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Las quemaduras son un problema de interés en salud pública ya que generan un alto índice de morbimortalidad a nivel mundial, las quemaduras térmicas son las más prevalentes y pueden alterar la integridad anatómica, funcional y estética de la piel, aspectos fundamentales para la autoestima del paciente y su capacidad para reintegrarse a la sociedad. Al revisar la literatura sobre el tratamiento de estas afecciones encontramos diversos tratamientos, entre ellos el uso de membrana amniótica humana, la cual ha tenido un impacto importante en el manejo de quemaduras al funcionar como andamio biológico con cualidades regenerativas y antiinflamatorias. El presente artículo tiene como objetivo sintetizar la información actual que describe las aplicaciones de membranas amnióticas humanas en quemaduras, realizamos una revisión exploratoria sistemática de la literatura desde 2010 hasta 2021.
Burns are a problem of interest in public health since they generate a high rate of morbidity and mortality worldwide, thermal burns are the most prevalent and can alter the anatomical, functional and aesthetic integrity of the skin, fundamental aspects for the patient's self-esteem and their ability to reintegrate into society. At review literature about the treatment of these conditions, we find various treatments, including the use of human amniotic membrane, which has had a significant impact on burn management by functioning as a biological scaffold with regenerative and anti-inflammatory qualities. The present article aims to synthesize the current information that describes the applications of human amniotic membranes in burns. We carry out a systematic exploratory review of the literature from 2010 to 2021.
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INTRODUCTION: Leprosy is an ancient and chronic infectious disease caused by 2 mycobacteria (Mycobacterium leprae and Mycobacterium lepromatosis). Recently, our research group observed that HES-1, an innate cellular component of the Notch signaling pathway, is related to the pathogenesis of leprosy. Therefore, it could be helpful in its detection. OBJECTIVE: To determine the expression of HES-1 in the skin of patients with paucibacillary (PB) leprosy. METHODS: A cross-sectional, descriptive, observational study was conducted. Forty-five skin samples from patients with leprosy were evaluated (30 samples from MB leprosy and 15 from PB leprosy) using immunohistochemistry of HES-1 and S-100. RESULTS: PB leprosy biopsies revealed a reduction of HES-1 in 66.7% of the epidermis, 80% of the eccrine glands, and 62.5% of the hair follicles of these patients, with statistical differences in the control group (P < 0.0001). Besides, HES-1 showed similar utility to S-100 immunostaining in detecting the MB and PB leprosy. CONCLUSIONS: HES-1 is a transcriptional factor also reduced in PB patients' epidermis and skin appendages. Finally, our data show that HES-1 could be a biomarker in diagnosing PB and MB leprosy.
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Hanseníase Multibacilar , Hanseníase Paucibacilar , Hanseníase , Humanos , Fatores de Transcrição , Fatores de Transcrição HES-1 , Estudos Transversais , Sensibilidade e Especificidade , Mycobacterium leprae , Hanseníase Multibacilar/microbiologiaRESUMO
Introduction: The coronavirus disease 2019 (COVID-19) was originally identified in the city of Wuhan, China, in December 2019. Current evidence indicates that the COVID-19-causing virus is transmitted person-to-person through direct contact and droplets. Objective: To estimate Sars-CoV-2 virus infection rate in hospital employees according to their job responsibilities. Materials and methods: Retrospective cohort study to detect Sars-CoV-2 infection in hospital employees, carried out between February 2020 and October 2021. The Kaplan Meier procedure was carried out to estimate the virus infection rate based on variables such as gender, age and job description. Results: There was a difference in infection rate between young and older adult age groups (Log Rank=18.6 gl=1 p=<0.0001). A significant difference was also found between young adult and older adult groups (Log Rank=10.6 gl=1 p=0.0011). Conclusions: The older adult group showed a higher infection rate than that observed in younger age groups. These findings highlight the occupational risk of Sars-CoV-2 infection in health workers, especially in older employees. Therefore, it is necessary to maintain safety measures in order to reduce infection risks.
