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Despite multiple studies of the impact of climate change on temperate tree species, experiments on tropical and economically important tree crops, such as cacao (Theobroma cacao L.), are still limited. Here, we investigated the combined effects of increased temperature and atmospheric carbon dioxide concentration ([CO2]) on the growth, photosynthesis and development of juvenile plants of two contrasting cacao genotypes: SCA 6 and PA 107. The factorial growth chamber experiment combined two [CO2] treatments (410 and 700 p.p.m.) and three day/night temperature regimes (control: 31/22 °C, control + 2.5 °C: 33.5/24.5 °C and control + 5.0 °C: 36/27 °C) at a constant vapour pressure deficit (VPD) of 0.9 kPa. At elevated [CO2], the final dry weight and the total and individual leaf areas increased in both genotypes, while the duration for individual leaf expansion declined in PA 107. For both genotypes, elevated [CO2] also improved light-saturated net photosynthesis (Pn) and intrinsic water-use efficiency (iWUE), whereas leaf transpiration (E) and stomatal conductance (gs) decreased. Under a constant low VPD, increasing temperatures above 31/22 °C enhanced the rates of Pn, E and gs in both genotypes, suggesting that photosynthesis responds positively to higher temperatures than previously reported for cacao. However, dry weight and the total and individual leaf areas declined with increases in temperature, which was more evident in SCA 6 than PA 107, suggesting the latter genotype was more tolerant to elevated temperature. Our results suggest that the combined effect of elevated [CO2] and temperature is likely to improve the early growth of high temperature-tolerant genotypes, while elevated [CO2] appeared to ameliorate the negative effects of increased temperatures on growth parameters of more sensitive material. The evident genotypic variation observed in this study demonstrates the scope to select and breed cacao varieties capable of adapting to future climate change scenarios.
Assuntos
Cacau , Temperatura , Mudança Climática , Árvores , Dióxido de Carbono , Folhas de Planta/fisiologia , Fotossíntese/fisiologiaRESUMO
Introducción. El diagnóstico adecuado de los tumores de la unión esofagogástrica es esencial para el tratamiento de estos pacientes. La clasificación propuesta por Siewert-Stein define las características propias, factores de riesgo y estrategias quirúrgicas según la localización. El objetivo de este estudio fue describir las características de los pacientes con adenocarcinoma de la unión esofagogástrica tratados en nuestra institución. Métodos. Estudio retrospectivo, descriptivo, de corte longitudinal, que incluyó los pacientes con diagnóstico de adenocarcinoma de la unión esofagogástrica intervenidos quirúrgicamente en el Instituto Nacional de Cancerología, Bogotá, D.C., Colombia, entre enero de 2012 y mayo de 2017. Resultados. Se operaron 59 pacientes (84,7 % hombres), con una edad media de 62,5 años. En su orden de frecuencia los tumores fueron tipo II (57,6 %), tipo III (30,7 %) y tipo I (11,9 %). El 74,6 % recibieron neoadyuvancia y se realizó gastrectomía total en el 73 % de los pacientes. La concordancia diagnóstica moderada con índice Kappa fue de 0,56, difiriendo con la endoscópica en 33,9 %. El 10,2 % de los pacientes presentó algún tipo de complicación intraoperatoria. La supervivencia a tres años en los tumores tipo II fue del 89,6 % y del 100 % en aquellos con respuesta patológica completa. Conclusión. Es necesario el uso de diferentes estrategias para un proceso diagnóstico adecuado en los tumores de la unión esofagogástrica. En esta serie, los pacientes Siewert II, aquellos que recibieron neoadyuvancia y los que obtuvieron una respuesta patológica completa, tuvieron una mejor supervivencia a tres años
Introduction: Proper diagnosis of gastroesophageal junction tumors is essential for the treatment of these patients. The classification proposed by Siewert-Stein defines its own characteristics, risk factors and surgical strategies according to the location. This study describes the characteristics of patients with adenocarcinoma of the esophagogastric junction treated at our institution. Methods. Retrospective, descriptive, longitudinal study, which includes patients diagnosed with adenocarcinoma of the esophagogastric junction who underwent surgery at the National Cancer Institute in Bogotá, Colombia, between January 2012 and May 2017. Results. Fifty-nine patients (84.7% men) were operated on, with a mean age of 62.5 years. In their order of frequency, the tumors were type II (57.6%), type III (30.7%) and type I (11.9%). 74.6% received neoadjuvant therapy and total gastrectomy was performed in 73% of the cases. The moderate diagnostic concordance with the Kappa index was 0.56, differing from the endoscopic one in 33.9%. 10.2% of the patients presented some type of intraoperative complication. Three-year survival in type II tumors was 89.6% and 100% in those with complete pathologic response. Conclusion. The use of different strategies is necessary for an adequate diagnostic process in tumors of the esophagogastric junction. In this series, Siewert II patients, those who received neoadjuvant therapy, and those who obtained a complete pathological response had a better three-year survival
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Humanos , Neoplasias Esofágicas , Junção Esofagogástrica , Neoplasias Gástricas , Sobrevida , ClassificaçãoRESUMO
The antimicrobial activity and biological efficiency of silver nanoparticles (AgNps) have been widely described and can be modeled through stabilizing and reducing agents, especially if they exhibit biocidal properties, which can enhance bioactivity against pathogens. The selective action of AgNps remains a major concern. In this regard, the use of plant extracts for the green synthesis of nanoparticles offers advantages because it improves the toxicity of Nps for microorganisms and is harmless to normal cells. However, biological evaluations of the activity of AgNps synthesized using different reducing agents are determined independently, and comparisons are frequently overlooked. Thus, we investigated and compared the antifungal and cytotoxic effects of two ecological AgNps synthesized from Moringa oleifera aqueous leaf extract (AgNp-M) and glucose (AgNp-G) against azole-resistant clinical isolates of Candida spp. and nontumor mammalian cells. Synthesized AgNps exhibited an antifungal effect on planktonic cells of drug-resistant C. albicans and C. tropicalis (MIC 0.21-52.6 µg/mL). The toxicity was influenced by size. However, the use of M. oleifera extracts allows us to obtain AgNps that are highly selective and nongenotoxic to Vero cells due to modifications of the shape and surface. Therefore, these results suggest that AgNp-M has antimicrobial potential and deserves further investigation for biomedical applications.
