RESUMO
INTRODUCTION: One of the major concerns with post-acute sequelae of COVID-19 (PASC) is the development of pulmonary fibrosis, for which no approved pharmacological treatment exists. Therefore, the primary aim of this open-label study was to evaluate the safety and the potential clinical efficacy of a prolonged-release pirfenidone formulation (PR-PFD) in patients having PASC-pulmonary fibrosis. METHODS: Patients with PASC-pulmonary fibrosis received PR-PFD 1800 mg/day (1200 mg in the morning after breakfast and 600 mg in the evening after dinner) for three months. Blood samples were taken to confirm the pharmacokinetics of PR-PFD, and adverse events (AEs) were evaluated monthly using a short questionnaire. Symptoms, dyspnea, and pulmonary function tests (spirometry, diffusing capacity for carbon monoxide, plethysmography, and 6-min walk test [6MWT]) were evaluated at baseline, and one and three months after having started the PR-PFD treatment. RESULTS: Seventy subjects with mild to moderate lung restriction were included. The most common AEs were diarrhea (23%), heartburn (23%), and headache (16%), for which no modifications in the drug study were needed. Two patients died within the first 30 days of enrolment, and three opted not to continue the study, events which were not associate with PR-PFD. Pulmonary function testing, 6MWT, dyspnea, symptoms, and CT scan significantly improved after three months of treatment with PR-PFD. CONCLUSION: In patients with PASC pulmonary fibrosis, three months' treatment with PR-PFD was safe and showed therapeutic efficacy. Still, it remains to be seen whether the pulmonary fibrotic process remains stable, becomes progressive or will improve.
Assuntos
COVID-19 , Fibrose Pulmonar Idiopática , Pneumonia , Humanos , COVID-19/complicações , Progressão da Doença , Dispneia/tratamento farmacológico , Dispneia/etiologia , Fibrose Pulmonar Idiopática/complicações , Fibrose Pulmonar Idiopática/tratamento farmacológico , Fibrose Pulmonar Idiopática/diagnóstico , Fenótipo , Pneumonia/tratamento farmacológico , Piridonas/efeitos adversosRESUMO
SUMMARY: Based on the new concepts of the modified Le Fort III osteotomy (MLFIIIO), Three variations of this technique are implemented: (A) the modified osteotomy Le Fort III Champy (1980) technique to be described with the use of surgical guides, and subciliary approach or an transconjunctival approach. Excellent technique for horizontal advancement no further to 6 mm, without requiring any type of graft.. (B) The modified Le Fort III osteotomy in "Z": to solve horizontal (posterior anterior) problems of more than 6 mm without bone grafting. It is itself a modification of the technique described by Champy. (C) The modified Le Fort III osteotomy ascending: modified the original technique described by Bell and Epker with interpositional grafts, was modified by the called ascendant, making it higher in cases where the patient has an acceptable nasal bridge, but exorbitism the lateral wall of the orbit. Le Fort III osteotomy combined with a Le Fort I osteotomy and a front implant. METHOD: As pointed out in Part I for the modified oblique Le Fort III osteotomy, methods for the design of the osteotomy Le Fort III property will depend on the requirements of individual patients, and this has led us to design specific techniques for the deformity. RESULTS: Patients have a right projection of the middle third, and protection of the eyeball. CONCLUSIONS: The techniques presented for the advancement of the middle third have excellent results with the ability to be tailored to each patient deformity.
RESUMO
Anthropogenic debris ingestion has been reported for green turtles in all their life stages worldwide. The aim of the present study is to evaluate the marine debris ingestion by green turtles stranded in Uruguayan coast between 2005 and 2013. Debris items were categorized and quantified by frequency of occurrence, relative weight, volume and number of items. A total of 96 dead stranded turtles were analyzed and 70% presented debris in their guts. The majority of debris found were plastic, being hard plastics the most abundant in weight. We found no differences in debris ingestion in stranded turtles a long the Uruguayan coast. However we detected a negative correlation between the presence of debris and turtle's size. Smaller turtles are new recruits to neritic grounds indicating that the early juvenile stage of this species is the most vulnerable to this threat in the Southwestern Atlantic.
