RESUMO

La salud mental se vio gravemente afectada durante la cuarentena por covid-19, y es que la población mundial no estaba preparada para vivir un confinamiento estricto, generando altos niveles de ansiedad, depresión y estrés. Aun más notables en el personal de salud que estuvo en la primera línea de atención de la pandemia. Objetivos: Determinar la influencia de la cuarentena por COVID-19 en la salud mental del personal de salud Materiales y métodos: Se realizó un estudio observacional descriptivo de corte transversal durante el periodo de noviembre-febrero de 2022 en el centro Médico Britalis Montecristi- Manabí- Ecuador. La muestra quedó conformada por 49 trabajadores de salud entre médicos enfermeras, personal técnico y de servicio, seleccionada por el método no probabilístico. Se utilizó un cuestionario con las variables demográficas de edad, sexo, categoría ocupacional, para la variable manifestaciones psicológicas, en el instrumento se incluyó la Escala DASS 21 (Escala de Depresión, Ansiedad y Estrés.). Resultados: Predominó el sexo masculino y el grupo de edades de 36 a 45 años, en la asociación de las manifestaciones psicológicas con estas variables se observó que el estrés, la ansiedad y la depresión en su nivel de muy severo fue más común en el sexo femenino y en el grupo de edades de 25-35 años. En la categoría ocupacional prevalecieron los médicos seguido de las enfermeras. Conclusión: En relación con las manifestaciones psicológicas el estrés, la ansiedad y la depresión en el nivel muy severo predominaron en las enfermeras(AU)

Mental health was seriously affected during the covid-19 quarantine, and the world population was not prepared to live in strict confinement, generating high levels of anxiety, depression and stress. Even more notable in the health personnel who were on the front lines of the pandemic. Objectives: To determine the influence of the COVID-19 quarantine on the mental health of health personnel. Materials and methods: A cross-sectional descriptive observational study was carried out during the period November-February 2022 at the Britalis Montecristi-Manabí Medical Center. - Equator. The sample was made up of 49 health workers, including doctors, nurses, technical and service personnel, selected by the non-probabilistic method. A questionnaire was used with the demographic variables of age, sex, occupational category, for the psychological manifestations variable, the DASS 21 Scale (Depression, Anxiety and Stress Scale) was included in the instrument. Results: The male sex and the age group from 36 to 45 years prevailed, in the association of psychological manifestations with these variables it was observed that stress, anxiety and depression at their very severe level were more common in the sex female and in the age group of 25-35 years. In the occupational category, doctors prevailed, followed by nurses. Conclusion: In relation to the psychological manifestations, stress, anxiety and depression at the very severe level prevailed in the nurses(AU)

Assuntos

RESUMO

El trauma dentoalveolar se define como aquella lesión de extensión e intensidad variable y de ori- gen accidental o intencional, causada por fuerzas que actúan sobre el órgano dentario y los tejidos que lo rodean. Se puede diagnosticar a simple vista o con ayuda de la radiografía, se debe tratar sin demora para preservar la vitalidad de la pulpa, sobre todo en casos de niños y adolescentes, to- mando en cuenta la formación radicular. El trau- ma dental es motivo de urgencia por el dolor que provocan en los pacientes, la prevalencia varia del 26 al 76% de las lesiones dentales en dentición permanente (AU)

