynecological cancer screening in women aged 25-69 years, according to the Demographic and Family Health Survey (ENDES) for the years 2019 and 2020. Materials and methods: Quantitative, observational, analytical cross- sectional study. It was a secondary database analysis obtained by ENDE for the years 2019 and 2020. Generalized linear Poisson family crude and adjusted models were used to estimate the association. The measure of association. The measure of association used was the adjusted prevalence ratio (Rpa) with 95% confidence interval (95% CI). Results: We worked with a total of 18,113 women aged 25-69 who were interviewed at the ENDES 2019-2020. In the descriptive analysis, it is observed that 19.3% did not take a PAP smear (PAP) and 53.6% did not perform "screening for breast cancer". Women with a primary education level have 19% and 58% more opportunities to present interference for taking PAP and screening for breast cancer respectively (RPa: 1,19, 95% CI 1.08-1,31 and RPa:1.58, 95% CI 1:51 1:64). Living in the jungle increases 56%and 20%more chance of presenting interference for taking PAP and screening for breast cancer respectively (RPa: 1.46, 95% CI 1.42-1.71 and RPa: 1.20, 95% CI: 1.15- 1.25). The level of knowledge increases the interference for taking PAP and screening for breast cancer by 43% and 3% respectively (RPa: 1.43, 95% CI: 1.34- 1.54 and RPa: 1.03, 95% CI:1.00 -1.06) Conclusions: Sociodemographic, sociocultural and economic factors have a marked influence on the performance of gynecological cancers such as cervical cancer and breast cancer, so it is necessary to implement strategies to promote the prevention of these pathologies.
Objetivo: Identificar los factores asociados con la interferencia de los cribados para cánceres ginecológicos en mujeres peruanas de 25 69 años de edad, según la Encuesta Demográfica y de Salud Familiar (ENDES) de los años 2019 y 2020. Materiales y métodos: Estudio cuantitativo, observacional, analítico de corte transversal. Fue un análisis de base de datos secundaria obtenido por ENDES de los años 2019 y 2020. Se usó modelos lineales generalizados de familia Poisson crudas y ajustadas para poder estimar la asociación. La medida de asociación utilizada fue la razón de prevalencia ajustada (RPa) con un intervalo de confianza al 95% (IC95%). Resultados: Se trabajó con un total de 18113 mujeres peruanas de 25-69 años entrevistadas en la ENDES 2019-2020. En el análisis descriptivo se observa que un 19,3% no se realizó la toma de Papanicolaou (PAP) y 53,6 no se realizó "cribado para cáncer de mama". Las mujeres con nivel educativo primario tienen 20% y 58% más oportunidades de presentar interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.20, IC95%: 1.09-1.32 y RPa: 1.58, IC95%: 1.52-1.65). Vivir en la selva aumenta en 57% y 20% más oportunidades de presentar interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.57, IC95%: 1.43-1.71 y RPa: 1.20, IC95%: 1.15-1.25). El nivel de conocimiento aumenta en un 44% y 4% la interferencia para la toma de PAP y cribado para cáncer de mama respectivamente (RPa: 1.44, IC95%: 1.34-1.54 y RPa: 1.04, IC95%: 1.01-1.07). Conclusión: Los factores sociodemográficos, socioculturales y económicos influyen de manera marcada en la realización de los cribados de cánceres ginecológicos como el cáncer de cuellouterino y el cáncer de mama, por lo que es necesario implementar estrategias para promover la prevención de estas patologías.
RESUMO
Hydrothermally synthesized Linde type A (LTA) and faujasite X (FAU-X) zeolites are low-cost and environmentally benign inorganic carriers for environmental applications. In this study, (oxy)hydroxides were incorporated onto LTA and FAU-X zeolites to promote the phosphate adsorption. The performance of LTA-Fe and FAU-X-Fe was evaluated through batch adsorption assays. A complete evaluation was performed to recover phosphate from synthetic wastewater. The effect of pH, concentration, equilibrium, and kinetic parameters on phosphate adsorption and its further reuse in sorption-desorption cycles were evaluated. LTA-Fe and FAU-X-Fe are effective for adsorption of phosphate at neutral (e.g., pH 7.0 ± 0.2) and in a broad range of phosphate concentrations. Higher ratios of adsorption capacities were obtained by synthetic zeolites enriched with iron in comparison to their parent forms. The phosphate adsorption occurred through hydrogen bonding and complexation reactions between protonated iron hydroxyl groups and phosphate anions. The phosphate monolayer adsorption was followed by diffusion through the internal pores and 80% of the equilibrium adsorption was reached within 50 min. The LTA-Fe and FAU-X-Fe can be used for phosphate recovery from wastewater treatment plants. The use of LTA-Fe and FAU-X-Fe in a tertiary wastewater treatment stage could allow to reduce the phosphate-phosphorous content, reaching the regulatory levels (equal 1 mg L-1 total phosphorous). The phosphate adsorption using LTA-Fe and FAU-X-Fe does not require pH adjustment, and it is endothermic. The reusability of both iron zeolites is limited, and they can be finally disposed for soil amendment applications.