Assuntos
Dieta , Monitoramento Ambiental/métodos , Conteúdo Gastrointestinal/química , Plásticos/análise , Tartarugas/crescimento & desenvolvimento , Poluentes Químicos da Água/análise , Animais , Ingestão de Alimentos , UruguaiRESUMO
Aging increases the vulnerability to stress and risk of developing depression. These changes have been related to a reduction of dehydroepiandrosterone (DHEA) levels, an adrenal steroid with anti-stress effects. Also, adult hippocampal neurogenesis decreases during aging and its alteration or impaired is related to the development of depression. Besides, it has been hypothesized that DHEA increases the formation of new neurons. However, it is unknown whether treatment with DHEA in aging may stimulate the dendrite maturation of newborn neurons and reversing depressive-like signs evoked by chronic stress exposure. Here aged male rats (14 months old) were subjected to a scheme of chronic mild stress (CMS) during six weeks, received a treatment with DHEA from the third week of CMS. Changes in body weight and sucrose preference (SP) were measured once a week. DHEA levels were measured in serum, identification of doublecortin-(DCX)-, BrdU- and BrdU/NeuN-labeled cells was done in the dentate gyrus of the hippocampus. CMS produced a gradual reduction in the body weight, but no changes in the SP were observed. Treatment enhanced levels of DHEA, but lack of recovery on body weight of stressed rats. Aging reduced the number of DCX-, BrdU- and BrdU/NeuN- cells but DHEA just significantly increased the number of DCX-cells in rats under CMS and controls, reaching levels of young non-stressed rats (used here as a reference of an optimal status of health). In rats under CMS, DHEA facilitated dendritic maturation of immature new neurons. Our results reveal that DHEA improves neural plasticity even in conditions of CMS in middle age rats. Thus, this hormone reverted the decrement of DCX-cells caused during normal aging.
Assuntos
Envelhecimento/efeitos dos fármacos , Desidroepiandrosterona/farmacologia , Dendritos/efeitos dos fármacos , Giro Denteado/efeitos dos fármacos , Psicotrópicos/farmacologia , Estresse Psicológico/tratamento farmacológico , Envelhecimento/fisiologia , Envelhecimento/psicologia , Animais , Antígenos Nucleares/metabolismo , Peso Corporal/efeitos dos fármacos , Bromodesoxiuridina , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Doença Crônica , Desidroepiandrosterona/sangue , Dendritos/metabolismo , Dendritos/patologia , Giro Denteado/metabolismo , Giro Denteado/patologia , Sacarose Alimentar , Proteínas do Domínio Duplacortina , Proteína Duplacortina , Masculino , Proteínas Associadas aos Microtúbulos/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Neurogênese/efeitos dos fármacos , Neurogênese/fisiologia , Neuropeptídeos/metabolismo , Psicotrópicos/sangue , Distribuição Aleatória , Ratos Wistar , Estresse Psicológico/metabolismo , Estresse Psicológico/patologiaRESUMO
Chrysactinia mexicana A. Gray (Asteraceae) and Turnera diffusa Willd (Turneraceae) are employed in traditional medicine as aphrodisiacs; however, there is no scientific evidence supporting the prosexual properties of C. mexicana. The aim of this study was to determine whether an aqueous extract of C. mexicana (Cm) stimulates rat male sexual behavior in the sexual exhaustion paradigm. Sexually exhausted (SExh) male rats were treated with Cm (80, 160, and 320 mg/kg), an aqueous extract of T. diffusa (Td), or yohimbine. The sexual exhaustion state in the control group was characterized by a low percentage of males exhibiting mounts, intromissions, and ejaculations and no males demonstrating mating behavior after ejaculation. Cm (320 mg/kg), Td, or yohimbine significantly increased the proportion of SExh rats that ejaculated and resumed copulation after ejaculation. In males that exhibited reversal of sexual exhaustion, Cm (320 mg/kg) improved sexual performance by reducing the number of intromissions and shrinking ejaculation latency. The effects of treatments on sexual behavior were not related with alterations in general locomotion. In conclusion, the prosexual effects of Cm, as well as those of Td, are established at a central level, which supports the traditional use of C. mexicana for stimulating sexual activity.
