RESUMO
BACKGROUND: Whether a patient's outcomes are better when receiving nutritional counselling during cardiac rehabilitation (CR) has been scarcely described. We compared changes in weight, waist circumference (WC) and blood pressure (BP) in patients attending CR with and without nutritional counselling. METHODS: A retrospective analytical study was conducted in which two groups of patients who completed a phase II CR (36 sessions) were compared: CONTROL [n = 144, mean (SD) age = 59 (12) years, 17% females], comprising patients without nutritional counselling (attended between 2003 and 2009), and NUT [n = 128, mean (SD) age = 60 (13) years, 27% females], comprising patients with dietitian-delivered nutritional counselling (attended between 2010 and 2019). Repeated-measures analysis of variance was used to compare changes in weight, WC, and BP during CR between groups. Logistic regression models determined the probability of reducing weight and systolic BP (SBP). RESULTS: NUT group decreased weight [-1.3 (3.1) kg; P < 0.0001] and WC [-3.0 (3.8) cm; P < 0.0001] to a greater extent than CONTROL [weight: -0.4 (3.1) kg; P = 0.51; WC: -1.4 (4.5) cm; P = 0.02]. In CONTROL, 7% reduced ≥ 5% weight and 31% reduced ≥ 10 mmHg SBP, whereas, in the NUT group, 18% reduced ≥ 5% weight and 47% reduced ≥ 10 mmHg SBP. Patients in NUT (versus CONTROL) were more likely to lose ≥ 5% of weight (odds ratio = 4.27, 95% confidence interval = 1.69-10.80; P < 0.01) and reduce SBP ≥ 10 mmHg (odds ratio = 3.15, 95% confidence interval = 1.58-6.27; P < 0.01). CONCLUSIONS: Patients who received nutritional counselling during CR improved anthropometric measures and were more likely to lose weight and reduce SBP than patients without nutritional counselling.
Assuntos
Reabilitação Cardíaca , Pressão Sanguínea , Aconselhamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Circunferência da CinturaRESUMO
BACKGROUND: To assess the effectiveness of a psychoeducational intervention program designed to facilitate the performance of a series of steps of oral examination in children, adolescents and adults with autism spectrum disorder (ASD), in the Bio-Bio region, Chile. MATERIAL AND METHODS: A prospective, quasi-experimental study with pre-intervention, post-intervention and maintenance tests was carried out. Behavior was measured using Frankl's scale and the number of steps of a dental examination completed (1-10 steps) was also recorded. Only 104 of the 188 subjects with ASD that agreed to participate in the study met all the inclusion criteria. RESULTS: 82 people with ASD completed the psychoeducational intervention. The mean number of steps achieved pre- and post-intervention was 4.1 and 9.4, resulting in a clinically and statistically significant difference. Regarding behavior, the median in the pre-test was 2 (negative behavior) and in the post-test it increased to 3 (positive behavior), this difference being relevant and statistically significant. A maintenance test one month later on 63 people with ASD found no variations in behavior and in the number of examination steps completed. CONCLUSIONS: The proposed intervention was effective as an increase of more than 5 in the number of steps of examination completed was achieved. Frankl's behavior rating also increased, from negative to positive, in a group of children, adolescents and adults with ASD.