RESUMO
OBJECTIVE: To assess the clinical applicability of the current definitions of bronchopulmonary dysplasia (BPD) and their ability to predict subsequent respiratory outcomes. STUDY DESIGN: In this retrospective cohort study, data were collected from 104 preterm infants (mean gestational age, 25.8 weeks) diagnosed with BPD between 2010 and 2018 at a single tertiary care center. The infants were classified according to the following definitions: 2001 National Institute of Child Health and Human Development (NICHD), 2017 Canadian Neonatal Network (CNN), 2018 NICHD, and 2019 Neonatal Research Network (NRN). Logistic regression and the area under the receiver operating characteristic curve (AUC) were used to assess the predictive ability of each definition on mortality or severe respiratory morbidity at 18-24 months of age. RESULTS: All patients could be adequately classified by each definition, except for the 2001 NICHD definition, in which 11.4% were unclassifiable. The prevalence of BPD was 49% by the 2017 CNN definition and 70% by the 2018 NICHD and 2019 NRN definitions. The best regression model was the one that included the 2018 NICHD definition, which had an accuracy of 85.6% and a significantly higher AUC compared with the 2001 NICHD (0.891 vs 0.824; P = .015) and 2017 CNN (0.891 vs 0.811; P = .036) definitions, but not compared with the 2019 NRN definition (0.891 vs 0.833; P = .09). CONCLUSIONS: The current definitions of BPD showed a good predictive ability for mid-term respiratory outcomes, with the highest ability for the 2018 NICHD definition. Further studies are needed to establish the most appropriate definition of BPD.
Assuntos
Displasia Broncopulmonar , Lactente , Criança , Recém-Nascido , Humanos , Displasia Broncopulmonar/diagnóstico , Displasia Broncopulmonar/epidemiologia , Recém-Nascido Prematuro , Estudos Retrospectivos , Canadá/epidemiologia , Idade GestacionalRESUMO
Resumen El objetivo de esta investigación fue revisar sistemáticamente los estudios realizados en México sobre programas de prevención para los trastornos de la conducta alimentaria y de la ingesta de alimentos (TAIA) y sus variables asociadas. La investigación se realizó considerando las directrices de la Declaración PRISMA e incluyó estudios publicados entre el año 2006 y 2020. La búsqueda se realizó en las bases de datos EBSCO, WILEY, Scopus, Dialnet, Redalyc, Taylor & Francis, Scielo y el buscador Google académico, utilizando los términos "trastorno de la conducta alimentaria" OR "trastornos alimentarios" AND "intervención" OR "prevención" AND "México" y en inglés los términos equivalentes fueron "Eating disorder" AND "intervention" OR "prevention" AND "Mexico". Se encontraron 12 artículos, ocho (67%) se enfocaron a la prevención primaria selectiva (muestra entre 15 y 58 participantes), principalmente dirigidos a mujeres adolescentes (75%). Se identificaron cuatro estudios (33%) sobre prevención primaria (muestra entre 120 y 388 participantes) en varones, mujeres adolescentes y adultos jóvenes. La mayoría de los estudio (67%) utilizó la psicoeducación, y las estrategias cognitivo-conductuales (58%). En general, se encontraron resultados positivos sobre los niveles de insatisfacción corporal, la preocupación por el peso y la comida y la conducta alimentaria compulsiva. Se concluye que es necesario aumentar en México la producción de investigaciones sobre programas preventivos de TAIA y sus factores asociados, así como generar evidencias sólidas de los resultados de la intervención.
Abstract The objective of this research was to systematically review the studies carried out in Mexico on prevention programs for eating disorders and their associated variables. The research was carried out considering the guidelines of the PRISMA Declaration and included studies published between 2006 and 2020. The search was carried out in the EBSCO, WILEY, Scopus, Dialnet, Redalyc, Taylor & Francis, Scielo databases and the Academic Google search engine, using the terms "eating behavior disorder" OR "eating disorders" AND "intervention" OR "prevention" AND "Mexico" and in English the equivalent terms were "Eating Disorder" AND "intervention" OR "prevention" AND " Mexico". Twelve articles were found, eight (67%) focused on selective primary prevention (sample between 15 and 58 participants), mainly aimed at adolescent women (75%). Four studies (33%) on primary prevention (sample between 120 and 388 participants) in males, female adolescents and young adults were identified. Most of the studies (67%) removed psychoeducation, and cognitive-behavioral strategies (58%). Overall, positive results were found on levels of body dissatisfaction, weight and food concerns, and compulsive eating behavior. It is concluded that it is necessary to increase in Mexico the production of research on preventive programs of TAIA and its associated factors, as well as to generate solid evidence of the results of the intervention.
