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1.
Environ Geochem Health ; 43(10): 4265-4282, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33843010

RESUMO

Marmato, Colombia, has been an important centre of gold mining since before the first Spanish colonizers arrived in 1536. The Marmato deposit is hosted in a dacite and andesite porphyry stock as sheeted sulphide-rich veinlet systems. The district is currently experiencing a surge in both major mining projects and artisanal mining, driven by sustained high gold prices. Ore from small-scale and artisanal gold mining is processed in numerous small mills (entables) around Marmato, which impact surface water quality through the discharge of milled waste rock slurry, highly alkaline cyanide-treated effluent, and high dissolved metal loads. To investigate the impact of artisanal mining and ore processing, water samples were collected in January 2012 from streams around Marmato. The average dissolved metal concentrations in impacted streams were Zn, 78 mg L-1; Pb, 0.43 mg L-1; Cu, 403 µg L-1 Cd, 255 µg L-1; As, 235 µg L-1; Ni, 67 µg L-1; Co, 55 µg L-1; Sb, 7 µg L-1; and Hg, 42 ng L-1, exceeding World Health Organization drinking water guidelines. In addition, arsenic speciation was conducted in-situ and indicated that 91-95% of inorganic arsenic species is in the form of As(V). Spatial analysis of the data suggests that entables processing ore for artisanal miners are the main contributor to water pollution, with high sediment loads, alkalinity and elevated concentrations of dissolved arsenic, cadmium, mercury and lead, caused by the processing of gold-bearing sulphides in the entables. Geochemical data from surface water were compared to a comprehensive data set of whole rock analyses from drill core and channel samples from the deposit, indicating that the deposit is significantly enriched in gold, silver, lead, zinc, arsenic, antimony, and cadmium compared to crustal averages, which is reflected in the surface water geochemistry. However, elevated mercury levels in surface water cannot be explained by enrichment of mercury in the deposit and strongly suggest that mercury is being added to concentrates during ore processing to amalgamate fine gold.


Assuntos
Mercúrio , Poluentes Químicos da Água , Colômbia , Monitoramento Ambiental , Ouro , Mercúrio/análise , Mineração , Poluentes Químicos da Água/análise , Qualidade da Água
2.
Sci Rep ; 9(1): 1417, 2019 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-30723222

RESUMO

Formation of the Panama Isthmus, that had global oceanographic and biotic effects in the Neogene, is generally associated with tectonic uplift during collision of the Panama volcanic arc with South America. However, new field, geochemical and geochronological data from the Culebra Cut of the Panama Canal suggest that volcanism also contributed to the Isthmus emergence in the Early Miocene. This volcanism is recorded in a newly-recognised Central Panama volcanic field that includes several phases of development. Early activity of this field along the Panama Canal was associated with proximal effusive to explosive felsic products during formation of subaerial stratovolcanoes and possible domes ca. 21 Ma. This was followed by a period of marine transgression ca. 21-18 Ma, with more distal volcanism documented by tuffs that deposited in marine to terrestrial environments. Finally, proximal mafic volcanism formed tephra cones in a monogenetic field ca. 18(-?) Ma. This was associated with phreatomagmatic processes in a coastal environment, with remarkable kilometre-wide subvolcanic peperitic intrusions. We propose based on these observations that formation of the Central Panama volcanic field was critical in shaping regional topography, and that this could have actively contributed to obstruction and closure of an interoceanic strait in Central Panama.

3.
West Indian med. j ; West Indian med. j;62(9): 831-834, Dec. 2013. graf, tab
Artigo em Inglês | LILACS | ID: biblio-1045764

RESUMO

OBJECTIVE: To determine the correlation of ultrasonographic estimation of fetal weight and actual birthweight and the impact of the level of resident s training on the results. METHODS: This was a prospective study of 90 women with term pregnancies. Ultrasound estimated fetal weight (EFW) was calculated by a pre-programmed Hadlock formula. Days from ultrasound to delivery were less than seven. The EFW was compared to the actual birthweight at delivery. The year of training of the resident that performed the ultrasound was recorded. Exclusion criteria included diabetes mellitus and known fetal anomalies. RESULTS: Mean age was 28 years, parity was 0 to 4 and mean gestational age was 38 weeks. There was an average over-estimation of 64.8 grams. The difference between mean EFW and mean birthweight was not significant (p = 0.067). The difference between mean EFW and mean birthweight when calculated according to year of residency was not significant, p = 0.075 and 0.402for junior and senior residents, respectively. CONCLUSION: There is good correlation between residents' ultrasonographic estimation of fetal weight and actual birthweight at the UHWI. There was no significant difference in correlation between senior and junior residents. Developments in computer technology might contribute to decrease in the learning curve.


