RESUMO
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
Assuntos
Gastroenterologia , Lactente , Criança , Feminino , Humanos , Cocos , Consenso , América Latina , Fenômenos Fisiológicos da Nutrição do LactenteRESUMO
Pain is a complex sensory and emotional experience with nociceptive, nociplastic, and neuropathic components. An involvement of neurotropic B vitamins (B1 - thiamine, B6 - pyridoxine, and B12 - cyanocobalamin) as modulators of inflammation and pain has been long discussed. New evidence suggests their therapeutic potential in different pain conditions. In this review, we discuss the main role of neurotropic B vitamins on different nociceptive pathways in the nervous system and to describe their analgesic action mechanisms. The performed literature review showed that, through different mechanisms, these vitamins regulate several inflammatory and neural mediators in nociceptive and neuropathic pain. Some of these processes include aiming the activation of the descending pain modulatory system and in specific intracellular pathways, anti-inflammatory, antioxidative and nerve regenerative effects. Moreover, recent data shows the antinociceptive, antiallodynic, and anti-hyperalgesic effects of the combination of these vitamins, as well as their synergistic effects with known analgesics. Understanding how vitamins B1, B6, and B12 affect several nociceptive mechanisms can therefore be of significance in the treatment of various pain conditions.
Assuntos
Neuralgia , Complexo Vitamínico B , Humanos , Piridoxina/uso terapêutico , Vitamina B 12/uso terapêutico , Tiamina/uso terapêutico , Complexo Vitamínico B/uso terapêutico , Analgésicos/uso terapêutico , Neuralgia/tratamento farmacológicoRESUMO
INTRODUCTION: Health-disease processes are established and programmed in the first 1500 days of life, a period in which nutrition and the microbiota play a fundamental role. Feeding practices vary, according to regional sociocultural characteristics. The Early Nutrition Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) established the goal of identifying the main feeding practices in the first 1500 days that were recommended by health professionals in Latin America. MATERIALS AND METHODS: A survey was conducted on the aspects of maternal-infant and young child nutrition during the first 1500 days of life. An open invitation was extended to Latin American healthcare professionals to anonymously answer the online survey. RESULTS: A total of 1284 surveys from participants in 18 Latin American countries were analyzed. The mean age of the participants was 37.14⯱â¯11.1 years, 75.7% were women, 64.7% were physicians, and the rest were nutritionists/nutriologists. A total of 71.4% were familiar with the concept of the first 1000 days of life, 95% answered that exclusive breastfeeding should be carried out up to 6 months of age, and 34.3% responded that complementary feeding should be begun between 4 and 6 months of age. There was scant knowledge regarding nutrition in the pregnant woman. Adherence to traditional complementary feeding practices was evident. CONCLUSIONS: In a group of Latin American healthcare professionals, knowledge about nutrition in the first 1000-1500 days of life of an individual is still incomplete and insufficient, showing the need for continued training of healthcare professionals, with respect to those themes.
Assuntos
Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do Lactente , Lactente , Criança , Gravidez , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Pré-Escolar , Masculino , América Latina , Inquéritos e Questionários , Atenção à SaúdeRESUMO
Resumen El tiroides ectópico es una alteración congénita infrecuente que presenta una prevalencia entre 1/100.000-1/300.000. En el 90% de los casos se encuentra en la línea media cervical, siendo los casos de tiroides ectópico cervical lateral muy infrecuentes. Presentamos el caso de una paciente de 44 años que consultó por presentar una tumoración submandibular izquierda de más de seis meses de evolución. Las pruebas de imagen (ecografía, tomografía computarizada y gammagrafía) sugirieron un bocio ectópico multinodular; la punción aspiración con aguja fina (PAAF) informó de tejido tiroideo sin atipias (Bethesda II) y el estudio sanguíneo de hormonas tiroideas fue normal, orientando finalmente el caso como un bocio multinodular ectópico submandibular eutiroideo. Ante la ausencia de síntomas y signos sugerentes de malignidad, en conjunto con una PAAF con características de benignidad, se decidió realizar seguimiento. En el momento que presentó clínica por efecto masa se decidió realizar la exéresis de la lesión, que confirmó el diagnóstico de bocio multinodular ectópico. Los casos descritos en la literatura de bocio multinodular ectópico submandibular como único tejido tiroideo funcionante son excepcionales. El tiroides ectópico se debe considerar en el diagnóstico diferencial de una masa submandibular. Aunque actualmente no existe un consenso en relación con el manejo de dicha patología, el crecimiento de la masa puede contribuir a la decisión de una exéresis completa del tiroides ectópico, aun tratándose del único tejido tiroideo funcionante.