RESUMO
RESUMEN Introducción: Los estudiantes universitarios padecen alteraciones psicológicas durante el confinamiento por la COVID-19, que es necesario atender de manera oportuna, para evitar complicaciones mayores. Objetivo: Determinar el efecto de una intervención breve, en línea, para reducir síntomas de ansiedad, depresión y estrés en estudiantes universitarios durante la pandemia por la COVID-19. Métodos: Diseño cuasiexperimental, longitudinal (pretest-postest con un seguimiento) de un grupo experimental y un grupo control. Participó una muestra no probabilística intencional de 44 universitarios varones y mujeres de entre 18 y 24 años, quienes contestaron en los 3 momentos de evaluación la Escala de Ansiedad y Depresión Hospitalaria y la Escala de Estrés Percibido. Se llevó a cabo una intervención breve en línea, basada en psicoeducación y técnicas cognitivo conductuales para reducir ansiedad, depresión y estrés. Los datos grupales se analizaron con la prueba no-paramétrica de Friedman y de manera individual se calculó el cambio clínico objetivo. Resultados: No hubo diferencias significativas en los 2 grupos en los 3 momentos de evaluación (x2 r; gl = 2; p > 0,05), pero al analizar el cambio clínico objetivo en el grupo experimental, se determinó que entre el pretest-postest y pretest-seguimiento, 40,7 % y 37,0 % de los participantes, presentaron un cambio clínico objetivo positivo en ansiedad. Para depresión fue positivo en 25,9 % y 18,5 %, y en estrés 11,1 % y 33,3 %, se observó en esta última variable, un incremento del porcentaje de universitarios con cambio positivo a través del tiempo. Conclusión: La intervención breve en línea redujo síntomas de ansiedad, depresión y estrés en universitarios durante la pandemia.
ABSTRACT Introduction: University students suffer psychological alterations during confinement due to COVID-19, that need to be addressed to in a timely manner to avoid further complications. Objective: Determine the effect of a brief online intervention to reduce anxiety, depression, and stress symptoms in university students during the COVID-19 pandemic. Methods: Quasi-experimental-longitudinal design (pretest-posttest and one follow-up) of experimental and control group, 44 male and female university students between 18 and 24 years old were selected through a non-probabilistic intentional sampling, who answered the Hospital Anxiety and Depression Scale and the Perceived Stress Scale in three times of evaluation. A brief online intervention based on psychoeducation and cognitive-behavioral techniques was carried out to reduce anxiety, depression, and stress. Group data was analyzed with Friedman's non-parametric test and the clinical-objective-change was calculated individually. Results: There were no significant differences in the two groups at the three time of evaluation (x2r; gl = 2; p > 0.05), but when analyzing the clinical-objective-change in the experimental group, it was determined that between the pretest-posttest and pretest-follow up, 40,7 % y 37,0 % of the participants, presented a positive clinical-objective-change in anxiety. For depression, was also positive in 25,9% y 18,5 %; and in stress was of 11,1 % y 33,3 %, we can appreciate in this last variable an increase in the student´s percentage with a positive change through time. Conclusion: Brief online intervention reduced symptoms of anxiety, depression, and stress in university students during the COVID-19 pandemic.
RESUMO
The development of obesity entails a chronic low-grade inflammatory state with increased pro-inflammatory cells, mainly in visceral adipose tissue (VAT). Additionally, dietary patterns have an influence on the regulation of chronic inflammation. Dietary Approaches to Stop Hypertension (DASH) include foods with an anti-inflammatory profile and that have positive impacts on body composition (BC), suggesting improvements in inflammatory processes. OBJECTIVE: To analyze the impact of the DASH diet on cellular immunity, anthropometric, biochemical and BC parameters in patients with overweight and obesity, who could present metabolic syndrome. METHODOLOGY: Lymphocyte subpopulations, biochemical parameters, anthropometric parameters, and BC before and 8 weeks after intervention with the DASH diet in persons with overweight and obesity were measured. RESULTS: Fifty-nine young adults participated in the study. After the intervention, no significant changes in biochemical parameters were observed, although a significant decrease in nearly all of the anthropometric and BC variables was found: waist circumference (p < 0.001), percentage and kilograms of fat (p < 0.001 and p < 0.025, respectively), VAT (p < 0.020), and weight (p < 0.001), as well as total lymphocytes and double-positive TCD4+ cells. A relation between changes in leukocyte subpopulations (monocytes, natural killer, helper and cytotoxic lymphocytes, and naive TCD4+ cells) and metabolic improvements (glucose, triglycerides, total cholesterol and LDL-c) was also found. CONCLUSIONS: The DASH diet promotes positive changes in lymphocyte subpopulations, anthropometric parameters and BC in persons with overweight and obesity. Future studies should elucidate the cellular and molecular mechanisms through which the DASH diet produces inmunometabolic improvement.