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Anti-Infecciosos , Nanopartículas Metálicas , Animais , Chlorocebus aethiops , Antifúngicos/toxicidade , Candida , Antibacterianos/farmacologia , Prata/toxicidade , Azóis/toxicidade , Nanopartículas Metálicas/toxicidade , Substâncias Redutoras , Células Vero , Extratos Vegetais/farmacologia , Anti-Infecciosos/farmacologia , Testes de Sensibilidade Microbiana , MamíferosRESUMO
OBJETIVO: Algunas investigaciones realizadas en comunidades universitarias alrededor del mundo, muestran como durante esta etapa se presentan cambios significativos frente a los estilos y dinámicas de vida los estudiantes. En este estudio se identificaron indicadores antropométricos y patrones alimentarios que caracterizan a los estudiantes universitarios de la Facultad de Ciencias de la Nutrición y los Alimentos de la Universidad CES (Colombia) en el período 2018 y 2019. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional y descriptivo, con datos provenientes de fuentes de información secundarias donde reposaba la información de los indicadores antropométricos y patrones alimentarios de los estudiantes durante el periodo en mención, las cuales fueron revisadas el primer semestre del año 2022. RESULTADOS: Tomando en cuenta el indicador de índice de masas corporal (IMC) de los evaluados, el 2,7% presento obesidad, el 18,3% sobrepeso, el 72,3 % adecuación, el 6,2 % bajo peso y un 0,4% bajo peso severo. Se encontró que los alimentos de mayor consumo diario fueron cereales refinados, raíces, plátanos y tubérculos, verduras, lácteos reducidos en grasa, carnes magras, huevos, grasas de origen vegetal y azúcares. Respecto a los alimentos con mayor consumo ocasional o sin consumo, se encuentran los cereales integrales, lácteos enteros, carnes altas en grasas, grasa de origen animal y claras de huevo. CONCLUSIONES: resultados develan que la mayor parte de los investigados reflejo un IMC normal y un menor porcentaje evidencian problemas asociados con la malnutrición, un 6,6 % presentó déficit de peso, mientras que un 21,0% presento exceso de peso, a la par se observan patrones alimentarios protectores como un elevado porcentaje de consumo diario de frutas, verduras, carnes magras, grasas de origen vegetal y consumo ocasional o no consumo de lácteos enteros, carnes altas en grasa y grasa de origen animal.
OBJECTIVE: Some investigations carried out in university communities around the world show how during this stage significant changes are presented regarding the styles and dynamics of life of the students. In this study, anthropometric indicators and eating patterns that characterize university students of the Faculty of Nutrition and Food Sciences of the CES University in the period 2018 and 2019 were identified. MATERIALS AND METHODS: Retrospective, observational and descriptive study, with data from secondary information sources where the information on the anthropometric indicators and eating patterns of the students rested during the period in question, which were reviewed the first semester of 2022. RESULTS: Taking into account the mass index indicator (BMI) of those evaluated, 2,7% present obesity, 18,3% overweight, 72,3% adequacy, 6,2% underweight and 0,4% severe underweight. It was found that the foods with the highest daily consumption were refined cereals, roots, bananas and tubers, vegetables, reduced-fat dairy products, lean meats, eggs, fats of vegetable origin, and sugars. Regarding foods with greater occasional consumption or without consumption, there are whole grains, whole milk products, high-fat meats, fat of animal origin and egg whites. CONCLUSIONS: the results reveal that the majority of those investigated reflect a normal BMI and a lower percentage show problems associated with malnutrition, 6.6% presented weight deficit, while 21,0% presented excess weight, at the same time they are observed protective food patterns such as a high percentage of daily consumption of fruits, vegetables, lean meats, fats of vegetable origin and occasional consumption or non-consumption of full-fat dairy products, meats high in fat and fat of animal origin.
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Humanos , Masculino , Feminino , Adulto Jovem , Antropometria , Estado NutricionalRESUMO
Abstract Introduction: Post-surgical esophagojejunal anastomosis fistulas can be life-threatening. Currently, there are several treatment alternatives. In recent years, endoscopic negative pressure therapy has emerged as an innovative treatment for these fistulas, offering numerous benefits. Case presentation: A 72-year-old man diagnosed with gastric adenocarcinoma of the body and fundus underwent total gastrectomy with D2 lymphadenectomy and Roux-en-Y anastomosis with curative intent in a quaternary care hospital in Popayán, Colombia. However, in the postoperative period, he presented systemic inflammatory response syndrome and acute abdomen due to an esophagojejunal fistula. Initial management included a laparotomy, two peritoneal washings, and an abdominal drainage. Then the patient developed frozen abdomen, so it was not possible to access the esophagojejunal anastomosis. Fistula closure was attempted by inserting a self-expandable metallic stent, yet the procedure was not successful. Salvage therapy was started using an endoscopic vacuum-assisted closure (VAC) system. After 5 replacements of the VAC system, complete drainage of the intra-abdominal collection, complete closure of the peritoneal cavity, and closure of the esophagojejunal leak, with a small residual diverticular formation, were achieved. The patient's condition improved progressively, resuming oral intake 20 days after initiation of VAC therapy. In addition, no new abdominal complications were reported during the follow-up period (17 months). Conclusions: Endoscopic VAC therapy is a new safe and effective alternative to treat complex post-surgical fistulas caused by esophagojejunal anastomosis.
