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COVID-19, caused by the SARS-CoV-2 virus, is a highly pathogenic emerging infectious disease. Healthcare personnel (HCP) are presumably at higher risk of acquiring emerging infections because of occupational exposure. The prevalence of COVID-19 in HCP is unknown, particularly in low- to middle-income countries like El Salvador. The goal of this study was to determine the seroprevalence of anti-SARS-CoV-2 antibodies among HCP in El Salvador just prior to vaccine rollout in March 2021. We evaluated 2176 participants from a nationally representative sample of national healthcare institutions. We found 40.4% (n = 880) of the study participants were seropositive for anti-spike protein antibodies. Significant factors associated with infection included younger age; living within the central, more populated zone of the country; living in a larger household (≥7 members); household members with COVID-19 or compatible symptoms; and those who worked in auxiliary services (i.e., housekeeping and food services). These findings provide insight into opportunities to mitigate SARS-CoV-2 risk and other emerging respiratory pathogens in HCP in El Salvador.
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Aims and Objectives: The aim of this study was to describe the mechanism of dental implants osseointegration in patients with congenital and degenerative genetic bone disorders. Materials and Methods: A PubMed and Scopus documents search was carried out between November 2021 in the, using words such as "osseointegration," "degenerative disease," "congenital disease," and "dental implants." Results: The thirteen articles selected dealt with dental implants osseointegration in patients with congenital and degenerative bone disorders. The influence and repercussion of these diseases on the bone system, as well as the osseointegration process were described from healing to bone remodeling. In addition, certain articles described some considerations to improve the osseointegration process in patients suffering from these types of conditions. Conclusions: Within the limitations of this literature review we can conclude that osseointegration in patients with ectodermal dysplasia and osteoporosis could be achieved. However, the planning process for dental implant placement in these patients should be more meticulous and individualized considering the degree of tissue involvement as well as the patient's age and skeletal development compared to systemically healthy patients.
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Aim: The aim of this article is to describe the existing scientific literature on photodynamic therapy (PDT) effectiveness for peri-implantitis treatment. Materials and Methods: A date-restricted electronic search strategy was performed in PubMed and Scopus databases. The following words were used: "peri-implant photodynamic therapy," "photodynamic therapy in implantology," "effectives of photodynamic therapy in peri-implantitis," "Antimicrobial Photodynamic Therapy," "Photodynamic Therapy for the treatment of peri-implantitis," and "Mechanical debridement and photodynamic therapy in implantology." Results: Of the 15 articles, 13 articles were selected, of which 11 were prospective and experimental studies and 2 were longitudinal. The PDT effectiveness of peri-implantitis inflammation treatment was the most reported and investigated. Conclusion: There is scientific evidence that may support the use of PDT for peri-implantitis treatments. However, even more studies would still be needed to have solid evidence.
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Background: The "Bridge Project" is a Mexico in Alliance with St. Jude (MAS) initiative developed in 2019 to improve access, accuracy, and timeliness of specialized diagnostic studies for patients with suspected acute lymphoblastic leukemia (ALL). The project strategy relies on service centralization to improve service delivery, biological characterization, risk-group classification, and support proper treatment allocation. Methods: This is an ongoing prospective multisite intersectoral quality improvement (QI) project available to all patients 0-18 years of age presenting with suspected ALL to the 14 actively participating institutions in 12 Mexican states. Institutions send specimens to one centralized laboratory. From a clinical standpoint, the project secures access to a consensus-derived comprehensive diagnostic panel. From a service delivery standpoint, we assess equity, timeliness, effectiveness, and patient-centeredness. From an implementation science standpoint, we document feasibility, utility, and appropriateness of the diagnostic panel and centralized approach. This analysis spans from July 2019 to June 2023. Results: 612 patients have accessed the project. The median age was 6 years (IQR 3-11), and 53% were males. 94% of the specimens arrived within 48 hours, which documents the feasibility of the centralized model, and 100% of the patients received precise and timely diagnostic results, which documents the effectiveness of the approach. Of 505 (82.5%) patients with confirmed ALL, 463/505 (91.6%) had B-cell ALL, and 42/505 (8.3%) had T-cell ALL. High-hyperdiploidy was detected by DNA index in 36.6% and hypodiploidy in 1.6%. 76.6% of the patients had conclusive karyotype results. FISH studies showed t(12;21) in 15%, iAMP21 in 8.5%, t(1;19) in 7.5%, t(4;11) in 4.2%, t(9;22) in 3.2%, del(9)(p21) in 1.8%, and TRA/D (14)(q11.2) rearrangement in 2.4%. Among B-cell ALL patients, 344/403 (85.1%) had Day 15 MRD<1% and 261/305 (85.6%) Day 84 MRD<0.01. For T-cell ALL patients 20/28 (71.4%) had Day 29 MRD<0.01% and 19/22 (86.4%) Day 84 MRD<0.01%. Conclusions: By securing access to a standardized consensus-derived diagnostic panel, the Bridge Project has allowed better characterization of childhood ALL in Mexico while producing unprecedented service improvements and documenting key implementation outcomes. We are using these results to inform iterative changes to the diagnostic panel and an associated treatment guideline (MAS-ALL18).
