RESUMO

BACKGROUND: During the COVID-19 pandemic, health service practices underwent significant changes, impacting the occurrence of health care-associated infections (HAIs). This study presents the epidemiology of bacterial infections and compares clinical data on nosocomial infections in hospitalized patients before and during the pandemic. METHODS: A unicentric, observational, retrospective cohort study was conducted with descriptive analyses on the microorganism identification and resistance profile. Patient's clinical data who had hospital-acquired infection (HAI), during their hospitalization in a tertiary hospital before and during the COVID-19 pandemic was compared by descriptive and inferential analyses. RESULTS: A total of 1,581 bacteria were isolated from 1,183 hospitalized patients. Among patients coinfected with COVID-19, there was a statistically significant increase in HAI-related deaths (P < .001) and HAI caused by multidrug-resistant organisms (P < .001), mainly by Acinetobacter baumannii and Staphylococcus aureus. A higher odds ratio of HAI-related deaths compared to the prepandemic period was observed (odds ratio 6.98 [95% confidence interval 3.97-12.64]). CONCLUSIONS: The higher incidence of multidrug-resistant bacteria and increased deaths due to HAI, especially in patients with COVID-19 coinfection, might be related to various factors such as increased workload, broad-spectrum antibiotic use, and limited resources. The pandemic has changed the profile of circulating bacteria and antimicrobial resistance. Prevention strategies should be considered to reduce the impact of these infections.

Assuntos

COVID-19 , Infecção Hospitalar , Centros de Atenção Terciária , Humanos , COVID-19/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Masculino , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Idoso , SARS-CoV-2 , Adulto , Idoso de 80 Anos ou mais , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Bactérias/isolamento & purificação , Bactérias/classificação , Bactérias/efeitos dos fármacos , Pandemias , Estudos de Coortes , Farmacorresistência Bacteriana Múltipla , Hospitalização/estatística & dados numéricos

RESUMO

BACKGROUND: Mechanical thrombectomy is the accepted treatment for acute ischemic stroke in Large Vessel Occlusion. The Barros Luco Trudeau hospital developed endovenous thrombolysis in 2010, and since 2012, implemented endovascular management, becoming the neurovascular center in the southern area of the metropolitan region. AIM: To describe endovascular management of acute ischemic stroke in a Chilean public hospital. Material and Methods: Analysis of patients with acute ischemic stroke that were treated with mechanical throm-bectomy from 2012 to 2019 in the Barros Luco Hospital. RESULTS: In the study period, a mechanical thrombectomy was carried out in 149 patients aged 61 ± 15 years (46% females). The average National institute of Health Stroke Scale (NIHSS) at presentation was 19 ± 4-5. Anterior or posterior circulation involvement was present in 89.9 and 10.1 % of patients. Twenty-five percent of patients were referred from other public centers. The mean lapse between onset of symptoms and thrombectomy was 266 ± 178 in. Ninety days after the procedure, 58% of patients had minimal or absent disability (Modified Ranson score of 0-2), and 19,2% died. CONCLUSIONS: Mechanical thrombectomy, according to this experience, has favorable clinical outcomes in patients with high NIHSS scores at entry.

Assuntos

Humanos , Masculino , Feminino , Isquemia Encefálica/etiologia , Acidente Vascular Cerebral/cirurgia , Acidente Vascular Cerebral/etiologia , Procedimentos Endovasculares/métodos , AVC Isquêmico/etiologia , Chile , Estudos Retrospectivos , Resultado do Tratamento , Trombectomia/métodos , Hospitais Públicos

RESUMO

BACKGROUND: Mechanical thrombectomy is the accepted treatment for acute ischemic stroke in Large Vessel Occlusion. The Barros Luco Trudeau hospital developed endovenous thrombolysis in 2010, and since 2012, implemented endovascular management, becoming the neurovascular center in the southern area of the metropolitan region. AIM: To describe endovascular management of acute ischemic stroke in a Chilean public hospital. MATERIAL AND METHODS: Analysis of patients with acute ischemic stroke that were treated with mechanical throm-bectomy from 2012 to 2019 in the Barros Luco Hospital. RESULTS: In the study period, a mechanical thrombectomy was carried out in 149 patients aged 61 ± 15 years (46% females). The average National institute of Health Stroke Scale (NIHSS) at presentation was 19 ± 4-5. Anterior or posterior circulation involvement was present in 89.9 and 10.1 % of patients. Twenty-five percent of patients were referred from other public centers. The mean lapse between onset of symptoms and thrombectomy was 266 ± 178 in. Ninety days after the procedure, 58% of patients had minimal or absent disability (Modified Ranson score of 0-2), and 19,2% died. CONCLUSIONS: Mechanical thrombectomy, according to this experience, has favorable clinical outcomes in patients with high NIHSS scores at entry.