Abstract Ectopic thyroid is an uncommon congenital disorder with a prevalence between 1/100,000-1/300,000. In 90% of cases, it is placed in cervical midline, being the cases of lateral cervical ectopic thyroid very infrequent. We present the case of a 44-year-old female patient who had a left submandibular mass during more than six months. Imaging tests (ultrasound, computed tomography and scintigraphy) suggested a multinodular ectopic goiter; fine needle aspiration (FNA) reported thyroid tissue without atypia (Bethesda II) and the thyroid hormone blood tests were normal, finally orienting the case as a euthyroid submandibular ectopic multinodular goiter. In the absence of symptoms and signs suggestive of malignancy, together with an FNA with benign characteristics, it was decided to follow up. When the patient presented clinical symptoms due to mass effect, it was decided to perform excision of the lesion, which confirmed the diagnosis of ectopic multinodular goiter. There are very few cases described in the literature of submandibular ectopic multinodular goiter as the only functioning thyroid tissue. Ectopic thyroid should be considered in the differential diagnosis of a submandibular mass. Although there is currently no consensus on the management of this pathology, the growth of the mass may contribute to the decision of a complete excision of the ectopic thyroid, even if it is the only functioning thyroid tissue.
Assuntos
Humanos , Feminino , Adulto , Coristoma/diagnóstico por imagem , Bócio Nodular/diagnóstico por imagem , Tireoidectomia/métodos , Tomografia Computadorizada por Raios X/métodos , Coristoma/cirurgia , Bócio Nodular/cirurgiaRESUMO
OBJECTIVE: The characterization of a sample of patients hospitalized with complications of the COVID-19 infection regarding potential prognostic factors, clinical evolution, and impact of rehabilitation treatment on functional, motor, and respiratory outcomes. METHOD: Descriptive, retrospective, longitudinal study of a cohort of patients under rehabilitation treatment admitted at Virgen de las Nieves University Hospital in Granada from March to June 2020, assessed upon admission, discharge and at 3 rd month using physical condition scales (IFIS) and functional assessment: general (Rankin, Barthel), respiratory (mMRC, BORG) and gait (FAC). RESULTS: 30 patients with a mean age of 62.8 (54-70) years were included, 80% with comorbidity: hypertension 66.7%, obesity 36.7%, diabetes 33.3%. The mean hospital stay was 45.4 days, with 86.7% requiring ICU (29.1 days) and 76.7% of them required mechanical ventilation. An 86.7% of the patients presented with complications, mostly with polyneuropathy-myopathy of the critical patient (83.3%). At discharge, 80% required walking assistance. The functionality index showed a "U"-evolution at admission, discharge and at 3 rd month (Barthel 93.8; 60.0; 91.6 respectively). A greater functional decline (Barthel < 60) was found in male patients, COPD, HT, obesity, and elevated protein C reactive at admission; and a more favourable evolution in those with elevated D-dimer and lymphocyte values upon admission. CONCLUSIóN: Hospital admission for COVID-19 patients involve complications at the functional, respiratory and gait levels that are mostly serious but partially reversible at 3 months with rehabilitation treatment. Potential prognostic factors are described and deserve prospective studies.
Assuntos
COVID-19 , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade , Estudos Prospectivos , Proteína C , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
The spontaneous aggregation of chitosan and carboxymethylchitosan polymers can be advantageous for the enzyme confinement on these colloidal systems during immobilization processes. The initial crucial step involves the polymer-enzyme adduct formation. The objective here is to determine the interactions that drive the adduct formation between these polymers and ß-galactosidase from Bacillus circulans. The chemical characterization of chitosan and its carboxymethyl-derivate allowed to explain their colloidal behavior and design the four-unit fragments ligands used for the docking study. The deacetylation degree (0.6 times lower), isoelectric point (5.2 instead 6.4) and substitution degree (DSO = 1.779 and DS2N = 0.441) of carboxymenthylchitosan are due to the hydroxide concentration (>25%) and 30 °C modification conditions. Favorable Van der Waals and H-bond interactions between chitosan-ß-galactosidase and contribution of electrostatic attraction mediated by calcium ions for carboxymethylchitosan-ß-galactosidase explained the zeta potential and dynamic light scattering results at pH 7.0. These interactions occur onto the external surface of this galactosidase, without affecting the catalytic activity. A cross-linked enzyme aggregates-type model was proposed for the formation of the adducts, based on the complementary experimental-docking results. They contribute understanding the behavior of polyelectrolyte chitosan-derived matrices for enzyme immobilization.
Assuntos
Biopolímeros/química , Quitosana/análogos & derivados , Quitosana/química , beta-Galactosidase/química , Biocatálise , Fenômenos Químicos , Enzimas Imobilizadas , Conformação Molecular , Simulação de Dinâmica Molecular , Análise Espectral , Relação Estrutura-AtividadeRESUMO
Low back pain, as well as other musculoskeletal disorders (neck pain, osteoarthritis, etc.), are a very frequent cause of consultation both in primary care and in other hospital specialties and are usually associated with high functional and work disability. Acute low back pain can present different nociceptive, neuropathic and nonciplastic components, which leads to consider it as a mixed type pain. The importance of the concept of mixed pain is due to the fact that the symptomatic relief of these pathologies requires a multimodal therapeutic approach to various pharmacological targets. The antinociceptive role of the B vitamin complex has been recognized for several decades, specifically the combination of Thiamine, Pyridoxine and Cyanocobalamin (TPC). Likewise, there is accumulated evidence that indicates an adjuvant analgesic action in low back pain. The aim of the present review is to present the existing evidence and the latest findings on the therapeutic effects of the TPC combination in low back pain. Likewise, some of the most relevant mechanisms of action involved that can explain these effects are analyzed. The reviewed evidence indicates that the combined use of PCT has an adjuvant analgesic effect in mixed pain, specifically in low back pain and other musculoskeletal disorders with nociceptive and neuropathic components. This effect can be explained by an anti-inflammatory, antinociceptive, neuroprotective and neuromodulatory action of the TPC combination on the descending pain system.
