RESUMO
A qualitative study of thermal transfers is carried out from a record of measurements (time series) of meteorological variables (temperature, relative humidity and magnitude of wind speeds) and pollutants (PM10, PM2.5 and CO) in six localities located at different heights in the geographic basin of Santiago de Chile. The measurements were made in two periods, 2010-2013 and 2017-2020 (a total of 2,049,336 data), the last period coinciding with a process of intense urbanization, especially high-rise construction. The measurements, in the form of hourly time series, are analyzed on the one hand according to the theory of thermal conduction discretizing the differential equation of the temporal variation in the temperature and, on the other hand, through the theory of chaos that provides the entropies (S). Both procedures demonstrate, comparatively, that the last period of intense urbanization presents an increase in thermal transfers and temperature, which affects urban meteorology and makes it more complex. As shown by the chaotic analysis, there is a faster loss of information for the period 2017-2020. The consequences of the increase in temperature on human health and learning processes are studied.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Humanos , Poluentes Atmosféricos/análise , Temperatura , Urbanização , Material Particulado/análise , Meteorologia , Monitoramento Ambiental/métodos , Poluição do Ar/análise , Estações do Ano , ChinaRESUMO
BACKGROUND: Topical and systemic steroids are the first line of treatment of non infectious inflammatory ocular disease. Immunosuppresants are reserved as a second line treatment. AIM: To evaluate the role of Azathioprine (AZA) as a coadyuvant immunosuppressive treatment for non infectious ocular inflammatory diseases (OIDs) resistant to systemic steroid therapy in a retrospective, noncomparative interventional case series. PATIENTS AND METHODS: Patients using oral Prednisone due to an active or recurrent OID, without clinical response, and not receiving any other immunosuppressive treatment were studied. A standard protocol of oral Prednisone (0.5 mg/kg/ day) and oral AZA (2-3 mg/kg/day) during one year was used. Ocular and systemic monthly evaluations were done including relapse rate, steroid dosage, inflammatory score and visual acuity. RESULTS: Thirty patients (10 male) aged 18-75 years (mean 44 years) were studied. Three had bilateral anterior uveitis, one had pars planitis, four had diffuse uveitis, eight Vogt-Koyanahi-Harada syndrome, three Behget's disease, three necrotizing scleritis and eight had retinochoroidopathy A complete initial response was observed in 26 patients (87%). The time of response was between 1 to 6 months (mean 2.65 months). Seventeen percent of these had a relapse 6 to 12 months after AZA was started. In 61 %, visual acuity improved. The ocular inflammatory score decreased in 86.5%. Eleven patients had mild controlled side effects that did not require discontinuation of AZA. CONCLUSIONS: Combined systemic steroid and oral AZA therapy is safe and effective in controlling steroid resistant non infectious inflammatory ocular diseases.
Assuntos
Azatioprina/uso terapêutico , Imunossupressores/uso terapêutico , Uveíte/tratamento farmacológico , Adolescente , Adulto , Idoso , Azatioprina/efeitos adversos , Doenças da Coroide/tratamento farmacológico , Resistência a Medicamentos , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/tratamento farmacológico , Estudos Retrospectivos , Esclerite/tratamento farmacológico , Esteroides/uso terapêutico , Síndrome Uveomeningoencefálica/tratamento farmacológicoRESUMO
Background: Topical and systemic steroids are the first line of treatment of non infectious inflammatory ocular disease. Immunosuppresants are reserved as a second line treatment. Aim: To evaluate the role ofAzathioprine (AZA) as a coadyuvant immunosuppressive treatment for non infectious ocular inflammatory diseases (OIDs) resistant to systemic steroid therapy in a retrospective, noncomparative interventional case series. Patients and methods: Patients using oral Prednisone due to an active or recurrent OID, without clinical response, and not receiving any other immunosuppressive treatment were studied. A standard protocol of oral Prednisone (0.5 mg/kg/ day) and oral AZA (2-3 mg/kg/day) during one year was used. Ocular and systemic monthly evaluations were done including relapse rate, steroid dosage, inflammatory score and visual acuity. Results: Thirty patients (10 male) aged 18-75 years (mean 44 years) were studied. Three had bilateral anterior uveitis, one had pars planitis, four had diffuse uveitis, eight Vogt-Koyanahi-Harada syndrome, three Behget's disease, three necrotizing scleritis and eight had retinochoroidopathy A complete initial response was observed in 26 patients (87 percent). The time of response was between 1 to 6 months (mean 2.65 months). Seventeen percent of these had a relapse 6 to 12 months after AZA was started. In 61 percent, visual acuity improved. The ocular inflammatory score decreased in 86.5 percent. Eleven patients had mild controlled side effects that did not require discontinuation of AZA. Conclusions: Combined systemic steroid and oral AZA therapy is safe and effective in controlling steroid resistant non infectious inflammatory ocular diseases.