Assuntos

Isquemia Encefálica , Procedimentos Endovasculares , AVC Isquêmico , Acidente Vascular Cerebral , Feminino , Humanos , Masculino , Acidente Vascular Cerebral/cirurgia , Acidente Vascular Cerebral/etiologia , AVC Isquêmico/etiologia , Chile , Resultado do Tratamento , Isquemia Encefálica/etiologia , Trombectomia/métodos , Hospitais Públicos , Estudos Retrospectivos , Procedimentos Endovasculares/métodos

RESUMO

Hymenaea martiana is a species popularly known in Northeastern Brazil as "jatobá" and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-¹, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.(AU)

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Hymenaea martiana é uma espécie popularmente conhecida no Nordeste do Brasil como “jatobᔠe usada na medicina popular para tratar a dor e a inflamação. O objetivo deste trabalho foi avaliar a atividade antinociceptiva e anti inflamatória de H. martiana. No presente estudo, foram avaliados os efeitos do extrato etanólico bruto (Hm-EtOH) e da fração acetato de etila (Hm-AcOEt) em modelos de nocicepção e inflamação em camundongos. Foram utilizados estímulos químicos (contorções abdominais induzidas por ácido acético e teste da formalina) e estímulo térmico (teste da placa quente) para avaliação da atividade antinociceptiva, enquanto no perfil anti-inflamatório foi utilizado o teste do edema de pata induzido por carragenina e migração de leucócitos para a cavidade peritoneal. A presença do flavonoide astilbina nas amostras foi caracterizada através de análise por CLAE-DAD-EM. Hm-EtOH e o Hm-AcOEt (100, 200 e 400 mg.kg-¹, i.p.) reduziram significativamente o número de contorções abdominais e diminuíram o tempo de lambida da pata no teste da formalina. No teste da placa quente, houve aumento do tempo de latência dos animais. Hm-EtOH e Hm-AcOEt inibiram significativamente o aumento do edema após a administração de carragenina, bem como inibiram a migração de leucócitos no teste de peritonite. A análise por CLAE-DAD-EM de Hm-EtOH e Hm-AcOEt revelou a presença do flavonoide astilbina nas amostras. De acordo com os resultados deste estudo, tanto Hm-EtOH quanto o Hm-AcOEt possuem atividades antinociceptiva e anti-inflamatória, o que pode estar relacionado à presença do flavonoide. Os resultados reforçam o uso popular desta planta.(AU)

Assuntos

Animais , Camundongos , Hymenaea/química , Anti-Inflamatórios/análise , Plantas Medicinais/efeitos adversos

RESUMO

Hymenaea martiana is a species popularly known in Northeastern Brazil as "jatobá" and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-¹, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.

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Hymenaea martiana é uma espécie popularmente conhecida no Nordeste do Brasil como “jatobᔠe usada na medicina popular para tratar a dor e a inflamação. O objetivo deste trabalho foi avaliar a atividade antinociceptiva e anti inflamatória de H. martiana. No presente estudo, foram avaliados os efeitos do extrato etanólico bruto (Hm-EtOH) e da fração acetato de etila (Hm-AcOEt) em modelos de nocicepção e inflamação em camundongos. Foram utilizados estímulos químicos (contorções abdominais induzidas por ácido acético e teste da formalina) e estímulo térmico (teste da placa quente) para avaliação da atividade antinociceptiva, enquanto no perfil anti-inflamatório foi utilizado o teste do edema de pata induzido por carragenina e migração de leucócitos para a cavidade peritoneal. A presença do flavonoide astilbina nas amostras foi caracterizada através de análise por CLAE-DAD-EM. Hm-EtOH e o Hm-AcOEt (100, 200 e 400 mg.kg-¹, i.p.) reduziram significativamente o número de contorções abdominais e diminuíram o tempo de lambida da pata no teste da formalina. No teste da placa quente, houve aumento do tempo de latência dos animais. Hm-EtOH e Hm-AcOEt inibiram significativamente o aumento do edema após a administração de carragenina, bem como inibiram a migração de leucócitos no teste de peritonite. A análise por CLAE-DAD-EM de Hm-EtOH e Hm-AcOEt revelou a presença do flavonoide astilbina nas amostras. De acordo com os resultados deste estudo, tanto Hm-EtOH quanto o Hm-AcOEt possuem atividades antinociceptiva e anti-inflamatória, o que pode estar relacionado à presença do flavonoide. Os resultados reforçam o uso popular desta planta.

Assuntos

Animais , Camundongos , Anti-Inflamatórios/análise , Hymenaea/química , Plantas Medicinais/efeitos adversos

RESUMO

Abstract Hymenaea martiana is a species popularly known in Northeastern Brazil as jatobá and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-1, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.