Assuntos
Complexo Vitamínico B , Dor nas Costas , Humanos , Piridoxina , Tiamina , Vitamina B 12RESUMO
The electrical behavior of photovoltaic materials related with Cu2ZnTiS4and Cu2ZnSnS4materials were analyzed as function of synthesis temperature in accordance with a new mathematical model based on the Kramers-Kronig equations with a high reliability. The samples were obtained through a hydrothermal route and a subsequent thermal treatment of solids at 550 °C for 1 h under nitrogen flow (50 ml min-1). The characterization was done by x-ray diffraction, ultraviolet spectroscopy (UV), Raman spectroscopy, atomic force microscopy (AFM) and solid state impedance spectroscopy (IS) techniques. The structural characterization, confirm the obtention of a tetragonal material with spatial groupI-42m, oriented along (1 1 2) facet, with nanometric crystal sizes (5-6 nm). The AFM and Raman analysis confirm a high level of chemical homogeneity and correlation with the synthesis temperature, associated with the roughness of the samples. The UV spectroscopy confirm a band gap around 1.4-1.5 eV, evidencing the effectiveness of the synthesis process. The IS results at room temperature with a probability of 95%, confirm a high consistency of data with respect to values of real and imaginary impedance, allowing to obtain information of the conductance, reactance and inductance, achieving conductivity values around 10-5and 10-3Ω-1 m-1in comparison with traditional mathematical models used for this purpose.
RESUMO
BACKGROUND AND OBJECTIVE: The minimal erythema dose (MED), an essential measurement in studies of skin photosensitivity, requires establishing MED values for specific populations, given genetic variation. Different ways to assess erythema are also relevant. We aimed to determine MED values in a sample of Colombian patients and correlations between MED and Fitzpatrick skin type. We also studied concordance correlation between MEDs and two alternative ways to assess erythema. PATIENTS AND METHODS: Cross-sectional study of 113 individuals in Bogotá, Colombia. We used a solar simulator to measure UV-A radiation and combined UV-A and UV-B (UVA+UVB) radiation, o se podría suprimir este término porque UVA y UVB son términos conocidos for MED calculation. Narrowband UV-B (NBUVB) radiation was measured in a phototherapy cabin. Erythema was assessed visually and with a Mexameter MX 18 device. RESULTS: The median MEDs of UVA+UVB radiation were 22mJ/cm2 for Fitzpatrick skin typesI andII, and 33 and 43mJ/cm2, respectively, for typesIII andIV. The MEDs of UV-A radiation were 22, 42, 86, and 100J/cm2 for typesI, II, III, andIV, respectively. The MEDs of NBUVB light were 390, 550, 770, and 885mJ/cm2 for the 4 skin types. The correlation between MEDs and skin types ranged from 0.5 to 0.69. Lin's concordance correlation coefficients between visual and Mexameter assessments of erythema were greater than 0.8 in all cases. CONCLUSION: This study allowed us to understand MED values for UV-A, UVA+UVB, and NBUVB according to different skin types in the Colombian population. Concordance correlation coefficients between the different methods of erythema assessment were very good. Correlations between MEDs and skin types were moderate to good.
Assuntos
Eritema , Pigmentação da Pele , Colômbia , Estudos Transversais , Humanos , Raios Ultravioleta/efeitos adversosRESUMO
La evaluación del Programa de Control de la Tuberculosis de Chile muestra un creciente aumento de casos de tuberculosis en pacientes extranjeros en las comunas de Santiago de mayor incidencia de esta enfermedad. Mediante la evaluación de los casos diagnosticados durante una década se comprobó un creciente aporte de casos de tuberculosis en el grupo de inmigrantes, desde cerca de 10% el año 2005 hasta cerca de 30% en 2014. La mayor proporción de casos de extranjeros ocurre en la comuna de mayor incidencia (Santiago), con cifras iniciales de 17% el año 2005, llegando a 29% en 2015. La eficacia del tratamiento en los inmigrantes (87,6%) está cerca de la meta nacional (90%) y es mejor que la de los chilenos (81,5%). Encontramos una proporción mayor de casos extranjeros que abandonan la terapia (11%) en relación a los chilenos (7,7%), pero la letalidad en extranjeros es menor (1,5%) que la de los chilenos (10,6%). Se deberán reforzar las estrategias de control de tuberculosis, focalizadas en la población extranjera.
The assessment of Chilean Tuberculosis Control Program shows a growing increase of tuberculosis cases in foreign patients in communes of the city of Santiago with higher incidence of this disease. Through the evaluation of the cases diagnosed in a decade we found an increasing contribution of foreigners, ranging from about 10% in 2005 to 30% in 2014. The greatest proportion of tuberculosis cases in foreigners was detected in Santiago, the commune with the highest incidence. In this area, tuberculosis incidence ranged from 17% in 2005, to 29% in 2015. Treatment efficiency in foreigners (87.6%) is close to our national goal (90%) and better than in Chilean patients (81.5%). We found a higher proportion of foreign cases defaulting therapy (11%) in relation to Chilean (7.7%), but the death rate in foreigners was less than in Chileans (1.5 versus 10.6%). We must strengthen tuberculosis control strategies focused on foreigner populations.