Introducción: La enfermedad por coronavirus 2019 se identificó originalmente en la ciudad de Wuhan, China, en diciembre de 2019. La evidencia actual indica que el virus que causa la COVID-19 se transmite de persona a persona a través del contacto directo y gotitas. Objetivo: Estimar la tasa de infección por el virus Sars-CoV-2 en empleados de hospitales según sus responsabilidades laborales. Materiales y métodos: Estudio de cohorte retrospectivo para detectar infección por Sars-CoV-2 en empleados de hospitales, realizado entre febrero 2020 y octubre 2021. Se realizó el procedimiento de Kaplan Meier para estimar la tasa de infección del virus según género, edad y descripción del trabajo. Resultados: Hubo una diferencia en la tasa de infección entre los grupos de edad de adultos jóvenes y mayores (Log Rank=18,6 gl=1 p=<0,0001). Se encontró una diferencia significativa entre grupos de adultos jóvenes y adultos mayores (Log Rank=10.6 gl=1 p=0.0011). Conclusiones: Los adultos mayores presentaron una tasa de infección superior a la observada en grupos de edades más jóvenes. Se resalta el riesgo ocupacional de infección por Sars-CoV-2 en los trabajadores de la salud, especialmente en los empleados de mayor edad. Es necesario mantener las medidas de seguridad para reducir los riesgos de infección.
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Humanos , Masculino , Feminino , SARS-CoV-2 , Hospitais , Vírus , Saúde Ocupacional , Pessoal de Saúde , InfecçõesRESUMO
In this review, the authors explored the clinical features of frontotemporal dementia (FTD), focusing on treatment. The clinical features of FTD are unique, with disinhibition, apathy, loss of empathy, and compulsions common. Motor changes occur later in the illness. The two major proteins that aggregate in the brain with FTD are tau and TDP-43, whereas a minority of patients aggregate FET proteins, primarily the FUS protein. Genetic causes include mutations in MAPT, GRN, and C9orf72. There are no medications that can slow FTD progression, although new therapies for the genetic forms of FTD are moving into clinical trials. Once a diagnosis is made, therapies should begin, focusing on the family and the patient. In the setting of FTD, families experience a severe burden associated with caregiving, and the clinician should focus on alleviating this burden. Advice around legal and financial issues is usually helpful. Careful consideration of environmental changes to cope with abnormal behaviors is essential. Most compounds that have been used to treat dementia of the Alzheimer's disease type are not effective in FTD, and cholinesterase inhibitors and memantine should be avoided. Although the data are scant, there is some evidence that antidepressants and second-generation antipsychotics may help individual patients.
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Demência Frontotemporal , Proteína C9orf72/genética , Inibidores da Colinesterase , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Demência Frontotemporal/diagnóstico , Demência Frontotemporal/genética , Demência Frontotemporal/terapia , Humanos , Memantina , Mutação , Proteína FUS de Ligação a RNA/genéticaRESUMO
Objective: To describe the demographic characteristics, initial psychiatric diagnoses, and the time to reach a diagnosis of probable behavioral variant frontotemporal dementia (bvFTD) in a public psychiatric hospital in Cali, Colombia. Methods: We retrospectively reviewed the medical records of 28 patients who were diagnosed with probable bvFTD based on a multidisciplinary evaluation that included a structural MRI, neuropsychological testing, functional assessment, and neurological exam. Prior to this evaluation, all patients were evaluated by a psychiatrist as part of their initial consultation at the hospital. The initial consultation included the Neuropsychiatric Inventory and diagnoses based on the DSM-V. Demographics, clinical features, and initial psychiatric misdiagnoses were extracted from clinical records and summarized in the full sample and by gender. Results: The study sample had a mean education of 10.0 years (SD = 4.9) and 68.0% were female. In the full sample, 28.6% were initially diagnosed with dementia, and 71.4% with a psychiatric disorder. The psychiatric diagnosis at initial consultation differed by gender. Women were most likely to be diagnosed with depression (26.3%) or bipolar disorder (26.3%), while the men were most likely to be diagnosed with anxiety (33.3%) or a psychotic disorder (22.2%). Psychotic symptoms were common (delusions, 60.7% and hallucinations, 39.3%), and the pattern of neuropsychiatric symptoms did not differ by gender. Conclusions: This is one of few case series of bvFTD in a Colombian population, where bvFTD is a recognizable and prevalent disorder. In this psychiatric hospital, the majority of patients with bvFTD were initially diagnosed with a primary psychiatric condition. There was a gender difference in psychiatric diagnosis, but not in neuropsychiatric symptoms. In this sample, the rate of psychiatric misdiagnosis, as well as the psychotic symptoms, were higher compared to rates described in other countries. These results highlight the need for interventions to improve bvFTD diagnosis in under-represented populations.
