RESUMO
The Covid-19 pandemic has caused major changes in many sectors of society worldwide. The issue of medical education stands out since it had to adapt to the rules of social isolation, ensuing discussions about the computerization of teaching methodology, particularly in neuroanatomy. In particular, the latter showed satisfactory adaptability to new technologies and highly promising learning results. During this review, we aim to evaluate the current state of neuroanatomy teaching and evaluate the possibilities of incorporating technology into teaching-learning of human anatomy in a post-pandemic world.
RESUMO
In indicated preterm births such a Gestational Diabetes Mellitus (GDM), little is known about the role of the amnion membranes. Investigating the role of amnion membrane inflammation in response GDM may suggest novel pathophysiologic mechanisms. We hypothesize that increased GDM inflammatory mediators may weaken the amnion membrane predisposing them to infection. Maternal and fetal serum and amnion membrane biopsies were collected from 20 GDM and 38 normoglycemic subjects (control) who underwent elective cesarean sections. Cytokines and adipokines were evaluated in serum and amnion culture supernatant samples. Amnion membrane biopsies from GDM and control subjects were studied: fresh frozen for RNA analysis for Toll-like receptor expression; cultured with LPS to test membrane permeability, and inflammation LPS + anti-TLR4 for testing mechanism. GDM was associated with higher fetal serum leptin (p = 0.004) and IL-10 (p = 0.04) compared to controls. Amnion membrane explants from GDM had higher levels of IL-6 (p = 0.019), and lower expression of Claudin-4 (p = 0.007) and increased permeability (p = 0.046) compared to controls. GDM membranes treated with LPS showed an increased expression of IL-10 (p = 0.013); IL-6 (p = 0.004) and TNF-α (p = 0.0005) but did not affect membrane permeability. LPS and anti-TLR4 antibody treatment reduced the production of TNF-α in controls (p = 0.03) and GDM (p = 0.007) compared to LPS alone. Fetal inflammatory response seems more balanced in GDM and does not impact membrane permeability function even with an infectious stimulus. Light fetal membrane inflammatory response may explain lack of preterm labor in GDM. Concluding, benign inflammation in the membranes may not be harmful for pregnancy maintenance.
Assuntos
Diabetes Gestacional/imunologia , Membranas Extraembrionárias/imunologia , Trabalho de Parto Prematuro/epidemiologia , Adulto , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/patologia , Membranas Extraembrionárias/patologia , Feminino , Humanos , Inflamação/sangue , Inflamação/complicações , Inflamação/diagnóstico , Inflamação/imunologia , Mediadores da Inflamação/sangue , Trabalho de Parto Prematuro/imunologia , Placenta/imunologia , Placenta/patologia , Gravidez , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: 2-octylcyanoacrylate (2OCA) is a liquid monomer that polymerizes on contact with a surface by an exothermic reaction creating a strong and flexible film. The addition of sodium bicarbonate accelerates the polymerization. The aim was to use the combination of 2OCA and sodium bicarbonate in the treatment of zygomatic arch fractures in an animal model and to evaluate the biocompatibility and bone healing. METHODS: twenty animals were subjected to bilateral zygomatic arch fracture under surgical sedation, and using 2OCA fixation and sodium bicarbonate for the experimental side and without fixation for the control side. Observation was over a period from two to four weeks, assessing biocompatibility, stability and consolidation. RESULTS: at the end of two and four weeks the twenty animals showed the presence of osseous callus and continuity of marrow channel measured by macroscopic and radiography examinations. CONCLUSIONS: the use of 2-octylcyanoacrylate and sodium bicarbonate led to the stabilization and reduction of bilateral zygomatic arch fractures in an animal model without adverse reactions.
Assuntos
Cianoacrilatos , Fixação de Fratura/métodos , Bicarbonato de Sódio , Adesivos Teciduais , Fraturas Zigomáticas/tratamento farmacológico , AnimaisRESUMO
OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.
Assuntos
Apêndice , Doenças do Ceco/complicações , Colecistite/complicações , Vesícula Biliar/patologia , Mucocele/complicações , Idoso de 80 Anos ou mais , Doenças do Ceco/diagnóstico , Doenças do Ceco/cirurgia , Colecistite/patologia , Gangrena , Humanos , Masculino , Mucocele/diagnóstico , Mucocele/cirurgiaRESUMO
Objetivo: descripción de un caso de mucocele apendicular y colecistitis aguda gangrenada, atendido en el Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS. Caso clínico: hombre de 80 años de edad que ingresó al hospital con diagnóstico de colecistitis aguda y tumor abdominal de etiología desconocida, dolor abdominal de 10 días de evolución localizado en hipocondrio derecho, sin fiebre ni pérdida importante de peso. Los exámenes de laboratorio mostraron únicamente leucocitosis moderada. La tomografía computarizada abdominal mostró vesícula biliar con paredes engrosadas y datos de agudización, así como tumor abdominal en fosa iliaca derecha. Se exploró quirúrgicamente con los siguientes hallazgos: colecistitis aguda supurada y tumoración apendicular de 20 cm de longitud, sin datos de malignidad. Se realizó colecistectomía y apendicectomía. El periodo posoperatorio transcurrió sin incidentes. El diagnóstico histopatológico fue de mucocele apendicular no roto. El paciente fue dado de alta a los cinco días. Pasados cinco meses de la intervención, se encontraba asintomático.
OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Apêndice , Colecistite/complicações , Doenças do Ceco/complicações , Mucocele/complicações , Vesícula Biliar/patologia , Colecistite/patologia , Doenças do Ceco/diagnóstico , Doenças do Ceco/cirurgia , Gangrena , Mucocele/diagnóstico , Mucocele/cirurgiaRESUMO
Objetivo: Describir y comparar la habilidad en el cuidado de los cuidadores familiares de personas con enfermedad crónica, en aquellos que se encuentran vinculados a programas docente-asistenciales de tres unidades académicas de enfermería que pertenecen a la red de trabajo en cuidado al paciente crónico y su familia. Materiales y métodos: Su metodología responde a una comparación de estudios descriptivos, cuantitativos, de corte transversal, con una muestra de 45 cuidadores de la Universidad de la Sabana, 90 de Unillanos y 90 de la Universidad Nacional de Colombia. El instrumento para la recolección de la información fue el Inventario de habilidad de cuidado, CAI®, de Ngozi Nkongho. Resultados: Al finalizar el estudio se evidenció un comportamiento similar en la habilidad de cuidado de los cuidadores en las tres instituciones. Estos resultados confirman los hallazgos de la literatura. Conclusiones: Es clara la necesidad de incluir en las políticas de salud pública y en la academia procesos que preparen a los profesionales de enfermería en el cuidado de los cuidadores de enfermos crónicos discapacitados...
Assuntos
Cuidadores , Educação em Saúde , Doença CrônicaRESUMO
El presente trabajo mide y compara la habilidad de cuidado de un grupo de cuidadores informales de pacientes en situación de enfermedad crónica discapacitante. El instrumento utilizado fue el Inventario de Habilidad de Cuidado (CAI) de Ngozi Nkongo, el cual mide la habilidad que tienen las personas para cuidar cuando están en una relación con otros, a partir del desarrollo de tres componentes: conocimiento, paciencia y valor. El análisis se basó en la determinación de cada una de estas categorías en dos grupos de cuidadores -de pacientes de consulta externa y del servicio de hospitalización-. En cada uno de los grupos se analizaron 37 afirmaciones de los cuidadores con respecto a su forma de pensar, sentir y actuar dentro de su experiencia de cuidado. Los hallazgos permitieron la comprensión y el conocimiento real de la situación de cuidado de personas que, sin tener la orientación adecuada y el apoyo efectivo, adelantan acciones de cuidado a personas con altas demandas de cuidado como son los adultos mayores con enfermedad crónica discapacitante. Finalmente, se presentan algunas sugerencias que fortalecen la experiencia de cuidado, particularmente en cuidadores informales para ser abordadas desde la asistencia, la docencia y la investigación en enfermería.
This work measures and compares the abilities of a group of temporary caretakers that have critically disabling illness patients. The tool that was used for this study was Ngozi Nkongo's CAI, which measures the ability to care for another with whom one has a relation, by developing three components: knowledge, patience, and courage. The analysis was based on the determination of each of theses categories in two groups of caretakers out patients, and in patients-. In each one of the groups, 37 affirmations of the caretakers were analysed regarding the way they think, feel, and act considering their care taking experience. The findings enable one to understand and to acquire real knowledge of the delicate...
Assuntos
Cuidadores , Doença CrônicaRESUMO
Objetivo: describir la presentación clínica y el tratamiento de un paciente con neoplasia pancreática neuroendocrina y hemorragia de tubo digestivo. Antecedentes: los tumores neuroendocrinos del páncreas son neoplasias relativamente raras; cuando no son funcionantes el cuadro clínico es inespecífico y se manifiestan hasta que la neoplasia ha adquirido grandes dimensiones. La hemorragia masiva de tubo digestivo alto es una manifestación clínica poco frecuente de este tipo de tumores. Método: se presenta un caso en el cual se requiere tratar una hemorragia masiva de tubo digestivo alto con pancreatoduodenectomía de urgencia por una neoplasia ulcerada de la cabeza del páncreas. Conclusión: la pancreatoduodenectomía es sin duda el procedimiento de elección para control de la hemorragia masiva duodenal en presencia de una neoplasia neuroendocrina del páncreas ulcerada.