Assuntos
Abordagens Dietéticas para Conter a Hipertensão , Imunidade Celular , Obesidade/dietoterapia , Obesidade/imunologia , Adulto , Composição Corporal , Índice de Massa Corporal , Feminino , Hispânico ou Latino , Humanos , Leucócitos/patologia , Modelos Lineares , Masculino , Obesidade/metabolismo , Adulto JovemRESUMO
Introducción: Los hábitos de vida de los estudiantes universitarios, con poco tiempo para su realización debido al estrés académico, prácticas, horario de clase y estudio, suelen ser poco saludables, por tanto, pueden influir negativamente en el rendimiento académico. Objetivo: Analizar los hábitos de vida en periodo evaluativo y su influencia en el rendimiento académico en estudiantes universitarios del grado en enfermería. Métodos: Estudio observacional descriptivo de tipo transversal realizado en el momento del examen a 488 estudiantes de los cuatro cursos del grado en enfermería de una universidad al sur de España, en el curso académico 2018. Los instrumentos empleados fueron: un cuestionario con datos sociodemográficos y otro cuestionario de hábitos de estilo de vida. El análisis de la información se realizó través de estadísticos descriptivos, pruebas paramétricas y no paramétricas y correlación lineal. Se respetaron las consideraciones éticas para estudios con humanos. Resultados: El 53,30 por ciento de la muestra realizaba ejercicio físico de forma regular, siendo similar en los cuatro cursos evaluados para los hombres mientras que en las mujeres aumentó de 31,11 por ciento en 1º a 61,26 por ciento en 4º curso. No diferencias relevantes en el rendimiento académico según variables de estilo de vida excepto sueño. Conclusiones: Las horas de sueño dormidas, sobre todo la semana previa al examen se relacionan con mayor rendimiento académico. Nuestros resultados sugieren que los estilos de vida menos saludables conllevan a peor rendimiento académico(AU)
Introduction: The life habits of university students, with little time to carry them out due to academic stress, practices, class and study hours, are usually unhealthy; therefore, they can influence academic performance negatively. Objective: To analyze life habits in the evaluation period and their influence on academic performance in university students of the Nursing degree. Methods: Descriptive, cross-sectional and observational study carried out, in the academic year 2018, at the time of examination with 488 students from the four courses of the Nursing degree from a university in southern Spain. The instruments used were a questionnaire with sociodemographic data and another lifestyle habits quiz. Information analysis was carried out through descriptive statistics, parametric and nonparametric tests, and linear correlation. Ethical considerations for human studies were respected. Results: 53.30 percent of the sample did physical exercise on a regular basis, being similar for men in the four courses assessed, while for women it increased from 31.11 percent in first academic year to 61.26 percent in the fourth academic year. There were no relevant differences in academic performance according to lifestyle variables except sleep. Conclusions: The hours of sleep per se, especially during the week before the exam, are related to higher academic performance. Our results suggest that less healthy lifestyles lead to poorer academic performance(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Estresse Psicológico/etiologia , Estudantes de Enfermagem , Saúde do Estudante , Desempenho Acadêmico , Estilo de Vida , Epidemiologia Descritiva , Estudos Transversais , Coleta de Dados , Programas de Graduação em Enfermagem/métodos , Estudos Observacionais como AssuntoRESUMO
Una tormenta llamada COVID-19 lleva desestabilizando los sistemas de salud de casi todo el mundo. En casi 8 meses ha pasado de ser un reporte de neumonía atípica con etiología desconocida a ser la pandemia del siglo XXI. En el Perú, el primer caso confirmado fue el 06 de marzo, y hasta inicios de julio lleva cobrando la vida de más de 10 000 personas.
A storm called COVID-19 has been destabilizing the health systems of almost everything the world. In almost 8 months it has gone from being a report of atypical pneumonia with etiology unknown to be the pandemic of the 21st century. In Peru, the first confirmed case was March 6, and until the beginning of July has been claiming the lives of more than 10,000 people.
RESUMO
OBJECTIVE: Objectively evaluate the incidence of sciatic nerve injury after a total hip arthroplasty (THA) performed through a posterolateral approach. METHODS: Patients scheduled to undergo THA were evaluated preoperatively and postoperatively with electrophysiologic studies, the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) questionnaire and other methods described in the study. Patients older than 21 years with any of the following preoperative diagnoses: primary or secondary osteoarthritis, aseptic avascular necrosis, rheumatoid arthritis, and posttraumatic arthritis were included. Variables used for analysis were sex, age, and body mass index (BMI). The Mann-Whitney U and Wilcoxon tests and, Pearson and Spearman correlation statistics were used for analysis of categorical and continuous data respectively. RESULTS: Electrodiagnostic data showed alterations in 17 patients (70.8%). No signs of sciatic nerve injury. The mean preoperative and postoperative WOMAC scores were 40 and 74, respectively (p = 0.0001). Statistical differences were noted in sural sensory amplitude (SSA) and distal amplitude of the tibialis motor nerve in the female group (p=0.007; p=0.036, respectively). The SSA also demonstrated differences in the obese group (p=0.008). In terms of age, both the SSA (Pearson p=0.010 and Spearman p=0.024) and the proximal latency of the peroneal motor nerve (Pearson p=0.026 and Spearman p=0.046) demonstrated a decrease in amplitude and an increase in latency that was inversely related with age. CONCLUSION: According to our subclinical electrophysiological findings, surgeons that use the posterolateral approach in THA procedures must be conscious of the sciatic nerve's vulnerability to reduce possible clinical complications.
