RESUMO
Objective: Traditionally, perfectionism has been regarded as a commendable trait in the realm of sports and exercise. However, recent research has uncovered a paradoxical aspect of perfectionism in these domains. This umbrella review seeks to offer a comprehensive overview of the intricate role that perfectionism plays in sport and exercise performance. Method : As an umbrella review, we systematically explored three widely used scientific databases-PubMed, Scopus, and ISI-to identify relevant systematic reviewes and meta-analyses investigating the relationship between perfectionism and sports performance. Results: After careful evaluation, eight studies met our inclusion criteria and were included in the study. These eight eligible studies comprised five systematic reviews and three systematic review and meta-analysis publications. These publications have explored the correlation between perfectionism and sports performance in teenager and adult populations, as well as professional and amateur athletes. Most of the original articles included in these studies had a cross-sectional design and some of them were longitudinal research. All reviewed articles reported a significant correlation between perfectionism and sports performance, regardless of gender and age. In general, the main consensus of these studies is a moderate to high positive correlation between perfectionistic strivings and sports performance, as well as a moderate to high negative correlation between perfectionistic concerns and sports performance. Conclusion: In summary, perfectionism exhibits both positive and negative effects on athlete outcomes. Maladaptive perfectionism is linked to adverse consequences, while adaptive perfectionism can yield positive effects. Promisingly, psychological interventions such as mindfulness-based approaches and ACT-based interventions show potential in reducing perfectionism and enhancing athlete outcomes. Future research should delve deeper into the intricate relationship between perfectionism and athlete performance and continue to devise interventions that counteract the detrimental effects of perfectionistic tendencies.
RESUMO
Breast cancer is one of the leading causes of death in the female population because of the resistance of cancer cells to many anticancer drugs used. Curcumin has cytotoxic activities against breast cancer cells, although it has limited use due to its poor bioavailability and rapid metabolic elimination. The synthesis of metal complexes of curcumin and curcuminoids is a relevant topic in the search for more active and selective derivatives of these molecular scaffolds. However, solubility and bioavailability are concomitant disadvantages of these types of molecules. To overcome such drawbacks, the preparation of inclusion complexes offers a chemical and pharmacologically safe option for improving the aqueous solubility of organic molecules. Herein, we describe the preparation of the inclusion complex of dimethoxycurcumin magnesium complex (DiMeOC-Mg, (4)) with beta-cyclodextrin (DiMeOC-Mg-BCD, (5)) in the stoichiometric relationship 1:1. This new inclusion complex's solubility in aqueous media phosphate buffer saline (PBS) was improved by a factor of 6x over the free metal complex (4). Furthermore, 5 affects cell metabolic rate, cell morphology, cell migration, induced apoptosis, and downregulation of the matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), and signal transducer and activator of transcription-3 (STAT3) expression levels on MD Anderson metastasis breast-231 cancer (MDA-MB-231) cell lines. Results of an antitumor assay in an in ovo model showed up to 30% inhibition of tumor growth for breast cancer (MDA-MB-231) when using (5) (0.650 mg/kg dose) and 17.29% inhibition with the free homoleptic metal complex (1.5 mg/kg dose, (4)). While the formulation of inclusion complexes from metal complexes of curcuminoids demonstrates its usefulness in improving the solubility and bioavailability of these metallodrugs, the new compound (5) exhibits excellent potential for use as a therapeutic agent in the battle against breast cancer.
Assuntos
Antineoplásicos , Curcumina , Curcumina/análogos & derivados , Magnésio , beta-Ciclodextrinas , beta-Ciclodextrinas/química , Curcumina/farmacologia , Curcumina/química , Curcumina/farmacocinética , Humanos , Animais , Antineoplásicos/farmacologia , Antineoplásicos/química , Magnésio/química , Apoptose/efeitos dos fármacos , Feminino , Linhagem Celular Tumoral , Fator de Transcrição STAT3/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias da Mama/metabolismo , Movimento Celular/efeitos dos fármacos , Solubilidade , Complexos de Coordenação/farmacologia , Complexos de Coordenação/química , Complexos de Coordenação/síntese química , Embrião de Galinha , Metaloproteinase 9 da Matriz/metabolismoRESUMO
BACKGROUND: Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure. OBJECTIVE: The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico. METHODS: A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305). RESULTS: The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries. CONCLUSION: It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.