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Resumo Hymenaea martiana é uma espécie popularmente conhecida no Nordeste do Brasil como jatobá e usada na medicina popular para tratar a dor e a inflamação. O objetivo deste trabalho foi avaliar a atividade antinociceptiva e anti-inflamatória de H. martiana. No presente estudo, foram avaliados os efeitos do extrato etanólico bruto (Hm-EtOH) e da fração acetato de etila (Hm-AcOEt) em modelos de nocicepção e inflamação em camundongos. Foram utilizados estímulos químicos (contorções abdominais induzidas por ácido acético e teste da formalina) e estímulo térmico (teste da placa quente) para avaliação da atividade antinociceptiva, enquanto no perfil anti-inflamatório foi utilizado o teste do edema de pata induzido por carragenina e migração de leucócitos para a cavidade peritoneal. A presença do flavonoide astilbina nas amostras foi caracterizada através de análise por CLAE-DAD-EM. Hm-EtOH e o Hm-AcOEt (100, 200 e 400 mg.kg-1, i.p.) reduziram significativamente o número de contorções abdominais e diminuíram o tempo de lambida da pata no teste da formalina. No teste da placa quente, houve aumento do tempo de latência dos animais. Hm-EtOH e Hm-AcOEt inibiram significativamente o aumento do edema após a administração de carragenina, bem como inibiram a migração de leucócitos no teste de peritonite. A análise por CLAE-DAD-EM de Hm-EtOH e Hm-AcOEt revelou a presença do flavonoide astilbina nas amostras. De acordo com os resultados deste estudo, tanto Hm-EtOH quanto o Hm-AcOEt possuem atividades antinociceptiva e anti-inflamatória, o que pode estar relacionado à presença do flavonoide. Os resultados reforçam o uso popular desta planta.

RESUMO

Hymenaea martiana is a species popularly known in Northeastern Brazil as "jatobá" and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-1, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.

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Hymenaea martiana é uma espécie popularmente conhecida no Nordeste do Brasil como "jatobá" e usada na medicina popular para tratar a dor e a inflamação. O objetivo deste trabalho foi avaliar a atividade antinociceptiva e antiinflamatória de H. martiana. No presente estudo, foram avaliados os efeitos do extrato etanólico bruto (Hm-EtOH) e da fração acetato de etila (Hm-AcOEt) em modelos de nocicepção e inflamação em camundongos. Foram utilizados estímulos químicos (contorções abdominais induzidas por ácido acético e teste da formalina) e estímulo térmico (teste da placa quente) para avaliação da atividade antinociceptiva, enquanto no perfil anti-inflamatório foi utilizado o teste do edema de pata induzido por carragenina e migração de leucócitos para a cavidade peritoneal. A presença do flavonoide astilbina nas amostras foi caracterizada através de análise por CLAE-DAD-EM. Hm-EtOH e o Hm-AcOEt (100, 200 e 400 mg.kg-1, i.p.) reduziram significativamente o número de contorções abdominais e diminuíram o tempo de lambida da pata no teste da formalina. No teste da placa quente, houve aumento do tempo de latência dos animais. Hm-EtOH e Hm-AcOEt inibiram significativamente o aumento do edema após a administração de carragenina, bem como inibiram a migração de leucócitos no teste de peritonite. A análise por CLAE-DAD-EM de Hm-EtOH e Hm-AcOEt revelou a presença do flavonoide astilbina nas amostras. De acordo com os resultados deste estudo, tanto Hm-EtOH quanto o Hm-AcOEt possuem atividades antinociceptiva e anti-inflamatória, o que pode estar relacionado à presença do flavonoide. Os resultados reforçam o uso popular desta planta.

Assuntos

Animais , Coelhos , Hymenaea , Fabaceae , Brasil , Extratos Vegetais/farmacologia , Carragenina , Analgésicos/farmacologia , Anti-Inflamatórios/farmacologia

RESUMO

Hymenaea martiana is a species popularly known in Northeastern Brazil as "jatobá" and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-1, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.