Assuntos
Artroplastia de Quadril/efeitos adversos , Eletrodiagnóstico , Complicações Pós-Operatórias/diagnóstico , Nervo Isquiático/lesões , Neuropatia Ciática/diagnóstico , Adulto , Fatores Etários , Idoso , Artroplastia de Quadril/métodos , Índice de Massa Corporal , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Neuropatia Ciática/epidemiologia , Neuropatia Ciática/etiologia , Nervo Sural/fisiopatologia , Inquéritos e Questionários , Nervo Tibial/fisiopatologiaRESUMO
BACKGROUND: Fruits and vegetables have been associated with outbreaks of disease in different countries. The apple (Malus domestica Borkh) and its products have been reported as vehicles for illness outbreaks. To create strategies to prevent pathogen survival it is necessary to understand how pathogens persist on fruit. This paper assessed the ability of Salmonella to attach to, and to colonize, the surface of three apple cultivars: 'Rayada', 'Golden Delicious' and 'Red Delicious'. RESULTS: Salmonella was able to colonize and generate biofilms on the surface of apples with a soil suspension as the only source of nutrients. Significant differences in Salmonella attachment were seen among the three cultivars of apple studied. Using SEM, attached cells and the formation of exopolysaccharides and biofilms on the three apple cultivars were demonstrated. In all cultivars, the development of Salmonella was only seen in apples stored at 15 and 22 °C, with average increases in the population of 1.4 and 2.3 Log CFU/apple, respectively. At 5 °C, Salmonella growth was inhibited. CONCLUSION: Salmonella can colonize apple surfaces under environmental conditions (relative humidity, temperature and nutrients) occurring in primary apple production. © 2018 Society of Chemical Industry.
Assuntos
Aderência Bacteriana , Malus/classificação , Malus/microbiologia , Salmonella/crescimento & desenvolvimento , Salmonella/fisiologia , Biofilmes , Frutas/crescimento & desenvolvimento , Frutas/microbiologia , Malus/crescimento & desenvolvimento , Salmonella/genética , Salmonella/isolamento & purificação , TemperaturaRESUMO
INTRODUCTION: A number of parenteral infections in third-world countries are caused by blood transfusions. Our objective was to determine the prevalence of and factors associated with infected blood obtained by the Honduran Red Cross through blood donations, to ensure the safety of the donated blood. MATERIALS AND METHODS: This study used a cross-sectional analytical design based on the secondary analysis of data. Information on blood donors from San Pedro Sula, Honduras, between 2014 and 2016 were obtained from the database of the Honduran Red Cross. Data analysis was performed in two phases. The first phase described the variables, with the values presented as frequencies and percentages for categorical variables. The second phase involved a statistical analysis using generalized linear models. RESULTS: The proportions of donors who tested positive for syphilis, core hepatitis, hepatitis B, human T-cell lymphotropic virus, human immunodeficiency virus, and hepatitis C infections were 45% (n = 447), 35% (348), 11% (105), 10% (97), 6% (59), and 3% (24), respectively. The results of multivariate analysis demonstrated that the number of women positive for HIV infection was lower than that of men (p = 0.006). Older participants were more likely to be positive for core hepatitis (p = 0.029) and syphilis (p<0.001) infection but less likely to be positive for hepatitis B (p<0.001), hepatitis C (p = 0.027), human immunodeficiency virus (p<0.001), and human T-cell lymphotropic virus (p<0.001) infection compared to younger participants. Replacement donors had an increased likelihood of positivity for core hepatitis (p = 0.003) infections but a decreased likelihood of positivity for human T-cell lymphotropic virus infection (p = 0.001). DISCUSSION: The high prevalence of infectious diseases in Honduras warrants the need for monitoring donated blood to prevent infected blood from being provided for transfusions. Furthermore, education efforts through the creation of prevention programs are necessary to educate the Honduran population, especially younger individuals, about transfusion-transmissible infections.
Assuntos
Doadores de Sangue , Seleção do Doador , Infecções , Adulto , Estudos Transversais , Feminino , Honduras/epidemiologia , Humanos , Infecções/sangue , Infecções/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Cruz VermelhaRESUMO
Background: Currently there is great interest in developing clinical applications of platelet-rich plasma to enhance bone repair. Aim: To assess bone regeneration in mandibular fractures, with the application of this adjuvant. Methods: Twenty patients with mandibular fractures were included in a randomized clinical trial. Patients of the experimental group (n = 10) were submitted to internal fracture reduction and administration of platelet-rich plasma, and patients of the control group (n = 10) were submitted to the same surgical procedure without plasma application. Radiologic assessment was made before and at 1 and 3 months after surgery. X-rays were digitalized for analyze intensity and density as reflection of bone regeneration. Results: The average age was 32 ± 11.3 years and 31.2 ± 8.48 years respectively (p = 0.76). The radiographic intensity and density in the experimental group at the 1st and 3rd month were higher in contrast to the control group (p < 0.005). Bone regeneration time was 3.7 ± 0.48 and 4.5 ± 0.52 weeks respectively (p = 0.002). There was no morbidity related to the application of the platelet-rich plasma. Conclusion: The platelet-rich plasma increased the bone intensity and density in the fracture trace allowing bone regeneration and recovery in shorter time than patients in which it was not used.