Assuntos
Humanos , Masculino , Feminino , Tuberculose/epidemiologia , Emigrantes e Imigrantes , Serviços de Saúde/estatística & dados numéricos , Chile/epidemiologia , Incidência , Estudos RetrospectivosRESUMO
Resumen Introducción: La muerte de un hijo es un proceso complejo y dramático; el equipo de salud describe dificultades para abordar esta situación. Objetivos: Identificar en la literatura científica las principales prácticas de los profesionales en la atención de padres o familiares de un recién nacido que fallece en institución hospitalaria y determinar cuáles facilitan el desarrollo del duelo. Metodología de búsqueda: Revisión integrativa de la literatura científica. 33 artículos superaron la evaluación de calidad metodológica y se incluyeron en la revisión. Resultados: Se identificaron dos tipos de prácticas que los profesionales desarrollan con la familia en duelo: de soporte, por ejemplo facilitar el acercamiento al bebé fallecido y la fotografía postmortem; y de no soporte, por ejemplo la ausencia de consentimiento previo antes de que un grupo de estudiantes presencien un procedimiento específico o asumir actitudes hostiles hacia el paciente. Discusión: Como reportan otros estudios, las prácticas de soporte tienen como base una comunicación veraz, adecuada y permanente entre el profesional y los familiares. Las prácticas de no soporte podrían relacionarse con el estrés de los profesionales, ante el fallecimiento de los pacientes y de las características propias de la formación médica. Conclusiones: Los profesionales desarrollan diversas prácticas en el acompañamiento al familiar doliente, algunas de las cuales brindan un mejor desarrollo del duelo, como las prácticas de soporte. MÉD. UIS. 2017;30(3):89-100.
Abstract Introduction: A child's death is a complex and painful process; the health staff describes difficulties to affront it. Objective: To identify the practices performed by the health staff to tackle the family of a newborn death into the hospital and determine which facilitates the grieving process. Searching methodology: Integrative review of scientific literature. 33 articles surpassed the methodological quality assessment and were included in the review. Results: Two kinds of practices were identified: support practices, such as facilitating the approach to the deceased baby and the postmortem photography; and non-support practices, such as the absence of prior consent before a group of students witness a specific procedure or hostile attitudes towards the patient. Discussion: The support practices are based on a truthful, adequate and ongoing communication between family and staff. On the contrary, the non-support practices are in relation with the high stress professionals are feeling, which come from the nature of the death event and the medical education characteristics. Conclusions: Professionals implement practices in the acompaniment to the suffering family member, some of which allow a better development of the grieving process. MÉD.UIS. 2017;30(3):89-100.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Pesar , Morte Perinatal , Unidades de Terapia Intensiva , Pediatria , Recém-Nascido , Saúde MentalRESUMO
INTRODUCTION: Stroke is a leading cause of mortality and disability. Policosanol has been effective in brain ischemia models. The aim of this study is to investigate whether policosanol, added to aspirin therapy within 30 days of stroke onset, is better than placebo + aspirine for the long-term recovery of non-cardioembolic ischemic stroke subjects. PATIENTS AND METHODS: Randomized, double-blind, placebo-controlled study. Eighty patients (mean age: 69 years) within 30 days of onset, with a modified Rankin Scale score (mRS) 2 to 4, were included. They were randomized in two groups (policosanol + aspirine or placebo + aspirine) for 12 months. RESULTS: Policosanol + aspirine decreased significantly mean mRS from the first interim check-up (1.5 months). The treatment even improved after long-term therapy. More policosanol + aspirin (87.5%) than placebo + aspirine (0%) patients achieved mRSs <= 1. Policosanol + aspirine increased significantly Barthel Index, lowered LDL-cholesterol and increased HDL-cholesterol versus placebo + aspirin. CONCLUSIONS: Long-term (12 months) administration of policosanol + aspirin given after suffering non-cardioembolic ischemic stroke was shown to be better than placebo + aspirin in improving functional outcomes when used among patients with non-cardioembolic ischemic stroke of moderate severity.
TITLE: Efecto a largo plazo del policosanol en la recuperacion funcional de pacientes con ictus isquemico no cardioembolico: estudio de un año.Introduccion. El ictus es una causa principal de mortalidad y discapacidad. El policosanol ha sido eficaz en modelos de isquemia cerebral. Este estudio investiga si el tratamiento a largo plazo con policosanol, añadido a la terapia con acido acetilsalicilico (AAS), dentro de los 30 dias posteriores a un ictus, es mejor que el placebo + AAS en la recuperacion de los pacientes. Pacientes y metodos. Estudio aleatorizado, doble ciego, controlado con placebo. Se incluyeron 80 pacientes (edad media: 69 años) que sufrieron un ictus en los 30 dias previos y con una puntuacion de 2-4 en la escala de Rankin modificada (mRS). Se distribuyeron aleatoriamente en dos grupos y recibieron policosanol + AAS o placebo + AAS durante 12 meses. Resultados. El tratamiento con policosanol + AAS disminuyo significativamente la puntuacion en la mRS desde el primer control intermedio (1,5 meses). El efecto del tratamiento incluso mejoro con la terapia a largo plazo. El numero de pacientes que alcanzaron valores de mRS menores o iguales a 1 fue superior en el grupo de policosanol + AAS (87,5%) que en el de placebo + AAS (0%). El tratamiento con policosanol + AAS aumento significativamente el indice de Barthel, disminuyo el colesterol LDL y aumento el colesterol HDL frente a placebo + AAS. Conclusiones. El tratamiento a largo plazo (12 meses) con policosanol + AAS fue mas efectivo que el tratamiento con placebo + AAS en la recuperacion funcional de los pacientes despues de sufrir un ictus isquemico no cardioembolico de moderada gravedad.