Resumen Introducción. Las fístulas de las anastomosis esófago-yeyunales postquirúrgicas pueden llegar a ser mortales. En la actualidad, existen varias alternativas de tratamiento, y en los últimos años la terapia endoscópica de presión negativa se ha convertido en un método innovador y con grandes ventajas para el manejo de estas fístulas. Presentación del caso. Hombre de 72 años diagnosticado con adenocarcinoma gástrico de cuerpo y fondo a quien se le realizó una gastrectomía total con linfadenectomía D2 y una anastomosis en Y de Roux con intención curativa en un hospital de cuarto nivel en Popayán, Colombia. Sin embargo, en el posoperatorio presentó síndrome de respuesta inflamatoria sistémica y abdomen agudo producto de fístula esófago-yeyunal. Se realizó manejo inicial con laparotomía, dos lavados de cavidad peritoneal y drenaje abdominal. Posteriormente, el paciente desarrolló abdomen congelado, por lo que no fue posible acceder a la anastomosis esófago-yeyunal. Se intentó cierre de fístula mediante la inserción de prótesis metálica autoexpandible, pero el procedimiento no fue exitoso. Se inició terapia de rescate mediante sistema de cierre asistido por vacío (VAC) por vía endoscópica. Luego de 5 recambios del sistema VAC, se logró el drenaje completo de la colección intraabdominal encontrada, el cierre completo de la cavidad peritoneal y el cierre de la fuga esófago-yeyunal, con una pequeña formación diverticular residual. La condición del paciente mejoró progresivamente, con reinicio de la vía oral a los 20 días del inicio de la terapia VAC. Además, no se reportaron nuevas complicaciones abdominales en el periodo de seguimiento (17 meses). Conclusión. La terapia endoscópica de VAC es una nueva alternativa segura y efectiva para el tratamiento de fístulas postquirúrgicas complejas producto de anastomosis esófago-yeyunales.
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Introducción: Las enfermedades trasmitidas por alimentos se producen por la ingestión de alimentos y/o bebidas contaminados. Objetivo: Identificar los agentes causales que influyen en la aparición de estas enfermedades. Métodos: Se realizó un estudio observacional, descriptivo y transversal del total de brotes de enfermedades trasmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019. Las variables analizadas fueron: número de brotes, muestras de alimentos y muestras de heces fecales para coprocultivo, entre otras. Resultados: En todos los brotes se aisló un solo tipo de agente bacteriano, con predominio de las bacterias gramnegativas, donde la Salmonella fue el microorganismo más identificado. Los principales grupos de alimentos relacionados con la aparición de dichos brotes resultaron ser la carne y sus derivados, así como la ensalada fría. Conclusiones: La vigilancia epidemiológica de brotes de enfermedades transmitidas por alimentos, permitió identificar el verdadero agente causal en los brotes de ETA, al demostrarse identidad entre los aislamientos bacterianos obtenidos de muestras de alimentos y heces fecales.
Introduction: Diseases transmitted by foods take place due to the ingestion of foods and/or contaminated drinks. Objective: To identify the causal agents that influence in the emergence of these diseases. Methods: An observational, descriptive and cross-sectional study of all the diseases outbreaks transmitted by foods was carried out in Santiago de Cuba, from January, 2018 to December, 2019. The analyzed variables were: number of outbreaks, samples of foods and samples of stools for coproculture, among others. Results: In all the outbreaks a single type of bacterial agent was isolated, with prevalence of the gram-negative bacterias, where Salmonella was the most identified microorganism. The main groups of foods related to the emergence of these outbreaks were meat and its derived products, as well as cold salad. Conclusions: The epidemiologic surveillance of diseases outbreaks transmitted by foods, allowed to identify the true causal agent in the FTD outbreaks, when the identity between the bacterial isolations obtained from samples of foods and stools was demonstrated.
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Contaminação de Alimentos , Ingestão de Alimentos , Monitoramento Epidemiológico , Surtos de DoençasRESUMO
Introducción: La ciencia cubana ha brindado aportes significativos para el enfrentamiento a la COVID-19, lo que ha facilitado, mediante diversas investigaciones, la predicción, el diseño de modos de enfrentamiento, así como el perfeccionamiento de protocolos terapéuticos y de los modelos de actuación. Objetivo: Caracterizar a pacientes sospechosos y positivos a la COVID-19 ingresados en un centro de aislamiento de Santiago de Cuba. Métodos: Se efectuó un estudio observacional, descriptivo y transversal de los 731 pacientes sospechosos y positivos a la COVID-19, ingresados en el hospital de aislamiento de la Facultad de Medicina No. 2 de Santiago de Cuba, desde enero hasta marzo del 2021, con vistas a caracterizarles según algunas variables clínicas y epidemiológicas seleccionadas, a saber: edad, sexo, antecedentes patológicos personales y síntomas al momento del diagnóstico. Resultados: Del total de pacientes predominaron el sexo masculino (50,8 %) y los grupos etarios de 21-30 y de 51 60 años (21,6 y 20,7 %, respectivamente). En relación con el número de confirmados primaron las féminas (29,2 %) y las áreas de salud con más afectados resultaron ser los policlínicos 28 de Septiembre (22,5 %), 30 de Noviembre (16,8 %) y Mario Muñoz Monroy (14,6 %); asimismo, sobresalieron la hipertensión arterial, el asma bronquial y otras alergias como antecedentes patológicos personales, además de la tos, la fiebre y el malestar general como manifestaciones clínicas. Cabe destacar que 45,6 % de los pacientes con prueba positiva estaban asintomáticos al momento del diagnóstico. Conclusiones: La COVID- 19 constituye un problema prioritario de salud pública y el enfrentamiento a esta terrible pandemia no solo ha traído consigo aplazar metas y transformar objetivos de vida en todos los sectores y naciones, sino también ha implicado redefinir constantemente estrategias y modos de hacer en la búsqueda de un mejor control de la enfermedad.