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Cutaneous leishmaniasis (CL) is a parasitic disease that produces chronic skin ulcers. Although it has a worldwide presence, it is a neglected disease that still requires novel tools for its management. In order to study the use of optical tools in CL, this article presents a preliminary study of the correlation between CL histopathological and optical parameters. Optical parameters correspond to absorption and scattering coefficients obtained from diffuse reflectance spectra of treated CL in golden hamsters. Independently, histopathological data were collected from the same hamsters. As a result, after Spearman correlation and the Kruskal-Wallis test, inverse correlation was found between absorption/scattering optical parameters and inflammatory histopathological values, such as the scattering parameter related to the diameter of fibroblasts with the histopathological parameters of fibrosis, polymorphonuclear neutrophils, lymphocytes, plasmocytes, hyperplasia, and Leishmania, and the absorption parameter oxygen saturation showed a relation with the granulation tissue histopathological parameter. These correlations agree with the expected behavior of tissue composition during the healing process in CL. The results correspond to a proof of concept that shows that optical diffuse reflectance-based tools and methods could be considered as an alternative to assist in CL diagnosis and treatment follow-up.
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Leishmaniose Cutânea , Úlcera Cutânea , Animais , Cricetinae , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Linfócitos , Saturação de Oxigênio , ÚlceraRESUMO
ResumenLa producción agrícola de monocultivo permanente de banano y plátano en la parte media del Río Grande (Turbo - Antioquia) requiere de la aplicación de diferentes plaguicidas. Prácticas inapropiadas en la producción y cultivos de plátano realizadas en esta región a menudo conllevan a contaminación con agroquímicos que llegan a este cuerpo de agua por procesos de lixiviación y escorrentía. Los peces son los vertebrados más utilizados como especies bioindicadoras de la calidad del agua porque son muy sensibles a la presencia de contaminantes en el ambiente. El objetivo de esta investigación fue comparar la frecuencia de eritrocitos micronucleados (EMN) en sangre periférica de ejemplares de peces sabaleta (Brycon henni) procedentes de dos estaciones del Río Grande que difieren en su grado de contaminación por agroquímicos. Se evaluó la frecuencia de EMN en sangre periférica de peces B. henni procedentes de cada estación durante dos épocas de lluvia de 2010 y dos época secas de 2011. Las muestras de sangre fueron obtenidas de la vena caudal, fijadas durante 24 horas y luego teñidas con Giemsa. La frecuencia de EMN fue significativamente mayor en el área impactada por agroquímicos. La frecuencia media de EMN fue mayor en la estación con impacto directo de agroquímicos (0.15±0.18) que en la estación poco alterada (0.06±0.08). Además, la frecuencia de EMN en B. henni fue significativamente mayor en la época seca. Los resultados de este estudio indican que el análisis de las EMN en B. henni puede ser recomendada como un método adecuado para la detección in situ de agentes genotóxicos en el ambiente.