Antecedentes: Actualmente existe interés en el desarrollo de aplicaciones clínicas del plasma rico en plaquetas (PRP) para mejorar la regeneración ósea (RO). Objetivo: Evaluar la RO en fracturas mandibulares con la aplicación de PRP. Métodos: Ensayo clínico controlado. Se incluyeron 20 pacientes con fractura de ángulo mandibular. El grupo de estudio (n = 10) se sometió a reducción de la fractura, fijación interna y aplicación de PRP, y el grupo control (n = 10) al mismo procedimiento sin administración de plasma. Se evaluaron en el preoperatorio y al primer y tercer mes posterior a la reducción mediante digitalización radiográfica para evaluar la regeneración ósea. Resultados: El promedio de edad fue de 32 ± 11.3 y 31.2 ± 8.48 años, respectivamente (p = 0.76). La intensidad y la densidad radiográfica al mes y a los 3 meses fueron superiores en el grupo de estudio que en el grupo control (p< 0.005). El tiempo de regeneración fue de 3.7 ± 0.48 y 4.5 ± 0.52 semanas, respectivamente (p = 0.002). Conclusiones: El PRP aumentó la intensidad y la densidad ósea en el trazo de las fracturas, sugestivas de RO, y recuperación en menor tiempo, en contraste con el grupo control.
Assuntos
Regeneração Óssea/fisiologia , Fixação Interna de Fraturas/métodos , Fraturas Mandibulares/terapia , Plasma Rico em Plaquetas , Adulto , Densidade Óssea/fisiologia , Terapia Combinada , Feminino , Humanos , Masculino , Fraturas Mandibulares/metabolismo , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
La obesidad es un problema de salud pública creciente a nivel mundial. Se ha clasificado como una enfermedad ocasionada por acumulación excesiva de triglicéridos en el tejido adiposo (TA). El TA visceral (TAV), se considera un factor importante en el desarrollo de enfermedades crónicas no transmisibles. Esto principalmente porque el adipocito aumenta en tamaño y número, lo cual lleva a hipoxia, liberación de ácidos grasos, movilización y activación de subpoblaciones leucocitarias (linfocitos T, B, macrófagos, neutrófilos y eosinófilos), liberación de mediadores proinflamatorios (factor de necrosis tumoral- α (TNF-α), interleucina (IL)-6, resistina) y disminución en la secreción de antiinflamatorios (adiponectina, IL-10, IL-4 e IL-13). Estos cambios en el TAV generan un estado de inflamación crónica de baja intensidad, que se ha relacionado con resistencia a la insulina (RI). La RI es el signo fundamental para el desarrollo del Síndrome Metabólico (SM), que inicialmente se presenta localmente en el TAV y después se vuelve sistémica. En la investigación de la obesidad y el desarrollo de sus comorbilidades, la trascendencia del TAV en la interacción entre células adiposas e inmunitarias, así como de liberación de mediadores para desencadenar el proceso inflamatorio crónico, es clave para el desarrollo de RI y SM; sin embargo, se ha observado que la masa músculo-esquelética está implicada en este proceso, aparte de las células y mediadores de los que se sabe su participación. De esta manera a los linfocitos T CD4 y T CD8 se les señala como proinflamatorios, en cambio a los eosinófilos y a la adiponectina se les clasifica como protectores del proceso.
Obesity is a widespread public health problem worldwide. This disease has been classified as a condition caused by excessive accumulation of triglycerides in adipose tissue (TA). Visceral TA is an important factor in the development of several chronic diseases, since the adipocyte increases in size and number, leading to hypoxia, fatty acid release, mo-bilization and activation of leukocyte subpopulations (macrophages, neutrophils, eosinophils, NK cells, T lymphocytes and B); release of pro-inflammatory mediators (TNF-á, IL-6, PAI-1, resistin and visfatin), and decreased secretion of anti-inflammatory cytokines (adiponectin, IL-10, IL-4 and IL-13). These changes in TAV generate a chronic inflammation state of low inten-sity, that has been linked to insulin resistance (IR), initially local and then becomes systemic, which represents the determining factor for the development of metabolic syndrome (SM). The transcendence of TAV in the interaction between adipose and immune cells, as well as the release of mediators that trigger the chronic inflammatory process, is key for the development of IR and SM. However, in the investigation of obesity and the development of its comorbidities, it has been observed that the skeletal-muscle mass is involved in this process, apart from the cells and mediators of which their participation is known. In this way, TCD4 and TCD8 lymphocytes are recognized as pro-inflammatory. In contrast, eosinophils and adiponectin are considered as protective of the process.