RESUMO
Introducción: En los últimos años se ha incrementado la evidencia sobre la adquisición de habilidades o conductas críticas para el desempeño escolar, sin que esto sea conclusivo acerca de la efectividad de intervenciones en el aula. El objetivo de este proyecto es identificar la ocurrencia de los elementos que definen la adquisición de habilidades o conductas críticas para el desempeño escolar y describirlas desde las dimensiones de actividades de participación del escolar. Métodos: Estudio observacional-descriptivo con una muestra de 28 preescolares y escolares evaluados entre septiembre del 2008 y marzo del 2009 en una institución prestadora de servicio en Cali, Colombia. El procedimiento fue identificar las capacidades de ejecución de los niños usando el inventario de desarrollo de Battell, para luego describir la repercusión en las actividades de participación del escolar. Resultados: El 61,5% de los niños se identificaron con dificultad en las habilidades motoras; el 56%, en el área personal social, y el 46,2%, en el área adaptativa, áreas fundamentales para la participación en las actividades escolares. Estos niños no han desarrollado la capacidad de controlar los músculos de forma integrativa. Presentaron dificultades en la interacción social y en las habilidades propias a la realización de las actividades diarias. Conclusión: Los resultados encontrados en el estudio sugieren la necesidad de aumentar el estudio sobre la relevancia del desarrollo de habilidades motoras, personal-social y adaptativas. Se requiere conocer y aprender estrategias con la colaboración los profesionales encargados del desarrollo
Introduction: In recent years, evidence regarding acquisition of skills or critic behaviors for school performance has increased though there it is not conclusive in terms of the effectiveness in class participation. The purpose is to define the elements implicated in the acquisition of such skills or critical behaviors and describe them from the perspective of school activities involving participation. Methods: Descriptive, observational study with a sample of 28 pre- school and primary school students during September 2008 and March 2009 at a public institution in the city of Cali, Colombia. The procedure was the identification of child performance capabilities using Battells developmental inventory to describe afterwards the repercussions on students participation in school activities. Results: 61.5% of the children show motor difficulties; 56% exhibit socio and personal difficulties, while 46.2% reveal adaptive difficulties. These areas are fundamental for school participation in the different activities. These children have not developed the ability for an integrated control of their muscles. They also exhibit difficulties regarding social interactions and regarding the skills necessary in the performance of daily activities. Conclusion: The results found in this study suggest the need to enhance the study on the relevance to develop motor, personal-social, and adaptive skills in cooperation with developmental professionals. It is necessary to know and learn strategies in cooperation with the developmental professionals
Assuntos
Desenvolvimento Infantil , Pré-Escolar , Relações InterpessoaisRESUMO
INTRODUCTION: In recent years, evidence regarding acquisition of skills or critic behaviors for school performance has increased though there it is not conclusive in terms of the effectiveness in class participation. The purpose is to define the elements implicated in the acquisition of such skills or critical behaviors and describe them from the perspective of school activities involving participation. METHODS: Descriptive, observational study with a sample of 28 preschool and primary school students during September 2008 and March 2009 at a public institution in the city of Cali, Colombia. The procedure was the identification of child performance capabilities using Battell's developmental inventory to describe afterwards the repercussions on student's participation in school activities. RESULTS: 61.5% of the children show motor difficulties; 56% exhibit socio and personal difficulties, while 46.2% reveal adaptive difficulties. These areas are fundamental for school participation in the different activities. These children have not developed the ability for an integrated control of their muscles. They also exhibit difficulties regarding social interactions and regarding the skills necessary in the performance of daily activities. CONCLUSION: The results found in this study suggest the need to enhance the study on the relevance to develop motor, personal-social, and adaptive skills in cooperation with developmental professionals. It is necessary to know and learn strategies in cooperation with the developmental professionals.
