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Aim: To compare the safety in terms of hypoglycemic events and continuous glucose monitoring (CGM) metrics during aerobic exercise (AE) of using temporary target (TT) versus suspension of insulin infusion (SII) in adults with type 1 diabetes (T1D) using advanced hybrid closed-loop systems. Methods: This was a randomized crossover clinical trial. Two moderate-intensity AE sessions were performed, one with TT and one with SII. Hypoglycemic events and CGM metrics were analyzed during the immediate (baseline to 59 min), early (60 min to 6 h), and late (6 to 36 h) post-exercise phases. Results: In total, 33 patients were analyzed (44.6 ± 13.8 years), basal time in range (%TIR 70-180 mg/dL) was 79.4 ± 12%, and time below range (%TBR) <70 mg/dL was 1.8 ± 1.7% and %TBR <54 mg/dL was 0.5 ± 0.9%. No difference was found in the number of hypoglycemic events, %TBR <70 mg/dL and %TBR <54 mg/dL between TT and SII. Differences were found in the early phase, with better values when using TT for %TIR 70-180 mg/dL (83.0 vs. 65.3, P = 0.005), time in tight range (%TITR 70-140 mg/dL) (56.3 vs. 41.5, P = 0.04), and time above range (%TAR >180 mg/dL) (15.3 vs. 31.8, P = 0.01). In the diurnal period, again %TIR was better for TT use (82.1 vs. 73.1, P = 0.02) and %TAR (15.0 vs. 22.96, P = 0.04). No significant differences were found in the CGM metrics during the different phases of AE. Conclusion: Our data appear to show that the use of TT compared with SII is equally safe in all phases of AE. However, the use of TT allows for a better glycemic profile in the early phase of exercise.
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El síndrome obstructivo sinusoidal es una causa de hipertensión portal hepática postsinusoidal. Se produce como consecuencia de agentes hepatotóxicos que lesionan el endotelio de la vénula central, lo que lleva a un bloqueo del flujo sanguíneo y congestión que generan hipertensión portal postsinusoidal. Esta patología es muy rara y su principal causa es el trasplante de células hematopoyéticas, aunque también se han descrito otras causas como el uso de agentes hepatotóxicos que incluyen quimioterapia, radioterapia e ingesta de alcaloides. La clínica de estos pacientes no varía significativamente con respecto a la clínica de los pacientes con otras causas de hipertensión portal por lo que las imágenes diagnósticas juegan un papel clave en el enfoque de estos pacientes. Se describe el caso de un paciente de 16 años de edad con antecedente de consumo de sustancias psicoactivas, quien se presenta con hipertensión portal hepática postsinusoidal por consumo de nitritos de alquilo.
The sinusoidal obstructive syndrome is a cause of post-sinusoidal hepatic portal hypertension. Caused by hepatotoxic agents that damage the endothelium of the central venule, which results in obstruction of the blood flow and congestion, leading to post-sinusoidal portal hypertension. This pathology is very rare, and its main etiology is hematopoietic cell transplantation, although other etiologies have been described such as the use of hepatotoxic agents that include chemotherapy, radiotherapy, and intake of alkaloids. The clinical presentation of these patients does not vary significantly with respect to the other causes of portal hypertension, and therefore diagnostic images play a key role in the initial approach of these patients. We present the case of a 16 year old patient with a history of consumption of psychoactive substances, who showed portal hypertension due to the consumption of alkyl nitrites.
Assuntos
Hepatopatia Veno-Oclusiva , Imageamento por Ressonância Magnética , Hipertensão PortalRESUMO
Resumen Objetivo. Describir la microbiota que se encuentra en la cavidad bucal de caninos en condición de abandono de la Fundación Razas Únicas en el municipio de Chía -Cundinamarca. Métodos. Para el estudio se tomaron 29 muestras orales con escobillón a 23 caninos de la Fundación Razas Únicas del municipio de Chía - Cundinamarca. 23 muestras se recolectaron para identificación de bacterias aerobias y anaerobias facultativas, las cuales se transportaron en medio líquido tripticasa soya y 6 muestras para recuperación de bacterias anaerobias estrictas transportadas en medio VMGA-III. El aislamiento de los microorganismos se realizó en medios selectivos y la identificación con el sistema BD BBL™ Crystal™. Resultados. De las 29 muestras analizadas se aislaron 59 bacterias, entre ellas 15 géneros y 15 especies diferentes como; Escherichia coli, Proteus mirabilis, Citrobacter freundii, Enterobacter sakazakii, Enterobacter cloacae, Enterococcus durans, Enterococcus faecalis, Eikenella corrodens, Porphyromonas endodontalis, Fusobacterium spp y Capnocytophaga spp. De acuerdo con la revisión de la literatura, las bacterias anaerobias encontradas están principalmente relacionadas con enfermedad periodontal y las enterobacterias con contaminación oro-fecal.