RESUMO
BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation. Patients were randomly assigned to receive oral glutamine (0.5 g/kg/day) or maltodextrin 3 days before surgery. Cardiac injury markers as troponin-I, creatine phosphokinase, and creatine phosphokinase-Mb were measured at 1, 12, and 24 hours postoperatively. RESULTS: At 12 and 24 hours serum markers levels were significantly lower in the glutamine group compared with controls (p = 0.01 and p = 0.001, respectively) (p = 0.004 and p < 0.001, respectively). Overall, complications were significantly lower in the glutamine group (p = 0.01, RR = 0.54, 95% CI 0.31-0.93). Mortality was observed with 2 cases of multiple organ failure in control group and 1 case of pulmonary embolism in glutamine group (p = 0.50). CONCLUSION: Preoperative oral glutamine standardized at a dose of 0.5 g/kg/day in our study group showed a significant reduction in postoperative myocardial damage. Lower cardiac injury markers levels, morbidity and mortality were observed in patients receiving glutamine.
Assuntos
Ponte Cardiopulmonar/efeitos adversos , Glutamina/administração & dosagem , Glutamina/uso terapêutico , Traumatismos Cardíacos/prevenção & controle , Revascularização Miocárdica/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Adulto , Idoso , Biomarcadores/sangue , Feminino , Traumatismos Cardíacos/patologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Isquemia Miocárdica/cirurgia , Miocárdio/patologia , Projetos Piloto , Cuidados Pré-OperatóriosRESUMO
ResumenAntecedentes:las infecciones del tracto urinario representan motivo de consulta médica ambulatoria frecuentemente. Los altos y crecientes índices de resistencia antibiótica implican un reto para el médico tratante.Objetivo:obtener información epidemiológica del perfil de sensibilidad de las bacterias aisladas en los urocultivos.Metodología:entre febrero y junio de 2014, se recolectaron 602 resultados de urocultivos en diferentes laboratorios de las ciudades de San Pedro Sula y El Progreso, en Honduras. Las variables analizadas fueron sexo, edad y bacteria, y los antibióticos que presentaban mayor porcentaje de sensibilidad y resistencia en los urocultivos. Se utilizó el método de Kirby Bauer para valorar los perfiles de resistencia y sensibilidad en todos los laboratorios. Se elaboró una lista de 47 antibióticos de todos los laboratorios. Se correlacionaron las variables para describir los perfiles de resistencia y sensibilidad de la lista de antibióticos.Resultados:las bacterias aisladas fueron E. Coli (70,4%), Enterobacter spp (7,8%), Klebsiella spp (6,3%), Citrobacter spp (6,1%), Proteus spp (2,8%), Staphylococcus s spp (2,7%), Pseudomona aeruginosa (1,8%), Streptococcus spp (1,2%), Hafnia alveii (0,3%), Morganella morgagni (0,2%), Serratia marcenscens (0,2%), Neisseria gonorrhoeae (0,2%). De 602 muestras, la sensibilidad general reportada fue: fosfomicina (n=415, 68,9%), amikacina (n=412, 68,4%), nitrofurantoína (n=376, 62,4%), gentamicina (n=364, 60,4%) y ceftriaxona (n=307, 50%). Se reportó una resistência general a trimetoprim sulfametoxazol (n=302, 50,1%), ciprofloxacina (n=230, 38,2%), levofloxacina (n=221, 36,7%), norfloxacina (n=220, 36,5%) y amoxicilina+ácido clavulánico (n=204, 33,8%).Conclusiones:los resultados de este estudio revelan que por su buen perfil de sensibilidad, antibióticos como la fosfomicina y la nitrofurantoína pueden ser una opción terapéutica empírica viable en pacientes con infecciones del tracto urinario bajo no complicadas, previo a utilizar antibióticos de amplio espectro, evitando así el desarrollo de resistencia antibiótica.
AbstractBackground:Urinary Tract Infections represent a frequent reason of ambulatory medical consult.The high and increasing percentages of antibiotic resistance represent a challenge for the physician treating them.Aim:To obtain epidemiological information of the sensibility profile from bacteria isolated in urine cultures.Methods:Between February and June of 2014, 602 urine culture samples were collected from different laboratories in the cities of San Pedro Sula and El Progreso, Honduras. The variables analyzed were sex, age and bacteria, antibiotics with higher sensibility and with higher resistance in urine culture. The Kirby Bauer method was used to determine the sensitivity and resistance profiles of each urine culture. A total of 47 antibiotics were used in all the laboratories. The variables were correlated to describe the resistance and sensibility profiles of the list of antibiotics.Results:The bacteria isolated were E. Coli (70.4%), Enterobacter spp (7.8%), Klebsiella spp (6.3%), Citrobacter spp (6.1%), Proteus spp (2.8%), Staphylococcus s spp (2.7%), Pseudomona aeruginosa (1.8%), Streptococcus spp (1.2%), Hafnia alveii (0.3%), Morganella morgagni (0.2%), Serratia marcenscens (0.2%), Neisseria gonorrhoeae (0.2%). From 602 samples, the general sensitivity reported was: fosfomycin (n=415, 68.9%), amikacin (n=412, 68.4%), nitrofurantoin (n=376, 62.4%), gentamicin (n=364, 60.4%) y ceftriaxone (n=307, 50%). The resistance for all the samples reported was as follows trimetoprim sulfametoxazole (n=302, 50.2%), ciprofloxacin (n=230, 38.2%), levofloxacin (n=221, 36.7%), norfloxacin (n=220, 36.5%) y amoxicilin+clavulanic acid (n=204, 33.9%).Conclusions:The results in this research reveal that due to their good sensitivity profile, antibiotics like fosfomycin and nitrufurantoin can be a viable empiric therapy in patients with low urinary, or not complicated tract infection before using wide spectrum antibiotics, always personalizing according to the clinical state of the patient and trying to avoid the development of antibiotic resistance.