Assuntos
Transtorno do Espectro Autista , Diagnóstico Bucal/métodos , Educação de Pacientes como Assunto , Adolescente , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Chile , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto JovemRESUMO
RESUMEN Fundamento: La persistencia del virus papiloma posterior a la conización del cuello uterino, se ha considerado un factor de riesgo para la persistencia de lesiones intra epiteliales (LIE) causadas por virus papiloma. Para determinar la asociación entre persistencia de lesión cervical y la presencia del virus papiloma posterior a la conización del cuello uterino, se realizó un estudio observacional prospectivo en un grupo de 123 pacientes portadoras de lesiones intraepiteliales de alto grado (LIEAG) tratadas con conización. Material y métodos: Se siguieron a 123 pacientes portadoras de LIEAG, ingresadas a la Unidad de Patología Cervical entre Abril de 2013 y Abril de 2014, las que fueron seguidas por 2 años hasta Abril de 2016. Se realizó genotipificación antes, y entre 4 a 6 meses posterior a la conización. Los datos se tabularon considerando la edad, paridad, tipo de virus, persistencia de LIE, reconización o requerimiento de histerectomía posterior. Resultados: La mediana de la edad fue de 37 años, el 91% fueron multíparas, y solo el 9% fueron nulíparas. El 56% ingresó por NIE III y el 44% por NIE II. Los virus más frecuentes fueron el 16, 31,58, 52 y 56. La persistencia de virus papiloma se constató en el 37% de las pacientes conizadas. La persistencia de LIE se observó en el 27% de las pacientes que fueron positivas para virus papiloma posterior a la conización, en comparación a sólo el 5% en las que fueron negativas. Del total de pacientes positivas para virus papiloma posterior a la conización, 12 de ellas presentaron persistencia de lesión confirmadas histológicamente por biopsia cervical, 8 pacientes requirieron recono por LIE de alto grado, 2 pacientes fueron a histerectomía y en 2 casos se realizó seguimiento estricto por NIE I. Cuando la tipificación post cono fue negativa solamente 3 pacientes requirieron conización y en sólo una se realizó seguimiento estricto por NIE I. Conclusión: La persistencia del virus papiloma posterior a la conización se asocia a mayor persistencia de LIEAG, mayor frecuencia de reconización o histerectomía posterior.
ABSTRACT Backgroud: The persistence of papilloma virus after conization of the cervix has been considered a risk factor for the persistence of cervical intra epithelial lesion (CIN) caused by papilloma virus. Aim: In order to determine the association between cervical lesion persistence and the presence of papilloma virus after conization, a prospective observational study was performed in a group of 123 patients with intraepithelial lesions treated with conization. Material and methods: We followed 123 patients with high grade CIN who were admitted to the Cervical Pathology Unit, between April 2013 and April 2014; they were followed for 2 years until April 2016. Viral genotyping was done before, and among the 4 to 6 months after the LEEP. Data were tabulated considering age, parity, type of virus, persistence of CIN, reconization or requirement of posterior hysterectomy. Results: The median age was 37 years, 91% were multiparous, and only 9% were nulliparous. 56% had NIE III and 44% NIE II. The most frequent viruses were 16, 31, 58, 52 and 56. The persistence of papillomavirus was present in 37% of patients. The persistence of CIN was observed in 27% of patients who were positive for papilloma virus after conization, compared to only 5% in those who were negative. Of the total number of patients positive for papilloma virus, in 12 of them had intra epitelial lesions were confirmed by cervical biopsy, 8 patients required recone for high grade CIN, 2 patients underwent hysterectomy, and 2 patients underwent follows up strictly by CIN I. When post cone typing was negative only 3 patients required conization and only one was followed strictly by CIN I.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Conização , Infecções por Papillomavirus/patologia , Papillomaviridae/fisiologia , Biópsia , Neoplasias do Colo do Útero/complicações , Estudos Prospectivos , Seguimentos , Displasia do Colo do Útero/cirurgia , Displasia do Colo do Útero/patologia , Colposcopia , Citodiagnóstico , Infecções por Papillomavirus/genética , Estudo ObservacionalRESUMO
Biodesulfurization (BDS) in a bioreactor packed with a catalytic bed of silica containing immobilized Rhodococcus rhodochrous was studied. Various bed lengths and support particle sizes were evaluated for BDS of dibenzothiophene (DBT) and gas oil. The sulfur-containing substrates were introduced separately into the bioreactor at different feed flows. Higher removal of sulfur from DBT and gas oil was achieved with a long bed, lower substrate flow, and larger sizes of immobilization particles. The packed bed bioreactor containing metabolic active cells was recycled and maintained BDS activity.
Assuntos
Biocatálise , Reatores Biológicos/microbiologia , Gases/isolamento & purificação , Óleos/isolamento & purificação , Rhodococcus/metabolismo , Dióxido de Silício/farmacologia , Enxofre/isolamento & purificação , Tiofenos/isolamento & purificação , Biocatálise/efeitos dos fármacos , Biodegradação Ambiental/efeitos dos fármacos , Células Imobilizadas/citologia , Células Imobilizadas/efeitos dos fármacos , Tamanho da Partícula , Reciclagem , Rhodococcus/citologia , Rhodococcus/efeitos dos fármacos , Fatores de TempoRESUMO
OBJECTIVE: Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort. MATERIALS AND METHODS: Cases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV-associated factors on non-AIDS-defining conditions. RESULTS: Among 6007 patients in follow-up, 130 had an SNA event (0.86 events/100 person-years of follow-up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non-AIDS-defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T-cell count prior to index date (P = 0.0056, with an average difference of more than 100 cells/µL) and area under the CD4 cell curve in the year previous to index date (P = 0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors. CONCLUSIONS: The incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.