OBJETIVO: Determinar la correlación de la estimación ultrasonográfica del peso fetal y el peso real al nacer, y el impacto del nivel de formación del residente en los resultados. MÉTODOS: Se trató de un estudio prospectivo de 90 mujeres con embarazos a término. El peso fetal estimado (PFE) por ultrasonido fue calculado mediante una fórmula de Hadlock preprogramada. Los días transcurridos desde el ultrasonido hasta el parto fueron menos de siete. Se comparó el PFE con el peso real en el parto. Se registró el año de formación del residente que realizó el ultrasonido. Los criterios de exclusión criterios incluyeron diabetes mellitus y anomalías fetales conocidas. RESULTADOS: La edad promedio fue 28 años; la paridad fue de 0 a 4; la edad gestacional fue de 38 semanas. Hubo una sobreestimación promedio de 64.8 gramos. La diferencia entre el PFE promedio y el peso promedio al nacer no fue significativa (p = 0.067). La diferencia entre el PFE promedio y el peso promedio al nacer calculada según el año de residencia no fue significativa, siendo p = 0.075 y 0.402 para médicos en la primera y última etapa de su residencia, respectivamente. CONCLUSIÓN: Existe una buena correlación entre la estimación ultrasonográfica del peso fetal, realizada por los residentes, y el peso real al nacer en el HUWI. No hubo ninguna diferencia significativa en la correlación entre los residentes en sus primeras y últimas etapas. Los desarrollos en la tecnología informática pueden contribuir a la disminución de la curva de aprendizaje.


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Peso ao Nascer , Ultrassonografia Pré-Natal , Competência Clínica , Peso Fetal , Internato e Residência , Estudos Prospectivos
4.
West Indian med. j ; West Indian med. j;62(7): 593-598, Sept. 2013. graf, tab
Artigo em Inglês | LILACS | ID: biblio-1045710

RESUMO

OBJECTIVE: To see if black Jamaican postmenopausal women who had hysterectomy were at increased risk of osteoporosis. To assess the risk of osteoporosis in hysterectomized Jamaican postmenopausal patients. METHOD: We reviewed 809 women (403 hysterectomized and 406 controls) for cardiovascular disease risk. We did a demographic history and examination looking at blood pressure, waist hip ratio and body mass index and investigations done included fasting blood glucose and total and high density lipoprotein (HDL) cholesterol. We also measured bone density at the heel in all women using the Achilles ultrasound bone densitometer looking at T-score and Z-score. RESULTS: There was a significant association of hysterectomy status and bone mineral density (BMD) status with a smaller than expected proportion of women with osteoporosis in the hysterectomy group (χ2 = 18.4; p = 0.001). The mean T-score was significantly higher in the hysterectomized women, adjusting for age, waist circumference and sociodemographic factors. The relationship between the various predictors and BMD was explored by stepwise regression modelling. The factors that were significantly related to low BMD were hysterectomy status, age, waist circumference and being employed. CONCLUSION: Hysterectomy was not found to be a significant risk factor for osteoporosis. The osteoporosis risk among menopausal women in Jamaica appears to be due to other risk factors which probably existed prior to the operation.