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Azatioprina/uso terapêutico , Imunossupressores/uso terapêutico , Uveíte/tratamento farmacológico , Azatioprina/efeitos adversos , Doenças da Coroide/tratamento farmacológico , Resistência a Medicamentos , Quimioterapia Combinada , Seguimentos , Imunossupressores/efeitos adversos , Doenças Retinianas/tratamento farmacológico , Estudos Retrospectivos , Esclerite/tratamento farmacológico , Esteroides/uso terapêutico , Síndrome Uveomeningoencefálica/tratamento farmacológicoRESUMO
A carotid cavernous fistula is an abnormal communication between a branch of the carotid artery and the cavernous sinus generating an arteriovenous fistula that can cause severe ocular damage. We hereby report two cases of carotid cavernous fistulas. A 69-year-old male with a 2-month history of right eyelid swelling and red eye aggrarated by diplopia, exophthalmus, and limitation of ocular movements one week before consulting. On admisson his visual acuity, in the right eye was good (0.5) and biomicroscopy showed arterialization of conjunctival vessels. All orbital CAT scan showed a dilatation of the superior orbital vein characteristic of carotid cavernous fistula. A balloon balloon tramponade of the fistula was performed too late (after 3 weeks) and the eye went blind. A 39-year-old female consulted for an acute proptosis of the right eye and severe visual loss. Biomicroscopy showed arterialization of the conjunctival vessels and the CAT scan disclosed a dilatation of the superior orbital vein. She was immediately subjected to a neuroradiological fistula closure with recovery of visual acuity to 1.0 (20/20). Our main purpose is to emphasize the importance of the opportune diagnosis and treatment of these fistulas to prevent visual loss and eventual blindness, as occurred in our first patient.
Assuntos
Cegueira/prevenção & controle , Fístula Carótido-Cavernosa/complicações , Baixa Visão/etiologia , Adulto , Idoso , Cegueira/diagnóstico , Cegueira/etiologia , Fístula Carótido-Cavernosa/diagnóstico , Fístula Carótido-Cavernosa/terapia , Feminino , Humanos , Masculino , Baixa Visão/diagnóstico , Acuidade VisualRESUMO
El síndrome bronquial obstructivo (SBO) y las neumonías (N) son afecciones frecuentes en los niños, motivan la mayor cantidad de consultas en atención primaria y pueden originar hospitalizaciones, predisponer a enfermedades crónicas e incluso producir la muerte del menor. El objetivo del presente estudio es conocer el comportamiento del SBO y N en el niño entre los 0 y 14 años de edad. Se determina en cada niño la frecuencia de episodios, consultas, hospitalizaciones, días de hospitalización, calculando el riesgo de enfermar por edad y sexo en 475 menores de 15 años beneficiarios de un consultorio del área norte de Santiago. Ellos consultaron al menos una vez por estas causas entre abril y julio de 1999 y se observaron durante ocho meses, siendo tratados según las normas ministeriales vigentes. Para obtener la información se adhirió un cuestionario a la ficha del niño en la primera consulta. Resultados: la tasa de enfermedad fue de 26,9 cada 100 meses-niño observación. Esta disminuye de 38 por ciento en menores de un año a 29,5 por ciento entre los 1 y 2 años, 23 por ciento en preescolares y alrededor de 20 por ciento en los escolares. El 60,2 por ciento de los niños presentó solo SBO, 29,7 por ciento N y el resto ambas. El 61,7 por ciento de los niños tuvieron 1 ó 2 episodios; el máximo de episodios fue 14. El 69,3 por ciento de los niños estuvo enfermo entre 3 y 15 días; la mediana de consultas fue de 3,8, el máximo 22. Requirieron hospitalización 5,2 por ciento de los niños. Los riesgos de enfermar son significativamente mayores en los varones y en los menores de un año. Se destaca que en más de la mitad de los hogares de estos niños se fuma dentro de la casa. Con los resultados de este estudio se pretende dar a conocer el comportamiento del SBO y N en el niño de 0 a 14 años, en cuanto a riesgos y consultas. Se demuestra que estas enfermedades son importantes en todos los grupos de edad, aunque su magnitud es diferente