Abstract:The permanent monoculture of bananas and plantains farming in the middle of Río Grande (Turbo - Antioquia) requires the application of a variety of pesticides. Inappropriate banana production practices in this region, have often led to waterbody pollution by agrochemicals from leachate and runoff processes. Currently, fish are the most common vertebrates used as bioindicators of water quality, because they are very sensitive to the presence of contaminants. Our main goal with this study was to compare the frequency of micronucleated erythrocytes (MNE) in peripheral blood specimens of fish Brycon henni, from two locations (polluted and unpolluted) in the Rio Grande. We evaluated the frequency of MNE in peripheral blood samples of fish B. henni from each location during two rainy seasons in 2010 and two dry seasons in 2011. Blood samples were collected, fixed for 24 h, and then were stained with Giemsa. Among results, we found that the median frequency of MNE was higher in the polluted site by agrochemical discharges (0.15±0.18), than in the unimpacted site (0.06±0.08). Furthermore, the frequency of MNE in B. henni during the dry season was highly significant for both locations. The results of this study indicated that the analysis of MNE in B. henni could be recommended as a suitable method for in situ detection of environmental genotoxins. Rev. Biol. Trop. 65 (1): 405-414. Epub 2017 March 01.
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Animais , Poluição Química da Água/análise , Monitoramento Ambiental/métodos , Rios/química , Eritrócitos/efeitos dos fármacos , Characidae/sangue , Praguicidas/toxicidade , Estações do Ano , Fatores de Tempo , Testes para Micronúcleos , Colômbia , Estatísticas não ParamétricasRESUMO
The permanent monoculture of bananas and plantains farming in the middle of Río Grande (Turbo - Antioquia) requires the application of a variety of pesticides. Inappropriate banana production practices in this region, have often led to waterbody pollution by agrochemicals from leachate and runoff processes. Currently, fish are the most common vertebrates used as bioindicators of water quality, because they are very sensitive to the presence of contaminants. Our main goal with this study was to compare the frequency of micronucleated erythrocytes (MNE) in peripheral blood specimens of fish Brycon henni, from two locations (polluted and unpolluted) in the Rio Grande. We evaluated the frequency of MNE in peripheral blood samples of fish B. henni from each location during two rainy seasons in 2010 and two dry seasons in 2011. Blood samples were collected, fixed for 24 h, and then were stained with Giemsa. Among results, we found that the median frequency of MNE was higher in the polluted site by agrochemical discharges (0.15±0.18), than in the unimpacted site (0.06±0.08). Furthermore, the frequency of MNE in B. henni during the dry season was highly significant for both locations. The results of this study indicated that the analysis of MNE in B. henni could be recommended as a suitable method for in situ detection of environmental genotoxins.
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Characidae/sangue , Monitoramento Ambiental/métodos , Eritrócitos , Rios/química , Poluição Química da Água/análise , Animais , Colômbia , Eritrócitos/efeitos dos fármacos , Testes para Micronúcleos , Praguicidas/toxicidade , Valores de Referência , Estações do Ano , Estatísticas não Paramétricas , Fatores de Tempo , Poluentes Químicos da Água/toxicidade , Poluição Química da Água/efeitos adversosRESUMO
Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis, as well as different perspectives on classification, may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper, we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.