RESUMO
INTRODUCTION: We describe the technique and present the preliminary results of the laparoscopic radical cystectomy technique with the extracorporeal creation of a "y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture (Fontana). MATERIALS AND METHOD: We describe the technique step by step and we present a series of 15 patients that underwent this surgery between November 2005 and August 2009, with special emphasis on the duration of the surgery, urinary diversion time, intraoperative and postoperative complications, daytime and night time continence and the frequency of postoperative micturition. RESULTS: The mean follow-up of the series was 24 months (6-32). The mean duration of surgery was 280 (range 210-345) minutes and the mean urinary diversion time was 54.5 (range 40-75) minutes. There were no intraoperative complications and the average hospitalization time was 7 (range 5-15) days. During the follow-up, there were 5 late postoperative complications, 2 cases of urinary infection with good response to antibiotic treatment and 3 uretero-neovesical anastomosis strictures, which were treated with percutaneous balloon dilation, with a good functional result. No lithiasis was found in the neobladder. Complete daytime continence was obtained in 13/14 patients (92.9%) and complete night time continence in 6/14 (42.9%). One patient (6.7%) required clean intermittent self-catheterization as the patient did not micturate spontaneously. CONCLUSIONS: The creation of a "Y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture is a feasible, fast and safe technique and it provides promising functional results. Further follow-up is required to determine its long-term results.
Assuntos
Cistectomia/métodos , Íleo/cirurgia , Laparoscopia/métodos , Grampeamento Cirúrgico/métodos , Suturas , Derivação Urinária/métodos , Coletores de Urina , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/cirurgia , Seguimentos , Humanos , Complicações Intraoperatórias/epidemiologia , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/cirurgia , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologiaRESUMO
INTRODUCTION AND OBJECTIVES: hemorrhagic cystitis (HC) after pelvic radiotherapy occurs in 2-8% of patients. A variety of treatments have been described, most of them with uncertain results. We assessed the efficacy of hyperbaric oxygen therapy (HBOT) in HC cases. PATIENTS AND METHODS: retrospective analysis of patients with HC after pelvic radiotherapy receiving HBOT at our center between January 2002 and January 2010. Our protocol included 40 sessions of HBOT in a multiplace hyperbaric chamber with 90minutes of 100% oxygen breathing at 2.2 atm. Success was evaluated in terms of total or partial stop of bladder bleeding. Telephone follow-up was updated at the time of submission in all cases. RESULTS: twenty-five patients were treated (21 male, 4 female); the mean age was 66.7 years. Twenty men were irradiated for prostate cancer and one for bladder cancer. Three women had cervix cancer and one endometrial cancer. In all cases previous conservative treatment had failed and HBOT was considered only after other measures failed. All the patients responded to HBOT and none recurred after end of treatment at a mean follow-up of 21.2 months. There were no serious complications. CONCLUSION: HBOT is a highly effective and safe, non-invasive therapy for HC secondary to pelvic radiation; it should be considered as first line alternative in these difficult cases.