Assuntos
Doenças Cardiovasculares/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Hospedeiro Imunocomprometido , Hepatopatias/epidemiologia , Neoplasias/epidemiologia , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/imunologia , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Doenças Cardiovasculares/imunologia , Métodos Epidemiológicos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Hepatopatias/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias/imunologia , Insuficiência Renal/epidemiologia , Insuficiência Renal/imunologia , América do Sul/epidemiologiaRESUMO
Se muestra la experiencia, en implante de marcapasos, por el electrofisiólogo, en un estudio retrospectivo, descriptivo, en los años 2000 a 2002 en el servicio de cardiología del Hospital EsSalud E Rebagliati M. Fueron evaluados 355 casos: 314 como primo implante y 41 por recambio de generador. Las características clínicas y electrocardiográficas, son parecidas a otras publicaciones. El sexo masculino predominó sobre el femenino (59.2 por ciento vs. 40.8 por ciento), el promedio edad recae sobre los 70 años, siendo los grupos etarios mayoritarios, entre los 70 a 80 años. Los síntomas predominantes fueron síncope (25 por ciento), disnea (19 por ciento), mareos (11 por ciento) y fatiga (11 por ciento). Los hallazgos EKG: BAV completo (38.5 por ciento), Síndrome Bradi-taquicardia (18.1 por ciento), FA con Bradicardia (13.6 por ciento), BAV II-Mz 2 (11.7 por ciento), Pausa sinusal (11.1 por ciento). La causa fue idiopática en el 95.5 por ciento. Los modos de estimulación escogidas VVI en el 88 por ciento, DDR en 9 por ciento y VVIR en 3 por ciento. Las complicaciones peri operatorias, en el 3.5 por ciento de casos, de baja significación clínica y de estos el hematoma en su mayoría (63.6 por ciento). La presencia del electrofisiólogo y el seguimiento de los pacientes a través de la denominada Clínica de Marcapasos permiten cubrir eficientemente la demanda de nuestro hospital.
Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Marca-Passo Artificial/estatística & dados numéricos , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
The lichens Ramalina celastri (Spreng.) Krog & Swinsc., Punctelia microsticta (Müll. Arg.) Krog and Canomaculina pilosa (Stizenb.) Elix & Hale were transplanted simultaneously to 17 urban-industrial sites in a northwestern area of Córdoba city, Argentina. The transplantation sites were set according to different environmental conditions: traffic, industries, tree cover, building height, topographic level, position in the block and distances from the river and from the power plant. Three months later, chlorophyll a, chlorophyll b, phaeophytin a, soluble proteins, hydroperoxy conjugated dienes, malondialdehyde concentration and sulfur accumulation were determined, and a pollution index was calculated for each sampling site. Redundancy analysis was applied to detect the variation pattern of the lichen variables that can be 'best' explained by the environmental variables considered. The present study provides information about both the specific pattern response of each species to atmospheric pollution, and environmental conditions that determine it. As regards pollutants emission sources R. celastri showed a chemical response associated mainly with pollutant released by the power plant and traffic. P. microsticta and C. pilosa responded mainly to industrial sources. Regarding environmental conditions that affect the spreading of air pollutants and their incidence on the bioindicator, the topographic level and tree cover surrounding the sampling site were found to be important for R. celastri, tree cover surrounding the sampling site and the building height affected P. microsticta, while building height did so for C. pilosa.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Líquens/crescimento & desenvolvimento , Líquens/fisiologia , Biomarcadores , Clorofila/análise , Clorofila A , Meio Ambiente , Monitoramento Ambiental , Centrais Elétricas , Proteínas/análise , Sensibilidade e Especificidade , Emissões de VeículosRESUMO
The atmospheric quality and distribution of heavy metals were evaluated throughout a wide region of Argentina. In addition, the biomonitor performance of Tillandsia capillaris Ruiz & Pav. f. capillaris was studied in relation to the accumulation of heavy metals and to its physiologic response to air pollutants. A sampling area of 50,000 km2 was selected in the central region of the Argentine Republic. This area was subdivided into grids of 25 x 25 km. Pools of T. capillaris, where present, were collected at each intersection point. From each pool three sub-samples were analyzed independently. Furthermore, five replicates were collected at 20% of the points in order to analyze the variability within the site. The content of