RESUMO
BACKGROUND: A psychometric study of the Family Adaptability and Cohesion Scale (FACES III) has been conducted in Spanish-speaking countries from the perspective of the classical test theory. However, this approach has limitations that affect the psychometric understanding of this scale. OBJECTIVE: Accordingly, this study used the item response theory to investigate the psychometric performance of the items. Furthermore, it evaluated the differential performance of the items for Colombia and Chile. METHOD: For this purpose, 518 health science students from both countries participated. Confirmatory Factor Analysis was used. RESULTS: The study results revealed that the cohesion and adaptability items presented adequate discrimination and difficulty indices. In addition, items 5, 8, 13, 17, and 19 of cohesion indicated differential functioning between students from both countries, with Chilean students exhibiting a greater discriminatory power. Further, the Colombian group exhibited a greater discriminatory power for item 18 of adaptability. CONCLUSIONS: The study concluded that the items of FACES III indicated adequate psychometric performance in terms of their discriminative capacity and difficulty in Chile and Colombia.
Assuntos
Estudantes , Humanos , Psicometria , Chile , Colômbia , Análise Fatorial , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Abstract Background Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure. Objective The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico. Methods A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305). Results The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries. Conclusion It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.
RESUMO
The crystal structure determination of metal complexes of curcuminoids is a relevant topic to assess their unequivocal molecular structure. We report herein the first two X-ray crystal structures of homoleptic metal complexes of a curcuminoid, namely Dimethoxycurcumin (DiMeOC), with gallium and indium. Such successful achievement can be attributed to the suppression of interactions from the phenolic groups, which favor an appropriate molecular setup, rendering Dimethoxycurcumin gallium ((DiMeOC)2-Ga) and Dimethoxycurcumin indium ((DiMeOC)3-In) crystals. Surprisingly, the conformation of ligands in the crystal structures shows differences in each metal complex. Thus, the ligands in the (DiMeOC)2-Ga complex show two different conformers in the two molecules of the asymmetric unit. However, the ligands in the (DiMeOC)3-In complex exhibit three different conformations within the same molecule of the asymmetric unit, constituting the first such case described for an ML3 complex. The cytotoxic activity of the (DiMeOC)2-Ga complex is 4-fold higher than cisplatin against the K562 cell line and has comparable activity towards U251 and PC-3 cell lines. Interestingly, this complex exhibit three times lesser toxicity than cisplatin and even slightly lesser cytotoxicity than curcumin itself.
Assuntos
Antineoplásicos , Complexos de Coordenação , Gálio , Gálio/farmacologia , Gálio/química , Complexos de Coordenação/farmacologia , Complexos de Coordenação/química , Cisplatino , Índio/química , Diarileptanoides , Linhagem Celular Tumoral , Ligantes , Antineoplásicos/farmacologiaRESUMO
The first single crystal structure of the homoleptic copper (II) ML2 complex (M=Cu (II), L = curcumin) was obtained and its structure was elucidated by X-ray diffraction showing a square planar geometry, also confirmed by EPR. The supramolecular arrangement is supported by C-H···O interactions and the solvent (MeOH) plays an important role in stabilizing the crystal packing Crystallinity was additionally assessed by XRD patterns. The log P value of the complex (2.3 ± 0.15) was determined showing the improvement in water solubility. The cytotoxic activity of the complex against six cancer cell lines substantially surpasses that of curcumin itself, and it is particularly selective against leukemia (K562) and human glioblastoma (U251) cell lines, with similar antioxidant activity to BHT. This constitutes the first crystal structure of pristine curcumin complexed with a metal ion.