Assuntos
Cistite/terapia , Hemorragia/terapia , Oxigenoterapia Hiperbárica , Lesões por Radiação/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Antecedentes. Los niños con dificultades en el procesamiento y modulación sensorial, se han evaluado e intervenido en el ámbito de la discapacidad. La clasificación internacional del funcionamiento, la discapacidad y de la salud constituye un marco por el que estos niños pueden manejarse de forma integral. Objetivos. Describir los elementos que definen la condición de procesamiento sensorial desde las dimensiones de funcionamiento y actividades de participación y los elementos del procesamiento sensorial. Desde la CIF analizar la ocurrencia de las condiciones de procesamiento sensorial de un grupo de pre-escolares y escolares con dificultades en las actividades cotidianas. Material y métodos. Estudio exploratorio-descriptivo, de seis pre-escolares y 22 escolares que asistieron al SERH entre septiembre 2008 y marzo 2009. Se contrastó y codificó la lista de clasificación con cada elemento del perfil sensorial y se utilizó una matriz que contempló funciones corporales, actividades y participación con el código correspondiente. Resultados. Se encontró compatibilidad entre las funciones y actividades de participación y las secciones del procesamiento sensorial, pero no en relación con los factores por la especificidad de la prueba. La caracterización de las condiciones de procesamiento sensorial es viable con la utilización de referentes combinados. Conclusión. Para brindar alternativas apropiadas de manejo a los niños con dificultades sensoriales se requiere aumentar, mediar y difundir en los profesionales y familiares el conocimiento sobre el procesamiento sensorial y su funcionamiento, lo mismo que sobre la estimulación que se demanda para disminuir su impacto en las actividades cotidianas de los niños.
Assuntos
Pré-Escolar , Atividades Cotidianas , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Pensamento , Transtornos do Comportamento SocialRESUMO
The alimentary canal and the reproductive tract of males and females of Hypothenemus hampei Ferrari are described. The alimentary canal of H. hampei showed the crop with several spine-like structures and the midgut with few gastric caeca. We evidenced for the first time that adult females need to feed on coffee in order to produce viable eggs before and during oviposition period. The presence of air bubbles inside the anterior midgut may be due to starvation rather than the response of the environment during flying as previously reported. Two ovaries and the same structures and arrangements common to individuals of the Curculionidae beetles composed the female reproductive system. The male reproductive tract showed a significant difference with respect to other Curculionidae and even other Scolytinae species as it showed a sclerotized aedeagus with several pore-like structures in the terminal portion where sperm is released during mating.
Assuntos
Besouros/anatomia & histologia , Animais , Feminino , Trato Gastrointestinal , Masculino , ReproduçãoRESUMO
The alimentary canal and the reproductive tract of males and females of Hypothenemus hampei Ferrari are described. The alimentary canal of H. hampei showed the crop with several spine-like structures and the midgut with few gastric caeca. We evidenced for the first time that adult females need to feed on coffee in order to produce viable eggs before and during oviposition period. The presence of air bubbles inside the anterior midgut may be due to starvation rather than the response of the environment during flying as previously reported. Two ovaries and the same structures and arrangements common to individuals of the Curculionidae beetles composed the female reproductive system. The male reproductive tract showed a significant difference with respect to other Curculionidae and even other Scolytinae species as it showed a sclerotized aedeagus with several pore-like structures in the terminal portion where sperm is released during mating.
El estudio morfológico del tracto digestivo y el sistema reproductor de machos y hembras de Hypothenemus hampei Ferrari se describe a continuación. El tracto digestivo presenta un arreglo típico descrito para otros insectos. Ahora las diferencias morfológicas se encontraron en el buche del estomodeo, en donde se observaron estructuras espinosas y en el mesenteron se observo un número reducido de ciegos gástricos. Se evidenció por primera vez el comportamiento de la alimentación de las hembras de H. hampei, que requiere aparentemente de la ingesta del endosperma del café para poder producir huevos viables durante la oviposición. La presencia de burbujas de aire al interior del ventrículo anterior se cree que puede ser debido al hambre, más que a la respuesta al medio ambiente durante el vuelo como lo indicaban anteriores observaciones. El sistema reproductor de la hembra presenta dos ovarios y un arreglo estructural común a especímenes de la familia Curculionidae. El sistema reproductor masculino mostró una diferencia significativa con respecto a otros miembros de la familia Curculionidae e incluso a otra especie de la tribu Scolytinae presentando un aedeagus esclerotizado compuesto de varios orificios en la porción terminal, por donde el esperma se expulsa durante el apareamiento.