Co, Cu, Fe, Ni, Mn, Pb and Zn was determined by Atomic Absorption Spectrometry. Chemical-physiological parameters were also determined to detect symptoms of foliar damage. Chlorophylls, phaeophytins, hydroperoxy conjugated dienes, malondialdehyde and sulfur were quantified in T. capillaris. Some of these parameters were used to calculate a foliar damage index. Data sets were evaluated by one-way ANOVA, correlation analysis, principal component analysis and mapping. Geographical distribution patterns were obtained for the different metals reflecting the contribution of natural and anthropogenic emission sources. According to our results it can be inferred that Fe, Mn and Co probably originated in the soil. For Pb, the highest values were found in the mountainous area, which can be attributed to the presence of Pb in the granitic rocks. Ni showed mainly an anthropogenic origin, with higher values found in places next to industrial centers. For Zn the highest values were in areas of agricultural development. The same was observed for Cu, whose presence could be related to the employment of pesticides. The foliar damage index distribution map showed that the central and southeastern zones were the ones where the major damage in the bioindicator was found. The central zone coincides with the city of Córdoba whereas the southeastern area is strictly agricultural, so the high values found there could be related to the use of pesticides.
Assuntos
Monitoramento Ambiental/métodos , Poluentes Ambientais/análise , Metais Pesados/análise , Tillandsia/química , Agricultura , Argentina , Poluentes Ambientais/farmacocinética , Fenômenos Geológicos , Geologia , Metais Pesados/farmacocinética , Praguicidas , Folhas de Planta/efeitos dos fármacos , Poluentes do Solo , Espectrofotometria AtômicaRESUMO
A diagnostic study was done on Melia azedarach L. in relation to atmospheric pollutants in Córdoba city, Argentina. The study area receives regional pollutants, and it was categorized taking into account traffic level, industrial level, location of the sample point in relation to the corner, treeless condition, building type, topographic level and distance to the river. Water content and Specific Leaf Area (SLA) were calculated; and concentrations of soluble proteins, sulphur, hydroperoxy conjugated dienes (HPCD), chlorophylls (Total Chl) and pheophytins (Total Paeoph) were determined in leaf samples. HPCD correlated positively with industry, topographic level and distance to the river, and with a combination of the environmental variables (ECI); pigments correlated negatively with traffic level and with ECI; Total Phaeoph/Total Chl ratio correlated positively with traffic, building and ECI. On the basis of our results, traffic level, industrial level, building type, topographic level and distance to the river are the environmental variables to bear in mind when selecting analogous sampling points in a passive monitoring program. An approximation to predict tree injury may be obtained by measuring water content, soluble proteins, sulphur, HPCD and pigments as they are responsible for the major variability of data. This study revealed that M. azedarach was sensitive to air pollutants from traffic and industry. Thus, in those sampling sites with the maximum score for traffic level, industrial level and ECI, the highest values of the parameters that indicate foliar damage together with the least pigment concentration were observed.
Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental/métodos , Poluentes Ambientais/análise , Plantas/química , Saúde da População Urbana , Argentina , Colesterol/análise , Feofitinas/análise , Proteínas de Plantas/análise , Enxofre/análiseRESUMO
Diabetic ketoacidosis is manifested by elevated blood glucose levels, ketosis and metabolic acidosis with increased anion gap. A transitory hyperchloremic acidosis, with normal anion gap, can appear. We report a 21 years old female with a type 2 diabetes mellitus, admitted to the emergency room of a general hospital with hyperglycemia, absence of ketonemia, severe hypokalemia and hyperchloremic metabolic acidosis. Initially, she was diagnosed and treated as a severe diabetic ketoacidosis. Normal blood glucose levels were rapidly achieved but electrolyte and acid base alterations persisted, leading to the suspicion that another associated condition was causing the acidosis and hypokalemia. Urinary pH and anion gap measurement, the study of renal acidification and a bicarbonate overload test lead to the diagnosis of a distal renal tubular acidosis, secondary to a Sjögren syndrome, that was confirmed with a Schirmer test and positive anti Ro antibodies. In this diabetic patient, the acute hyperglycemia intensified the hypokalemia of her distal renal tubular acidosis and unchained the acute metabolic condition.