RESUMO
We report herein the synthesis and characterization of three heterocyclic curcuminoid ligands and their homoleptic metal complexes with magnesium and copper. Thus, N-methyl-2-pyrrolecarboxaldehyde, Furan-2-carboxaldehyde, and 2-Thiophenecarboxaldehyde were condensed with 2,4-pentanedione-boron trioxide complex. The first N-methyl-2-pyrrole curcuminoid and its Mg(II) complex are reported. All curcuminoid ligands and their corresponding metal complexes were characterized by infrared spectroscopy (IR), liquid state nuclear magnetic resonance (LSNMR), electron paramagnetic resonance (EPR), mass spectrometry (MS) and single crystal X-ray diffraction (SCXRD). The ThiopheneCurc-Cu (9) constitutes the first case of a "conformationally-heteroleptic" complex. The unique six-peaks star arrangement for the ThiopheneCurc ligand derived from the supramolecular description is reported. The metal complexes of FuranCurc-Mg (5) and ThiopheneCurc-Cu (9) have a good antioxidant effect (IC50 = 11.26 ± 1.73 and 10.30 ± 0.59 µM), three and two times higher than their free ligands respectively. Additionally, (5) shows remarkable cytotoxicity against colon cancer adenocarcinoma cell line HCT-15, comparable to that of cisplatin, with a negligible toxic effect in vitro towards a healthy monkey kidney cell line (COS-7).
Assuntos
Antineoplásicos , Complexos de Coordenação , Diarileptanoides , Complexos de Coordenação/química , Cisplatino , Antioxidantes/farmacologia , Espectroscopia de Ressonância de Spin Eletrônica , Cobre/química , Cristalografia por Raios X , Ligantes , Antineoplásicos/químicaRESUMO
The worldwide known and employed spice of Asian origin, turmeric, receives significant attention due to its numerous purported medicinal properties. Herein, we report an optimized synthesis of curcumin and symmetric curcuminoids of aromatic (bisdemethoxycurcumin) and heterocyclic type, with yields going from good to excellent using the cyclic difluoro-boronate derivative of acetylacetone prepared by reaction of 2,4-pentanedione with boron trifluoride in THF (ca. 95%). The subsequent cleavage of the BF2 group is of significant importance for achieving a high overall yield in this two-step procedure. Such cleavage occurs by treatment with hydrated alumina (Al2O3) or silica (SiO2) oxides, thus allowing the target heptanoids obtained in high yields as an amorphous powder to be filtered off directly from the reaction media. Furthermore, crystallization instead of chromatographic procedures provides a straightforward purification step. The ease and efficiency with which the present methodology can be applied to synthesizing the title compounds earns the terms "click" and "unclick" applied to describe particularly straightforward, efficient reactions. Furthermore, the methodology offers a simple, versatile, fast, and economical synthetic alternative for the obtention of curcumin (85% yield), bis-demethoxycurcumin (78% yield), and the symmetrical heterocyclic curcuminoids (80-92% yield), in pure form and excellent yields.
Assuntos
Curcumina , Curcumina/química , Diarileptanoides , Dióxido de Silício , Curcuma/química , Extratos Vegetais/químicaRESUMO
Curcumin, the most important secondary metabolite isolated from Curcuma longa, is known for its numerous purported therapeutic properties and as a natural dye. Herein, based on curcumin's intrinsic fluorescence, a search for improved curcumin-based fluorophores was conducted. Within the set of semi-synthetic curcumin derivatives i.e. mono (1), di (2), tri (3), tetra (4) benzylated and dibenzyl-fluoroborate (5), the fluorescence properties of 2 and 5 in solution outstood with a two-fold quantum yield compared to curcumin. Furthermore, all benzylated derivatives showed a favorable minimal cytotoxic activity upon screening at 25 µM against human cancer and non-tumoral COS-7 cell lines, with a reduction of its cytotoxic effect related to the degree of substitution. Fluorophores 2 and 5 are versatile bioimaging tools, as revealed by Confocal Fluorescence Microscopy (CFM), and showed permeation of living cell membranes of astrocytes and astrocytomas. When 2 is excited with a 405- (blue) or 543-nm (green) laser, it is possible to exclusively and intensively visualize the nucleus. However, the fluorescence emission fades as the laser wavelength moves towards the red region. In comparison, 5 allows selective visualization of cytoplasm when a 560-nm laser is used, showing emission in the NIR region, while it is possible to exclusively observe the nucleus at the blue region with a 405-nm laser.