Assuntos
Animais , Feminino , Masculino , Besouros/anatomia & histologia , Trato Gastrointestinal , ReproduçãoRESUMO
INTRODUCTION: The purpose of this phase II study was to evaluate the efficacy and safety of neoadjuvant docetaxel/gemcitabine treatment in a biweekly regimen. MATERIALS AND METHODS: Patients with stage II/III breast cancer were treated with docetaxel (65 mg/m(2)) followed by gemcitabine (2500 mg/m(2)) every 2 weeks for 6 cycles. Patients with a clinical response or stable disease underwent mastectomy or breast-conserving surgery plus axillary dissection. After surgery, patients received 4 cycles of standard doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) every 21 days. RESULTS: Thirty-five patients were included in the trial. The overall response rate was 71.4% (95% CI: 53.7-85.4), with 8 complete and 17 partial responses. Breast conservation was possible in 59% of the patients. Toxicity was manageable. CONCLUSIONS: We consider biweekly docetaxel and gemcitabine could be an active and tolerable regimen option in the neoadjuvant setting sequentially with standard adjuvant doxorubicin-cyclophosphamide in patients with stage II or III breast cancer.
Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Ciclofosfamida/uso terapêutico , Desoxicitidina/análogos & derivados , Doxorrubicina/uso terapêutico , Taxoides/administração & dosagem , Adulto , Idoso , Quimioterapia Adjuvante , Desoxicitidina/administração & dosagem , Docetaxel , Esquema de Medicação , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , GencitabinaRESUMO
La disfunción eréctil puede ser una de las manifestaciones de enfermedad vascular generalizada, caracterizada por disfunción endotelial. Las estatinas pueden mejorar la función endotelial, incluso antes de alterar el perfil lipídico. Objetivo: Evaluar la mejoría de disfunción eréctil con atorvastatina en pacientes que no respondieron inicialmente a sildenafil. Material y métodos: Estudio controlado, placebo, randomizado, doble ciego, en el cuál se incluyeron hombres con disfunción eréctil moderada a severa, apesar de un esquema adecuado de Sildenafil. Se definió disfunción eréctil con un cuestionario auto administrado, score < o = a 16, según el Indice Internacional de Función Eréctil. La mejoría en el score de disfunción eréctil con Sildenafil fue reevaluada a los 6 y 12 semanas de tratamiento con Atorvastatina (80mg/día) v/s placebo. Resultado: Se incluyeron 18 hombres (edad media de 62 +/-12 años), con un score medio de 7.9 +/-5.8 y una duración media de la disfunción eréctil de 5.2 años. El tratamiento con Atorvastatina disminuyó el colesterol LDL en un 39 por ciento y resultó en una mejoría en el score de 7.6 (p < 0.05) con Sildenafil; este efecto se mantuvo por 6 semanas. El grupo placebo si bien logró mejoría en el score, esta no tuvo significación estadística. Conclusión: El tratamiento con Atorvastatina mejora la función sexual y la respuesta a sidenafil oral en hombres que no respondieron inicialmente al tratamiento con Sildenafil. Los resultados de este estudio avalan la hipótesis de que la disfunción vascular endotelial contribuye a la disfunción eréctil en pacientes no respondedores a Sildenafil.