Assuntos

Fabaceae , Hymenaea , Analgésicos/farmacologia , Animais , Anti-Inflamatórios/farmacologia , Brasil , Carragenina , Camundongos , Extratos Vegetais/farmacologia

RESUMO

INTRODUCCIÓN Y OBJETIVOS: La deficiencia de vitamina D es muy prevalente durante la gestación, siendo cada vez más numerosos los estudios que relacionan esta condición con peores resultados perinatales. El objetivo del presente trabajo es describir los resultados perinatales y el curso del embarazo de una cohorte de gestantes deficitarias en vitamina D durante el primer trimestre del embarazo, suplementándolas con colecalciferol, así como establecer una comparación entre los resultados perinatales de aquellas pacientes con déficit o insuficiencia que lograron niveles normales de vitamina D en el tercer trimestre frente a aquellas que no lo lograron. Como objetivo secundario se describe el curso del embarazo de una cohorte de pacientes que durante el mismo periodo de tiempo del estudio presentaban normovitaminosis al inicio de la gestación. MÉTODOS: La cohorte de 190 pacientes analizada procede de casos consecutivos en la primera consulta de embarazo. Se determinaron los niveles de 25-hidroxivitamina D (25-OH-D) en la analítica del primer trimestre de 190 gestantes diferenciando entre valores normales (>30ng/mL), insuficiencia (30-15 ng/mL) y deficiencia (<15 ng/mL). Las pacientes con insuficiencia se suplementaron con 1000 UI/día de colecalciferol y las pacientes con deficiencia con 2000 UI/día. En el tercer trimestre se determinaron de nuevo los niveles de 25-OH-D en las pacientes suplementadas, suspendiendo la prescripción en caso de haberse normalizado los valores. Se comparan estadísticamente los resultados perinatales entre aquellas pacientes que mejoraron con la suplementación frente a aquellas que no lo hicieron. RESULTADOS: De las 190 pacientes analizadas, un 45% presentaban insuficiencia; un 27,5% deficiencia; y un 27,5% valores normales. De forma global, un 61% de las pacientes suplementadas habían normalizado sus niveles de vitamina D en la analítica del tercer trimestre, suspendiéndose la prescripción. De ese 61% normalizado, un 63% pertenecían al grupo de insuficiencia y un 37% al de deficiencia. Dentro del grupo suplementado con colecalciferol, un 1,4% de las pacientes desarrollaron hipertensión arterial, mientras que un 33% desarrollaron diabetes en el embarazo, de las cuales un 87% la controlaron exclusivamente con dieta y un 13% precisaron insulina. Un 3,6% de las gestaciones cursaron con retraso del crecimiento y la tasa de prematuridad fue igualmente del 3,6%. La tasa de cesáreas fue del 23%, de las cuales un 77% fueron indicadas intraparto y un 23% cesáreas programadas. El peso medio al nacimiento fue 3205g. Dentro del grupo con valores normales de 25-OH-D en el primer trimestre de la gestación, ninguna paciente desarrolló hipertensión arterial, mientras que un 15% presentaron diabetes gestacional controlada con dieta. Un 3,8% de dichas gestaciones cursaron con retrasos del crecimiento y la tasa de prematuridad fue del 1,9%. La tasa de cesáreas fue del 23%, de las cuales un 50% fueron indicadas intraparto y el 50% restante programadas. El peso medio al nacimiento fue de 3280g. En el análisis comparativo de los resultados perinatales entre el grupo de pacientes suplementadas que normalizaron sus cifras de vitamina D y aquellas que no lo hicieron, no se hallan diferencias estadísticamente significativas para ninguno de los parámetros analizados. CONCLUSIONES: La elevada tasa de hipovitaminosis D en la muestra analizada apoya la extensión del cribado y suplementación a todas las embarazadas y no solamente a aquellas con factores de riesgo. Dado que no se observaron diferencias estadísticamente significativas entre los niveles de vitamina D en el tercer trimestre y las variables perinatales estudiadas, podemos concluir que en nuestro estudio la suplementación con vitamina D no se ha comportado como factor protector de eventos obstétricos adversos.