OBJETIVO: Determinar si mujeres negras jamaicanas postmenopáusicas sometidas a histerectomía corrían mayor riesgo de osteoporosis. Evaluar el riesgo de osteoporosis en pacientes jamaicanas postmenopáusicas histerectomizadas. MÉTODO: Se examinaron 809 mujeres (403 histerectomizadas y 406 controles) para evaluar el riesgo de enfermedad cardiovascular. Hicimos una historia demográfica y un examen para obtener información sobre la presión arterial, el índice cintura/cadera ratio, y el índice de masa corporal. Asimismo, realizamos investigaciones que incluyeron pruebas de glucemia en ayunas, colesterol total, y colesterol de lipoproteínas de alta densidad (HDL). También medimos la densidad ósea en el talón de todas las mujeres, usando el densitómetro óseo ultrasónico modelo Achilles para obtener el T-score y el Z-score. RESULTADOS: Hubo una asociación significativa entre el estado de histerectomía y el estado de la densidad mineral ósea (DMO) con una proporción de mujeres con osteoporosis en el grupo de histerectomía (χ2 = 18.4; p = 0,001) más pequeña de lo esperada. El T-score promedio fue significativamente mayor en las mujeres histerectomizadas, ajustando por edad, circunferencia de la cintura y factores sociodemográficos. La relación entre los distintos factores predictivos y DMO fue explorada mediante regresión gradual stepwise modelado. Los factores que estuvieron significativamente relacionados con baja DMO fueron estado histerectomía, edad, circunferencia de la cintura y siendo empleado. CONCLUSIÓN: Se halló que la histerectomía no es un factor de riesgo significativo para la osteoporosis. El riesgo de osteoporosis entre las mujeres menopáusicas de Jamaica parece deberse a otros factores de riesgo que probablemente existían antes de la operación.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Densidade Óssea , Osteoporose Pós-Menopausa/epidemiologia , População Negra , Histerectomia/efeitos adversos , Ovariectomia/efeitos adversos , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/etnologia , Estudos Transversais , Fatores de Risco , Jamaica/epidemiologia
5.
J Obstet Gynaecol ; 33(3): 298-300, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23550864

RESUMO

There is a wide variation in reported incidence, risk factors and presentation of molar pregnancy. This necessitates population-based studies to determine these parameters at the University Hospital of the West Indies, which is a referral centre for these conditions. The incidence of molar pregnancy at the University Hospital of the West Indies was found to be 2.81 per 1,000, which fell in the range of worldwide values. Partial moles made up 61.1% and complete moles 31.0%. The mean age of the patients was 28.49 years old with 85% of patients aged between 20 and 40 years old. The median gestational age by dates was 12 weeks and vaginal bleeding was the most common presenting symptom (77%). A significant number of cases (52.2%) of molar pregnancy were diagnosed by routine histopathology for failed pregnancy and not by pre-evacuation ultrasound. The practice of routine assessment of tissue from failed pregnancy should therefore be encouraged in our population.


Assuntos
Mola Hidatiforme/epidemiologia , Neoplasias Uterinas/epidemiologia , Adolescente , Adulto , Gonadotropina Coriônica Humana Subunidade beta/sangue , Feminino , Idade Gestacional , Hospitais Universitários , Humanos , Mola Hidatiforme/complicações , Mola Hidatiforme/diagnóstico , Incidência , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Hemorragia Uterina/etiologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Índias Ocidentais/epidemiologia , Adulto Jovem
6.
West Indian Med J ; 62(7): 593-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24831895

RESUMO

OBJECTIVE: To see if black Jamaican postmenopausal women who had hysterectomy were at increased risk of osteoporosis. To assess the risk of osteoporosis in hysterectomized Jamaican postmenopausal patients. METHOD: We reviewed 809 women (403 hysterectomized and 406 controls) for cardiovascular disease risk. We did a demographic history and examination looking at blood pressure, waist hip ratio and body mass index and investigations done included fasting blood glucose and total and high density lipoprotein (HDL) cholesterol. We also measured bone density at the heel in all women using the Achilles ultrasound bone densitometer looking at T-score and Z-score. RESULTS: There was a significant association of hysterectomy status and bone mineral density (BMD) status with a smaller than expected proportion of women with osteoporosis in the hysterectomy group (χ2 = 18.4; p = 0.001). The mean T-score was significantly higher in the hysterectomized women, adjusting for age, waist circumference and sociodemographic factors. The relationship between the various predictors and BMD was explored by stepwise regression modelling. The factors that were significantly related to low BMD were hysterectomy status, age, waist circumference and being employed. CONCLUSION: Hysterectomy was not found to be a significant risk factor for osteoporosis. The osteoporosis risk among menopausal women in Jamaica appears to be due to other risk factors which probably existed prior to the operation.