Assuntos
Anticolesterolemiantes/uso terapêutico , Isquemia Encefálica/tratamento farmacológico , Álcoois Graxos/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Anticolesterolemiantes/administração & dosagem , Anticolesterolemiantes/efeitos adversos , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Aspirina/uso terapêutico , Dano Encefálico Crônico/etiologia , Isquemia Encefálica/sangue , Colesterol/sangue , Método Duplo-Cego , Quimioterapia Combinada , Álcoois Graxos/administração & dosagem , Álcoois Graxos/efeitos adversos , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hipercolesterolemia/dietoterapia , Masculino , Cooperação do Paciente , Recuperação de Função Fisiológica , Resultado do TratamentoRESUMO
The assessment of Chilean Tuberculosis Control Program shows a growing increase of tuberculosis cases in foreign patients in communes of the city of Santiago with higher incidence of this disease. Through the evaluation of the cases diagnosed in a decade we found an increasing contribution of foreigners, ranging from about 10% in 2005 to 30% in 2014. The greatest proportion of tuberculosis cases in foreigners was detected in Santiago, the commune with the highest incidence. In this area, tuberculosis incidence ranged from 17% in 2005, to 29% in 2015. Treatment efficiency in foreigners (87.6%) is close to our national goal (90%) and better than in Chilean patients (81.5%). We found a higher proportion of foreign cases defaulting therapy (11%) in relation to Chilean (7.7%), but the death rate in foreigners was less than in Chileans (1.5 versus 10.6%). We must strengthen tuberculosis control strategies focused on foreigner populations.
La evaluación del Programa de Control de la Tuberculosis de Chile muestra un creciente aumento de casos de tuberculosis en pacientes extranjeros en las comunas de Santiago de mayor incidencia de esta enfermedad. Mediante la evaluación de los casos diagnosticados durante una década se comprobó un creciente aporte de casos de tuberculosis en el grupo de inmigrantes, desde cerca de 10% el año 2005 hasta cerca de 30% en 2014. La mayor proporción de casos de extranjeros ocurre en la comuna de mayor incidencia (Santiago), con cifras iniciales de 17% el año 2005, llegando a 29% en 2015. La eficacia del tratamiento en los inmigrantes (87,6%) está cerca de la meta nacional (90%) y es mejor que la de los chilenos (81,5%). Encontramos una proporción mayor de casos extranjeros que abandonan la terapia (11%) en relación a los chilenos (7,7%), pero la letalidad en extranjeros es menor (1,5%) que la de los chilenos (10,6%). Se deberán reforzar las estrategias de control de tuberculosis, focalizadas en la población extranjera.
Assuntos
Humanos , Masculino , Feminino , Adulto , Tuberculose/epidemiologia , Emigração e Imigração , Emigrantes e Imigrantes , Tuberculose/prevenção & controle , Planos e Programas de Saúde , Chile/epidemiologia , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
La atresia de vías biliares es una colangiopatía obstructiva neonatal de etiología desconocida que produce una lesión del parénquima hepático y de la vía biliar intrahepática y extrahepática. Representa la causa más común de colestasis neonatal y trasplante hepático en la población pediátrica y se manifiesta como malformación aislada en la mayoría de los casos. Se presenta un caso de un paciente de 75 días de vida con atresia de vías biliares asociado a heterotaxia abdominal. El síndrome de atresia biliar y malformación esplénica ha sido descrito previamente como atresia de vías biliares asociado a malformaciones anatómicas del bazo, páncreas, alteraciones cardíacas y en menor frecuencia malformaciones genitourinarias. El pronóstico de los pacientes con atresia de vías biliares ha mejorado notoriamente con el reconocimiento temprano de los signos semiológicos y con la realización de la portoenterostomía (Kasai) en forma oportuna para lograr mejorar la sobrevida de los pacientes con atresia de vías biliares sindrómica.
Biliary atresia is an obstructive neonatal cholangiopathy of unknown etiology that produces damage to the parenchyma of the liver and to the intrahepatic and extrahepatic bile ducts. It is the most common cause of neonatal cholestasis and liver transplantation in the pediatric population. In most cases it manifests as an isolated malformation. This article presents the case of a 75 day old patient with biliary atresia associated with abdominal heterotaxy. Biliary atresia syndrome together with splenic malformation has been previously described, as have biliary atresia associated with anatomical malformations of the spleen, pancreas, and heart. It occurs with genitourinary malformations less frequently. The prognosis of patients with biliary atresia has significantly improved with early recognition of signs and symptoms and timely performance of hepatoportoenterostomy (Kasai portoenterostomy).