Assuntos
Núcleo Celular , Citoplasma , Diarileptanoides/química , Diarileptanoides/farmacologia , Corantes Fluorescentes/química , Corantes Fluorescentes/farmacologia , Imagem Molecular , Núcleo Celular/metabolismo , Curcumina/química , Curcumina/farmacologia , Citoplasma/metabolismo , Modelos Moleculares , Conformação Molecular , Imagem Molecular/métodos , Estrutura MolecularRESUMO
We report herein the synthesis and crystal structures of five new homoleptic copper complexes of curcuminoids. The scarcity of reports of homoleptic complex structures of curcuminoids is attributed to the lack of crystallinity of such derivatives, and therefore, their characterization by single crystal X-ray diffraction is rare. The ligand design suppressing the phenolic interaction by esterification or etherification has afforded a significant increase in the number of known crystal structures of homoleptic metal complexes of curcuminoids revealing more favorable crystallinity. The crystal structures of the present new copper complexes show four-fold coordination with a square planar geometry. Two polymorphs were found for DiBncOC-Cu when crystallized from DMF. The characterization of these new complexes was carried out using infrared radiation (IR), nuclear magnetic resonance (NMR), electron paramagnetic resonance (EPR), and single crystal X-ray diffraction (SCXRD) and the antioxidant and cytotoxic activity of the obtained complexes was evaluated.
Assuntos
Complexos de Coordenação/química , Cobre/química , Animais , Antioxidantes/síntese química , Antioxidantes/química , Antioxidantes/farmacologia , Linhagem Celular Tumoral , Complexos de Coordenação/síntese química , Complexos de Coordenação/farmacologia , Relação Dose-Resposta a Droga , Ligantes , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Modelos Moleculares , Conformação Molecular , Estrutura Molecular , Ratos , Análise EspectralRESUMO
Synthesis of biaryl-containing macrocycles has been carried out through a four-step approach comprising two Ugi four component reactions and a Suzuki-Miyaura macrocyclization. This protocol allowed the synthesis of 12- and 14-membered macrocycles. Cytotoxic activity evaluation showed that some of the molecules were effective against leukemia, glioblastoma and lung cancer cell lines (IC50 = 4.0, 5.9 and 7.6, respectively).
Assuntos
Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Compostos de Bifenilo/síntese química , Compostos de Bifenilo/farmacologia , Compostos Macrocíclicos/síntese química , Compostos Macrocíclicos/farmacologia , Antineoplásicos/química , Compostos de Bifenilo/química , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Cristalografia por Raios X , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Compostos Macrocíclicos/química , Modelos Moleculares , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
Curcumin and its derivatives have been extensively studied for their remarkable medicinal properties, and their chemical synthesis has been an important step in the optimization of well-controlled laboratory production. A family of new compounds that mimic the structure of curcumin and curcuminoids, here named retro-curcuminoids (7-14), was synthesized and characterized using 1D ¹H- and 13C-NMR, IR, and mass spectrometry; the X-ray structure of 7, 8, 9, 10, 12, 13, and 14 are reported here for the first time. The main structural feature of these compounds is the reverse linkage of the two aromatic moieties, where the acid chloride moiety is linked to the phenolic group while preserving α, ß-unsaturated ketone functionality. The cytotoxic screening of 7, 8, 9, and 10 at 50 and 10 µg/mL was carried out with human cancer cell lines K562, MCF-7, and SKLU-1. Lipid peroxidation on rat brain was also tested for compounds 7 and 10. Compounds 7, 8, and 10 showed relevant cytotoxic activity against these cancer cell lines, and 10 showed a protective effect against lipid peroxidation. The molecular resemblance to curcuminoids and analogs with ortho substituents suggests a potential source of useful bioactive compounds.