Assuntos

RESUMO

BACKGROUND: Skeletal muscle is one of the tissues most affected by stress conditions. The protein degradation in this tissue is vital for the supply of energy mediated by different proteolytic pathways such as the ubiquitin-proteasome (UPS), autophagy-lysosome (ALS) and the calpain/calpastatin system (CCS). Nevertheless, the regulation of this proteolytic axis under stress conditions is not yet completely clear. Chile is the main producer of rainbow trout (Oncorhynchus mykiss) in the world. This intensive fish farming has resulted in growing problems as crowding and stress are one of the major problems in the freshwater stage. In this context, we evaluated the crowding effect in juvenile rainbow trout kept in high stocking density (30 kg/m3) for 15, 45 and 60 days, using a control group of fish (10 kg/m3). RESULTS: Plasmatic cortisol and glucose were evaluated by enzyme immunoassay. The mRNA levels of stress-related genes (gr1, gr2, mr, hsp70, klf15 and redd1), markers of the UPS (atrogin1 and murf1) and CCS (capn1, capn1, cast-l and cast-s) were evaluated using qPCR. ALS (LC3-I/II and P62/SQSTM1) and growth markers (4E-BP1 and ERK) were measured by Western blot analysis. The cortisol levels increased concomitantly with weight loss at 45 days of crowding. The UPS alone was upregulated at 15 days of high stocking density, while ALS activation was observed at 60 days. However, the CCS was inactivated during the entire trial. CONCLUSION: All these data suggest that stress conditions, such as crowding, promote muscle degradation in a time-dependent manner through the upregulation of the UPS at early stages of chronic stress and activation of the ALS in long-term stress, while the CCS is strongly inhibited by stress conditions in the rainbow trout muscle farmed during freshwater stage. Our descriptive study will allow perform functional analysis to determine, in a more detailed way, the effect of stress on skeletal muscle physiology as well as in the animal welfare in rainbow trout. Moreover, it is the first step to elucidate the optimal crop density in the freshwater stage and improve the standards of Chilean aquaculture.

Assuntos

Assuntos

RESUMO

Resumen La mucormicosis es una infección causada por hongos del orden de los mucorales; las infecciones causadas por estos hongos generalmente se adquieren por vía respiratoria ya que las esporas de estos se encuentran en el ambiente. En pacientes inmunocomprometidos o diabéticos descompensados, estos microorganismos pueden causar cuadros fatales. Puede presentarse en varias localizaciones, en este caso se tratará la localización pulmonar. La fiebre, la hemoptisis y el infarto tisular son característicos de la mucormicosis pulmonar. Radiológicamente, se puede encontrar consolidación lobar, lesiones aisladas, enfermedad nodular y cavitación. Una vez realizado el diagnóstico de mucormicosis de cualquier localización, se deben identificar los factores predisponentes y corregirlos o atenuarlos. En esta ocasión se presenta el caso clínico de una paciente de 61 años de edad con diabetes mellitus tipo 2 (DM2) de 10 años de evolución que ingresa al servicio de urgencias de esta institución con descontrol glucémico de 520 mg/dL, acompañado de fiebre y con cuadro clínico de infección de vías respiratorias en tratamiento. Se realiza la presentación del caso, su comparación con la literatura disponible y las conclusiones a las que se llegaron.

Abstract Mucormycosis is an infection caused by organisms that belong to a group of fungi called Mucoromycotina in the order Mucorales; Infections caused by these microorganisms, are usually acquired through the respiratory route since the spores of fungi are found in the environment. These infections are more common among people with a weakened immune system or diabetic people, and they could be fatal. Mucormycosis can be found in several localizations but this case will focus specifically in the lung. The symptoms associated with it are fever, hemoptysis, and tissular infarct. Radiographically, lobar consolidation, isolate mass, nodular component and cavitation can be found. Once the diagnostics is made, in any location, its important to identify the risk factors, and try to correct or improve them. In this occasion, the we present the case of a 62-years-old female, with diabetes mellitus type 2 with and 10 years of evolution,. She arrives to the emergency room of this institution with uncontrolled blood glucose (520 mg / dL), accompanied by fever.and respiratory infection, and is treated by a multidisciplinary team (internal medicine, surgery and infectology). This is the presentation of the case, its comparison with the available literature and the conclusions of the author.

