RESUMO
BACKGROUND: Rh disease occurs following maternal alloimmunization, which can develop due to RhD blood group antigen incompatibility between a mother and her fetus. Despite developing robust clinical protocols for effective immunoprophylaxis over the last 50+ years, a significant global burden of Rh disease still exists, particularly in low/middle-income countries such as Mexico. MATERIALS AND METHODS: This study examined disparities in the allocation of maternal and child health resources, as well as clinical knowledge regarding Rh disease, to gain insight into why Rh disease remains prevalent in Mexico. To this end, an 11-question survey was sent to members of the Federación Mexicana de Colegios de Obstetricia y Ginecología (FEMECOG) to evaluate their knowledge of the availability and implementation of anti-RhD immunoglobulin prophylaxis in their practices and institutions, and about managing Rh disease by monitoring fetal anemia risk and providing intrauterine treatment when necessary. Responses were separated by region, and chi-square two-by-two contingency tests were performed to evaluate regional and institutional differences. RESULTS: Significant variations in prevention and treatment were found within the Mexican healthcare system, particularly, with regard to providing anti-RhD immunoglobulin to prevent alloimmunization, which is critically important for preventing Rh disease. Specifically, Regions 5, 6, and 7 were most lacking in this regard. DISCUSSION: This study highlights differences in the Mexican healthcare system in preventing and treating Rh disease. Closing the gap in the availability of anti-RhD immunoglobulin should take priority in future efforts aimed at providing equitable care, because this will lead to the more preferable outcome of preventing Rh disease, rather than forcing patients to seek out more complex measures for treating Rh disease after it develops. These data can be used to create strategies to understand and eliminate these healthcare disparities.
RESUMO
The growing demand for plant fiber-reinforced composites offers new opportunities to compete against glass fiber (GF)-reinforced composites, but their performance must be assessed, revised, and improved as much as possible. This work reports on the production and the flexural strength of composites from polypropylene (PP) and hemp strands (20-50 wt.%), using maleic anhydride-grafted PP (MAPP) as a compatibilizer. A computational assessment of the reaction between cellulose and MAPP suggested the formation of only one ester bond per maleic anhydride unit as the most stable product. We determined the most favorable MAPP dosage to be 0.06 g per gram of fiber. The maximum enhancement in flexural strength that was attained with this proportion of MAPP was 148%, corresponding to the maximum fiber load. The modified rule of mixtures and the assumption of similar coupling factors for tensile and flexural strength allowed us to estimate the intrinsic flexural strength of hemp strands as 953 ± 116 MPa. While falling short of the values for sized GF (2415 MPa), the reinforcement efficiency parameter of the natural fibers (0.209) was found to be higher than that of GF (0.045).
RESUMO
OBJECTIVE: Determinate instant and after 1-month non-dipper effect in hypertense patients after renal transplant by 24-hour ambulatory blood pressure monitoring in Hospital General de Zona No. 50, San Luis Potosí, Mexico. METHOD: Descriptive, longitudinal and prospective cohort study of a non-probability convenience sampling in post-transplant patients with hypertension. We collected data from MAPA and includes age, sex, cardiovascular risk factors in variables. Use of central tendency and dispersion measures for descriptive analysis and t Student for inferential analysis. RESULTS: 19 patients were included, 11 male (57.9%) and 8 females (42.1%), with age range 20 to 49 years (median of 30.2 years ± 7.7). Where the non-dipper effect in the first take was 89.5% and in the second take 84.2%. CONCLUSIONS: There is a high frequency of the non-dipper pattern in patients at one month of kidney transplant, the persistence of this hypertension may be, among others, by the use of immunosuppressants. A new category for non-dipper classification is described.
OBJETIVO: Determinar el efecto non-dipper inmediato y posterior a 1 mes en pacientes adultos hipertensos postrasplante renal con monitoreo continuo de la presión arterial de 24 horas, en el Hospital General de Zona No. 50 de San Luis Potosí, México. MÉTODO: Estudio de tipo cohorte, longitudinal, prospectivo, con muestreo no probabilístico por conveniencia de casos consecutivos en pacientes receptores de trasplante renal con hipertensión arterial. Se recogieron los siguientes datos: edad, sexo, factores de riesgo cardiovascular, uso de antihipertensivos o inmunosupresores, y monitoreo ambulatorio de la presión arterial de 24 horas. Se aplicaron medidas de tendencia central y de dispersión para análisis descriptivo, y prueba t de Student para análisis inferencial. RESULTADOS: Se incluyeron 11 hombres (57.9%) y 8 mujeres (42.1%), con una edad de 20 a 49 años (media 30.2 ± 7.7), en los que el efecto non-dipper inmediato fue del 89.5% y posterior a 1 mes fue del 84.2%. CONCLUSIONES: Existe una alta frecuencia del patrón non-dipper en pacientes a 1 mes del trasplante renal. La persistencia de la hipertensión puede ser, entre otras causas, por el uso de inmunosupresores. Se describe una nueva categoría para la clasificación non-dipper.
Assuntos
Hipertensão , Transplante de Rim , Adulto , Monitorização Ambulatorial da Pressão Arterial , Ritmo Circadiano , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
Se revisaron 122 pacientes tratados con estenosis traqueal benignas a diferentes niveles durante el período comprendido de 1983 a 1993. Se analizó la etiología, el sitio de la lesión, la patología asociada y los procedimientos de fondo que llevaron a esta condición. Los procedimientos quirúrgicos utilizados incluyen la reconstrucción de la carina, resección y anastomosis termino-terminal solo o en conjunto con otros procedimientos tales como plastías laríngeas en caso de estenosis laríngea asociada, y la colocación de dos prótesis de silastic. Se decanularon 110 (90 por ciento), 3 murieron, 5 tuvieron malos resultados y esperan nueva reconstrucción y 4 están en proceso de decanulación y 2 usan tubo en T de silastic permanente. La conclusión es que durante los últimos años ha habido un aumento de este tipo de lesiones; se hace hincapié en la frecuencia con que se producen por intubación prolongada, y la posibilidad de su corrección con los procedimientos quirúrgicos propuestos