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RESUMEN Fundamento: el procesamiento de imágenes es clave en la planificación de tratamientos de radioterapia con haces externos. En su ejecución pueden ocurrir errores humanos y fallos de equipos, que conllevan, entre otros efectos, a interpretaciones erróneas de imágenes diagnósticas, errores de contorneo de blancos, sobredosis a tejidos sanos o subdosis a tejidos tumorales, lo cual significa poner en riesgo a los pacientes sometidos a estas prácticas. Objetivo: caracterizar los riesgos asociados a los factores tecnológicos y humanos relacionados con el procesamiento de imágenes que pueden afectar a los pacientes sometidos a tratamientos de radioterapia con haces externos. Métodos: como base de estudio se empleó la práctica de radioterapia de intensidad modulada. Para caracterizar los iniciadores y las medidas de defensa relacionados con este procesamiento, se emplearon modelos de riesgo basados en análisis de modos y efectos de fallo y matriz de riesgo de la práctica de referencia, que fueron procesados con el software SECURE-MR-FMEA. Resultados: los análisis de sensibilidad sobre los modelos de radioterapia de intensidad modulada mostraron los efectos sobre el riesgo de los fallos asociados al procesamiento de imágenes. Conclusiones: se confirmó la importancia de aplicar el análisis de riesgo en el procesamiento de imágenes para elevar la seguridad de los pacientes durante los tratamientos de radioterapia con haces externos.
ABSTRACT Background: image processing is the key in planning external beam radiotherapy treatments. In its execution, human errors and equipment failures can occur, which lead, among other effects, to erroneous interpretations of diagnostic images, target contouring errors, overdose of healthy tissues or underdose of tumor tissues, which means putting patients at risk patients subjected to these practices. Objective: to characterize the risks associated with technological and human factors related to image processing that can affect patients undergoing radiotherapy treatments with external beams. Methods: intensity modulated radiotherapy was used as the basis of the study. To characterize the initiators and defense measures related to this processing, risk models were used based on analysis of failure modes and effects and the risk matrix of the reference practice, which were processed with the SECURE-MR-FMEA software. Results: the sensitivity analyzes on the intensity-modulated radiotherapy models showed the effects on the risk of failures associated with image processing. Conclusions: the importance of applying risk analysis in image processing to increase patient safety during external beam radiotherapy treatments was confirmed.