Assuntos
Humanos , Masculino , Lactente , Atresia Biliar , Síndrome de HeterotaxiaRESUMO
Analyses of faecal steroids in coastal sediments from Cienfuegos Bay Cuba indicate chronic sewage contamination at the main outfalls from the city, where concentrations of coprostanol up to 5400ngg(-)(1) (dry wt) were measured. In contrast, steroid concentrations and compositions from sites from the south part of the Bay are characteristic of uncontaminated sewage environments. The levels of coprostanol in the Cienfuegos sediments compares to the lower to mid-range of concentrations reported for coastal sediments on a world-wide basis, with sedimentary levels markedly below those previously reported for heavily impacted sites. This study delivers baseline data for further investigation of the effectiveness of the proposed sewerage plan promoted by the GEF project in Cienfuegos. Investigations on the correlations between faecal steroids and other organic contaminants confirmed that the major source of petroleum hydrocarbons within the bay was associated with the sewage effluents from the Cienfuegos city.
Assuntos
Baías/química , Colestanol/análise , Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Petróleo/análise , Esgotos/química , Esteroides/análise , Cuba , Monitoramento Ambiental/estatística & dados numéricos , Fezes/química , Hidrocarbonetos/análiseRESUMO
Las tortugas marinas han sido ampliamente investigadas y documentadas en las últimas décadas. La bioquímica sanguínea representa una valiosa herramienta diagnóstica para el monitoreo del estado de salud de la fauna silvestre El objetivo de este estudio fue determinar los valores bioquímicos en la sangre de la tortuga verde (Chelonia mydas) presente en la Alta Guajira, Venezuela. La extracción de las muestras sanguíneas se realizó de los senos cervicales dorsales en 28 ejemplares de tortugas verdes capturadas en redes y posteriormente liberadas. Fueron medidos el largo curvo del caparazón (LCC) y ancho curvo del caparazón (ACC) con una cinta métrica flexible. Se determinaron los valores bioquímicos de la sangre: proteínas totales, albúmina, fosfatasa alcalina, urea, creatinina, ácido úrico, colesterol, triglicéridos, glucosa y fósforo por colorimetría, utilizando kits comerciales; los minerales (calcio, hierro, magnesio, zinc) se determinaron por espectrofotometría de absorción y emisión (sodio, potasio). Los valores promedio fueron: 4,37 g/dL proteínas totales, 1,50 g/dL albúmina, 119,63 U/L fosfatasa alcalina, 27,60 mg/dL urea, 0,17 mg/dL creatinina, 3,36 mg/dL ácido úrico, 180,77 mg/dL colesterol, 32,24 mg/dL triglicéridos, 130,07 mg/dL glucosa, 5,20 mg/dL fósforo, 7,94 mg/dL calcio, 44,02 µg/dL hierro, 196,68 meq/L sodio, 4,75 meq/L potasio, 4,99 mg/dL magnesio y 2,11 mg/L zinc. Estos resultados se encuentran dentro de los intervalos de referencia documentados para la especie, a excepción de la fosfatasa alcalina, triglicéridos, colesterol y la urea, los cuales presentaron las mayores variaciones.
Sea turtles have been widely investigated and reviewed over the last decades. Blood biochemistry represents a valuable diagnostic tool for monitoring the health condition of wildlife. The aim of this study was to determine the blood biochemistry values of green turtles (Chelonia mydas) present in the Alta Guajira, Venezuela. Blood samples were collected of the dorsal cervical sinuses from 28 green turtles captured in gill nets. The turtles were released later. The curved carapace length (CCL) and curved carapace width (CCW) were measured with a flexible measuring tape. The following values were established using commercial kits: total proteins, albumin, alkaline phosphatase, urea, creatinine, uric acid, cholesterol, triglycerides, glucose, and phosphorus by colorimetry; the minerals were determined by emission (sodium, potassium) and absorption spectrometry (calcium, iron, magnesium, zinc). The mean values obtained were: total proteins (4.37 g/dL), albumin (1.50 g/dL), alkaline phosphatase (119.63 U/L), urea (27.60 mg/dL), creatinine (0.17 mg/dL), uric acid (3.36 mg/dL), cholesterol (180.77 mg/dL), triglycerids (32.24 mg/dL), glucose (130.07 mg/dL), phosphorus (5.20 mg/dL), calcium (7.94 mg/dL), iron (44.02 µg/dL), sodium (196.68 meq/L), potassium (4.75 meq/L), magnesium (4.99 mg/dL) and zinc (2.11 mg/L). These results fall within the reference intervals documented in this species, except for the alkaline phosphatase, triglycerides, cholesterol, and urea, which showed the largest variations.