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INTRODUCTION AND OBJECTIVES: Vitamin D deficiency is highly prevalent during pregnancy, with an increasing number of studies linking this condition with worse perinatal outcomes. The objective of this present work is to describe the perinatal results and the course of pregnancy in a cohort of pregnant women deficient in vitamin D during the first trimester of pregnancy, supplementing them with cholecalciferol, as well as to establish a comparison between perinatal results of those patients with deficiencnieve or insufficiency who achieved normal levels of vitamin D in the third trimester compared to those who did not. As a secondary objective, the course of pregnancy is described in a cohort of patients who presented normal levels at the beginning of gestation during the same period of time of the study. METHODS: The cohort of 190 patients analyzed comes from consecutive cases in the first pregnancy visit. The levels of 25-hydroxyvitamin D (25-OH-D) were determined in the analysis of the first trimester of 190 pregnant women, differentiating between normal values (> 30ng / mL), insufficiency (30-15 ng / mL) and deficiency (<15 ng / mL). Patients with insufficiency were supplemented with 1000 IU/day of cholecalciferol and patients with deficiency with 2000 IU/day. In the third trimester, the 25-OH-D levels were determined again in the supplemented patients, suspending the prescription if the values had normalized. Perinatal outcomes are statistically compared between those patients who improved with supplementation versus those who did not. RESULTS: Of the 190 patients analyzed, 45% had insufficiency; 27.5% deficiency; and 27.5% normal values. Overall, 61% of the supplemented patients had normalized their vitamin D levels in the third trimester analysis, suspending the prescription. Within that 61% normalized, 63% belonged to the insufficiency group and 37% to the deficiency group. In the group supplemented with cholecalciferol, 1.4% of the patients developed arterial hypertension, while 33% developed diabetes in pregnancy, of which 87% controlled it exclusively with diet and 13% required insulin. 3.6% of pregnancies had intrauterine growth restriction and the prematurity rate was also 3.6%. The caesarean section rate was 23%, of which 77% were indicated intrapartum and 23% scheduled caesarean sections. The mean weight at birth was 3205g. Within the group with normal 25-OH-D values in the first trimester of pregnancy, no patient developed hypertension, while 15% had diet-controlled gestational diabetes. 3.8% of these pregnancies had intrauterine growth restriction and the prematurity rate was 1.9%. The cesarean section rate was 23%, of which 50% were indicated intrapartum and the remaining 50% scheduled. The mean weight at birth was 3280g. In the comparative analysis of the perinatal results between the group of supplemented patients who normalized their vitamin D levels and those who did not, no statistically significant differences were found for any of the parameters analyzed. CONCLUSIONS: The high rate of hypovitaminosis D in the analyzed sample supports the extension of screening and supplementation to all pregnant women and not only to those with risk factors. Since no statistically significant differences were observed between vitamin D levels in the third trimester and the perinatal outcomes studied, we can conclude that in our study vitamin D supplementation has not behaved as a protective factor against adverse obstetric events.

Assuntos

Humanos , Feminino , Gravidez , Deficiência de Vitamina D/tratamento farmacológico , Resultado da Gravidez , Colecalciferol/uso terapêutico , Terceiro Trimestre da Gravidez , Primeiro Trimestre da Gravidez , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Estudos de Coortes , Suplementos Nutricionais

RESUMO

Background: Two recurrent TERT (telomerase reverse transcriptase) promoter mutations, C228T and C250T, have been reported in thyroid carcinomas and were correlated with high-risk clinicopathological features and a worse prognosis. Although far more frequent in the poorly differentiated and undifferentiated thyroid cancer, the TERT promoter mutations play a significant role on PTC recurrence and disease-specific mortality. However, the prevalence varies considerably through studies and it is uncertain if these differences are due to population variation or the methodology used to detect TERT mutations. In this study we aim to compare three different strategies to detect TERT promoter mutations in PTC. Methods: DNA was isolated from formalin-fixed paraffin-embedded (FFPE) specimens from 89 PTC and 40 paired lymph node metastases. The prevalence of the hot spot TERT C228T and C250T mutations was assessed in FFPE samples using TaqMan SNP genotyping assays. Random samples were tested by Sanger Sequencing and droplet digital PCR (ddPCR). Results: In general, 16 out of 89 (18%) PTC samples and 14 out of 40 (35%) lymph node metastases harbored TERT promoter mutations by TaqMan assay. Sanger sequencing, performed in random selected samples, failed to detect TERT mutations in four samples that were positive by TaqMan SNP genotyping assay. Remarkably, ddPCR assay allowed detection of TERT promoter mutations in six samples that harbor very low mutant allele frequency (≤ 2%) and were negative by both genotype assay and Sanger Sequencing. Conclusion: This study observed a good concordance among the methodologies used to detect TERT promoter mutations when a high percentage of mutated alleles was present. Sanger analysis demonstrated a limit of detection for mutated alleles. Therefore, the prevalence of TERT promoter mutations in PTC may be higher than previously reported, since most studies have conventionally used Sanger sequencing. The efficient characterization of genetic alterations that are used as preoperative or postoperative diagnostic, risk stratification of the patient and individualized treatment decisions, mainly in highly heterogeneous tumors, require highly sensitive and specific approaches.