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Este documento tiene como objetivo presentar la evidencia disponible sobre las opciones terapeutas contra el Covid-19. Se presentan 2 Tablas, la primera resume la descripción de cada medicamento y la conclusión con respecto a su uso como tratamiento contra el SARS-Covid-2, de acuerdo con la evidencia disponible al momento y en la segunda tabla se muestra esta evidencia
This document aims to present the available evidence on the therapeutic options against Covid-19. Two tables are presented, the first one summarizes the description of each drug and the conclusion regarding its use as a treatment against SARS-Covid-2, according to the evidence available at the time and the second table shows this evidence
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Terapêutica , Infecções por Coronavirus , Preparações FarmacêuticasRESUMO
In this study, we investigated the impact of a TiO2 nanotube (NT) interlayer on the electrochemical performance and service life of Sb and Bi-doped SnO2-coatings synthesized on a titanium mesh. Ti/SnO2-SbBi electrode was synthetized by a thermal decomposition method using ionic liquid as a precursor solvent. Ti/TiO2-NT/SnO2-SbBi electrode was obtained by a two-step electrochemical anodization, followed by the same process of thermal decomposition. The synthesized electrodes were electrochemically characterized and analyzed by scanning electron microscopy and energy dispersive X-ray spectroscopy. Terephthalic acid (TA) experiments showed that Ti/SnO2-SbBi and Ti/TiO2-NT/SnO2-SbBi electrodes formed somewhat higher amounts of hydroxyl radicals (HO) compared with the mesh boron doped diamond (BDD) anode. Electrochemical oxidation experiments were performed using iodinated contrast media (ICM) as model organic contaminants persistent to oxidation. At current density of 50 A m-2, BDD clearly outperformed the synthesized mixed metal oxide (MMO) electrodes, with 2 to 3-fold higher oxidation rates observed for ICM. However, at 100 and 150 A m-2, Ti/SnO2-SbBi had similar performance to BDD, whereas Ti/TiO2-NT/SnO2-SbBi yielded even higher oxidation rates. Disappearance of the target ICM was followed by up to 80% removal of adsorbable organic iodide (AOI) for all three materials, further demonstrating iodine cleavage and thus oxidative degradation of ICM mediated by HO. The presence of a TiO2 NT interlayer yielded nearly 4-fold increase in anode stability and dislocated the oxygen evolution reaction by +0.2 V. Thus, TiO2 NT interlayer enhanced electrode stability and service life, and the electrocatalytic activity for the degradation of persistent organic contaminants.
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Meios de Contraste/química , Poluentes Químicos da Água/química , Purificação da Água/métodos , Boro/química , Diamante/química , Eletrodos , Nanotubos/química , Oxirredução , Óxidos/química , Titânio/químicaRESUMO
Las técnicas de control de riesgo, actualmente disponibles, no satisfacen la inmediatez necesaria para la vigilancia de los efectos, de los frecuentes fallos de equipos y errores humanos asociados a las prácticas de radioterapia. La metodología propuesta, en el artículo, integra las bases de datos sobre las secuencias accidentales posibles en prácticas médicas, con empleo de radiaciones ionizantes, con una herramienta desarrollada para la actualización dinámica del riesgo, en condiciones operacionales variables. Un resultado inmediato del análisis es el conocimiento de los nuevos escenarios de peligro en los que se trabaja, bajo cualquier combinación de indisponibilidades de contribuyentes al riesgo, el que se basa en múltiples capacidades de estudios detallados y mímicos de procesos y de secuencias accidentales. Estas capacidades garantizan el monitoreo dinámico del riesgo para cualquier estado de los escenarios de estudio.
The techniques of risk control at the moment available they don't satisfy the necessary speed to the surveillance of the effects from the equipment failures and human errors during practical of radiotherapy. The methodology proposed in this paper integrates databases on possible accident sequences in medical practices using ionizing radiation with a tool for dynamic updating of operational conditions risk variables. An immediate result of the analysis is the knowledge of the new scenarios of danger, under any combination of unavailability to the risk, based on multiple study capacities and mimics for the processes and sequences. These capacities guarantee the instantaneous risk monitoring for any state of the studied scenarios.
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En el ejercicio de las actividades médico-sanitarias se pueden ver transgredidos derechos de los usuarios como la vida e integridad física y mental por parte de los prestadores de salud que realizan procedimientos de cirugía plástica estética. Pueden ser profesionales liberales cuando se hace referencia a la responsabilidad médica o prestadores sanitarios en el caso de la responsabilidad de las clínicas que realizan procedimientos estéticos. Estas personas que son eventuales causantes de daños pueden generar perjuicios al paciente, sus causahabientes y perjudicados indirectos. El presente escrito es producto de una investigación de tipo exploratoria de revisión, mediante el cual se indaga, compila, revisa e integra el resultado de una investigación bibliográfica, en la que se agruparon y sistematizaron los documentos relacionados con el tema objeto de la investigación. El tema es la responsabilidad médico-sanitaria derivada de procedimientos estéticos y el seguro de responsabilidad civil que cubre dicha responsabilidad, relacionando lo anterior con la reparación integral de las víctimas del hecho médico-sanitario dañoso...
In medical-sanitary practice, user rights such as life and physical and mental integrity may be transgressed by healthcare providers who perform aesthetic plastic surgery procedures. They may be liberal professionals, when referring to medical liability, or sanitary providers in the case of the liability of clinics which carry out aesthetic procedures. These individuals who could eventually cause harm may generate injuries to patients who are their assignees and indirect negatively affected subjects. This article results from an exploratory research through which we inquired, compiled, reviewed and integrated the results of a literature review which consolidated and standardized documents related to the research topic. The topic is medical-sanitary liability derived from aesthetic procedures and the civil liability insurance coverage of said responsibility relating the latter with the inclusive compensation of the victims of the adverse medical-sanitary event...