Assuntos
Antineoplásicos , Curcumina/análogos & derivados , Estirenos/química , Animais , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Ácidos Cumáricos/química , Cristalografia por Raios X , Humanos , Células MCF-7 , Masculino , Ressonância Magnética Nuclear Biomolecular , Ratos , Ratos WistarRESUMO
Las lesiones focales de los órganos intra - abdominales comprenden un amplio espectro, produciendo desde pocas o inaparentes consecuencias, hasta un deterioro significativo de la calidad de vida pudiendo representar una condición severa asociada con mal pronóstico y alta mortalidad. Determinar el diagnóstico citológico de lesiones focales intra-abdominales mediante punción aspiración con aguja fina en pacientes que acuden al Servicio de Gastroenterología del Hospital Central Universitario Antonio María Pineda. Barquisimeto. Estado Lara. Se realizó una investigación de tipo descriptiva transversal, practicándose punción aspiración con aguja fina a todos los pacientes con lesiones focales intra-abdominales que acudierón al Servicio de Gastroenterología del HCUAMP durante el periodo Julio 2008 - Diciembre 2008 excluyéndose aquellos con ausencia de un trayecto seguro para la aguja, poca abordabilidad de la lesión, trastornos de coagulación o trombocitopenia severa, infecciones de la piel en el área de la punción, enfermedades neurológicas agudas, estado crítico o terminal y pacientes poco colaboradores. 62% de los pacientes con lesiones focales intra-abdominales pertenecían al sexo femenino y 38% al sexo masculino. 54% de los pacientes tenían entre 40 y 69 años. La localización intra-abdominal más frecuente de las lesiones fue Hígado en 84%, Páncreas en 10% Retroperitoneo en 4% y Bazo en 2%. La categoría citológica fue benigna en 30% seguido de 23% maligna y 7% sospechosa para malignidad mientras que en 37% no se reportaron hallazgos citológicos patológicos. El diagnóstico citológico más frecuente de las lesiones benignas fue Absceso en 65%. De los pacientes con lesiones categorizadas como malignas, 62% presentó diagnóstico citológico de Adenocarcinoma, 15% Carcinoma, 15% neoplasia epitelial neuroendocrina y 8% Linfoma. No se presentaron complicaciones. La principal limitación fue la no disponibilidad de patólogo en el momento de la toma de las muestra...
Focal lesions in intra-abdominal organs comprehend a wide spectrum, resulting into a few or non-apparent consequences up to a significant damage of living standards, which might represent a severe condition associated with a bad patient outlook and high morbidity. Determining the cytological diagnosis of intraabdominal focal lesions by puncture/aspiration with fine needle in patients attending the Hospital Central Universitario Antonio Maria Pinedas (HCUAMP) Gastroenterology Service, at Barquisimeto, State of Lara. A cross-sectioned descriptive research was developed; fine-needle puncture/aspiration was practiced on all patients with intra-abdominal focal lesions who attended the HCUAMPs Gastroenterology Service between July-September 2008, excluding those who did not show a safe routing for the needle, scarce approachability to the lesion, coagulation disturbances, severe thrombocytopenia, skin infection on the puncture area, acute neurologic diseases, critical or terminal stage, and uncooperative patients. 62% of patients with intra-abdominal focal lesions were female, and 38% were male. 54% of patients were between 40 and 69 years old. The most frequent intra-abdominal lesions were: Liver, 84%; Pancreas, 10%; retroperitoneum, 4%; and Spleen, 2%. Cytological category was 30% benign, followed by 23% malignant; and 7% probably malignant, while 37% did not report pathologic cytological findings. The most frequent cytological diagnosis in benign lesions was 65% of abscess. From the patients with lesions categorized as malignant, 62% presented a cytological diagnosis of adenocarcinoma; 15%, Carcinoma; 15%, neuroendocrinal epithelial neoplasm; and 8% Lymphoma. No complications were present. The non availability of pathologist at the time of sample collection was the main limitation. The puncture/aspiration by ultrasound-guided fine needle in intraabdominal focal lesions is a rapid and efficient diagnosis alternative, rendering high specificity...