Introduction: Erectile dysfunction (ED) may be one manifestation of a generalized vascular disordercharacterized by endothelial dysfunction. Statins may improve endothelial function, even before modifying the lipid profile. Objective: We sought to determine whether the addition of a statin would improve ED in men who initially responded poorly to sildenafil. Methods: Men with moderate to severe ED despite an adequate sildenafil trial were enrolled in this randomized, double-blind, placebo-controlled pilot study. ED was defined using a validated self-administered questionnaire as a score of <16 on the International Index of Erectile Function (erectile function domain score range of 6-30). Improvement in ED score withsildenafil and atorvastatin (80 mg daily) versus sildenafil and placebo was reassessed at 6 and 12 weeks of treatment. Results: Eigthteen men (mean age 62 +/- 12 years) with a mean domain score of 7.9 +/- 5.8 anda mean duration of ED of 5.2 years were enrolled in the study. Treatment with sildenafil and atorvastatin decreased mean low-density lipoprotein cholesterol by 39 percent and resulted in an improvement in erectile function domain score of 7.6 (P < 0.036). This effect was observed at 6 weeks of treatment. The increase in domain score in the sildenafil and placebo group was not statistically significant. Conclusions: Addition of atorvastatin to oral sildenafil significantly improves ED in men who initially responded poorly to sildenafilalone. The results of this pilot study supports the hypothesis that vascular endothelial dysfunction contributesto ED in sildenafil nonresponders and deserves further testing in a large clinical trial.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Disfunção Erétil/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pirróis/uso terapêutico , Ácidos Heptanoicos/uso terapêutico , Vasodilatadores , Endotélio Vascular/fisiopatologia , Método Duplo-Cego , Piperazinas , Purinas , SulfonasRESUMO
This study presents the epidemiological analysis of 20,699 reported spider bites involving the Loxosceles genus in the state of Paraná, Brazil, from 1993 to 2000. The incidence rate in the period was 290.24/100,000 inhabitants. The results show that 95.04% of the accidents occurred in two Health Regions of the state: greater metropolitan Curitiba (92.9%) and Irati (2.14%). The major incidence was recorded in greater metropolitan Curitiba (559.1/100,000). Loxosceles bites were more frequent in females (61%) than in males. Antivenin therapy was not necessary in 95.4% (19,662) of the cases. From the cases in which information about the time elapsed between the bite and medical treatment was recorded (9,679), 31.8% received treatment from 6 to 48 hours after the bite. Among the cases with severity rate recorded (12,096), 2.1% were severe, 50.4% moderate, and 47.4% mild. Seven deaths from Loxosceles bites were recorded, corresponding to a fatality rate of 0.03%.
RESUMO
This study presents the epidemiological analysis of 20,699 reported spider bites involving the Loxosceles genus in the state of Paraná, Brazil, from 1993 to 2000. The incidence rate in the period was 290.24/100,000 inhabitants. The results show that 95.04 percent of the accidents occurred in two Health Regions of the state: greater metropolitan Curitiba (92.9 percent) and Irati (2.14 percent). The major incidence was recorded in greater metropolitan Curitiba (559.1/100,000). Loxosceles bites were more frequent in females (61 percent) than in males. Antivenin therapy was not necessary in 95.4 percent (19,662) of the cases. From the cases in which information about the time elapsed between the bite and medical treatment was recorded (9,679), 31.8 percent received treatment from 6 to 48 hours after the bite. Among the cases with severity rate recorded (12,096), 2.1 percent were severe, 50.4 percent moderate, and 47.4 percent mild. Seven deaths from Loxosceles bites were recorded, corresponding to a fatality rate of 0.03 percent.
Assuntos
Animais , Masculino , Feminino , Picada de Aranha/epidemiologia , Animais Peçonhentos , Brasil/epidemiologiaRESUMO
El score de Gleason por biopsia prostática es uno de los elementos utilizados para determinar el pronóstico y planificar la conducta terapéutica en pacientes con cáncer de próstata clínicamente localizado. Una aproximación preoperatoria precisa de esta variable es importante para posibilitar una adecuada información sobre opciones de tratamiento. Estudios han evidenciado la potencial inexactitud de esta variable clave en la aproximación clínica de estos pacientes. Existen escasos reportes respecto a las características clínicas y características histopatológicas de este grupo subetapificado. Material y métodos: Se estudiaron los pacientes sometidos a biopsia por sextantes (12 cores) en el Servicio de Urología del Hospital Salvador durante los años 2000-2004, a los que se les realizó prostatectomía radical retropúbica. Se excluyeron los pacientes que habían recibido terapia hormonal neoadyuvante y aquellos con biopsia realizada en el extrasistema. Se analizó la correlación entre el Gleason de biopsia y el de la muestra de prostatectomía, además se evaluó la presencia de elementos patológicos de mal pronóstico en la pieza definitiva (márgenes quirúrgicos comprometidos, compromiso de cápsula y de vesículas seminales). Resultados: Se obtuvo un total de 190 casos. El porcentaje de subetapificación según score de Gleason: <6, 6, y 7, fue de 85 por ciento, 56 por ciento, y 34 por ciento respectivamente. La presencia de elementos patológicos de mal pronóstico fue mayor en el subgrupo subetapificado que en el grupo que mantuvo su score para los casos en que el Gleason de biopsia fue <6; compromiso de cápsula (60 por ciento vs 33 por ciento); compromiso de margen quirúrgico (46 por ciento vs 25 por ciento). Esta diferencia no fue significativa para el segmento subetapificado cuando el Gleason fue >=6. Conclusiones: El grado de Gleason de biopsia prostática transrectal es un predictor limitado del score de Gleason final en los pacientes que se someten a prostatectomía r...