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Humanos , Direitos do Paciente , Cirurgia Plástica , Compensação e Reparação , PesquisaRESUMO
BACKGROUND AND OBJECTIVES: Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis. METHODS: This study compared the effectiveness of IO access in relation to IV access for infusion of anesthetics agents (ketamine, midazolam, and fentanyl) and fluids during hemodynamic studies. The anesthetic induction time, procedure duration, anesthesia recovery time, adequate hydration, and IV and IO puncture complications were compared between groups. RESULTS: The puncture time was significantly smaller in IO group (3.6 min) that in IV group (9.6 min). The anesthetic onset time (56.3 second) for the IV group was faster than IO group (71.3 second). No significant difference between groups were found in relation to hydration (IV group, 315.5 mL vs IO group, 293.2 mL), and anesthesia recovery time (IO group, 65.2 min vs IV group, 55.0 min). The puncture site was reevaluated after 7 and 15 days without signs of infection or other complications. CONCLUSIONS: Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access.
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Anestesia/métodos , Cardiopatias/congênito , Cardiopatias/fisiopatologia , Hemodinâmica , Estudos de Viabilidade , Feminino , Humanos , Lactente , Infusões Intraósseas , MasculinoRESUMO
JUSTIFICATIVA E OBJETIVOS: O acesso intraósseo (IO) tem sido utilizado com bons resultados em situações de emergência quando não há acesso venoso disponível para a administração de fluidos e fármacos. O objetivo do presente estudo foi avaliar se o acesso IO é uma técnica útil para a administração de anestesia e fluidos no estudo hemodinâmico quando é impossível obter acesso periférico. Este estudo foi realizado na Unidade de Hemodinâmica de um hospital universitário, com 21 lactentes que apresentavam doença cardíaca congênita agendados para estudo hemodinâmico diagnóstico. MÉTODOS: Este estudo comparou a efetividade do acesso IO em relação ao EV para a infusão de anestésicos (cetamina, midazolam e fentanil) e fluidos durante estudo hemodinâmico. Tempo de indução anestésica, duração do procedimento, tempo de recuperação da anestesia, hidratação e complicações das punções EV e IO foram comparados entre os grupos. RESULTADOS: O tempo de punção foi significativamente menor no grupo IO (3,6 minutos) do que no grupo EV (9,6 minutos). O tempo de início da ação do anestésico foi mais rápido no grupo EV (56,3 segundos) do que no grupo IO (71,3 segundos). Não foram observadas diferenças significativas entre os dois grupos em relação à hidratação (grupo EV 315,5 mL vs. grupo IO 293,2 mL) e o tempo de recuperação da anestesia (grupo IO 65,2 min vs grupo EV 55,0 min). O sítio da punção foi reavaliado após 7 e 15 dias, não apresentando sinais de infecção ou outras complicações. CONCLUSÕES: Os resultados demonstraram superioridade da infusão IO em relação ao tempo de punção. Devido à sua manipulação bastante fácil e à sua eficiência, a hidratação e a anestesia feitas através de infusão IO se revelaram satisfatórias para estudos hemodinâmicos sem a necessidade de outros acessos.
BACKGROUND AND OBJECTIVES: Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis. METHODS: This study compared the effectiveness of IO access in relation to IV access for infusion of anesthetics agents (ketamine, midazolam, and fentanyl) and fluids during hemodynamic studies. The anesthetic induction time, procedure duration, anesthesia recovery time, adequate hydration, and IV and IO puncture complications were compared between groups. RESULTS: The puncture time was significantly smaller in IO group (3.6 min) that in IV group (9.6 min). The anesthetic onset time (56.3 second) for the IV group was faster than IO group (71.3 second). No significant difference between groups were found in relation to hydration (IV group, 315.5 mL vs IO group, 293.2 mL), and anesthesia recovery time (IO group, 65.2 min vs IV group, 55.0 min). The puncture site was reevaluated after 7 and 15 days without signs of infection or other complications. CONCLUSIONS: Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access.