Assuntos
População Negra , Densidade Óssea , Histerectomia/efeitos adversos , Osteoporose Pós-Menopausa/epidemiologia , Ovariectomia/efeitos adversos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Jamaica/epidemiologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/etnologia , Osteoporose Pós-Menopausa/etiologia , Fatores de Risco
7.
West Indian Med J ; 62(9): 829-32, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25117389

RESUMO

OBJECTIVE: To determine the correlation of ultrasonographic estimation of fetal weight and actual birthweight and the impact of the level of resident's training on the results. METHODS: A prospective study of 90 women with term pregnancies. Ultrasound estimated fetal weight (EFW) was calculated by a preprogrammed Hadlock formula. Days from ultrasound to delivery were less than seven. The EFW was compared to the actual birthweight at delivery. The year of training of the resident that performed the ultrasound was recorded. Exclusion criteria included Diabetes mellitus and known fetal anomalies. RESULTS: Mean age was 28 years, parity zero to four, mean gestational age 38 weeks. There was an average over-estimation of 64.8 grams. The difference between mean EFW and mean BWT was not significant (p = 0.067). The difference between mean EFW and mean BWT when calculated according to year of residency was not significant, p = 0.075 and 0.402 for junior and senior residents, respectively. CONCLUSION: There is good correlation between resident's ultrasonographic estimation of fetal weight and actual birthweight at the UHWI. There was no significant difference in correlation between senior and junior residents. Development in computer technology might contribute to decrease in the learning curve.

9.
Climacteric ; 14(5): 558-64, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21545273

RESUMO

OBJECTIVE: Pumpkin seed oil is rich in phytoestrogens and animal studies suggest that there is some benefit to supplementation in low estrogen conditions. This study is the first to evaluate the benefit of pumpkin seed oil in postmenopausal women. METHODS: This pilot study was randomized, double-blinded and placebo-controlled. Study participants included 35 women who had undergone natural menopause or had iatrogenically entered the climacteric due to surgery for benign pathology. Wheat germ oil (placebo; n = 14) and pumpkin seed oil (n = 21) were administered to eligible participants over a 12-week period at a dose of 2 g per day. Serum lipids, fasting plasma glucose and blood pressure were measured and an 18-point questionnaire regarding menopausal symptoms was administered; the atherogenic index was also calculated. Differences between groups, as well as before and after the period of supplementation, were evaluated with Student's t-test, Wilcoxon matched-pair signed-ranked test and Mann-Whitney test, as appropriate (Stata version 10.1). RESULTS: Women receiving pumpkin seed oil showed a significant increase in high density lipoprotein cholesterol concentrations (0.92 ± 0.23 mmol/l vs. 1.07 ± 0.27 mmol/l; p = 0.029) and decrease in diastolic blood pressure (81.1 ± 7.94 mmHg vs. 75.67 ± 11.93 mmHg; p < 0.046). There was also a significant improvement in the menopausal symptom scores (18.1 ± 9.0 vs. 13.2 ± 6.7; p < 0.030), with a decrease in severity of hot flushes, less headaches and less joint pains being the main contributors. Women in the group receiving wheat germ oil reported being more depressed and having more unloved feeling. CONCLUSION: This pilot study showed pumpkin seed oil had some benefits for postmenopausal women and provided strong evidence to support further studies.


Assuntos
HDL-Colesterol/sangue , Cucurbita/química , Óleos de Plantas/administração & dosagem , Pós-Menopausa/sangue , Sementes/química , Idoso , Pressão Sanguínea/efeitos dos fármacos , Método Duplo-Cego , Feminino , Fogachos/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Fitoestrógenos/administração & dosagem , Fitoterapia , Projetos Piloto , Placebos
10.
West Indian med. j ; West Indian med. j;59(6): 625-632, Dec. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-672691

