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7.
Ultrasound Obstet Gynecol ; 58(2): 238-244, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-32798234

RESUMO

OBJECTIVE: To describe changes in fetal Doppler parameters during a novel technique for open fetal microneurosurgery for open spina bifida (OSB) repair. METHODS: This was a prospective study of 44 fetuses undergoing open fetal surgery for OSB repair using a novel microneurosurgery approach that is characterized by a mini-hysterotomy (diameter of 15 mm), minimal fetal manipulation and maintenance of a constant normal amniotic fluid volume throughout the procedure. Doppler velocimetry of the umbilical artery (UA), fetal middle cerebral artery (MCA) and ductus venosus (DV) was performed before the start of surgery and at prespecified timepoints during fetal surgery. UA pulsatility index (PI) > 95th percentile, DV-PI > 95th percentile, MCA-PI < 5th percentile and cerebroplacental ratio (CPR) < 5th percentile were considered abnormal. RESULTS: Median gestational age at fetal surgery was 25.2 weeks (range, 22.9-27.9 weeks). Doppler recordings were successfully obtained in all cases during all timepoints throughout the surgery. As compared with Doppler values before surgery, there was a significant increase in the proportion of fetuses with MCA-PI < 5th percentile (63.6% vs 13.6%; P < 0.001), CPR < 5th percentile (65.9% vs 15.9%; P < 0.001) and DV-PI > 95th percentile (22.7% vs 0%; P = 0.01) and a non-significant increase in the proportion of fetuses with UA-PI > 95th percentile (11.4% vs 0%; P = 0.12) during fetal surgery. None of the fetuses showed absent or reversed end-diastolic velocity in the UA or absent or reversed DV a-wave at any stage during OSB repair. All abnormal Doppler parameters returned to normal after surgery. CONCLUSIONS: During open fetal surgery for OSB repair, a small hysterotomy, reduced fetal manipulation and maintenance of a normal amniotic fluid volume seem to prevent severe fetal Doppler abnormalities. The mild Doppler changes observed during fetal surgery could be a manifestation of fetal adaptation to the stress of fetal surgery. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Espinha Bífida Cística/cirurgia , Adulto , Líquido Amniótico , Velocidade do Fluxo Sanguíneo , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/diagnóstico por imagem , Gravidez , Estudos Prospectivos , Fluxo Pulsátil , Resultado do Tratamento , Ultrassonografia Doppler , Artérias Umbilicais/diagnóstico por imagem , Adulto Jovem
8.
Nanomaterials (Basel) ; 10(6)2020 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-32545858

RESUMO

In this paper we report on the influence of polysaccharides' molecular structure on the antibacterial activity and cytotoxicity of composites based on silver nanoparticles (AgNPs) immobilized into carboxymethyl-cellulose (CMC). These composites were green synthesized from the reduction of silver ions into aqueous solutions of the polysaccharide, using CMC with different degree of substitution (DS) and molecular weight (Mw). The composites were characterized by transmission electron microscopy (TEM), as well as infrared (ATR-FTIR), ultraviolet (UV-Vis), Raman, and X-ray photo-electron (XPS) spectroscopic techniques. The antibacterial activity was evaluated with minimum inhibitory concentration against Enterococcus faecalis. The cytotoxicity of composites was assessed against human gingival fibroblast. Experimental evidence suggests that particle size distribution and morphology of AgNPs change according to the quantity of silver precursor added to the reaction, as well as the DS and Mw of CMC used for composites preparation. This is related to the dispersion of silver precursor into aqueous solutions of the polysaccharide and the formation of Ag-O coordination bonds among AgNPs and COO- moieties of CMC. Moreover, these coordination bonds modify the ability of nanoparticles to produce and release Ag+ into aqueous dispersion, adjusting their antibacterial activity and the induction of cytotoxicity into the tested biological environments.