Introduction: Cuban science has offered significant contributions for the confrontation to the COVID-19, what has facilitated, by means of diverse investigations, the prediction, design of confrontation ways, as well as the improvement of therapeutic protocols and performance models. Objective: To characterize suspicious and positive patients to the COVID-19 admitted to an isolation center from Santiago de Cuba. Methods: An observational, descriptive and cross-sectional study of the 731 suspicious and positive patients to the COVID-19 was carried out. They were admitted to the Medicine Faculty No. 2 isolation hospital from Santiago de Cuba, from January to March, 2021, aimed at characterizing them according to some selected clinical and epidemiologic variables, that is: age, sex, personal pathological history and symptoms at the moment of the diagnosis. Results: Of the total of patients there was a prevalence of the male sex (50.8 %) and the 21-30 and 51-60 age groups (21.6 and 20.7 %, respectively). In connection with the number of confirmed cases there was a prevalence of females (29.2 %) and the health areas with more affected patients were 28 de Septiembre (22.5 %), 30 de Noviembre (16.8 %) and Mario Muñoz Monroy polyclinics (14.6 %); also, hypertension, bronchial asthma and other allergies are notable as personal pathological history, besides cough, fever and diffuse discomfort as clinical signs. It is remarkable that 45.6 % of the patients with positive test were asymptomatic at the moment of the diagnosis. Conclusions: The COVID-19 constitute a high-priority problem of public health and the confrontation to this terrible pandemic not only has brought in itself to postpone goals and transform objectives of life in all sectors and nations, but it has also implied to constantly redefine strategies and ways of doing in the search of a better control of the disease.
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Coronavirus , COVID-19 , COVID-19/epidemiologia , Reação em Cadeia da PolimeraseRESUMO
The purpose of this study is to examine successful aging among Spanish-speaking older adults in Costa Rica and in Spain using the proactive framework proposed by Kahana et al. (2014). More specifically, we hypothesized that older adults' life satisfaction would be positively associated with the frequency and perceived level of social support, spirituality/having purpose in life, and the use of proactive physical, cognitive, and social self-care behaviors. Our results confirmed these hypotheses, not only for the overall group of participants, but also separately for older adults in Costa Rica and in Spain. The present study contributes to the literature of successful aging among older adults, by examining the protective factors associated with life satisfaction among Spanish speaking older adults in Costa Rica and in Spain. It identifies specific protective factors (spirituality/purpose in life, social support, and self-care) associated with the values and preferences held by participants in the study.
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Envelhecimento Saudável , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Cognição , Costa Rica , Comparação Transcultural , Feminino , Envelhecimento Saudável/etnologia , Envelhecimento Saudável/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Satisfação Pessoal , Autocuidado/psicologia , Apoio Social , Espanha , EspiritualidadeRESUMO
Introducción: Las enfermedades transmitidas por alimentos se producen por ingestión de un alimento, incluido el agua, que puede estar contaminado por diversos agentes. Objetivo: Caracterizar los agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 100,0 % de los brotes de enfermedades transmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019, para lo cual se seleccionaron muestras de alimentos y heces fecales. La caracterización de las bacterias aisladas se basó en los resultados del crecimiento y otras pruebas bioquímicas-metabólicas. Se utilizaron resultados del aislamiento y confirmación de los agentes identificados en cada uno de los brotes a partir de las muestras antes citadas. Entre las variables analizadas figuraron: número de brotes, muestras de alimentos, de heces fecales y resultados de pruebas bioquímicas y metabólicas. Resultados: Se obtuvo un aislamiento de agentes bacterianos en 100,0 % de las muestras de alimentos. Hubo una mayor frecuencia de bacterias Gram negativas (82,0 %) y la menor correspondió a microorganismos Gram positivos (18,0 %). La Salmonella D fue el microorganismo más frecuente. Conclusiones: Este resultado representa un instrumento para el diagnóstico etiológico de los brotes de enfermedades transmitidas por alimentos en Santiago de Cuba.
Introduction: Diseases transmitted by foods are produced due to ingestion of a food, including water that can be contaminated by diverse agents. Objective: To characterize the bacterial agents isolated in diseases outbreaks transmitted by foods. Methods: An observational, descriptive and cross-sectional study of 100.0 % of the diseases outbreaks transmitted by foods in Santiago de Cuba, from January, 2018 to December, 2019 was carried out, for which samples of foods and stools were selected. The characterization of the isolated bacterias was based on the results of growth and other biochemical-metabolic tests. Results of the isolation and confirmation of agents identified in each one of the outbreaks from the samples mentioned above were used. Among the analyzed variables we can mention: number of outbreaks, samples of foods, samples of stools and results of biochemical and metabolic tests. Results: An isolation of bacterial agents was obtained in 100.0 % of foods samples. There was a higher frequency of Gram negative bacterias (82.0 %) and the lower corresponded to Gram positive microorganisms (18.0 %). Salmonella D was the most frequent microorganism. Conclusions: This result represents an instrument for the etiological diagnosis of diseases outbreaks transmitted by foods in Santiago de Cuba.
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Bactérias , Meios de Cultura , Doenças Transmitidas por Alimentos/epidemiologia , Surtos de DoençasRESUMO
Introducción: La tuberculosis es una enfermedad infectocontagiosa que afecta a un gran número de personas a escala mundial. Objetivo: Describir las características de dicha enfermedad en el municipio de Mella, atendiendo a algunos determinantes sociodemográficos, socioculturales, de la conducta social, biológicos, ambientales y de los servicios de salud e identificar en la comunidad los factores de riesgo presentes. Métodos: Se realizó un estudio con diseños combinados, de tipo ecológico y de corte transversal. El universo quedó constituido por los 7 casos notificados con tuberculosis pulmonar en el municipio de Mella, provincia de Santiago de Cuba, desde el 2016 hasta el 2018. Resultados: Entre los grupos de riesgo más afectados figuraron: adultos mayores, alcohólicos, diabéticos y desnutridos; con mayor incidencia en el sexo masculino. Entre otros hallazgos se detectaron las posibles asociaciones entre la incidencia de la tuberculosis y los factores de riesgo. Conclusiones: Las tasas de incidencias se asociaron de forma directa con la densidad poblacional, el hacinamiento, la poca ventilación y la insuficiente iluminación.