RESUMO

OBJECTIVE: To determine differences in prevalence of cardiovascular risks and diseases in black Jamaican postmenopausal women who had hysterectomy (hysgroup) compared with those without (control). METHOD: Eight hundred and nine (809) women (hysterectomized (HYSGRP) = 403; non-hysterectomized (controls) = 406) were enrolled. Sociodemographic information and lifestyle history, measured blood pressure, waist hip ratio, body mass index, fasting blood glucose, total and HDL cholesterol were obtained. RESULTS: Of the 809 women, complete cardiovascular risk data were available in 341 controls and 328 in the HYSGRP group. There was no difference in mean age, blood pressure and body mass indices between the subjects excluded and the subjects in the data analytical sample. A significantly lower proportion ofwomen in the control group exercised, attained post-secondary education and were of higher parity. Systolic (mean difference with 95% CI; 6 (3, 9) mmHg and diastolic (3 (1, 5) mmHg) blood pressure were lower in the HYSGRP compared with controls but total cholesterol (0.2 (0.07 to 0.4) mmol/L was greater. HDL cholesterol was not different between both groups 1.3 mmol/L (SD 0.3) vs 1.3 mmol/L [SD 0.4] (p = 0.8435). There was no difference in the prevalence of diabetes, hypertension and high waist-hip ratio in hysterectomized women compared with controls adjusting for hormone replacement therapy usage, cigarette smoking, exercise and educational status. Within the HYSGRP, there was also no difference in cardiovascular disease or risk in women who had bilateral oophorectomy compared with women who had at least an ovary preserved at time ofoperation. CONCLUSION: Hysterectomy was not associated with an increased risk of cardiovascular disease. This must be taken cautiously since data did not allow for analysis on duration of menopause.


OBJETIVO: Determinar las diferencias en la prevalencia de riesgos y enfermedades cardiovasculares en mujeres negras jamaicanas menopáusicas con histerectomía, en comparación con las que no tuvieron esta operación (control). MÉTODO: Se enrolaron ochocientas nueve (809) mujeres (histerectomizadas (HYSGRP) = 403; no histerectomizadas (controles) = 406). Se obtuvo información sobre datos demográficos e historia del estilo de vida, mediciones de la presión arterial, índice cintura/cadera, glucemia en ayunas, así como el colesterol total y HDL. RESULTADOS: De 809 mujeres, había disponible datos completos sobre el riesgo cardiovascular en 341 controles, y 328 en el grupo HYSGRP. No hubo diferencias significativas en relación con la edad promedio, la presión arterial, y el índice de masa corporal entre los sujetos excluidos y los sujetos en las muestras del análisis de datos. Una proporción significativamente menor de mujeres en el grupo de control practicado, tuvo educación post-secundaria y fueron de paridad más alta. La presión arterial sistólica (diferencia promedio con 95% CI; 6 (3 a 9 mmHg)) y la presión arterial diastólica (3 (1 a 5 mmHg)) fueron más bajas en el grupo de la histerectomía HYSGRP en comparación con el grupo de control, pero el colesterol (0.2 (0.07 a 0.4)) fue mayor. El colesterol HDL no fue diferente entre los dos grupos: 1.3 mmol/L (SD 0.3) frente a 1.3 mmol/L [SD 0.4] (p = 0.8435). No hubo diferencia en cuanto a laprevalencia de la diabetes, la hipertensión, y el alto índice cintura/cadera en las mujeres histerectomizadas, en comparación con los controles ajustándose en relación con el uso de la terapia de reemplazo hormonal, el hábito defumar, el ejercicio, y el nivel educacional. Dentro del grupo HYSGRP tampoco hubo diferencias con respecto a las enfermedades cardiovasculares o riesgos en mujeres operadas de ooforectomía bilateral, en comparación con las mujeres a las que se les preservó por lo menos un ovario en el momento de la operación. CONCLUSIÓN: La histerectomía no estuvo asociada con un aumento de riesgo de la enfermedad cardiovascular. No obstante, esta conclusión debe tomarse con cautela, ya que los datos no permitieron el análisis en el período de duración de la menopausia.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Doenças Cardiovasculares/etiologia , Histerectomia , Ovariectomia , População Negra , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Jamaica/epidemiologia , Modelos Lineares , Prevalência , Fatores de Risco , Estatísticas não Paramétricas
11.
West Indian Med J ; 59(6): 625-32, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21702234