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Objetivo Evaluar la calidad del aire en tres sitios del Valle de Aburrá (Antioquia) a través de la determinación de la genotoxicidad del PM10 en linfocitos humanos. Métodos A partir del valor de referencia de PM10 para Colombia (50 μg/m3/año) se eligieron tres sitios del Valle de Aburrá con diferente promedio de PM10, Barbosa con 25 μg/m3, Corantioquia con 44 μg/m3y Facultad de Minas con 91 μg/m3. Los filtros de PM10 expuestos por 24 horas, se analizaron en la épocas de lluvia, transición y seca entre Julio de 2011 y abril de 2012. Con el extracto orgánico obtenido en cada filtro se trataron linfocitos humanos para evaluar in vitro el daño en el ADN por medio del ensayo Cometa Alcalino. Resultados Todos los sitios indujeron genotóxicidad altamente significativa (p< 0.001) respecto al control negativo, presentando el mayor daño durante la época de transición. Se observaron diferencias significativas (p<0.05) en la genotoxicidad inducida por el PM10 entre los tres sitios evaluados. Conclusiones Aunque los valores de PM10 reportados para Barbosa y Corantioquia fueron inferiores al nivel máximo permisible, se encontró actividad genotóxica del PM10 proveniente tanto de ellos como de Facultad de Minas cuyo valor de PM10 es superior a la norma. Estos resultados indican que únicamente el monitoreo fisicoquímico del material particulado es insuficiente para evaluar el riesgo relativo sobre la población expuesta. En consecuencia, estos estudios deben ser complementados con biomarcadores de genotoxicidad como el ensayo cometa.(AU)
Objective Assessing air quality by determining PM10 genotoxicity in human lymphocytes at three locations in the Valle de Aburrá (Antioquia department). Methods Three sites were chosen in the Valle de Aburrá (Barbosa, Corantioquia and the School of Mines) using Colombian reference (50 g/m3) and PM10content values, having annual low (25 mg /m3), medium (44 ug/m3) and high PM10 average (91 ug/m3). PM10filters were analyzed during three different seasons between 2011 and 2012: rainy, transitional and dry. Human lymphocytes were treated with the organic extract obtained from each filter to evaluate DNA damage using an alkaline comet assay. Results Genotoxicity was found to be highly significant (p<0.001) in all cases, compared to the negative control. The highest damage (six times) was seen in material from the School of Mines and during the transitional period. Differences were found between material from Barbosa and Corantioquia regarding that from the School of Mines concerning the induction of damage. Conclusions Although the PM10 values reported for Barbosa and Corantioquia were below the maximum permitted level, genotoxic activity was found for PM10from both sites as well as for the School of Mines. These results show that physical-chemical monitoring of particulate matter is not enough for assessing the exposed population's relative risk. Such analysis should thus be accompanied by using genotoxicity biomarkers, such as the comet assay.(AU)
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Biomarcadores , Poluição Ambiental/análise , Colômbia , Ensaio Cometa/instrumentação , Genotoxicidade/métodosRESUMO
Deoxypyridinoline (DPD) and bone-specific alkaline phosphatase (BAP) have been regarded as systemic determinants of bone remodelling. Owing this fact, this study aimed to determine whether the variations in the salivary concentration of these two biomarkers as detected through a longitudinal follow-up with four consecutive visits may be linked with the different phases of orthodontic tooth movement (OTM). Twenty-two healthy subjects who required fixed appliance therapy not involving tooth extractions/surgical procedures were selected. Unstimulated whole saliva samples were collected from each patient prior to fitting the orthodontic appliances and 24-48 hours, 2 weeks, and 5 weeks after the activation. Salivary DPD and BAP concentrations were determined by enzyme-linked immunosorbent assay. The data were analysed using non-parametric statistics. There were no statistically significant differences in salivary levels of biomarkers regarding demographic and clinical parameters. Overall, although DPD values revealed an increasing nature after force application and BAP values showed a descending trend, only the former showed statistically significant changes over time. Furthermore, p ost hoc comparisons for DPD salivary levels revealed significant differences between every paired sampling times, except for the pair baseline test/24-48 hours test. Synchronously, a moderate positive significant correlation between both salivary biomarkers was observed at 2 weeks test. The findings indicate that although salivary levels of DPD and BAP may act as indicators of increased bone remodelling, it appears that DPD dominates the earlier phases of OTM, whereas BAP might serve as indicator of bone formation as soon as the tooth movement stops.