Assuntos
Complicações do Diabetes , Cetoacidose Diabética/complicações , Acidose Tubular Renal/complicações , Doença Aguda , Adulto , Diabetes Mellitus/diagnóstico , Cetoacidose Diabética/diagnóstico , Feminino , HumanosRESUMO
/ A diagnostic study was done on Ligustrum lucidum Ait. f. tricolor (Rehd.) Rehd. in relation to atmospheric pollutants in Cordoba city, Argentina. The study area receives regional pollutants and was categorized taking into account traffic level, industrial density, type of industry, location of the sample point in relation to the street corner, treeless condition, and topographic level. Dried weight/fresh weight ratio (DW/FW) and specific leaf area (SLA) were calculated, and concentrations of chlorophylls, carotenoids, total sulfur, soluble proteins, malondialdehyde (MDA), and hydroperoxy conjugated dienes (HPCD) were determined in leaf samples. Sulfur content correlates positively with traffic density and SLA correlates negatively with some combinations of the categorical variables; MDA correlates positively with topographic level and total protein concentration correlates negatively with treeless condition. On the basis of our results, traffic, location of trees, type of industry, situation of a tree with respect to others, and topographic level are the environmental variables to bear in mind when selecting analogous sampling points in a passive monitoring program. An approximation to predict tree injury may be obtained by measuring DW/FW ratio, proteins, pigments, HPCD, and MDA as they are responsible for the major variability of data.KEY WORDS: L. lucidum Ait. f. tricolor (Rehd.) Rehd.; Air pollution; Sulfur accumulation; Pigments; Urban environment; Argentina
RESUMO
Findings of a nutritional evaluation study, using triceps skinfold, are reported. The study was carried out in 1,615 school-children from 5 to 12 years, pertaining to the low socioeconomic status of the city of Córdoba, Argentina. Measurements were done during the years 1983 and 1984 by Center's examiners with a Lange caliper, according to international anthropometric methodology. Interintra observer technical error was found to be within tolerance limits reported by other authors. Local standards were used to determine the prevalence of thinness and excessive fatness, by comparing them to tricep skinfold of each child, and selecting those children where this parameter presented values less than or equal to 10th percentile and fatness greater than or equal to 90th percentile. Furthermore, comparison between median triceps skinfold of the examined group, the local standards and Frisancho's norms for US population was also made. Results revealed that: a) the prevalence of thinness (19.9%) was almost twice the percentage expected for a normal population; in contrast, occurrence of excessive fatness (6.4%) was found to be below the expected value; b) prevalence of thinness was not statistically associated to age nor sex; c) frequency of excessive fatness was significantly higher in the 8-11 year-old male group (8, 9%, p much less than 0.0005) and in the girls group (10.8%), P much less than 0.005) the prevalence of fatness in girls increased with age, and figures revealed that from eight years onwards this exceeded the expected percentage, and d) median triceps skinfold of the group under study was generally below local and foreign norms. It is concluded that potential or real nutrition problems as those mentioned above, may be grossly identified using the triceps skinfold as the single anthropometric indicator.
Assuntos
Obesidade/epidemiologia , Magreza/epidemiologia , Fatores Etários , Argentina , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Valores de Referência , Estudos de Amostragem , Fatores Sexuais , Dobras Cutâneas , Fatores SocioeconômicosAssuntos
Sepse/epidemiologia , Infecções Estafilocócicas/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Chile , Feminino , Humanos , Lactente , Masculino , Desnutrição Proteico-Calórica/complicações , Sepse/complicações , Sepse/etiologia , Fatores Sexuais , Staphylococcus aureus/isolamento & purificaçãoRESUMO
Analisis clinico de 11 ninos ingresados a la Unidad de Infecciosos, Servicio de Pediatria, Hospital Regional de Valdivia, entre los meses de enero de 1976 y septiembre de 1980, con diagnostico de Septicemia Estafilococica confirmado bacteriologicamente en todos los casos. Destaca mayor incidencia en ninos sobre 2 anos de edad, eutroficos, ligero predominio en varones, y como puerta de entrada principal, lesiones de piel. Los parenquimas mas afectados fueron el pulmonar y osteoarticular. De los casos analizados hubo recuperacion en 10, quedando 6 de ellos con secuelas osteoarticulares y un paciente que fallece