RESUMO

OBJECTIVE: To determine differences in prevalence of cardiovascular risks and diseases in black Jamaican postmenopausal women who had hysterectomy (hysgroup) compared with those without (control). METHOD: Eight hundred and nine (809) women (hysterectomized (HYSGRP) = 403; non-hysterectomized (controls) = 406) were enrolled. Sociodemographic information and lifestyle history, measured blood pressure, waist hip ratio, body mass index, fasting blood glucose, total and HDL cholesterol were obtained. RESULTS: Of the 809 women, complete cardiovascular risk data were available in 341 controls and 328 in the HYSGRP group. There was no difference in mean age, blood pressure and body mass indices between the subjects excluded and the subjects in the data analytical sample. A significantly lower proportion of women in the control group exercised, attained post-secondary education and were of higher parity. Systolic (mean diference with 95% CI; 6 (3, 9) mmHg and diastolic (3 (1, 5) mmHg) blood pressure were lower in the HYSGRP compared with controls but total cholesterol (0.2 (0.07 to 0.4) mmol/L was greater HDL cholesterol was not different between both groups 1.3 mmol/L (SD 0.3) vs 1.3 mmol/L [SD 0.4] (p = 0.8435). There was no difference in the prevalence of diabetes, hypertension and high waist-hip ratio in hysterectomized women compared with controls adjusting for hormone replacement therapy usage, cigarette smoking, exercise and educational status. Within the HYSGRP there was also no diference in cardiovascular disease or risk in women who had bilateral oophorectomy compared with women who had at least an ovary preserved at time of operation. CONCLUSION: Hysterectomy was not associated with an increased risk of cardiovascular disease. This must be taken cautiously since data did not allow for analysis on duration of menopause.


Assuntos
Doenças Cardiovasculares/etiologia , Histerectomia , Ovariectomia , População Negra , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Jamaica/epidemiologia , Modelos Lineares , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estatísticas não Paramétricas
12.
West Indian med. j ; West Indian med. j;57(4): 403-405, Sept. 2008. ilus
Artigo em Inglês | LILACS | ID: lil-672387

RESUMO

In this case of a male adult Caucasian cadaver, variations were noted involving the location of the C5 ventral ramus descending anterior and superolateral to the anterior scalene muscle. An unusual communicating branch was discovered that originated from C5 at the midpoint of the anterior scalene muscle, two centimeters proximal to Erb's point, to communicate with C6 and another communicating branch originating from C6 to C7. Awareness of the possibility of this variation is of great importance during certain surgical procedures. Comparison of this case with the literature is discussed.


En este caso de un cadáver adulto varón caucásico, se observaron variaciones que involucraban la localización de la rama ventral del quinto nervio cervical (C5) anterior descendente y superior lateral en relación con el músculo escaleno anterior. Se descubrió una rama comunicante inusual que se originaba a partir del C5 en el punto medio del músculo escaleno anterior, dos centímetros próximo al punto de Erb, para comunicarse con el C6 y otra rama comunicante son su punto de origen en C6 hasta C7. Conocer la posibilidad de esta variación es de gran importancia durante la realización de ciertos procedimientos quirúrgicos. Se discute la comparación de este caso con la literatura.


Assuntos
Humanos , Masculino , Plexo Braquial/anormalidades , Plexo Braquial/anatomia & histologia , Plexo Braquial/patologia , Plexo Braquial/cirurgia , Cadáver
14.
West Indian Med J ; 57(4): 403-5, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19566024

RESUMO

In this case of a male adult Caucasian cadaver, variations were noted involving the location of the CS ventral ramus descending anterior and superolateral to the anterior scalene muscle. An unusual communicating branch was discovered that originated from C5 at the midpoint of the anterior scalene muscle, two centimeters proximal to Erb's point, to communicate with C6 and another communicating branch originating from C6 to C7. Awareness of the possibility of this variation is of great importance during certain surgical procedures. Comparison of this case with the literature is discussed.