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Fosfatase Alcalina/análise , Aminoácidos/análise , Remodelação Óssea/fisiologia , Saliva/química , Técnicas de Movimentação Dentária , Adulto , Fosfatase Alcalina/metabolismo , Biomarcadores/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aparelhos Ortodônticos , Osteogênese/fisiologia , Projetos Piloto , Estatísticas não ParamétricasRESUMO
OBJECTIVE: Assessing air quality by determining PM(10) genotoxicity in human lymphocytes at three locations in the Valle de Aburrá (Antioquia department). METHODS: Three sites were chosen in the Valle de Aburrá (Barbosa, Corantioquia and the School of Mines) using Colombian reference (50 g/m3) and PM(10) content values, having annual low (25 mg /m3), medium (44 ug/m3) and high PM(10) average (91 ug/m3). PM10filters were analyzed during three different seasons between 2011 and 2012: rainy, transitional and dry. Human lymphocytes were treated with the organic extract obtained from each filter to evaluate DNA damage using an alkaline comet assay. RESULTS: Genotoxicity was found to be highly significant (p<0.001) in all cases, compared to the negative control. The highest damage (six times) was seen in material from the School of Mines and during the transitional period. Differences were found between material from Barbosa and Corantioquia regarding that from the School of Mines concerning the induction of damage. CONCLUSIONS: Although the PM10 values reported for Barbosa and Corantioquia were below the maximum permitted level, genotoxic activity was found for PM10f rom both sites as well as for the School of Mines. These results show that physical-chemical monitoring of particulate matter is not enough for assessing the exposed population's relative risk. Such analysis should thus be accompanied by using genotoxicity biomarkers, such as the comet assay.
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Dano ao DNA/efeitos dos fármacos , Linfócitos/efeitos dos fármacos , Material Particulado/toxicidade , Colômbia , HumanosRESUMO
En este artículo se presenta un consenso médico basado en el sistema de Bethesda del Instituto Nacionalde Cáncer (Estados Unidos) para el uso de la biopsia por aspiración con aguja fina en el manejo de nódulos tiroideos, realizado en conjunto con patólogos, radiólogos, endocrinólogos y otras especialidades médicas de Colombia, España, Chile, Venezuela, Estados Unidos y Panamá. En este trabajo se describen las indicaciones de la biopsia por aspiración con aguja fina de tiroides, requisitos previos, entrenamiento, acreditación, técnicas, terminología diagnóstica, pruebas complementarias y opciones de tratamiento. El objetivo del actual artículo es presentar ante la comunidad médica la clasificación de los reportes citológicos, el reporte de ecografía que propone usar el sistema de datos y el reporte de imágenes tiroideas (TIRADS, del inglés The Thyroid Imaging Reporting and Data System), el uso de la medición de tiroglobulina en biopsia por aspiración con aguja fina y técnicas de citología líquida;...
This article presents a medical consensus based on the Bethesda system of the National Cancer Institute (USA) for the use of fine needle aspiration biopsy in the management of thyroid nodules. This consensus was performed in conjunction with pathologists, radiologists, endocrinologists, and other medical specialties of Colombia, Spain, Chile, Venezuela, United States, and Panama. In this work was described the indications for fine needle aspiration biopsy of thyroid, prerequisites, training, accreditation, techniques, diagnostic terminology, additional tests and treatment options. The aim of this article is present to the medical community the classification of cytological report, ultrasound report using the data system, and the thyroid imaging reporting and data system (TIRADS); as well as, the use of thyroglobulin measurement in fine needle aspiration biopsy, and liquid-based cytology techniques...
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Humanos , Biópsia por Agulha Fina , Técnicas Citológicas , Nódulo da Glândula Tireoide , UltrassonografiaRESUMO
El linfoma primario del sistema nervioso central es una neoplasia rara que se encuentra con relativa frecuencia en pacientes con inmunosupresión. Se presenta el caso de una mujer de 38 años sin antecedentes relevantes, a quien se le resecó un tumor de ángulo ponto-cerebeloso izquierdo, cuya anatomopatología reportó un linfoma B de célula grande muy maligno. Se hicieron estudios en busca de inmunosupresión, los que fueron negativos. La paciente no se encontraba en el rango de edad de presentación de este tipo de tumor y sólo estudios moleculares genéticos podrían dar alguna explicación a este caso...
Primary central nervous system lymphoma is a rare condition which commonly presents in immunosuppressed patients. We present the case of a 38 year old female with no relevant previous medical history who underwent surgery for the removal of a mass located in her left cerebello pontine angle. Final pathology report was consistent with B cell lymphoma (large cell variant). A survey for hidden conditions which could predispose the patient to immunodeficiency was negative. The age of presentation for this case was also atypical. Further genetic and molecular testing could provide a possible explanation for this rare event...