9.
Ultrasound Obstet Gynecol ; 56(4): 516-521, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32068928

RESUMO

OBJECTIVE: To evaluate the impact of fetal endoscopic tracheal occlusion (FETO) on improving survival of fetuses with severe left-sided congenital diaphragmatic hernia (CDH), as compared with contemporaneous cases managed expectantly during pregnancy, in a country with suboptimal neonatal management. METHODS: In this prospective cohort study, consecutive fetuses with isolated left-sided CDH, normal karyotype and severe pulmonary hypoplasia (defined as liver herniation and observed/expected lung-to-head circumference ratio below 26%) were selected for FETO at less than 32 weeks of gestation in a single tertiary referral center in Queretaro, Mexico. Postnatal outcome (survival up to 28 days after birth) was compared between fetuses treated with FETO and contemporaneous cases with similar lung size managed expectantly during pregnancy. RESULTS: Twenty-five fetuses with isolated severe left-sided CDH treated with FETO were matched individually with 25 cases managed expectantly during pregnancy. Endotracheal placement of the balloon was performed successfully on the first attempt in all cases. The median gestational age (GA) at balloon placement was 29.1 (range, 25.6-31.8) weeks and 34.1 (range, 30.0-36.1) weeks at balloon removal. There were no technical problems with the introduction or removal of the balloon in any cases. The median GA at delivery was significantly lower in the group treated with FETO than in those managed expectantly (35.3 vs 37.7 weeks; P = 0.04). The survival rate was significantly higher in the group treated with FETO than in those without fetal intervention (32% vs 0%; P < 0.001). CONCLUSION: In settings with suboptimal neonatal management, FETO was associated with improved neonatal survival in fetuses with isolated left-sided CDH and severe pulmonary hypoplasia. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Resultado de supervivencia en una hernia diafragmática congénita grave del lado izquierdo, con y sin oclusión traqueal endoscópica fetal en un país con un tratamiento neonatal subóptimo OBJETIVO: Evaluar el impacto de la oclusión traqueal endoscópica fetal (OTEF) en la mejora de la supervivencia de los fetos con hernia diafragmática congénita (HDC) grave del lado izquierdo, en comparación con los casos actuales tratados como embarazo gestante, en un país con un tratamiento neonatal subóptimo. MÉTODOS: En este estudio prospectivo de cohortes, se seleccionaron fetos consecutivos con HDC aislada del lado izquierdo, cariotipo normal e hipoplasia pulmonar grave (definida como hernia hepática y una proporción observada/esperada de la circunferencia pulmonar-cabeza inferior al 26%) para una OTEF antes de las 32 semanas de gestación, en un único centro de medicina especializada terciaria en Querétaro (México). El resultado postnatal (supervivencia hasta los 28 días después del nacimiento) se comparó entre fetos tratados con OTEF y los casos contemporáneos con tamaño pulmonar similar, tratados como embarazo gestante. RESULTADOS: Veinticinco fetos con HDC grave aislada del lado izquierdo que habían sido tratados con OTEF fueron emparejados individualmente con 25 casos tratados como embarazo gestante. La colocación endotraqueal del globo se realizó con éxito en el primer intento en todos los casos. La mediana de la edad gestacional (EG) en el momento de la colocación del globo fue de 29,1 (rango, 25,6-31,8) semanas y 34,1 (rango, 30,0-36,1) semanas cuando se retiró el globo. En ningún caso hubo problemas técnicos con la introducción o la retirada del globo. La mediana de la EG en el momento del parto fue significativamente menor en el grupo tratado con OTEF que en el grupo tratado como gestante (35,3 vs 37,7 semanas; P=0,04). La tasa de supervivencia fue significativamente más alta en el grupo tratado con OTEF que en los casos sin intervención fetal (32% vs 0%; P<0,001). CONCLUSIÓN: En los entornos con un tratamiento neonatal subóptimo, la OTEF se asoció con una mejora de la supervivencia neonatal en los fetos con HDC aislada del lado izquierdo y con hipoplasia pulmonar grave. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Oclusão com Balão/mortalidade , Fetoscopia/mortalidade , Hérnias Diafragmáticas Congênitas/cirurgia , Pulmão/anormalidades , Traqueia/cirurgia , Oclusão com Balão/métodos , Cefalometria , Feminino , Fetoscopia/métodos , Feto/diagnóstico por imagem , Feto/embriologia , Feto/cirurgia , Hérnias Diafragmáticas Congênitas/embriologia , Humanos , Recém-Nascido , Pulmão/embriologia , México , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Prospectivos , Taxa de Sobrevida , Traqueia/embriologia , Resultado do Tratamento , Ultrassonografia Pré-Natal , Conduta Expectante/estatística & dados numéricos
10.
Carbohydr Polym ; 200: 289-296, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30177169