Assuntos

Mutação , Regiões Promotoras Genéticas , Análise de Sequência de DNA/métodos , Telomerase/genética , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Alelos , DNA/genética , Reações Falso-Negativas , Genótipo , Humanos , Metástase Linfática , Polimorfismo de Nucleotídeo Único , Prevalência , Prognóstico , Reprodutibilidade dos Testes , Câncer Papilífero da Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia

RESUMO

INTRODUCTION: The present paper aims to identify and characterize studies that assess the repercussions of parental rearing styles on development of psychopathological symptoms and to examine the possible relations between parental rearing behaviors and development of early maladaptive schemas (EMS). METHODS: A systematic search was conducted on the PsychNet, BVS, Scopus, Web of Science and PubMed databases for empirical studies published up to 2018 in Portuguese, English, or Spanish that investigated and characterized the effects of parental rearing styles. RESULTS: The electronic search identified 321 articles on the various different databases, only 22 of which met the criteria for inclusion and were read in full. Correlations were found between EMS and maternal rejection, parental rearing styles and depression in the studies. EMS were also found to act as mediators in the relationship between parental rearing styles and/or education and dysfunctional symptoms during personality development. CONCLUSIONS: In the studies selected, parental rearing styles stood out from other variables that influence personality development and activation of schematic patterns. It is therefore important to highlight the importance of conducting studies in this area to provide information that can promote care and prevention strategies in early childhood.

Assuntos

Educação Infantil/psicologia , Pais/psicologia , Transtornos da Personalidade/psicologia , Personalidade , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Poder Familiar/psicologia , Adulto Jovem

RESUMO

Abstract Introduction: The present paper aims to identify and characterize studies that assess the repercussions of parental rearing styles on development of psychopathological symptoms and to examine the possible relations between parental rearing behaviors and development of early maladaptive schemas (EMS). Methods: A systematic search was conducted on the PsychNet, BVS, Scopus, Web of Science and PubMed databases for empirical studies published up to 2018 in Portuguese, English, or Spanish that investigated and characterized the effects of parental rearing styles. Results: The electronic search identified 321 articles on the various different databases, only 22 of which met the criteria for inclusion and were read in full. Correlations were found between EMS and maternal rejection, parental rearing styles and depression in the studies. EMS were also found to act as mediators in the relationship between parental rearing styles and/or education and dysfunctional symptoms during personality development. Conclusions: In the studies selected, parental rearing styles stood out from other variables that influence personality development and activation of schematic patterns. It is therefore important to highlight the importance of conducting studies in this area to provide information that can promote care and prevention strategies in early childhood.

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Resumo Introdução: O objetivo do presente artigo é identificar e caracterizar estudos que avaliem a repercussão dos estilos parentais na formação de sintomas psicopatológicos e verificar uma possível relação dos padrões parentais com o desenvolvimento dos esquemas iniciais desadaptativos (EIDs). Método: Uma busca sistemática foi realizada nas seguintes bases de dados: PsychNet, BVS, Scopus, Web of Science e PubMed. Foram buscados estudos empíricos publicados até 2018, escritos em português, inglês ou espanhol, que investigassem e caracterizassem os efeitos dos estilos parentais. Resultados: A busca eletrônica identificou 321 artigos nas diferentes bases de dados, dentre os quais apenas 22 preencheram os critérios de seleção e foram lidos na íntegra. Os estudos demonstraram que há correlação entre EIDs, rejeição materna, estilos parentais e depressão. Também foi encontrada a participação dos EIDs como mediadores na relação entre estilos parentais e/ou educação e sintomas disfuncionais na formação da personalidade. Conclusão: Nos estudos selecionados, estilos parentais se destacaram entre as variáveis envolvidas na formação da personalidade e ativação dos padrões esquemáticos. Portanto, frisa-se a importância de estudos na área, a fim de aprofundar conhecimentos para promover saúde e melhores estratégias de prevenção em crianças.

Assuntos

Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Adulto Jovem , Pais/psicologia , Personalidade , Transtornos da Personalidade/psicologia , Educação Infantil/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Pessoa de Meia-Idade

RESUMO

The present context was designed to investigate the efficacy of devil fish (DF; Plecostomus sp.) silage and Staphylococcus saprophyticus on fermentation characteristics as well as greenhouse gases production mitigation attributes in horses. Four levels of ensiled DF at 0 (control DF0), 6 (DF6), 12 (DF12), and 18 (DF18) % were added into the diet. Moreover, three doses of S. saprophyticus (0, 1, and 3 mL/g dry matter [DM]) were used for in vitro fecal fermentation. The use of ensiled DF resulted in increased (P < .0001) pH during fermentation. The asymptotic gas production was the highest (P < .0001) in DF6, whereas other supplementation caused lower production than that of control. Lag time for the asymptotic gas production decreased (P < .05) with increasing dietary DF doses. Inclusion of S. saprophyticus resulted in the lowest (P < .05) gas production and mL/0.5 g DM incubated and thus, the reduced gas production up to 23.17% than that of control. The interaction of DF × S. saprophyticus showed the lowest gas production at DF18, whereas the highest production was estimated at DF6 without S. saprophyticus after 48 hours. The lowest emission of CO2 (P < .0001) was observed in DF18 inclusion, which was 15.25% lower than that of control at 48 hours of fermentation. In contrast, the lowest hydrogen (H2) production was estimated in DF0, whereas DF18 exhibited the highest. Inclusion of DF12 and DF18 reduced (P < .05) methane (CH4) emission by 58.24% and 59.33%, respectively. However, DF, S. saprophyticus, and DF × S. saprophyticus interaction had no significant effect (P > .05) on CH4 production. In conclusion, ensiled DF and S. saprophyticus could be supplemented in equine diet as promising alternatives to corn for mitigating the emission of greenhouse gases effectively.