Introduction: Tuberculosis is an infectocontagious disease that affects a great number of people worldwide. Objective: To describe the characteristics of this disease in the municipality of Mella, according to some social-demographic, social -cultural, social-behavioural, biological, environmental determinants as well as of health services and to identify the risk factors present in the community. Methods: An ecological, cross sectional study with combined designs was carried out. The universe was constituted by the 7 cases notified with lung tuberculosis in the municipality of Mella, Santiago de Cuba, from 2016 to 2018. Results: Among the most affected risk groups we can mention: elderly, alcoholic, diabetics and undernourished adults; with more incidence in male sex. Among other findings, the possible associations between the incidence of tuberculosis and the risk factors were detected. Conclusions: The rates of incidences were associated in a direct way to the populational density, overcrowding, little ventilation and scarce illumination.
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Tuberculose , Infecções Comunitárias Adquiridas , Desnutrição , AlcoolismoRESUMO
Resumen: Introducción: El síndrome de Burnout es una entidad que surge de una respuesta continua a condiciones de estrés crónico en ambientes de alta demanda de atención. La literatura internacional reporta la presentación de este síndrome entre residentes de 27 a 75%, dependiendo de la especialidad. Objetivo: Conocer la incidencia del síndrome en residentes de terapia intensiva en hospitales de tercer nivel de atención en Norteamérica. Material y métodos: Estudio prospectivo, transversal, observacional. Población: Residentes de Terapia Intensiva, en hospitales de tercer nivel (México y Canadá). Se empleó cuestionario Maslach, análisis SPSS 25, estadística descriptiva para distribución de variables, comparación entre grupos U de Mann-Whitney, comparación entre grupos prueba exacta de Fisher, p < 0.05. Resultados: El síndrome de Burnout está presente en 100% de los residentes de cuidados críticos estudiados. Conclusión: El síndrome de Burnout tiene una alta incidencia en residentes de cuidados críticos de hospitales de tercer nivel en Norteamérica. Se requiere mayor número de estudios, evaluar diferencias en programas de residencias para tener más información de la presentación de este síndrome en una de las especialidades que demandan el más alto nivel de atención y cuidado en los pacientes.
Abstract: Introduction: Burnout syndrome is an entity that arises from a continuous response to conditions of chronic stress in environments with high demand for attention. International literature reports presentation of this syndrome among residents from 27 to 75%, depending on the specialty. Objective: To know incidence of syndrome in residents of intensive care in hospitals of third level of care in North America. Material and methods: Prospective, cross-sectional, observational study. Population: Intensive therapy residents, in third level hospitals (Mexico and Canada). Maslach questionnaire was used, SPSS 25 analysis, descriptive statistics for distribution of variables, comparison between Whitney U Mann groups, comparison between Fisher's exact test groups, p < 0.05. Results: Burnout syndrome is present in 100% of the critical care residents studied. Conclusion: Burnout syndrome has a high incidence in critical care residents of tertiary hospitals in North America. More studies are required, evaluate differences in residency programs to have more information about the presentation of this syndrome in one of the specialties that demand highest level of attention and care in patients.
Resumo: Introdução: A síndrome de Burnout é uma entidade que surge de uma resposta contínua a condições de estresse crônico em ambientes de alta demanda de atenção. A literatura internacional relata a apresentação dessa síndrome entre os residentes de 27 a 75%, dependendo da especialidade. Objetivo: Conhecer a incidência da síndrome em residentes de terapia intensiva em hospitais de terceiro nível na América do Norte. Material e métodos: Estudo prospectivo, transversal, observacional. População: Residentes de terapia intensiva, em hospitais de terceiro nível (México e Canadá). Utilizou-se o questionário Maslach, análise SPSS 25, estatística descritiva para distribuição das variáveis, comparação entre os grupos Whitney U Mann, comparação entre os grupos de teste exato de Fisher, p < 0.05. Resultados: A síndrome de Burnout está presente em 100% dos residentes de terapia intensiva estudados. Conclusão: A síndrome de Burnout tem alta incidência em residentes de terapia intensiva de hospitais de terceiro nível na América do Norte. Requeremos mais estudos para avaliar as diferenças nos programas de residência para obter mais informações sobre a apresentação dessa síndrome em uma das especialidades que demandam o mais alto nível de atendimento e atendimento em pacientes.
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BACKGROUND: As resistance to insecticides increases in disease vectors, it has become exceedingly important to monitor populations for susceptibility. Most studies of field populations of Aedes aegypti have largely characterized resistance patterns at the spatial scale of the city or country, which may not be completely informative given that insecticide application occurs at the scale of the house or city block. Phenotypic resistance to pyrethroids dominates in Ae. aegypti, and it has been partially explained by mutations in the voltage-gated sodium channel gene. Here, we assess community-level patterns of four knockdown resistance (kdr) haplotypes (C1534/I1016, F1534/I1016, C1534/V1016 and F1534/V1016) in Ae. aegypti in 24 randomly chosen city blocks from a city in Yucatán State, Mexico, during both the dry and wet season and over two years. RESULTS: Three of the four haplotypes, C1534/I1016, C1534/V1016 and F1534/V1016 were heterogeneous between city blocks at all four sampling time points, and the double mutant haplotype, C1534/I1016, showed a significant increase following the wet season. The F1534/I1016 haplotype was rarely detected, similar to other studies. However, when haplotype frequencies were aggregated to a coarser spatial scale, the differences in space and time were obscured. CONCLUSIONS: Our results provide empirical evidence that the selection of kdr alleles is occurring at fine spatial scales, indicating that future studies should include this scale to better understand evolutionary processes of resistance in natural populations.