RESUMO

PURPOSE: To compare central (CCT) and peripheral corneal thickness (PCT) using Scheimpflug imaging (Pentacam), high-speed optical coherence tomography (Visante OCT), and ultrasound (US) pachymetry (Sonogage Corneo-Gage Plus) in normal, keratoconus-suspect, and post-laser in situ keratomileusis (LASIK) eyes. SETTING: Department of Refractive Surgery, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. METHODS: The CCT and PCT were retrospectively measured using US pachymetry, Scheimpflug imaging, and high-speed OCT from January 2006 to March 2008. The influence of age and absolute magnitude of corneal thickness were also analyzed. Analysis was by multivariate generalized estimating equations, multivariate linear regression, and linear regression plots. RESULTS: One hundred sixty-three eyes were analyzed. Ultrasound pachymetry CCT measurements were consistently higher than Scheimpflug and OCT measurements (mean difference 6.5 microm +/- 1.8 [SD] and 7.5 +/- 1.4 microm, respectively) (both P<.0005) in normal eyes; the difference was statistically similar and not greater with keratoconus suspicion, age, or absolute magnitude of corneal thickness (P>.05). Scheimpflug measurements were significantly lower than US pachymetry in post-LASIK eyes (P<.0005). There was no statistically significant difference (mean 0.9 +/- 1.4 microm) in Scheimpflug and OCT CCT measurements (P>.5), although Scheimpflug measurements were significantly lower in post-LASIK eyes (P<.0005). Scheimpflug PCT measurements were higher than OCT measurements, showing more agreement with increasing age (P = .017). CONCLUSIONS: Scheimpflug and OCT CCT measurements were reproducible but always thinner than US pachymetry in normal and keratoconus-suspect eyes. In post-LASIK eyes, OCT pachymetry maps were more accurate than Scheimpflug maps. The influence of age on PCT requires further study.

Assuntos

RESUMO

INTRODUCTION: Nodular regenerative hyperplasia (NRH) is a rare condition is associated to immune, neoplastic, vascular disorders, and certain drugs and toxins. Portal hypertension is the main complication. AIM: To report the case of a woman with NRH and aplastic anemia, association not previously described. CASE: A 31- year-old hispanic female presented with pancitopenia and cholestasis. Bone marrow biopsy: aplastic anemia. Abdominal ultrasound revealed multiple liver nodules, without hepato-splenomegaly. No abnormalities were noted in hepatic vessels. Antimitochondrial (AMAs) were positive. Coagulation tests were normal. Liver biopsy: hepatocite nodules with central atrophy and sinusoidal dilatation in the absence of significant fibrosis. No arteritis, thrombosis or bile duct damage was found. DISCUSSION: Pathogenesis of NRH remains unclear. The most accepted theory was developed by Wanless 24 years ago, and reinforced in 1997. It states that alterations in hepatic blood flow (portal obliterative venopathy) originate a specific response, initially consisting of apoptosis secondary to acute ischemia, with ensuing parenchymal atrophy and surrounding areas of liver regeneration and chronic ischemia. The common pathologic mechanism of all the diseases associated with NRH involves liver blood-flow abnormalities secondary to microthromboses, vascular congestion, or vasculitis. In the current case we were unable to document evidence of liver flow abnormalities. Noteworthy, there are previous descriptions of the as- sociation of NRH with primary biliary cirrhosis, and this patient was AMA positive, but without bile duct damage in liver biopsy. CONCLUSIONS: We cannot sustain Wanless' theory, and this is the first description of the association of NRH with aplastic anemia.

Assuntos

RESUMO

BACKGROUND: Neuroendocrine tumors are rare neoplasms which have a slow growth pattern. When liver metastases are diagnosed, treatment is controversial and it is focused in symptomatic control. AIM: To present a patient with a neuroendocrine tumor that arised from the ileocecal valve and it was diagnosed with carcinoid syndrome and treated with radical liver and colonic resection. A discussion of the different forms of treatment is presented. CASE REPORT: A 41 year-old woman was sent to our hospital with liver metastases and carcinoid syndrome from a neuroendocrine tumor of the ileocecal valve for treatment. Right colectomy, right hepatic trisectionectomy and radiofrequency ablation of two left sided lesions was performed as a first procedure. A second procedure was performed two months afterwards when resection of residual left sided lesions was done. After a two year follow up a 2 cm residual liver lesion was diagnosed and percutaneous radiofre-quency ablation was done. After four years of follow up the patient has been asymptomatic without tumor recurrence CONCLUSIONS: Radical surgical treatment of neu-roendocrine tumors controls symptomatology, improving quality of life and survival. However, this treatment should only be performed in a well selected group of patients.

Assuntos