Assuntos
Antibacterianos , Infecções Urinárias , Sensibilidade Química MúltiplaRESUMO
La prótesis sobre implantes es una buena alternativa de tratamiento frente a los tratamientos convencionales de prótesis total en pacientes con edentulismo total. Este tratamiento se ha venido realizando con éxito en los últimos años y constituye una realidad clínica de alto valor. El presente artículo reporta el caso clínico de un paciente de sexo masculino fumador donde se realizó la rehabilitación del maxilar superior con una prótesis tipo hibrida sobre 6 implantes. A continuación se describe paso a paso la elaboración de una prótesis implanto soportada, devolviéndole al paciente estética y funcionabilidad mejorando su calidad de vida...
The oral rehabilitation with implant prosthesis has been incorporated into dental practice as an alternative to conventional treatment in patients with complete edentulous. This treatment has been carried out successfully in recent years and is a clinical reality of high value. This article reports the case of a male patient with a history of being a smoker in which the rehabilitation of the upper jaw was restored with a hybrid type prosthesis on 6 implants. The following describes step by step the elaboration of implant-supported prosthesis, restoring the aesthetics and functionality thereby improving patient quality of life...
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Reabilitação BucalRESUMO
Pediatric acute liver failure is a syndrome ofsevere and sudden dysfunction of the hepatocytes which produces a failure in synthetic and detoxifyingfunction. It is an infrequent and severe disease butpotentiallyfatal, occurring in children with no prior history of liver disease. Etiology is related to the age and geographic region of the patient, recognizing the origin: metabolic, infectious, drug exposure, autoinmune, vascular and oncologic. Indeterminate cause where all the etiological search is negative, can range between 18 and 47%, depending on the center and access to the realization of etiological studies. The process which determines the liver injury is still not well known and is considered multifactorial. Essentially, it depends on host susceptibility, the cause and severity of the damage and the ability of liver regeneration. The clinical presentation depends on the etiology, which usually begins with an episode ofacute hepatitis, that in the following days or weeks presents unfavorable outcome, deepening jaundice, affecting the general state and presenting severe coagulopathy that characterizes the syndrome. The treatment consists of general measures which take into account the metabolic disorders, nutritional aspect, and the prevention and treatment of all complications that occur in the evolutionary course (infectious, neurological, etc). Besides it is also vital to implement the specific treatment of those diseases which can benefit from it (alloimmune hepatitis, galactosemia, tyrosinemia, herpes simplex infection, Wilson's disease, etc.). However, despite therapeutic advances, acute liver failure results in death or liver transplantation in over 45% ofcases.
Assuntos
Falência Hepática Aguda , Criança , Gastroenterologia , Humanos , Lactente , Recém-Nascido , América Latina , Falência Hepática Aguda/diagnóstico , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/terapia , Transplante de Fígado , Plasmaferese , Prognóstico , Índice de Gravidade de Doença , Sociedades MédicasRESUMO
El objetivo de este estudio fue describir y comparar las características antropométricas, composición corporal y somatotipo de patinadoras de patinaje artístico sobre ruedas por categorías (junior y senior) y por disciplinas (individual, parejas y danza). Fueron evaluadas 62 patinadoras profesionales (36 en la disciplina de libre, 13 en danza y 13 en parejas). El análisis estadístico utilizado fue una ANOVA para muestras independientes entre disciplinas, y una T de Student para las categorías (junior y senior). Entre la categoría junior y senior no se han encontrado diferencias estadísticas significativas. Las patinadoras junior presentaron un somatotipo endo-mesomorfo, y las patinadoras senior presentaron un somatotipo mesomorfo balanceado. El somatotipo de las patinadoras de parejas y danza fue el mesomórfico balanceado, y el de las patinadoras de libre fue endo-mesomórfico. Este estudio aporta datos biotipológicos de referencia para la población de elite de patinadoras sobre ruedas.
The aim of the study was to describe and compare anthropometric characteristics, body composition and somatotype of female roller skaters by levels (Junior and Senior) and by disciplines (freestyle, pairs and dance). Sixty-two world class female roller skaters were assessed (36 freestyle roller skaters, 13 dance roller skaters and 13 pair roller skaters). A one-way analysis of variance (ANOVA) was used to determine if significant differences existed in the anthropometric profile among skating discipline and a student t test in order to assess differences between junior and senior levels. There are no significant differences between junior and senior roller skaters. Junior female roller skaters show an endo-mesomorphic somatotype and senior female roller skaters show a balanced mesomorphic somatotype. Roller dance skaters and roller pair skaters show a balanced mesomorphic somatotype and roller freestyle skaters show an endo-mesomorphic somatotype. This paper, reports specific reference data for world class female roller skaters.