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Aedes/genética , Haplótipos , Resistência a Inseticidas/genética , Mosquitos Vetores/genética , Aedes/efeitos dos fármacos , Animais , Genótipo , Proteínas de Insetos/genética , Inseticidas/farmacologia , México , Mosquitos Vetores/efeitos dos fármacos , Proteínas Mutantes/genética , Mutação , Canais de Potássio de Abertura Dependente da Tensão da Membrana/genética , Piretrinas/farmacologiaRESUMO
OBJECTIVES: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene (HH) approach in Mexico, and analyze predictors of poor HH compliance. METHODS: From June 2002 to April 2006, we conducted a prospective, observational, before-and-after study in 8 intensive care units (ICUs) from 6 hospitals in 3 cities of Mexico. The approach included administrative support, availability of supplies, education and training, reminders in the workplace, process surveillance, and performance feedback. RESULTS: A total of 13,201 observations for HH opportunities were done in each ICU, during randomly selected 30-minute periods. Overall, HH compliance increased from 45% to 79% (95% confidence interval [CI], 69.1-86.5; P = 0.01). Univariate and multivariate analyses showed that several variables were significantly associated with poor HH compliance: males versus females (61% versus 66%; 95% CI, 0.91-0.96; P = 0.0001), physicians versus nurses (62% versus 67%; 95% CI, 0.91-0.97; P = 0.0001), and adult versus neonatal ICUs (67% versus 54%; 95% CI, 0.79-0.84; P = 0.0001), among others. CONCLUSIONS: Hand hygiene programs should focus on variables found to be predictors of poor HH compliance.
Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes/normas , Higiene das Mãos/organização & administração , Controle de Infecções/métodos , Unidades de Terapia Intensiva/normas , Adulto , Cidades , Feminino , Humanos , Recém-Nascido , Masculino , México , Estudos ProspectivosRESUMO
ABSTRACT Colombian flower growers are faced with economic and social problems, so they are looking for alternatives, which include Proteas, ornamentals that require research that ensures an appropriate, local technical management. One of the Proteas most likely to be involved in this search is the genus Leucadendron. Therefore, this study aimed to establish the best basis for rooting its cuttings. The experimental design was a split plot design with a factorial arrangement. Four substrates were evaluated in combination with two auxins, naphthaleneacetic acid (NAA) and indolebutiric acid (IBA), three doses each, plus a commercial control. Each treatment was repeated three times and the experimental unit consisted of 30 stakes at the first locality and 25 at the second one. The most relevant results showed that vermiculite was the best substrate for rooting cuttings of Leucadendron at both localities. Also, it was identified that IBA is the growth regulator which improved the rooting percentage, the root volume, the stem decreased the percentage of losses.
RESUMEN Los cultivadores colombianos de flores tradicionales están confrontados con problemas, tanto económicos como sociales, por lo que están buscando alternativas, que incluyen a las Proteas, ornamentales que requieren investigación, que asegura un manejo técnico. Una de las Proteas con más posibilidad de estar involucrado en este desarrollo es el género Leucadendron. El diseño experimental empleado fue un diseño de parcelas, divididas con arreglo factorial. Así, que el objetivo de este estudio fue establecer la base para el enraizamiento de las estacas. En combinación con dos auxinas, ácido 1-naftalenacético (ANA) y ácido indolbutírico (AIB), tres dosis de cada una y el control comercial, se evaluaron cuatro sustratos. Cada tratamiento, se repitió tres veces y cada unidad experimental consistió en 30 estacas, para la primera localidad y de 25, para la segunda. Los resultados más relevantes mostraron que el mejor sustrato para el enraizamiento de estacas de Leucadendron fue la vermiculita, en ambas localidades. También, se identificó que AIB es el regulador de crecimiento que mejoró el porcentaje de enraizamiento, el volumen de raíces, la longitud del tallo disminuyó el porcentaje de pérdidas.
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Resumen: Se presenta el caso de un paciente masculino en la quinta década de vida con diagnóstico de tumoración renal. Fue ingresado a cirugía para embolización selectiva de arteria renal ipsilateral al sitio de la lesión tumoral. Durante el periodo transoperatorio se presentó hemorragia masiva, por lo cual recibió múltiples transfusiones y se ingresó al área de terapia intensiva. Se documentó lesión renal aguda (AKIN III) y desarrollo de síndrome de dificultad respiratoria aguda (SDRA) grave de acuerdo con los Criterios de Berlín 2012. Se propusieron métodos no convencionales de ventilación entre los cuales la ventilación mecánica inversa, ventilación con liberación de presión (APRV)/bilateral y ventilación controlada a volumen y regulada a presión (PRVC) no mostraron mejoría. Se decidió cambio de estrategia a reclutamiento guiado por la capacidad residual funcional (CRF). Se observó una mejoría en los parámetros de ventilación y niveles de fracción de oxígeno inspirado (FiO2) y evolución grave con desarrollo de pancreatitis y sangrado que requirió intervención quirúrgica con posterior deceso del paciente. Se realiza presentación del caso así como de la revisión de la literatura para maniobras de reclutamiento guiado por CRF.
Abstract: We report the case of a male patient of the 5th decade of life with a diagnosis of renal tumor. Is entered surgery for selective embolization of renal artery ipsilateral to the site of the tumor lesion. During Trans operative, presented massive bleeding, receiving multiple transfusions, requiring admission to intensive care unit. Acute kidney injury (AKIN III) was documented, severe acute respiratory distress syndrome (ARDS) development according to criteria of Berlin 2012. Unconventional modes of ventilation among which were reverse ventilation, bi-level (APRV) and PRVC were used without improvement. It was decided to change recruitment strategy led by FRC in view, with improved ventilation parameters and levels of FiO2. Poor outcome with subsequent development of pancreatitis and bleeding requiring reoperation with subsequent death of the patient. Case presentation and review of the literature for recruitment maneuvers guided by FRC in view is performed.