Abstract Objective. To describe the microbiota found in the oral cavity of canines in condition of abandonment of the Razas Únicas Foundation in the municipality of Chía - Cundinamarca. Methods. For the study, 29 oral samples were taken with a brush from 23 canines from the Razas Únicas Foundation of the municipality of Chía - Cundinamarca. 23 samples were collected for identification of facultative aerobic and anaerobic bacteria, which were transported in soybean tripticase liquid medium and 6 samples for recovery of strict anaerobic bacteria transported in VMGA-III medium. The isolation of the microorganisms was carried out in selective media and identification with the BD BBL™ Crystal™ system. Results. From the 29 samples analyzed, 59 bacteria were isolated, including 15 genera and 15 different species such as Escherichia coli, Proteus mirabilis, Citrobacter freundii, Enterobacter sakazakii, Enterobacter cloacae, Enterococcus durans, Enterococcus faecalis, Eikenella corrodens, Porphyromonas endodontalis, Fusobacterium spp and Capnocytophaga spp. According to the review of the literature, the anaerobic bacteria found are mainly related to periodontal disease and the enterobacteria with oral-fecal contamination.
Assuntos
Doenças Periodontais , Enterococcus faecalis , Dente Canino , Microbiota , FusobacteriumRESUMO
OBJECTIVE: To evaluate the effects that a hand hygiene education program has on the compliance of health professionals in an ICU. METHODS: This was a quasi-experimental study with an interrupted time-series design, conducted over a 12-month period: the 5 months preceding the implementation of a hand hygiene education program (baseline period); the 2 months of the intensive (intervention) phase of the program; and the first 5 months thereafter (post-intervention phase). Hand hygiene compliance was monitored by one of the researchers, unbeknownst to the ICU team. The primary outcome measure was the variation in the rate of hand hygiene compliance. We also evaluated the duration of mechanical ventilation (MV), as well as the incidence of ventilator-associated pneumonia (VAP) at 28 days and 60 days, together with mortality at 28 days and 60 days. RESULTS: On the basis of 959 observations, we found a significant increase in hand hygiene compliance rates-from 31.5% at baseline to 65.8% during the intervention phase and 83.8% during the post-intervention phase, corresponding to prevalence ratios of 2.09 and 2.66, respectively, in comparison with the baseline rate (p < 0.001). Despite that improvement, there were no significant changes in duration of MV, VAP incidence (at 28 or 60 days), or mortality (at 28 or 60 days). CONCLUSIONS: Our findings indicate that a hand hygiene education program can increase hand hygiene compliance among ICU professionals, although it appears to have no impact on VAP incidence, duration of MV, or mortality.
Assuntos
Higiene das Mãos/métodos , Pessoal de Saúde/educação , Unidades de Terapia Intensiva , Avaliação de Programas e Projetos de Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Comportamento Cooperativo , Infecção Hospitalar/mortalidade , Infecção Hospitalar/prevenção & controle , Feminino , Desinfecção das Mãos , Higiene das Mãos/estatística & dados numéricos , Humanos , Análise de Séries Temporais Interrompida , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Pneumonia Associada à Ventilação Mecânica/mortalidade , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Estatísticas não Paramétricas , Fatores de TempoRESUMO
ABSTRACT Objective: To evaluate the effects that a hand hygiene education program has on the compliance of health professionals in an ICU. Methods: This was a quasi-experimental study with an interrupted time-series design, conducted over a 12-month period: the 5 months preceding the implementation of a hand hygiene education program (baseline period); the 2 months of the intensive (intervention) phase of the program; and the first 5 months thereafter (post-intervention phase). Hand hygiene compliance was monitored by one of the researchers, unbeknownst to the ICU team. The primary outcome measure was the variation in the rate of hand hygiene compliance. We also evaluated the duration of mechanical ventilation (MV), as well as the incidence of ventilator-associated pneumonia (VAP) at 28 days and 60 days, together with mortality at 28 days and 60 days. Results: On the basis of 959 observations, we found a significant increase in hand hygiene compliance rates-from 31.5% at baseline to 65.8% during the intervention phase and 83.8% during the post-intervention phase, corresponding to prevalence ratios of 2.09 and 2.66, respectively, in comparison with the baseline rate (p < 0.001). Despite that improvement, there were no significant changes in duration of MV, VAP incidence (at 28 or 60 days), or mortality (at 28 or 60 days). Conclusions: Our findings indicate that a hand hygiene education program can increase hand hygiene compliance among ICU professionals, although it appears to have no impact on VAP incidence, duration of MV, or mortality.