Assuntos

Gases de Efeito Estufa , Animais , Suplementos Nutricionais/análise , Cavalos , Rúmen/efeitos dos fármacos , Silagem/análise , Staphylococcus saprophyticus

RESUMO

Background: The aortic arch diseases exhibit high morbidity and mortality rates. Some surgical strategies recommend partial preservation of the aortic arch and the supra-aortic vessels, but the immediate and mediumterm mortality rates of patients undergoing this surgical strategy is uncertain. Objectives: To compare overall mortality and mid- term survival curve of patients undergoing surgical strategy of partial preservation of the aortic arch and supra-aortic vessels (group A) compared to conventional strategies of the aortic arch approach (group B); to assess cardiovascular mortality over time. Methods: Descriptive and retrospective study of the medical records of patients undergoing aortic arch repair surgery between February 2000 and July 2013. We analyzed 111 patients, 29 in group A and 82 in group B. The overall survival and survival from cardiovascular events were assessed by Kaplan-Meier test. Results: In- hospital mortality from any cause was 31% in group A and 29.3% in group B. At 1 year, 2 year, and 5 year general survival was similar between the groups. In-hospital, 2 years and 5 years mortality from cardiovascular causes was 13.8%, 14.8%, e 22.7% in group A and 26.8%, 34.6% e 50.9% in group B. The difference between the groups in 5 years showed statistical significance (p = 0.0234). Survival from cardiovascular causes in 2 years and 5 years was 85.2% and 77,3% in group A and 65.4% and 49,1% in group B. Occurrence of urgent and emergency procedures were greater in group A, but without statistical significance. Conclusions: There was no difference in all-cause mortality over time between the groups. Group A showed lower cardiovascular mortality at 5 years than group B

Assuntos

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Aorta Torácica/fisiopatologia , Aorta Torácica/cirurgia , Aneurisma Aórtico/cirurgia , Mortalidade , Sobrevivência , Doenças Cardiovasculares/mortalidade , Continuidade da Assistência ao Paciente , Coleta de Dados/métodos , Dissecação/métodos , Hemorragia/complicações , Próteses e Implantes , Estudos Retrospectivos , Fatores de Risco , Interpretação Estatística de Dados , Procedimentos Cirúrgicos Operatórios , Inquéritos e Questionários

Assuntos

Humanos , Feminino , Adulto , Embolia Pulmonar/terapia , Terapia Trombolítica/métodos , Tomografia Computadorizada por Raios X/métodos , Angioplastia/métodos , Perfusão/métodos , Artéria Pulmonar

RESUMO

Resumo Este artigo é resultado de pesquisa de campo realizada junto aos coletores de sementes e frutos oleaginosos - Produtos Florestais Não Madeireiros (PFNMs) - em áreas rurais de Salvaterra e Bragança, no estado do Pará. O objetivo é contribuir com os estudos empíricos sobre saúde e segurança ocupacional no extrativismo, ainda incipientes no Brasil, por falta de amparo técnico-científico relacionado à atividade extrativista e por falta de regulamentação específica para a área. A pesquisa, realizada a partir da coleta de dados primários e observacionais, aponta os riscos de saúde e segurança aos quais os coletores estão expostos e os métodos de prevenção de acidentes, a fim de identificar possíveis melhorias nas condições de trabalho em um contexto onde a regulamentação de padrões trabalhistas para autônomos, informais e extrativistas na Amazônia é praticamente inexistente. A metodologia se caracteriza como estudo de caso em profundidade com coleta de dados primários com adoção de métodos mistos para sua sistematização. Os resultados demonstram que novas práticas e normas precisam ser adotadas para que os riscos à saúde e à segurança dos coletores sejam minimizados, além de garantir fiscalização, incentivo e monitoramento de práticas de segurança adequadas à atividade e específicas para cada região.

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Abstract This article is the result of a field research conducted among collectors of oleaginous seeds and fruits - Non-Timber Forest Products (NTFP) - in the rural areas of Salvaterra and Bragança, in the state of Pará, Brazil. It aimed to contribute to empirical studies on health and occupational safety in extractivism, still incipient in Brazil due to the lack of technical-scientific support and the lack of specific regulation on the area. The research was conducted by the collection of primary and observational data that point out the risks to health and safety to which collectors are exposed to and the methods to prevent accidents in order to identify possible improvements to working conditions in a context in which labor regulation standards for autonomous, informal and extractive workers in the Amazon is practically inexistent. This paper's methodology is characterized as an embedded case study along with the collection of quantitative and qualitative data with the adoption of mixed methods for their systematization. The results show that new practices and norms should be adopted so the risks to health and safety of collectors are minimized, besides ensuring the inspection, incentives and monitoring of safety practices that are adequate to the activity and specific to each region.