Resumo: Apresenta-se o caso de um paciente do sexo masculino na quinta década de vida com um diagnóstico de tumor renal. É admitido a cirurgia para embolização seletiva da artéria renal ipsilateral no local da lesão tumoral. Durante o período transoperatório, apresenta uma hemorragia profusa, pelo que recebeu múltiplas transfusões, e foi admitido na unidade de terapia intensiva. Documenta-se insuficiência renal aguda (AKI lll) e o desenvolvimento de SDRA grave de acordo com critérios de Berlim 2012. Proporciona-se métodos não convencionais de ventilação, entre os quais estavam a ventilação mecânica inversa, ventilação com liberação de pressão (APRV)/bilateral e ventilação controlada a volume e regulada para pressão (PRVC) sem melhoria. Determina-se a mudança de estratégia de recrutamento guiado pela capacidade residual funcional (CRF). Apresenta uma melhoria nos parâmetros de ventilação e níveis da fração de oxigênio inspirado (FiO2). Evolução grave com subsequente desenvolvimento de pancreatite e sangrando, necessitou de intervenção cirurgica, com posterior morte do paciente. É feita apresentação do caso, bem como a revisão da literatura para manobras de recrutamento guiado pelo CRF.
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Background: One of the main water contaminants are Hg, Cd, Pb and As. The chain of contamination of these metals and metalloid follows a cyclical order: Industry, atmosphere, land, water, phytoplankton, zooplankton, fish, and humans. Currently, Hg, Cd, Pb and As researches are of interest because consumption of fish with high toxic metal and metalloid concentrations affects human health. Objective: Provide information on the characteristics of Hg, Cd, Pb and As in the problematic of fishing resource contamination, their implications on human health, and international evidence on studies conducted on Caranx, Scomberomorus, Epinephelus, Euthynnus, Lutjanus, thunnus and Megalops fish genera. Methods: Database, Science Direct, Pub Med, Escopus, Springer Link, and Scopus, available information was reviewed using the keywords: Heavy metals, water pollution, fish, mercury, cadmium, lead, arsenic, health risk, regulations, biomagnification, and bioaccumulation. Results: The metals that pose the highest risks for human health are mercury, cadmium, lead, and arsenic which cause important complications in the nervous system, kidneys, bones, lungs, and cardiovascular system due to their toxicity and possible carcinogenic effect. Fish contents of Hg, Cd, Pb and As varies depending on the zone, environmental conditions, the contamination level of the fishing site, and the characteristics of the fish, being some fish more prone to accumulating higher concentrations of these metals in their muscles; among the species, the metal that showed the highest risk was mercury, being in high concentrations in the largest, most enduring predatory fish. Conclusions: Studies submitted in this review, may be used as the base for future comparisons with Hg, Cd, Pb and As concentration values in different fish studies for the Caranx, Scomberomorus, Epinephelus, Euthynnus, Lutjanus, and Megalops genera in order to be able to determine consumption recommendations and warnings.
Antecedentes: Uno de los principales agentes contaminantes en las aguas son Hg, Cd, Pb y As. La cadena de contaminación de estos metales sigue un orden cíclico: industria, atmósfera, suelo, agua, fitoplancton, zooplancton, peces y humanos. Las investigaciones en Hg, Cd, Pb y As son de interés en la actualidad ya que el consumo de pescado con altas concentraciones de estos metales y metaloides tóxicos afecta la salud humana. Objetivo: Ofrecer información de las características del Hg, Cd, Pb y As en la problemática de contaminación de los recursos pesqueros, sus implicaciones para la salud humana y evidencias internacionales de los estudios realizados en los peces de los generos Caranx, Scomberomorus, Epinephelus, Euthynnus, Lutjanus y Megalops. Métodos: Se revisó información disponible en las bases de datos, Science Direct, Pub Med, Escopus, Springer Link, Scopus, utilizando las palabras clave: heavy metals, water, fish, mercury, cadmium, lead, arsenic, health risk, regulations, biomagnification, bioacumulation. Resultados: Los metales con mayor riesgo para la salud humana son mercurio, cadmio, plomo y arsénico, los cuales causan complicaciones importantes en el sistema nervioso, renal, óseo, pulmonar, cardiovascular debido a su toxicidad y posible efecto carcinogénico. El contenido de Hg, Cd, Pb y As en el pescado varía dependiendo de la zona, las condiciones medioambientales, el grado de contaminación del lugar de pesca y las características del pez, siendo algunos peces más propensos a acumular concentraciones más elevadas de estos metales en el músculo, entre las especies de peces, el metal que mostro mayor riesgo fue el mercurio, estando en altas concentraciones en los peces más grandes, de mayor longevidad y depredadores. Conclusiones: Los estudios presentados en esta revisión pueden servir como base para futuras comparaciones con valores de concentración de metales pesados en diferentes estudios de peces para los géneros Caranx, Scomberomorus, Epinephelus, Euthynnus, Lutjanus y Megalops, con la finalidad de poder establecer recomendaciones y advertencias sobre su consumo.