RESUMO Objetivo: Avaliar os efeitos da implementação de um programa de educação sobre higienização das mãos e a adesão a essa prática entre profissionais de uma UTI. Métodos: Estudo quase-experimental com séries temporais interrompidas conduzido ao longo de 12 meses: 5 meses antes do programa de educação (período basal), 2 meses durante a fase intensiva do programa (período de intervenção) e 5 meses durante a fase de manutenção do programa (período pós-intervenção). A avaliação da adesão às práticas de higienização das mãos foi feita por um dos pesquisadores sem conhecimento da equipe da UTI. O desfecho primário foi a variação da taxa de adesão à higienização das mãos. Também foram avaliadas a duração da ventilação mecânica (VM), a incidência de pneumonia associada à ventilação mecânica (PAVM) em 28 e 60 dias e mortalidade nos mesmos momentos. Resultados: Com base em 959 observações, houve um aumento nas taxas de adesão à higienização das mãos de 31,5% no período basal para 65,8% no período de intervenção e para 83,8% no período pós-intervenção, representando uma razão de prevalência 2,09 e 2,66 maior que o período basal, respectivamente (p < 0,001). Apesar desse aumento, não houve diferenças significativas em relação à duração da VM ou à incidência de PAVM e taxa de mortalidade em 28 e 60 dias. Conclusões: Neste estudo, o programa de educação em higienização das mãos aumentou a adesão a esse procedimento durante o período de monitorização, sem alterar as taxas de PAVM, a duração da VM e a mortalidade.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Avaliação de Programas e Projetos de Saúde , Pessoal de Saúde/educação , Higiene das Mãos/métodos , Unidades de Terapia Intensiva , Fatores de Tempo , Desinfecção das Mãos , Infecção Hospitalar/mortalidade , Infecção Hospitalar/prevenção & controle , Estatísticas não Paramétricas , Comportamento Cooperativo , Pneumonia Associada à Ventilação Mecânica/mortalidade , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Estimativa de Kaplan-Meier , Higiene das Mãos/estatística & dados numéricos , Análise de Séries Temporais Interrompida , Ensaios Clínicos Controlados não Aleatórios como AssuntoRESUMO
Objetivo. Se realiza una revisión sobre los aspectos degradativos de materia orgánica, obtención de energía y nutrientes de las bacterias anaerobias. La importancia de estos microorganismos es el papel que desempeñan en los procesos que contribuyen al mantenimiento de la vida misma. Dentro del metabolismo para la descomposición de macromoléculas, estos microorganismos realizan varios procesos: hidrólisis, acetogénesis y metanogénesis, entre otros, cobija reacciones que se realizan dependiendo de las características particulares de la bacteria y de las funciones que cumplen dentro del ciclo degradativo, para la obtención de nuevos productos dependiendo de las rutas bioquímicas o procesos fermentativos que allí se desarrollan.
Objective. A review of the degradation aspects of organic matter, obtaining energy and nutrients from anaerobic bacteria is performed. The importance of these organisms is the role they play in the processes contributing to the maintenance of life itself. Within the metabolism for the decomposition of macromolecules, these microorganisms perform several processes: hydrolysis acetogenesis and methanogenesis, among others, it covers reactions performed depending on the particular characteristics of the bacteria and of the roles in the degradative cycle for development of new products depending on the biochemical pathways or fermentation processes that take place there.