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Biópsia por Agulha/métodos , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais , Ultrassonografia , GastroenterologiaRESUMO
Introducción: La Colangiopancreatografía retrógrada endoscópica (CPRE) es el procedimiento de elección actual en la patología biliopancreática, principalmente en casos de obstrucción biliar y colangitis, jugando un rol importante en el tratamiento de las estenosis benignas y malignas de las vías biliares. Objetivo: Presentar la experiencia de la Unidad de Gastroenterología del Hospital Central Universitario Antonio María Pineda en CPRE en pacientes con patología bilio-pancreatica. Material y métodos: Se realizó un estudio descriptivo retrospectivo mediante la revisión de historias clínicas de pacientes con patología biliopancreática que ameritaron una CPRE en el Servicio de Gastroenterología del Hospital Central Universitario Antonio María Pineda durante 2004- 2007, excluyéndose las historias incompletas para la información requerida. Resultados: Se revisaron 322 casos encontrándose que 69% pertenecía al sexo femenino. El grupo etario predominante estuvo comprendido entre 30 y 42 años. La indicación de la CPRE fue Coledocolitiasis en 61% seguida de neoplasias bilio-pancreaticas en 17%. Los hallazgos ecográficos más frecuentes previos a la CPRE fueron la dilatación de vías biliares en 44% y coledocolitiasis en 19%. Los hallazgos más frecuentes encontrados en la CPRE fueron Odditis en 23%, cálculos en via biliar en 21% y dilatación coledociana en 15%. Se realizaron 202 papiloesfinterotomias, se colocaron 58 prótesis y realizaron 40 dilataciones con balón. El 88% de las CPRE fue exitoso siendo la principal complicación la hemorragia leve en 9%. Conclusiones: la CPRE es un procedimiento seguro y efectivo en el tratamiento y diagnóstico de algunas patologías del árbol hepatobiliar, con resultados de morbilidad comparables a los entregados por las series internacionales.
Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) is currently the first choice of treatment for biliopancreatic pathologies, mostly in cases of biliary obstruction and cholangitis, playing a leading role in the treatment of either benign or malign strictures of the biliary tree. Objectives: to present the experience at the Gastroenterology Department of the Antonio Maria Pineda Central University Hospital in patients undergoing ERCP for a biliopancreatic pathology. Materials and methods: a descriptive, retrospective study was conducted by review of clinical histories of patients with biliopancreatic pathology requiring the performance of an ERCP between years 2004-2007, excluding clinical histories with incomplete data. Results: overall, 322 histories were reviewed, 69% of the patients were female and a predominance of subjects aged 30-42 was found. The most frequent indication for ERCP was choledocolithiasis (61%), followed by biliopancreatic neoplasms (17%). The most common echographic findings previous to ERCP were dilation of the biliary tree in 44% and choledocolithiasis in 19% of the cases. Findings on ERCP were mostly odditis (23%), gallstones (21%) and choledocian dilation (16%). 202 papillotomies were performed, 58 prostheses were implanted and 40 balloon dilations were performed. Eighty-eight percent of the ERCPs were successful, with mild bleeding as the most frequent complication (9%). Conclusions: ERCP is both and effective and safe procedure for the treatment and diagnosis of some pathologies of the hepatobiliary tree, with morbidity results matching those seen in international series.