JUSTIFICATIVA Y OBJETIVOS: El acceso intraoseo (IO), se ha venido utilizando con buenos resultados en situaciones de emergencia, cuando no existe el acceso venoso disponible para la administracion de fluidos y farmacos. El objetivo del presente estudio es evaluar si el acceso IO es una tecnica util para la administracion de anestesia y de fluidos en el estudio hemodinamico cuando el acceso periferico es imposible de obtenerse. Ese estudio fue realizado en el laboratorio de hemodinamica de un hospital universitario, con 21 lactantes portadores de enfermedad cardiaca congenita que fueron seleccionados para un estudio hemodinamico diagnostico. MÉTODOS: Este estudio comparo la efectividad del acceso IO con relacion al EV para la infusion de anestesicos (quetamina, midazolam y fentanil), y de fluidos durante el estudio hemodinamico. El tiempo de induccion anestesica, la duracion del procedimiento, el tiempo de recuperacion de la anestesia, la adecuada hidratacion y las complicaciones de las punciones EV e IO se compararon entre los grupos. RESULTADOS: El tiempo de puncion fue significativamente menor en el grupo IO (3,6 minutos) que en el grupo EV (9,6 minutos). El tiempo de inicio de la accion de la anestesia fue mas rapido en el grupo EV (56,3 segundos) que en el grupo IO (71,3 segundos). No se observaron diferencias significativas entre los dos grupos con relacion a la hidratacion (grupo EV 315,5 mL vs. grupo IO 293,2 mL), y sobre el tiempo de recuperacion de la anestesia (grupo IO 65,2 min vs, grupo EV 55,0 min). El sitio de la puncion se evaluo nuevamente despues de 7 a 15 dias, y no presento senales de infeccion u otras complicaciones. CONCLUSIONES: Los resultados comparativos arrojaron una superioridad de la infusion IO con relacion al tiempo de puncion. Debido a su eficiencia y manipulacion bastante facil, la hidratacion y la anestesia que se hicieron por medio de la infusion IO demostraron ser satisfactorias para los estudios hemodinamicos sin la necesidad de otros accesos.
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Feminino , Humanos , Lactente , Masculino , Anestesia/métodos , Hemodinâmica , Cardiopatias/congênito , Cardiopatias/fisiopatologia , Estudos de Viabilidade , Infusões IntraósseasRESUMO
RESUMEN El trabajo presenta los resultados del Análisis Probabilista de Seguridad al proceso de tratamiento de radioterapia con un acelerador lineal de uso médico desarrollado por el Foro Iberoamericano de Organismos Reguladores Radiológicos y Nucleares. Se evaluaron las exposiciones accidentales potenciales durante el proceso de tratamiento del paciente, los trabajadores y miembros del público, aunque el énfasis del estudio se orientó hacia los pacientes. El método de análisis de modos de fallos y efectos se utilizó para definir los sucesos iniciadores de accidentes y los métodos de árboles de sucesos y árboles de fallo para determinar las secuencias accidentales que se pueden producir. Una vez cuantificada la frecuencia de ocurrencia de las secuencias accidentales se realizaron análisis de importancia para determinar los sucesos más significativos desde el punto de vista de la seguridad y se identificaron los principales contribuyentes al riesgo, así como las recomendaciones de seguridad más apropiadas para reducirlo.
ABSTRACT This paper presents the results of the Probabilistic Safety Assessment to the radiotherapy treatment with an Electron Linear Accelerator for Medical Use, which was conducted in the framework of the Iberian-American Forum of Radiological and Nuclear Regulatory Agencies. Potential accidental exposures during the treatment of patients, workers and members of the public were assessed, although the study was mainly focused on patients. The methodology of failure modes and effects analysis was used to define accident initiating events and methods of event tree and fault tree analysis to determine the accident sequences that may occur. After quantifying the frequency of occurrence of the accident sequences, an important analysis was carried out in order to determine the most significant events from the point of view of safety. The major contributors to risk were identified as well as the most appropriate safety recommendations to reduce it.
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Descrição dos principais aspectos da embolização do mioma uterino (EMU) sintomático, utilizando dados iniciais da casuística pessoal e revisão de literatura via Medline. A literatura demonstra melhora importante do sangramento uterino e dor pélvica após a EMU. A redução volumétrica dos nódulos de mioma e do útero após a EMU é observada em diversos estudos. O tempo de permanência hospitalar e recuperação pós EMU é menor quando comparado com a histerectomia ou miomectmia. Trabalhos randomizados ainda não foram executados para determinar qual é o melhor agente embolizante, duração da resposta clínica ao tratamento, efeitos na fertilidade e freqüência de complicações. Relatos de caso de gestação pós-EMU são descritos. A EMU representa alternativa terapêutica para o tratamento do mioma uterino. Em nossa casuística, a EMU é efetiva no controle dos sintomas e redução do volume uterino com baixa incidência de complicações. Em casos selecionados pode ser indicada a mulheres com desejo reprodutivo.