Assuntos

Humanos , Masculino , Feminino , População Rural , Condições de Trabalho , Saúde Ocupacional , Agricultura Florestal , Riscos Ocupacionais

RESUMO

BACKGROUND: This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). METHODS: In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. RESULTS: Mean cold ischemia time was high but not different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 ± 19.9 mL/min per 1.73 m2 vs 49.0 ± 26.9 mL/min per 1.73 m2; P = 0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m2 vs 54.4 ± 28.6 mL/min per 1.73 m2; P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed. CONCLUSIONS: In this cohort of recipients of deceased donor kidneys with high mean cold ischemia time and high incidence of DGF, the use of continuous machine perfusion was associated with a reduced risk of DGF compared with the traditional cold storage preservation method.

RESUMO

En el presente estudio se realizó una selección de cuatro sitios con alta presencia de poblaciones de chile silvestre en un área de 85 km2, correspondiente al municipio de Mocorito, Sinaloa, México. Mediante la observación en campo, se decidió realizar un perfil de suelo en cada uno de los sitios, el cual consistió en la descripción de campo, análisis físico-químico e hidrofísico y la clasificación de los diferentes tipos de suelo. De esta forma se logró identificar un tipo de suelo por cada población de chile silvestre, estos corresponden al tipo de suelo Vertisol, Fluvisol, Leptosol y Feozem.

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A selection of four sites was performed with high presence of populations of wild chilli in an area of 85 km2, corresponding to the municipality of Mocorito, Sinaloa, Mexico. Through field observations, it was decided to conduct a soil profile on each of the sites, which consisted in the description field and hidrofísico physicochemical analysis and classification of differents types of soil. Thus was identified a type of soil per population of wild chilli, these correspond to soil type Vertisol, Fluvisol, Leptosol and Feozem.

Assuntos

Solos Argilosos , Natureza

RESUMO

BACKGROUND: This study compared the use of static cold storage versus continuous hypothermic machine perfusion in a cohort of kidney transplant recipients at high risk for delayed graft function (DGF). METHODS: In this national, multicenter, and controlled trial, 80 pairs of kidneys recovered from brain-dead deceased donors were randomized to cold storage or machine perfusion, transplanted, and followed up for 12 months. The primary endpoint was the incidence of DGF. Secondary endpoints included the duration of DGF, hospital stay, primary nonfunction, estimated glomerular filtration rate, acute rejection, and allograft and patient survivals. RESULTS: Mean cold ischemia time was high but not different between the 2 groups (25.6 ± 6.6 hours vs 25.05 ± 6.3 hours, 0.937). The incidence of DGF was lower in the machine perfusion compared with cold storage group (61% vs. 45%, P = 0.031). Machine perfusion was independently associated with a reduced risk of DGF (odds ratio, 0.49; 95% confidence interval, 0.26-0.95). Mean estimated glomerular filtration rate tended to be higher at day 28 (40.6 ± 19.9 mL/min per 1.73 m2 vs 49.0 ± 26.9 mL/min per 1.73 m2; P = 0.262) and 1 year (48.3 ± 19.8 mL/min per 1.73 m2 vs 54.4 ± 28.6 mL/min per 1.73 m2; P = 0.201) in the machine perfusion group. No differences in the incidence of acute rejection, primary nonfunction (0% vs 2.5%), graft loss (7.5% vs 10%), or death (8.8% vs 6.3%) were observed...

Assuntos

Perfusão , Transplante de Rim

RESUMO

Se comunican cinco pacientes con mastocitosis cutánea, en la forma clínica de "telangiectasia macularis eruptiva perstans" (TMEP), con hallazgos clínicos asociados. En la mayoría de los pacientes, la enfermedad se presenta en adultos con manifestaciones clínicas limitadas a la piel, con buen pronóstico. Destacamos la importancia de su conocimiento por el dermatólogo, la necesidad de su estudio y seguimiento multidisciplinario.

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Five patients with cutaneous mastocytosis are presented with the clinical variant of "macularis eruptive telangiectasia perstans" (METP), with associated clinical findings. In most cases the disease occurs in adults with clinical manifestations limited to the skin with a good prognosis. We emphasize the importance of studying by a dermatologist and the necessity of interdisciplinary consideration and a proper follow-up.