RESUMO
El Síndrome de Rapunzel es una forma inusual de tricobezoar gástrico con extensión al intestino delgado, capaz de producir sintomas gastrointestinales desde dolor, nauceas, vómitos incluso obstrucción y perforación abdominal. Paciente femenino de 19 años de edad quien ingresa al Hospital Central Universitario Antonio María Pineda con enfermedad actual de 15 días de evolución caracterizada por dolor epigástrico acompañado de nauceas y vómitos postpandriales de intensidad progresiva evidenciandose al exámen físico una masa epigástrica palpable de aproximadamente 15cm de diámetro de consistencoa dura, no dolorosa, móvil, no adherida a planos profundos. Se realiza TAC abdominal donde se observa imágen heterogénea con capas concéntricas alternas con aire que ocupa estomago, fundus, cuerpo y antro con paso escaso de contraste a intestino delgado. Se lleva a mesa operatoria encontrándose tumoración que ocupa la totalidad de la cámara gástrica extendiéndose a duodeno, compuesta por pelos, moco y restos alimentarios realizándose remoción de la totalidad de la misma a través de una gastrostomía anterior. Evolución postoperatoria satisfactoria desde el puento de vista medico quirúrgico. La paciente es referida a consulta de psiquiatría por tricotilomanía y tricofagia. El síndrome de Rapunzel es una entidad clínica infrecuente de la cual existen pocos casos reportados en la literatura y que ocurre cuando un tricobezoar gástrico con cola se extiendo mas allá del piloro al intestino delgado incluso colon produciendo s¡ntomas gastrointestinales.
Assuntos
Humanos , Feminino , Bezoares/complicações , Gastroscopia , Obstrução Intestinal , Gastroenterologia , VenezuelaRESUMO
Con el objetivo de evaluar la aplicación del Método Necesidades Básicas Insatisfechas (NBI) en la detección de comunidades con mayor riesgo de desnutrición en los primeros 6 años de vida, se realizó un estudio de prevalencia en la Parroquia Juan Villegas, Barquisimeto, Venezuela. De la población de niños del grupo de edad de la zona, se obtuvo una muestra aleatoria estratificada y por conglomerados; se constituyeron cinco gradientes de barrios según el porcentaje de hogares con NBI. Se evaluaron 538 niños en 16 barrios a través de indicadores de NBI en la familia, encuesta Graffar Méndez Castellano peso y talla. El 10.8 por ciento de la muestra presentó desnutrición actual, el 25.3 por ciento déficit talla/edad, y el 5.8 por ciento sobrepeso; el porcentaje de niños con déficit nutricional crónico fue mayor en los gradientes NBI con peores condiciones de vida, siendo 30 por ciento en los barrios con 60-100 por ciento NBI. La presencia de viviendas inapropiadas, sin algún servicio básico, bajo nivel educativo de la madre, ingresos familiares tipo donaciones, y residencia en barrios con 60-100 por ciento NBI se asoció con mayor riesgo de presentar déficit talla/edad (riesgo relativo estimado:1.55, 1.29, 1.35, 2.43 y 1.2 respectivamente). El riesgo de déficit peso/edad fue mayor en quienes habitan viviendas inadecuadas, cuando existe hacinamiento crítico ó jefe de familia obrero no especializado (riesgo relativo estimado: 1.56, 1.34 y 1.39 respectivamente). El método utilizado ofrece ventajas para identificar las localidades y familias con mayor riesgo de desnutrición infantil, a fin de establecer en ellos programas de intervención nutricional
Assuntos
Humanos , Masculino , Pré-Escolar , Feminino , Criança , Peso Corporal , Desnutrição Proteico-Calórica/diagnóstico , Necessidades e Demandas de Serviços de Saúde , Condições Sociais , Peso-Estatura , Ciências da Nutrição , VenezuelaRESUMO
Para establecer si un programa para padres podía o no influir en métodos de crianza y patrones de función familiar se seleccionó un amuestra de 60 padres y representantes (20 de cada 3 escuelas diferentes) en la ciudad de Barquisimeto. Fueron sometidos a un programa controlado de entrenamiento de doce horas de duración, en el período enero 1994-julio 1994. Se realizaron: un pretest para detectar características de riesgo (nivel socieconómico, Apgar familiar y diagnóstico de función y nivel de satisfacción personal). Se realizaron 3 post-test (1 mes- 3 meses- 6 meses después del entrenamiento). Los resulatdos fueron. Deterioro del nivel socioeconómico en 2 de los 3 grupos. Deterioro del nivel de satisfacción personal. Alto índice de familias disfuncionales en la muestra