Assuntos
Humanos , Masculino , Biópsia/métodos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Prostatectomia , Técnicas de Diagnóstico Urológico , Valor Preditivo dos Testes , Estudos Retrospectivos , PrognósticoRESUMO
La incontinencia de orina de esfuerzo es un problema frecuente. La técnica de cincha suburetral esactualmente la más aceptada y ha demostrado buenos resultados a largo plazo. El objetivo del presentetrabajo es evaluar los resultados y las complicaciones de esta técnica en pacientes con antecedentes decirugía ginecológica o de incontinencia previa. Se evaluaron las pacientes sometidas a esta técnica porincontinencia de orina de esfuerzo durante el período entre enero 2001 y mayo 2003, seleccionando loscasos con antecedentes quirúrgicos mencionados. Se evaluó el resultado y las complicaciones, comparandocon un grupo control de pacientes sin antecedentes quirúrgicos. De 21 pacientes, cuatro presentaroncomplicaciones quirúrgicas (1 retención persistente que debió ser reoperada, 1 infección de heridaoperatoria, 1 perforación de vejiga, 1 dispareunia persistente). En el grupo control, se observó un casode perforación vesical. A un período de seguimiento promedio de 18 meses, 81 porciento de las pacientes conantecedentes se encontraban continentes vs 88 porciento del grupo control. Los pacientes con antecedentes decirugía ginecológica o urológica previa constituyen un grupo de mayor riesgo de complicaciones quirúrgicas.El resultado respecto a la continencia es levemente inferior, sin embargo, no es estadísticamentesignificativo.
Assuntos
Humanos , Feminino , Incontinência Urinária por Estresse/cirurgiaRESUMO
AIM: To describe the endoscopic findings in adult patients subjected to esophagogastroduodenoscopy (EGD) for the evaluation of heartburn, and establish a relationship between the presence of a hiatal hernia and erosive esophagitis. PATIENTS AND METHODS: We reviewed the endoscopic reports of all the patients older than 16 years old who were evaluated for heartburn in our institution, between December 1998 and December 2001. The statistical analysis to establish the relationship between Hiatal Hernia (HH) and Erosive Esophagitis (EE) was performed calculating the Odds Ratio (OR). RESULTS: A total of 1270 outpatient EGD were performed in the study period, of which 345 (27%) had persistent heartburn as the indication for the procedure. There were 174 females (50.43%) and 171 males (49.57%). Erosive esophagitis was diagnosed in 151 (44%). Fifty-eight (17%) patients had EE in the absence of a HH, 63 (18%) had HH in the absence of EE. Ninety-three patients (27%) had both HH and EE, 20 (6%) of patients had histologically confirmed Barrett's esophagus, 91 (26%) had other nonrelated findings such as antral gastritis and 36 (10%) had normal EGD. Of 156 patients with HH, 93 (59.6%) had also EE, whereas EE was present only in 58 of 189 (30.6%) patients who did not have HH, obtaining an OR of 3.33. CONCLUSIONS: Most of our patients with heartburn didn't have erosive esophagitis. In our series, patients with heartburn and a hiatal hernia have a three-fold risk of having erosive esophagitis compared with patients with heartburn and no hiatal hernia.