Assuntos
Plexo Braquial/anormalidades , Plexo Braquial/anatomia & histologia , Plexo Braquial/patologia , Plexo Braquial/cirurgia , Cadáver , Humanos , Masculino
15.
Rev. chil. pediatr ; 75(6): 536-542, nov. 2004. ilus
Artigo em Espanhol | LILACS | ID: lil-627425

RESUMO

En Uruguay las infecciones respiratorias agudas bajas son una importante causa de morbimortalidad. El empiema paraneumónico ha alcanzado cifras del 15% de los ingresos por neumonía en el Centro Hospitalario Pereira Rossell (CHPR). Objetivo: Identificar factores de riesgo de desarrollo de empiema en niños menores de 5 años que requieren ingreso hospitalario por diagnóstico de neumonía. Hipótesis: El retardo en el diagnóstico aumenta al menos 2 veces el riesgo de desarrollar empiema en menores de 5 años que requieren ingreso hospitalario por neumonía. Como hipótesis secundarias, las visitas reiteradas y el uso previo de antibióticos lo aumentan también. Método: Estudio observacional, prospectivo de una cohorte de niños menores de 5 años hospitalizados en el CHPR por neumonía. Interrogatorio a padres de síntomas de interés y exposición a factores. Registro de edad, sexo, estado nutricional, edad gestacional y peso al nacer. Los pacientes fueron seguidos hasta el alta hospitalaria. Resultados: Se siguieron 201 niños; 104 se presentaron con retardo en el diagnóstico, 152 con consultas reiteradas y 36 con uso previo de antibióticos; 70 niños desarrollaron empiema. El retardo en el diagnóstico se asoció a un aumento en el desarrollo de empiema de 1,9 veces (IC95% 1,3-2,9). Ni las consultas reiteradas ni el uso previo de antibióticos se comportaron como factores de riesgo. Conclusión: El retardo en el diagnóstico de neumonía aumenta hasta 2,9 veces el riesgo de desarrollar empiema en niños menores de 5 años con criterio de hospitalización en el CHPR. Las consultas reiteradas y el uso previo de antibióticos no lo aumentan. El reconocimiento precoz de los signos de neumonía podría disminuir esta complicación.


Lower respiratory infectious diseases are an important cause of morbidity-mortality in Uruguay. The parapneumonic empyema occurred in 15% of admissions for pneumonia at the Pereira Rossell Hospital Centre (PRHC). Objective: To identify risk factors for pleural empyema in children aged between 1 month and 5 years with community acquired pneumonia (CAP) admitted to hospital. Hypothesis: The delay in diagnosis increases the risk of pleural empyema two-fold. Secondary hypothesis, previous medical visits and use of antibiotics increase the risk of empyema. Methods: An observational, prospective cohort study was carried out on children admitted to the PRHC with a diagnosis of CAP. Symptoms duration, antibiotic use and previous medical visits were noted, and patients followed up until discharge. Results: Of 201 children, 104 had a delayed diagnosis of CAP, 152 were repeated seen, and 36 had previous antibiotics. 70 developed pleural empyema. The delayed diagnosis increased the risk of empyema by 1,9 (CI 95% 1,3-2,9). Previous medical visits or the use of antibiotics increased the risk. Conclusions: Delayed diagnosis of CAP increased the risk of empyema by as much as 2,9 times normal. The early appreciation of these signs and symptoms may decrease the risk of this complication.

16.
Leuk Lymphoma ; 40(3-4): 287-94, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11426550

RESUMO

Adult T-cell leukemia/lymphoma (ATL) is frequently a very aggressive malignancy with a poor survival despite aggressive multiagent chemotherapy. The combination of the antiretroviral drug zidovudine (AZT) and interferon alpha (IFNalpha) has been reported to induce remissions in patients with ATL. The purpose of this study was to evaluate the clinical response and toxicity following administration of a combination of IFNalpha-2b and AZT in patients with human T-cell lymphotropic virus type I (HTLV-I)-associated ATL. Eighteen patients with ATL (chronic. crisis, acute or lymphoma type) were treated with the combination of AZT (50 - 200 mg orally 5 times a day) and IFNalpha-2b (2.5 - 10 million units subcutaneously daily). Three patients had objective responses lasting more than one month. One patient had a clinical complete remission, lasting 21.6 months and two patients had partial remissions lasting 3.7 and 26.5 months. Six patients were not considered evaluable for response due to short and/or interrupted periods of treatment. Seventeen patients have died with a median survival time after initiation of therapy of 6 months. Neutropenia and thrombocytopenia were the dose limiting toxicities. In conclusion, the response rate in this study was lower than noted in the two previous published series. This may be due to the amount and type of prior treatment our patients had received.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Interferon-alfa/administração & dosagem , Leucemia-Linfoma de Células T do Adulto/tratamento farmacológico , Zidovudina/administração & dosagem , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/toxicidade , Intervalo Livre de Doença , Feminino , Humanos , Interferon alfa-2 , Interferon-alfa/toxicidade , Leucemia-Linfoma de Células T do Adulto/complicações , Leucemia-Linfoma de Células T do Adulto/mortalidade , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Proteínas Recombinantes , Indução de Remissão , Testes Cutâneos , Trombocitopenia/induzido quimicamente , Resultado do Tratamento , Zidovudina/toxicidade
18.
J Am Vet Med Assoc ; 208(12): 2027-30, 1996 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-8707678