RESUMO

In this paper, the synthesis of magnetic nanofibrous materials with a soft ferromagnetic response based on magnetite nanoparticles (SMON) loaded to aqueous carboxymethyl-cellulose (CMC)/polyvinyl-alcohol (PVA) polymeric blends is reported. The nanofibrous materials were obtained from the electrospinning of SMON-CMC/PVA blends with different SMON content, applying a constant tension of 15 kV. The synthesized samples were analyzed by transmission electron microscopy, scanning electron microscopy, attenuated total reflectance Fourier transform infrared, Raman and X-Ray photoelectron spectroscopy, as well as static magnetic measuring. Our experimental findings indicate that nanofibers' diameter decreases as SMON content in the electrospun polymeric blends is increased, since these magnetic nanoparticles diminish the interactions between PVA and CMC molecules, which improves their spinnability. Moreover, the spatial distribution of SMON in the fibers provides to the synthesized nanofibrous materials a novel soft ferromagnetic response at room temperature. This phenomenon is attributed to the formation of nanoparticles' aggregates that are discretely distributed in the nanofibers.

11.
Ultrasound Obstet Gynecol ; 49(6): 744-750, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27363854

RESUMO

OBJECTIVE: To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death. METHODS: A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleural effusion with severe lung compression was selected for percutaneous ultrasound-guided fetal laser ablation of the feeding artery (FLAFA) before 32 weeks' gestation in a single tertiary national referral center in Queretaro, Mexico. The primary outcomes were survival and need for postnatal surgery. RESULTS: FLAFA was performed successfully in all cases at a median gestational age of 24.9 (range, 24.4-31.7) weeks. After fetal intervention, dimensions in both lungs increased and fluid effusions resolved in all cases. All cases were delivered liveborn at term at a median gestational age of 39.6 (range, 38.0-39.7) weeks, without respiratory morbidity or need for oxygen support, resulting in perinatal survival of 100%. During follow-up, three (60%) cases showed progressive regression of the entire lung mass and did not require postnatal surgery, whereas in two (40%) cases a progressive decrease in size of the mass was observed but a cystic portion of the lung mass persisted and postnatal lobectomy was required. CONCLUSION: In fetuses with large hybrid lung lesions at risk of perinatal death, FLAFA is feasible and could improve survival and decrease the need for postnatal surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Doenças Fetais/cirurgia , Pneumopatias/diagnóstico , Artérias/cirurgia , Estudos de Coortes , Malformação Adenomatoide Cística Congênita do Pulmão/complicações , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem , Malformação Adenomatoide Cística Congênita do Pulmão/fisiopatologia , Feminino , Doenças Fetais/diagnóstico por imagem , Doenças Fetais/fisiopatologia , Terapias Fetais , Idade Gestacional , Humanos , Terapia a Laser , Pneumopatias/complicações , Pneumopatias/congênito , Pneumopatias/diagnóstico por imagem , Pneumopatias/fisiopatologia , Pneumopatias/cirurgia , México , Gravidez , Estudos Prospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção , Ultrassonografia Pré-Natal
12.
Carbohydr Polym ; 136: 46-53, 2016 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-26572327

RESUMO

In this contribution a novel green chemistry approach for the synthesis of nanofibrous materials based on blends of carboxymethyl-cellulose (CMC)-silver nanoparticles (AgNPs) composite and polyvinyl-alcohol (PVA) is proposed. These nanofibrous materials were obtained from the electrospinning of blends of aqueous solutions of CMC-AgNPs composite and PVA, which were prepared at different CMC/PVA weight ratios in order to electrospin nanofibers applying a constant tension of 15kV. The synthesized materials were characterized by means of transmission electron microscopy, scanning electron microscopy; as well as Fourier-transform infrared, ultraviolet and Raman spectroscopic techniques. Experimental evidence suggests that the diameter of the nanofibers is thinner than any other reported in the literature regarding the electrospinning of CMC. This feature is related to the interactions of AgNPs with carboxyl functional groups of the CMC, which diminish those between the later and acetyl groups of PVA.