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Feminino , Gravidez , Embolização Terapêutica/métodos , Leiomioma/irrigação sanguínea , Leiomioma/terapia , Procedimentos Cirúrgicos Minimamente Invasivos , Neoplasias Uterinas/irrigação sanguínea , Neoplasias Uterinas/terapia , Seleção de Pacientes , Radiologia IntervencionistaRESUMO
El presente trabajo, fue diseñado para identificar la prevalencia y distribución de las principales patologías de los maxilares encontradas en radiografías panorámicas, tomadas como medio auxiliar de diagnóstico en el examen de rutina en la consulta odontológica en pacientes de todas las edades que se atendieron y tomaron esta radiografía en una clínica Odontológica Docente Asistencial de Lima Metropolitana. De las 2,500 radiografías examinadas, se encontró que el 6.12 por ciento presentó alguna patología en los maxilares, de las cuales el 62 por ciento corresponde a sujetos de sexo masculino y 38 por ciento al sexo femenino, siendo en su mayor porcentaje 68 por ciento mayores de 24 años de edad. Las patologías que se encontraron con mayor frecuencia fueron los quistes de los maxilares con el 42 por ciento seguido por los casos de anodoncia 23 por ciento, luego los casos de dientes supernumerarios con el 18 por ciento y odontomas con el 16.3 por ciento y finalmente los keratoquistes con el 0.7 por ciento.
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Pessoa de Meia-Idade , Humanos , Anodontia , Dente Supranumerário , Doenças Maxilares , Odontoma , Epidemiologia DescritivaRESUMO
The liver transplantation technique advances have allowed the endovascular treatment of stenosis between hepatic vein and inferior vena cava, and this has become an established and widely acceptable method for the treatment of patients with end-stage liver disease. However, in spite of the advances in the surgical technique of liver transplantation there is relatively still a high incidence of postoperative complications, especially those related to vascular complications. One technical variant of orthotopic liver transplantation is the piggyback technique with conservation of the recipient vena cava, which is anastomosed to the graft hepatic veins. As a consequence of the increased number of liver transplants in children, there is a higher demand for endovascular treatment of vascular stenosis, such as those at the level of the hepatic veins. This leads to more consistent experience of endovascular treatment of the surgical vascular complications following liver transplantation. This article describes the case of a child submitted to liver transplantation with reduced graft (left lateral segment) who presented stenosis of the anastomosis between the hepatic vein and IVC 6 months later which was successfully treated by PTA.
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Cateterismo , Veias Hepáticas/patologia , Transplante de Fígado , Veia Cava Inferior/patologia , Anastomose Cirúrgica , Constrição Patológica/terapia , Feminino , Artéria Hepática/cirurgia , Veias Hepáticas/diagnóstico por imagem , Humanos , Lactente , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Microcirurgia , Período Pós-Operatório , Recidiva , Fluxo Sanguíneo Regional , Retratamento , Ultrassonografia Doppler , Veia Cava Inferior/diagnóstico por imagemRESUMO
Objetivos: estabelecer las bases para el tratamiento y atención de la mujer portadora de cardiopatía en edad fértil, caracterizando al grupo de gestantes atendidas en servicio. Métodos: realizó un estudio descriptivo y las mujeres fueran clasificadas según cardiopatía y grado de afctación funcional en relación con los resultados, se decribiendo las complicaciones durante el embarazo, parto y puerperio y los resultados perinatales. Variables analizadas; tipo de cardiopatía y clasificación funcional de als mismas, complicaciones obstétricas y/o cardiovasculares, edad gestacional al parto, modo de nacimiento, peso y puntaje de Apgar en el recién nacido y mortalidad materna y del recién nacido. Resultados: encontramos 129 valvulopatías adquiridas, 79 congénitas, 18 casos de trastornos del ritmo. Lesiones más frecuentes valvulopatías mitrales (92) y comunicaciones interauriculares (31). 21 pacientes presentaron empeoramiento funcional durante el embarazo. Aparecieron complicaciones cardiovasculares en 19 pacientes y obstétricas en 142. 14 requirieron ingreso en Servicios de Terapia Intensiva y tres fallecieron. Conclusiones: Se confirmó la asociación entre clasificación funcional y complicaciones cardiovasculares durante el embarazo, parto y puerperio. Las complicaciones obstétricas se comportan igual que en las gestaciones de pacientes sanas y más de mitad de los partos fueron eutócicos.