Assuntos
Animais , Análise Química do Sangue/veterinária , Bioquímica/métodos , Fauna Marinha/análise , Tartarugas/sangue , Medicina VeterináriaRESUMO
Las estadísticas actuales informan que el consumo de psicotrópicos va en aumento en la población joven y que está relacionado con factores sociodemográficos como la edad y el género, además de ciertos factores psicosociales, como la influencia de amigos y las relaciones intrafamiliares. El objetivo principal de este estudio es determinar las características socio-demográficas y de consumo de fármacos psicotrópicos en estudiantes de ciencias de la salud -medicina y enfermería. Se investigan, además, los grupos farmacológicos y fármacos de mayor uso, la prevalencia, la frecuencia del consumo y la persona que lo motiva. Se realiza un estudio de tipo descriptivo cross-sectional con 820 estudiantes encuestados, el 71,7% de ellos son de género femenino y la edad promedio del grupo es de 21,1 años. La prevalencia de consumo de psicotrópicos es de 18,3% en enfermería y 16% en medicina, sin ser esta diferencia estadísticamente significativa, y es mayor en hombres (19%) que en mujeres (10%), p=0.02. Los hallazgos de este estudio confirman la tendencia a nivel mundial de un alto consumo de medicamentos psicotrópicos entre la población joven, donde el grupo de los antidepresivos figura en el primer lugar (12.9%). Estos resultados no tienen en cuenta si el consumo se hace por prescripción médica o por automedicación.
Current Statistics report that psychotropic drugs consumption is increasing among young people and this is related to social and demographic factors such as age and gender, and also to psychosocial factors as friends influence and personal relations inside the family. The aim of this study is to determine social and demographic characteristics as well as prevalence and patterns of psychotropic drugs use among students of health sciences- medicine and nursery-. Pharmacological groups, the most used drugs, prevalence, frequency, and person who motivates psychotropic drugs consumption are also investigated. A cross-sectional study was carried out with 820 students queried, 71.7% are female, and the group average age is 21.1 years. Prevalence use of psychotropic drugs is 18.3% for nursery and 16.5% for medicine, but this difference is not statistically significant, and it is greater in men (19%) than in women (10%), p=0.02. The findings of this study confirm the world tendency of high psychotropic drugs consumption among young people, where antidepressants appear in the first place (12.9%) independent if the consumption comes of medical prescription or self-medication.
RESUMO
con el objetivo de evaluar la relación entre el comportamiento del zinc durante el embarazo y algunas variables estudiadas en embarazadas que tuvieron partos prematuros, se hizo un estudio de corte trasversal en 60 gestantes cuyos hijos nacieron entre las semanas 27 y 36, en la ciudad de Medellín, Colombia. La concentración media del metal y su error estándar fueron 7,33 ± 0,23 mg/L; no se observó una correlación entre los valores encontrados y la edad gestacional. Las gestantes sanas tuvieron una concentración media de zinc de 7,20 ± 0,25 mg/L, la cual fue significativamente menor que la de quienes tuvieron niños con crecimiento restringido, p = 0,03, pero similar a la de las que sufrieron hipertensión inducida, embarazos múltiples, fetos malformados o recibieron esteroides para la maduración pulmonar fetal. El percentil 75 de la curva de valores del zinc se estableció en 8,6 mg/L, y quienes se ubicaron por encima del mismo tuvieron un número significativamente mayor de fetos de sexo femenino, p = 0,011, y una tendencia no significativa a tener más fetos con restricción del crecimiento, p = 0,07. Las ubicadas por debajo del percentil 25, o sea de 6,2 mg/L, mostraron también tendencias no significativas a un número mayor de embarazos gemelares, p = 0,05 y de fetos malformados, p = 0,08. Los hallazgos de la muestra estudiada sugieren que puede existir asociación entre las concentraciones de zinc y efectos fetales importantes que se deben verificar en estudios posteriores que incluyan poblaciones mayores. Es llamativa la relación entre un zinc materno alto y el sexo femenino del feto, la cual podría estar indicando el efecto de factores hormonales específicos.Palabras claves: zinc, embarazo, parto prematuro.