Assuntos
Carboximetilcelulose Sódica/química , Química Verde , Nanofibras/química , Nanotecnologia , Prata/química , Técnicas de Química Sintética , Nanopartículas Metálicas/química , Modelos Moleculares , Conformação Molecular , Álcool de Polivinil/química
13.
Endoscopia (México) ; 10(2): 40-4, abr.-jun. 1999. graf, ilus
Artigo em Espanhol | LILACS | ID: lil-276439

RESUMO

Se estudiaron 30 pacientes con diagnóstico presuntivo de enfermedad ácido péptica mayores de 16 años, valorando la cavidad oral en cuanto a índice gingival de Loes y Silmess. Objetivo: detectar la presencia de Helicobacter pylori en el parodonto (espacio entre encía y diente) y antro gástrico con técnica PCR y NESTED PCR para determinar si el parodonto es un reservorio de Helicobacter pylori. Diseño: prospectivo, no comparativo, observacional, transversal. Resultados: Se revisaron 10 pacientes masculinos (33 por ciento) y 20 pacientes femeninos (66.6 por ciento) con un rango de edad 17 a 89 años. El grupo de pacientes estudiados presentaron en su mayoría enfermedad periodontal (80 por ciento). Detección de Helicobacter pylori por PCR: a) Región Parodontal: Positivos = 20 pacientes 66.6 por ciento; Negativos = 10 pacientes 33.3 por ciento. b) Región del antro gástrico: Positivos = 11 pacientes 36.6 por ciento; Negativos = 19 pacientes 63.3 por ciento. Pacientes que no tuvieron correlación entre la presencia de Helicobacter pylori en parodonto y antro gástrico = 27 pacientes (90 por ciento): I) parodonto + antro gástrico - = 18 pacientes 60 por ciento; II) Parodonto - y antro gástrico + = 9 pacientes 30 por ciento. Pacientes que tuvieron la misma correlación entre la presencia de Helicobacter pylori en parodonto y antro gástrico = 3 (10 por ciento). Conclusión: se logró identificar Helicobacter pylori en parodonto con técnica PCR. La presencia de Helicobacter pylory en antro gástrico en la mayoría de los casos estudiados no correlacionó con la presencia de Helicobacter pylory en el parondo


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antro Pilórico/microbiologia , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/patogenicidade , Periodonto/microbiologia , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase/estatística & dados numéricos , Endoscopia do Sistema Digestório/métodos , Endoscopia do Sistema Digestório , Úlcera Péptica/diagnóstico , Úlcera Péptica/etiologia
14.
Medicentro ; 2(3)1998.
Artigo em Espanhol | CUMED | ID: cum-20665

RESUMO

Al interpretar los resultados de las pruebas espirométricas se han utilizados valores de referncia o predicción mediante el análisis de regresión múltiple. Estos valores se encuentran asociados al sexo, edad, altura, diámetro biacromial, entre otros. Como se ha aprobado variación étnica, es importante tener los valores normales de las pruebas funcionales respiratorias en nuestro medio. Para cumplir este objetivo, se eligió una muestra aleatoria de 231 mujeres y 251 hombres, a los cuales se les realizaron las pruebas funcionales respiratorias utilizando un Microspiro HI-298, a partir de las cuales se obtuvieron las ecuaciones de regresión que nos permiten predecir los valores de las pruebas funcionales respiratorias: capacidad vital, capacidad vital forzadas, volumen espiratorio forzado en el primer segundo, flujo espiratorio pico y flujo máximo medio


Assuntos
Testes de Função Respiratória
15.
Rev. cienc. med. 3 dic ; 6(2): 157-64, mayo-ago. 1992. tab
Artigo em Espanhol | CUMED | ID: cum-17359

RESUMO

Se aplica un programa de ejercicios físicos, posturales (yoga) respiratorios y psicorrelajativos, creados por los autores a personas mayores de 45 años de un consultorio del médico de la familia del municipio de Sancti Spíritus, la patología que presenta, el consumo de medicamentos y resultados del test Behaviour Rating Scale de J.R. Williams. En el grupo experimental se comprueba una mejoria en la mayoria de las patologías, fundamentalmente la hipertensión arterial, la artrosis y las cardiopatías. La reducción y eliminación en el consumo de medicamentos también fue mayor en este grupo. La mejoria en el comportamiento social de las perdidas integradas al programa de ejercicios también fue superior, fundamentalmente en el autocuidado y autopreparación, conservación del aspecto personal.(AU)