Assuntos
Feminino , Gravidez , Serviço Hospitalar de Cardiologia , Complicações Cardiovasculares na Gravidez , Cuidado Pré-Natal , Epidemiologia DescritivaRESUMO
Na revascularizaçao cirúrgica do miocárdio, empregando-se a técnica de pinçamento intermitente de aorta, após o desclampeamento e a recuperaçao dos batimentos cardíacos, surgiu a polêmica da necessidade da ventilaçao pulmonar na prevençao de hipoxemia. O objetivo deste trabalho foi analisar a importância da ventilaçao pulmonar no transporte de oxigênio e equilíbrio ácido-base do sangue que irá perfundir o miocárdio após desclampeamento de aorta e recuperaçao dos batimentos cardíacos. Foram estudados dez pacientes submetidos a revascularizaçao cirúrgica do miocárdio, empregando-se a técnica de pinçamento intermitente de aorta com hipotermia moderada (ñ 32 graus Celsius). Em cinco pacientes (Grupo I), após o 1( desclampeamento de aorta, a ventilaçao pulmonar foi realizada simultaneamente à recuperaçao dos batimentos cardíacos. Nos outros cinco pacientes (Grupo II) nao se realizou a ventilaçao pulmonar. Foram analisados (Saturaçao de 0(2') PO(2') PCO(2) e pH) do sangue do átrio direito (AD), tronco pulmonar (AP), átrio esquerdo (AE), aorta (Ao), artéria radial (art. radial) e circuito da circulaçao extracorpórea (CEC) (arterial [art. CEC] e venoso [ven. CEC]), comparando-se os dois grupos. Nao houve diferença estatisticamente nos valores de saturaçao de 0(2) ambos os grupos. No Grupo I, os valores do PO(2) aumentaram significativamente. Houve aumento significante da PO(2) no Grupo II, contribuindo para reduçao significante de pH neste grupo. Os autores concluem que, embora nao tenha ocorrido hipoxemia, a acidose respiratória observada no Grupo II permite recomendar a ventilaçao pulmonar ao utilizar-se do pinçamento intermitente de aorta como forma de proteçao miócardica, pois sabe-se dos efeitos deletérios do aumento da concentraçao de íons hidrogênio ([H+]) na funçao contrátil do miocárdio.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Revascularização Miocárdica/métodos , Equilíbrio Ácido-Base , Oxigênio/metabolismo , Respiração ArtificialRESUMO
Se informa que el diagnóstico prenatal (DP) fue realizado a 7 embarazadas con un riesgo de 1 a 4 de tener un niño con fibrosis quística. Se destaca que el criterio para determinar los fetos afectados se basó en los resultados de la actividad de la fosfatasa alcalina total y en presencia de sus inhibidores L-fenilalanina y L-homoarginina, así como también se establecen los valores de actividad de la glutamiltranspeptidasa; estas determinaciones se realizaron en el líquido amniótico, en la semana 18 del embarazo. Se señala que en los ensayos bioquímicos en el líquido amniótico presentaron valores normales 5 embarazadas. En los 2 casos restantes se observó deficiencia de actividad de fosfatasa alcalina total y con el inhibidor fenilalanina, así como deficiencia de glutamiltranspeptidasa. En ambos casos se interrumpió el embarazo. Los 2 casos presentaron ileo meconial
Assuntos
Gravidez , Humanos , Feminino , Fibrose Cística/diagnóstico , Diagnóstico Pré-Natal , Fosfatase Alcalina , Amniocentese , Cuba , Homoarginina , Líquido Amniótico/análise , FenilalaninaRESUMO
Se presentan los resultados de un estudio retrospectivo de las gestantes del municipio Plaza de la Revolución que ingresaron durante 1983, con ruptura prematura de membranas en el Hospital Docente Ginecoobstétrico "Ramón González Coro". Se analizan su incidencia y la posible relación con algunos factores sociales y biológicos y se comparan con la literatura