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Adolescente , Doenças Cerebelares , Linfoma , Sistema Nervoso Central , Ângulo CerebelopontinoRESUMO
Introducción. La mamoplastia de aumento es un procedimiento muy común, no obstante las secuelas de dolor y síntomas sensoriales son desconocidas. Objetivo. Evaluar el impacto del uso de ketamina perioperatoria en las secuelas dolorosas y de síntomas neurológicos de pacientes sometidas a mamoplastia de aumento. Metodología. Este es un seguimiento a largo plazo de un ensayo clínico que incluyó 106 pacientes que habían sido sometidas a una mamoplastia estética de aumento que evaluaba la efectividad de Ketamina para dolor postoperatorio. La intensidad de dolor y la presencia o ausencia de síntomas neurológicos fueron recolectados. Resultados. Cincuenta pacientes consintieron en participar completando una entrevista telefónica. Los grupos no difirieron en cuanto a las variables demográficas y la técnica quirúrgica. Ambos grupos reportaron una alta incidencia de dolor moderado a intenso el primer día y la primera semana del postoperatorio (19 y 21 pacientes de los grupos ketamina y placebo respectivamente), con completa resolución de los síntomas a los tres meses. Tres participantes del grupo ketamina reportaron hipoestesia persistente y una participante sensación de ardor. Estos síntomas fueron marginalmente más frecuentes en el grupo placebo con siete participantes que reportaron hipoestesia y dos sensación de ardor. Conclusiones. En este estudio, la ketamina no tuvo un impacto significativo en la incidencia de dolor crónico posterior a mamoplastia estética de aumento. Existe una tendencia a sugerir que la ketamina podría tener algún papel en la reducción de síntomas neurológicos que resultaron ser más frecuentes de lo esperado (20 %).
Introduction. Augmentation mammoplasty is a common procedure but pain sequelae and sensory symptoms are unknown. Objective. To assess the impact of using perioperative Ketamine for painful sequelae and neurological symptoms in patients undergoing augmentation mammoplasty.Methodology. Long-term follow-up of a clinical study including 106 patients that underwent cosmetic augmentation mammoplasty to assess the effectiveness of Ketamine for postoperative pain. Pain intensity and the presence/absence of neurological symptoms were recorded. Results. A total of 50 patients agreed to participate by responding to a telephone interview. The groups did not differ in terms of demographic variables and the surgical technique. Both groups reported a high incidence of moderate/severe pain on the first day and the week following the operation (19 and 21 patients in the Ketamine and placebo groups, respectively), with complete resolution of symptoms after three months. Three participants in the Ketamine group reported persistent hypoesthesia and one reported a burning sensation. These symptoms were slightly more frequent in the placebo group, with 7 patients reporting hypoesthesia and two burning sensation.Conclusions. In this study, Ketamine had no significant incidence on chronic pain following cosmetic augmentation mammoplasty. There is a trend suggesting that Ketamine could play a role in reducing the neurological symptoms that exceeded the expected frequency (20 %).