RESUMO

OBJECTIVE: To determine concentrations of estrone sulfate in serum, estrone sulfate in urine, relaxin in serum, and progesterone in serum in pregnant llamas and alpacas and to assess the potential of these hormones as pregnancy indicators. DESIGN: Prospective study. ANIMALS: 19 parous pregnant camelids (8 llamas and 11 alpacas). PROCEDURE: Estrone sulfate concentrations (in serum and in urine) and progesterone concentrations (in serum) were determined by enzyme immunoassay. Relaxin concentrations (in serum) were measured by radioimmunoassay. Serum and urine samples were collected daily for the first 30 days after breeding and, thereafter, once weekly until parturition. RESULTS: Estrone sulfate concentrations (in serum and in urine) peaked twice during pregnancy. The first took place 21 days after breeding and the second during the last month of pregnancy. Relaxin concentrations increased at 3 months of gestation to > 20 ng/mL, decreased at 5 months to 5 ng/mL, then increased from 8 months of pregnancy until parturition. Progesterone concentrations were detectable 4 days after breeding and were maintained > 2 ng/mL throughout pregnancy. CLINICAL IMPLICATIONS: The first increase in estrone sulfate concentration over basal values may indicate early interaction between mother and embryo, whereas the second increase may reflect fetal viability. Use of estrone sulfate concentration to diagnose pregnancy in llamas and alpacas is highly dependent on time of sampling. Relaxin concentration in serum is a superior indicator of pregnancy after the second month in the Ilama and alpaca because its existence is suggestive of interaction between mother and fetus, and concentrations are greater than basal values for a long period of pregnancy. Progesterone is not a direct product of the embryo or fetus and only indirectly confirms a diagnosis of pregnancy.


Assuntos
Camelídeos Americanos/sangue , Estrona/análogos & derivados , Prenhez/sangue , Progesterona/sangue , Relaxina/sangue , Animais , Camelídeos Americanos/fisiologia , Estrogênios Conjugados (USP)/sangue , Estrogênios Conjugados (USP)/urina , Estrona/sangue , Estrona/urina , Feminino , Técnicas Imunoenzimáticas/veterinária , Gravidez , Testes de Gravidez/veterinária , Estudos Prospectivos , Radioimunoensaio/veterinária , Especificidade da Espécie
19.
Rev. SOCERJ ; 9(2): 51-4, abr.-jun. 1996.
Artigo em Português | LILACS | ID: lil-266153

RESUMO

A cardite reumática é responsável pela grande morbidade da febre reumática sendo o seu tratamento da maior importância para a reduçäo das complicaçöes e mortalidade associadas à doença. O tratamento pode ser dividido nas seguintes etapas: profilaxia primária, estabilizaçäo hemodinâmica, tratamento anti-inflamatório e profilaxia secundária. Algumas alternativas de tratamento, como pulsoterapia, seräo abordadas.


Assuntos
Humanos , Antibioticoprofilaxia/efeitos adversos , Antibioticoprofilaxia/estatística & dados numéricos , Febre Reumática/complicações , Febre Reumática/patologia , Febre Reumática/terapia , Miocardite/patologia , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/terapia , Penicilinas/efeitos adversos , Penicilinas/uso terapêutico , Prescrições de Medicamentos
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