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Humanos , Poluição da Água , Arsênio , Cádmio , Peixes , Chumbo , MercúrioRESUMO
INTRODUCTION: Patients with cystic fibrosis (CF) present lower airway infection with Pseudomonas aeruginosa. Treatment of initial infection is fundamental to reduce subsequent damage. MATERIAL AND METHODS: We evaluated the efficacy of eradication treatment of P. aeruginosa in patients with CF from northeast Mexico using two protocols: inhaled colistin/oral ciprofloxacin and nebulized tobramycin 300 mg/oral ciprofloxacin. The intervention group included 17 patients with CF and recent infection with P. aeruginosa. The control group consisted of 23 chronically colonized patients of comparable age. RESULTS: Patients received 27 courses of eradication treatment. P. aeruginosa was eradicated in 21/27 (77.77%). The infection free period was 16.9, 11.7 months (colistin) and 17 ± 9.7 months (tobramycin) with no statistically significant difference (P = 0.97). CONCLUSIONS: Treated patients maintained normal lung function, better nutritional status, and a better chest X-ray score. In the control group 17/23 (73.9%) patients died with no deaths in the study group.
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Antibacterianos/uso terapêutico , Fibrose Cística/complicações , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/isolamento & purificação , Administração por Inalação , Administração Oral , Antibacterianos/administração & dosagem , Criança , Pré-Escolar , Ciprofloxacina/administração & dosagem , Ciprofloxacina/uso terapêutico , Colistina/administração & dosagem , Colistina/uso terapêutico , Fibrose Cística/microbiologia , Fibrose Cística/mortalidade , Quimioterapia Combinada , Feminino , Humanos , Masculino , México , Estado Nutricional , Estudos Prospectivos , Infecções por Pseudomonas/etiologia , Fatores de Tempo , Tobramicina/administração & dosagem , Tobramicina/uso terapêutico , Resultado do TratamentoRESUMO
INTRODUCTION: sequential measurement of intra-abdominal pressure is of paramount importance for an early detection and appropriate therapeutic management of intra-abdominal hypertension and abdominal compartment syndrome. OBJECTIVE: to validate a device and technique developed to measure intra-abdominal pressure (an innovation of the Foley urinary catheter named intra-abdominal pressure catheter). METHODS: three different sets of measurements where done to test the intra-abdominal pressure catheter device: I. 50 measurements were done with the intra-abdominal pressure catheter device and compared against those measurements done using a manometer graded in cm H(2)O; II. Direct measurement of intra-abdominal pressure in five patients during elective laparoscopy vs the intraabdominal pressure catheter device; and III. Measurement of intra-abdominal pressure by the Kron method (Gold standard) vs intra-abdominal pressure catheter device in three patents with intra-abdominal hypertension/abdominal compartment syndrome. Measurements where compared with Pearson correlation test and Bland Altman statistics. RESULTS: I.Intra-abdominal pressure catheter vs graded manometer: r = 0.99, with a mean pressure difference of 0.27 ± 0.23 mmHg, CI (0.039 to 0.092 mmHg). II. Direct measurement of intra-abdominal pressure during laparoscopy vs intra-abdominal pressure catheter device: r = 0.93, with a mean pressure difference of 0.18 ± 0.84 mmHg, CI (-1.46 to 1.83 mmHg) and III. Measurement of intra-abdominal pressure by the Kron Method vs intra-abdominal pressure catheter device: r = 0.81, with a mean pressure difference of -0.41 ± 0.87, CI (-2.12 mmHg to 1.30 mmHg). CONCLUSIONS: the intra-abdominal pressure catheter device is a safe and reliable instrument for measuring intra-abdominal pressure.
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Cavidade Abdominal , Catéteres , Hipertensão Intra-Abdominal/diagnóstico , Manometria/instrumentação , Pressão , Cateterismo , Colecistectomia Laparoscópica , Desenho de Equipamento , Feminino , Humanos , Hipertensão Intra-Abdominal/fisiopatologia , Masculino , Manometria/métodosRESUMO
Changes in the cellular metabolism assessed by the variability of oxygen consumption (VO(2) ) and carbon dioxide production (VCO(2) ) as well as the association of serum glucose and insulin to energy spectral density (ESD) of VO(2) and VCO(2) were evaluated. Ten nonglucose intolerant and 10 glucose intolerant subjects, aged 21-70 years, were included. Glucose and insulin concentrations and VO(2) and VCO(2) records were collected every 10 min during 3 h. ESD of VO(2) and VCO(2) was estimated and associated with glucose and insulin concentrations. Statistical significance in glucose levels, insulin, and ESD of VO(2) and VCO(2) among nonglucose intolerant subjects and glucose and insulin among glucose intolerance subjects at postload glucose (PLG) state compared with basal state was found. Moreover, glucose was significantly higher in glucose intolerance subjects than nonglucose intolerant subjects for basal and PLG states. These results show an increment in ESD of VO(2) and VCO(2) at PLG state among nonglucose intolerant subjects and suggest that their measurement may be a key indicator of the variability of cellular metabolic activity and contribute to confirm disturbances in glucose metabolism.
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Glicemia/metabolismo , Dióxido de Carbono/metabolismo , Intolerância à Glucose/metabolismo , Insulina/sangue , Consumo de Oxigênio , Adulto , Idoso , Calorimetria Indireta/métodos , Dióxido de Carbono/análise , Metabolismo Energético , Jejum , Intolerância à Glucose/sangue , Humanos , Pessoa de Meia-Idade , Estatísticas não ParamétricasRESUMO
Despite the importance of randomized trials for well-informed decisions in health care, a large proportion of the results of these trials are not published, especially when they are negative. Publication bias has a negative impact in the treatment of patients, due to the distorted impression it leads to for new therapies. Clinical Trial Registries help to overcome this by providing transparency in the process of conducting research. The World Health Organization takes the position that the registration of interventional trials is a scientific, ethical and moral responsibility. Taking account of this global movement, the National Coordinating Centre of Clinical Trials and the Cuban Health Network, designed and implemented the Cuban Public Registry of Clinical Trials. The Registry was established in June 2007 and is intended for public service in Cuban territory, although it is open to registrants and patients outside Cuba. The Registry staff developed a strategy to become a Primary Registry of the World Health Organization, and this was achieved in February 2011.