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Humanos , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Seguimentos , Ketamina , Mamoplastia , Dor Pós-Operatória , Seguimentos , Ketamina , Dor Pós-OperatóriaRESUMO
Los trabajadores de la salud, especialmente el personal de enfermería, se encuentran expuestos a una importante variedad de factores de riesgo laborales y personales que pueden provocar accidentes de trabajo dependiendo del tipo de tareas que desempeñan y el puesto de trabajo que ocupan. La Clínica Villapilar ESE Rita Arango Álvarez del Pino de Manizales como institución de alta complejidad, y la cual tiene una gran demanda por parte de la población del departamento de Caldas, debido a la amplia cantidad de servicios hospitalarios y especializados que ofrece, fue la institución escogida para realizar esta investigación. Se estudiaron los factores laborales y personales que incidieron en la ocurrencia de accidentes de trabajo biológicos, así como la notificación de los mismos en el personal de enfermería tanto auxiliar como profesional durante el periodo de junio a noviembre de 2005. Se realizó un estudio cuantitativo descriptivo, en donde se utilizaron como instrumentos para la recolección de información: una encuesta estructurada de acuerdo a los parámetros de las normas ANSI-Z-2, revisión documental y una guía de observación; del análisis de los resultados se pudo concluir que: De 11 accidentes de trabajo notificados, 7 (63 por ciento) fueron en el personal de enfermería, siendo el más frecuente el accidente por punción, al cual se le realiza seguimiento según los protocolos establecidos. El 100 por ciento de la población que ha tenido accidentes de trabajo, ha notificado el hecho y, de éstos, el 90 por ciento considera que los elementos de protección personal que proporciona la institución son suficientes. Los resultados obtenidos son similares a los de otros centros hospitalarios en donde el riesgo de punción es el más frecuente. Dada la posibilidad de transmisión de agentes infecciosos por esta vía de entrada, se destaca la importancia de desarrollar programas preventivos de este frecuente accidente laboral.
Health workers, especially nursing personnel, are usually exposed to a large variety of work and personal risk factors that can cause industrial accidents depending on the types of duties they perform. VillaPilar ESE Rita Arango Alvarez del Pino Clinic of Manizales is an institution that develops complex surgeries and procedures. Because of this, its services are highly demanded by the people that live in the Department of Caldas. The clinic offers a wide range of specialized health services and this was the reason it was chosen to carry out this research process. The work and personal factors that influence the occurrence of biological work factors were studied, as well as the notification of these by professional and assistant nursing personnel from June to November 2005. A descriptive quantitative study was carried out, using the following tools for gathering information: a survey designed according to the regulations established by ANSI-Z-2 norms, document analysis and an observation guide. The conclusions include: from 11 reported work accidents, 7 (63%) happened to nursing personnel. The most frequent accident was puncturing, which is monitored according to the protocol established. 100% of the population that has had work accidents has notified the event, and 90% of them think that the personal protection tools provided by the institution are enough. The results obtained are similar to those of other hospital centers, where puncturing risk is the most frequent. Due to the possibility of transmission of infectious agents by this entry way, it its important to develop prevention programs against this frequent work accident (2).
Os trabalhadores da saúde, especialmente o pessoal de enfermaria, encontram-se expostos a uma importante variedade de fatores de risco laborais e pessoais que podem provocar acidentes de trabalho dependendo do tipo de tarefas que desempenham e o posto de trabalho que ocupam. A Clínica Vilapilar ESSE Rita Arango do Pino de Manizales como instituição de alta complexidade, e a qual tem uma grande demanda por parte da povoação do Estado de Caldas, devido à amplia quantidade de serviços hospitalarias e especializados que oferece, foi a instituição escolhida para realizar esta investigação. Estudaram-se os fatores laborais e pessoais que incidiam na ocorrência dos acidentes de trabalhos biológicos, assim como a notificação dos mesmos no pessoal de enfermaria tanto auxiliar durante o período de junho a novembro de 2005. Realizou-se um estúdio quantitativo, em onde utilizaram-se como instrumentos para a colheita de informação: uma enquête estruturada de acordo aos parâmetros das normas ANSI-Z-2, revisão documental e uma guia de observação; do análise dos resultados pôde- se concluir que: De 11 acidentes de trabalho notificados, 7 (63%) foram no pessoal de enfermaria. Sendo os mais freqüentes o acidente por punção ao qual se realiza seguimento conforme os protocolos estabelecidos. O 100% da povoação que tenha tido acidentes de trabalho, tem notificado o fato e, destes o 90% considera que os elementos proteção pessoal que proporciona a instituição são suficientes. Os resultados obtidos são similares aos outros centros hospitalarias em onde o risco de punção é o mais freqüente. Esta possibilidade de transmissão de agentes infecciosos por esta via de entrada, destaca-se a importância de desenvolver programas preventivos deste freqüente acidente de trabalho.