Assuntos
Humanos , Yoga , Exercícios Respiratórios
16.
Rev. Cienc. Med. 3 Dic ; 6(2): 157-164, mayo-ago. 1992. tab
Artigo em Espanhol | CUMED | ID: cum-32110

RESUMO

Se aplica un programa de ejercicios físicos, posturales (yoga) respiratorios y psicorrelajativos, creados por los autores a personas mayores de 45 años de un consultorio del médico de la familia del municipio de Sancti Spíritus, la patología que presenta, el consumo de medicamentos y resultados del test Behaviour Rating Scale de J.R. Williams. En el grupo experimental se comprueba una mejoría en la mayoría de las patologías, fundamentalmente la hipertensión arterial, la artrosis y las cardiopatías. La reducción y eliminación en el consumo de medicamentos también fue mayor en este grupo. La mejoria en el comportamiento social de las perdidas integradas al programa de ejercicios también fue superior, fundamentalmente en el autocuidado y autopreparación, conservación del aspecto personal.(AU)


Assuntos
Humanos , Yoga , Exercícios Respiratórios
17.
Artigo em Inglês | MEDLINE | ID: mdl-1342891

RESUMO

Thirty adult patients with a diagnosis of chronic urticaria were attended as outpatients at the Allergology Service, Clinical Surgical Hospital "Hnos. Ameijeiras". An accurate clinical history was made, humoral parameters such as erythrosedimentation, total eosinophil count, serum levels of immunoglobulins and complement fractions were measured, and a skin biopsy was done. Most of the patients with urticarial vasculitis showed almost permanent papulous reactions with fever and arthralgias. Duodenal smear was positive for Giardia lamblia in a high percentage of patients with urticarial vasculitis. Paraffin-embedded skin biopsy was very useful for measuring morphological variables, and it is recommended that this technique be used in recent reactions (< 24 h evolution).


Assuntos
Urticária/diagnóstico , Vasculite/diagnóstico , Adolescente , Adulto , Biópsia , Doença Crônica , Proteínas do Sistema Complemento/metabolismo , Diagnóstico Diferencial , Feminino , Humanos , Imunoglobulinas/sangue , Testes Imunológicos , Masculino , Pessoa de Meia-Idade , Pele/patologia , Urticária/complicações , Urticária/imunologia , Vasculite/complicações , Vasculite/imunologia
18.
Rev. cienc. med. 3 dic ; 3(2): 29-36, mayo-ago. 1989. tab, graf
Artigo em Espanhol | CUMED | ID: cum-17399

RESUMO

Se aplico la prueba de "Lavado de Nitrogeno" a un grupo de pacientes asmáticos y un grupo de control con el objetivo de conocer los datos más útiles que aporta la prueba y poder valorar la sensibilidad y confiabilidad para detectar alteraciones en la ventilación pulmonar de los pacientes asmáticos en el período de intercrisis.(AU)


Assuntos
Humanos , Asma , Testes de Função Respiratória
19.
Rev. Cienc. Med. 3 Dic ; 3(2): 29-36, mayo-ago. 1989. tab, graf
Artigo em Espanhol | CUMED | ID: cum-32314

RESUMO

Se aplicó la prueba de "Lavado de Nitrogeno" a un grupo de pacientes asmáticos y un grupo de control con el objetivo de conocer los datos más útiles que aporta la prueba y poder valorar la sensibilidad y confiabilidad para detectar alteraciones en la ventilación pulmonar de los pacientes asmáticos en el período de intercrisis.(AU)


Assuntos
Humanos , Asma , Testes de Função Respiratória
20.
Artigo em Espanhol | CUMED | ID: cum-15549

RESUMO

Se presenta el caso de un niño de 12 años con anquilosis de la articulación temporomandibular izquierda. A partir de un cuadro clínico, estudio radiográficos y valoración psicológica, se diseñó un plan de tratamiento que incluyó artroplastia. Además se utilizó la hipnosis y el bloqueo del nervio mandibular como coadyuvante de la fisoterpaia postoperatoria, con resultados altamente satisfactorios (AU)


Assuntos
Anquilose/terapia , Articulação Temporomandibular , Articulação Temporomandibular/cirurgia , Hipnose
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