Assuntos
Complicações na Gravidez , Parto , ZincoRESUMO
BACKGROUND: Policosanol is a mixture of higher aliphatic primary alcohols purified from sugar-cane wax. The mixture has cholesterol-lowering efficacy, its specific effects being to reduce serum total (TC) and low-density lipoprotein cholesterol (LDL-C), and to increase high-density lipoprotein cholesterol (HDL-C). The effects of policosanol on triglycerides (TG) are modest and inconsistent. Omega-3 fatty acids (FA) from fish oil protect against coronary disease, mainly through antiarrhythmic and antiplatelet effects. Omega-3 FA also have lipid-modifying effects, mostly relating to TG reduction. Thus, potential benefits could be expected from combined therapy with omega-3 FA and policosanol. OBJECTIVE: To investigate whether combined therapy with omega-3 FA + policosanol offers benefits compared with omega-3 FA + placebo with respect to the lipid profile of patients with type II hypercholesterolaemia. METHODS: This randomised, double-blind study was conducted in 90 patients with type II hypercholesterolaemia. After 5 weeks on a cholesterol-lowering diet, patients were randomised to omega-3 FA + placebo, omega-3 FA + policosanol 5 mg/day or omega-3 FA + policosanol 10 mg/day for 8 weeks. Omega-3 FA was supplied as 1g capsules (two per day); placebo and policosanol were provided in tablet form. Physical signs and laboratory markers were assessed at baseline and after 4 and 8 weeks on therapy. Drug compliance and adverse experiences (AEs) were assessed at weeks 4 and 8. The primary efficacy variable was LDL-C reduction; other lipid profile markers were secondary variables. RESULTS: After 8 weeks, omega-3 FA + policosanol 5 and 10 mg/day, but not omega-3 FA + placebo, significantly reduced LDL-C by 21.1% and 24.4%, respectively (both p < 0.0001). Omega-3 FA + policosanol 5 mg/day also significantly lowered TC (12.7%; p < 0.01) and TG (13.6%; p < 0.05), and significantly increased HDL-C (+14.4%; p < 0.001). Omega-3 FA + policosanol 10 mg/day significantly decreased TC (15.3%; p < 0.001) and TG (14.7%; p < 0.01), and significantly increased HDL-C (+15.5%; p < 0.0001). Omega-3 FA + placebo significantly reduced TG (14.2%; p < 0.05) but had no significant effect on other lipid profile variables. The proportion of randomised patients in the omega-3 FA + policosanol 5 or 10 mg/day groups that achieved LDL-C targets or reductions 15% was significantly greater than in the omega-3 FA + placebo group (p < 0.001). Combined therapy with omega-3 FA + policosanol 5 or 10 mg/day resulted in significantly greater changes in LDL-C, TC and HDL-C than treatment with omega-3 FA + placebo, but did not modify the TG response compared with the omega-3 FA + placebo group. Four patients (two in the omega-3 FA + placebo group and two in the omega-3 FA + policosanol 10 mg/day group) withdrew from the study; none of these withdrawals was due to AEs. Two patients reported mild AEs, namely nausea/headache (one in the omega-3 FA + placebo group) and heartburn (one in the omega-3 FA + policosanol 5 mg/day group). CONCLUSIONS: Policosanol 5 or 10 mg/day administered concomitantly with omega-3 FA 1 g/day improved LDL-C, TC and HDL-C, maintained the reduction in TG attributable to omega-3 FA monotherapy, and was well tolerated. Treatment with omega-3 FA + policosanol could be useful for regulating lipid profile in patients with type II hypercholesterolaemia, but further studies involving larger sample sizes are needed before definitive conclusions can be drawn.
Assuntos
Anticolesterolemiantes/uso terapêutico , Ácidos Graxos Ômega-3/uso terapêutico , Álcoois Graxos/uso terapêutico , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Lipídeos/sangue , Idoso , Anticolesterolemiantes/administração & dosagem , Colesterol/sangue , Relação Dose-Resposta a Droga , Método Duplo-Cego , Quimioterapia Combinada , Ácidos Graxos Ômega-3/administração & dosagem , Álcoois Graxos/administração & dosagem , Feminino , Humanos , Masculino , Triglicerídeos/sangueRESUMO
The main goal of hypercholesterolemia management for coronary prevention is to reduce serum low-density lipoprotein cholesterol (LDL-C) levels. D-003 is a mixture of high molecular weight aliphatic acids purified from sugarcane wax, while policosanol is a cholesterol-lowering drug purified from the same source, consisting in a mixture of higher aliphatic alcohols. No previous comparative study of both drugs in humans has been reported. This randomized, double-blind study compares the efficacy and tolerability of D-003 and policosanol (5 and 10 mg/day) in patients with type II hypercholesterolemia. After a baseline period, 100 patients were randomized to D-003 or policosanol both at 5 mg/day and 10 mg/day, for 8 weeks. D-003 and policosanol 5 mg/day reduced (p < 0.0001) LDL-C by 26.9% and 20.9%, respectively. These reductions increased with 10 mg/day (35.1% for D-003, 25.1% for policosanol. The reductions of LDL-C achieved with D-003 5 mg/day and 10 mg/day were greater (p < 0.05 and p < 0.001, respectively) than with policosanol. The frequency of patients treated with D-003 (5 mg/day) reaching LDL-C reductions > or = 15% (22/25, 88%) was greater (p < 0.01) than with policosanol (5 mg/day) (19/25, 76%), and the same was true for D-003 10 mg/day (25/25, 100%) and policosanol (22/25, 88%; p < 0.01). D-003 and policosanol (5 mg/day) also lowered (p < 0.001) total cholesterol (TC) (16.2% and 13.5%, respectively), and increased high-density lipoprotein cholesterol (HDL-C) by 15.3% (D-003) and 6.7% (policosanol). At 10 mg/day, D-003 and policosanol reduced (p < 0.001) TC (21.3% and 16.0%, respectively), while HDL-C was increased by 17.3% and 9.8%, respectively, D-003 being more effective than policosanol. Treatments did not affect triglycerides. Both drugs were well tolerated, with D-003 tolerated as well as policosanol. Three patients discontinued the study, none due to adverse events (AEs). Seven patients (three from the D-003 group and four from the policosanol group) experienced mild AEs. In conclusion, D-003 (5 and 10 mg/day) administered to patients with type II hypercholesterolemia was more effective than policosanol in lowering LDL-C and TC, and in increasing HDL-C. D-003 could be useful for treating type II hypercholesterolemia, but this subject deserves further clinical research.