estudiada al inicio del estudio. El nivel de función familliar mejoró en todos los grupos durante los 6 meses de observación. Las áreas de cambio más acentuado fueron expresión amorosa, comunicación efectiva, comprensión, tolerancia y establecimiento de normas. Los problemas de imagen y ejercicio de la autoridad y la presencia de límites intergeneracionales no evidenciaron cambios dado el poco tiempo de observación. Finalmente se infiere que la realización de actividades aducativas dirigidas a los padres con le propósito de informar y discutir las tareas de la función familiar adecuada y reflexionar acerca del rol de padres en la educación de los hijos, pueden producir cambios positivos en la familia, mejorando los métodos de crianza y los niveles de función familiar
Assuntos
Humanos , Masculino , Feminino , Educação Infantil , Educação , Relações Familiares , Renda , Métodos , Relações Pais-Filho , Desenvolvimento de Programas , MedicinaRESUMO
Con el objetivo de evaluar el estado nutricional de vitamina A en niños de siete años de comunidades suburbanas de Barquisimeto se realizó un estudio de corte transversal. Los barrios de la Parroquia Juan de Villegas (oeste de Barquisimeto) fueron clasificados en cinco estratos según el porcentaje de hogares con necesidades básicas insatifechas. Se realizó un muestreo estratificado por conglomerados, para seleccionar una muestra de 292 niños. A cada niño se le evaluó el estado nutricional por antropometría, el estrato socioeconómico por el método Graffar-Méndez-Castellano, y el retinol sérico por el método HPLC. En el 14 por ciento de la muestra se encontraron valores bajos de retinol (< 20 ug/dl), en el 55,1 por ciento valores marginales (20-29 ug/dl) y en el 30,8 por ciento valores normales. No se encontraron diferencias significativas en el promedio de retinol sérico según sexo, grupo de edad, estado nutricional y condiciones de vida, aunque se apreció una tendencia a mayor porcentaje de valores normales a mejores condiciones de vida. Los niños residentes en viviendas inadecuadas, sin servicios básicos, presentaron 2,3 veces mayor riesgo de deficiencia de vitamina A. Se encontró un porcentaje importante de niños con déficit subclínico de vitamina A, lo cual amerita programas específicos de prevención en el ámbito local, así como la investigación de la situación de este nutriente en el país
Assuntos
Humanos , Masculino , Feminino , Criança , Nutrição da Criança , Estado Nutricional , Proteínas de Ligação ao Retinol , Vitamina A , VenezuelaRESUMO
Mediante un muestreo probabilístico por procedimiento combinado (estratificado y sistemático) fue estudiada la prevalencia del asma en Barquisimeto y su evolución en relación con factores físicos y sociales presentes en la ciudad, en muchos vinculados a su crecimiento en los últimos 40 años. Se determinó una prevalencia acumulada de 19,5 por ciento en la población general con predominio en aquella de 0-18 años y dentro de ésta, en los varones. La actividad de la enfermedad (frecuencia de asmáticos sintomáticos para el momento de la investigación), fue significativamente mayor en la población infanto-juvenil y ligeramente superior al promedio entre los jefes de familia. Se exponen datos que evidencian que la frecuencia de asma en la población se ha incrementado progresivamente en el presente siglo y, especialmente, a partir de los años 60. Dentro de los mismos figura la incidencia que, en los últimos años, es más del doble de lo que era para la década de los 70. Se determinó que hay una alta población en riesgo de convertirse en asmática si consideramos que el 54 por ciento de los hogares tiene asmáticos en el grupo familiar y en Barquisimeto la calidad del ambiente se deteriora cada día más. Aunque la prevalencia es similar en los tres estratos estudiados, al analizar las cifras de prevalencia de los barrios, de acuerdo con su ubicación, encontramos un alto valor en aquellos ubicados al Norte de la ciudad, significativamente diferente a los valores obtenidos en los otros barrios y en el resto de la población. Coincide este dato con la ubicación de los mismos en el área vecina a la fábrica de cemento, cuyo polvillo recibe copiosamente debido a la dirección predominante de los vientos en Barquisimeto. Esto hace considerar a esta zona como crítica y aconseja profundizar las investigaciones para extraer conclusiones definitivas