RESUMO
Introducción: El objetivo de este trabajo es valorar los resultados funcionales, porcentaje de re-roturas y tiempo de reintegro laboral en pacientes con lesiones completas del manguito rotador (MR) reparadas artroscópicamente con fila simple.Materiales y métodos: se valoraron en forma retrospectiva ciento siete pacientes. Se incluyeron las lesiones completas tipo 1 y 2 de la clasificación Davidson y Burkhart, laborales, agudas. Se excluyeron lesiones parciales, masivas (mayores a 3 cm), evolucionadas más de seis meses, o que requirieron tratamientos adicionales. Se utilizaron para la valoración: Simple Shoulder Test (SST), Escala Visual Analógica (EVA), American Shoulder and Elbow Surgeons (ASES). En los casos de re-rotura se compararon los resultados finales para ambos grupos mediante Quick Disabilities of the Arm, Shoulder and Hand (QDASH).Resultados: con un seguimiento de 37.8 meses se obtuvieron los siguientes datos: scores SST 8.2 (68.8 ± 2.9%), EVA para valoración del dolor, el resultado fue 93.3% con dolor leve; ASES, la media fue 89%. Porcentaje de re-roturas: 7.5%. QDASH se diferenció en pacientes sin re-roturas 24.1 ± 2.4% y en los casos con re-rotura, 60.2 ± 4.1%. La media de tiempo al reintegro laboral fue de 7.5 ± 0.3 meses. Conclusión: consideramos que la técnica fila simple es una opción válida que nos permite obtener buenos resultados funcionales en lesiones seleccionadas, agudas, móviles de hasta 3 cm, incluso en pacientes con compensación laboral
Introduction: The objective of this study is to assess the functional results, the percentage of re-tears and the time to return to work, in patients with complete tears of the rotator cuff arthroscopically repaired using simple row suture.Materials and methods: one hundred and seven patients were retrospectively evaluated. Complete acute tears types 1 and 2 of the Davidson and Burkhart classification, in workers, were included. Partial, massive tears (greater than 3 cm), evolving for more than six months, or requiring additional treatments, were excluded. The following scores were used for the assessment of results: the Simple Shoulder Test (SST), the Visual Analog Scale (VAS) and the scale of the American Shoulder and Elbow Surgeons Society (ASES).Results: with a follow-up of 37.8 months, the following results were obtained: SST scores was 8.2 (68.8 ± 2.9%), VAS used for pain assessment was 93.3%, and the mean ASES was 89%. The percentage of re-tears was 7.5%. The QDASH differed in patients without re-rupture 27 ± 2.5% from the cases of re-rupture 60.2 ± 4.1%. Conclusion: we considered that the single row suture technique performed arthroscopically is a valid option that allows to obtain good functional results in selected acute rotator cuff injuries of up to 3 cm in worker population
Assuntos
Adulto , Pessoa de Meia-Idade , Artroscopia/métodos , Seguimentos , Resultado do Tratamento , Retorno ao Trabalho , Lesões do Manguito RotadorRESUMO
RESUMEN Introducción: La resistencia a la insulina es frecuente en el síndrome de ovario poliquístico, con diferencias entre fenotipos y discrepancias sobre cómo medirla. Objetivo: Identificar trastornos de la sensibilidad y resistencia a la insulina en mujeres con síndrome de ovario poliquístico, y determinar si es mayor en el fenotipo clásico. Métodos: Incluyó 152 mujeres: 45 sin síndrome de ovario poliquístico (Grupo I); 46 con síndrome de ovario poliquístico clínico (Grupo II); 61 con síndrome de ovario poliquístico clásico (Grupo III). Se realizó prueba de tolerancia a la glucosa oral, se calcularon índices de sensibilidad o resistencia a la insulina en ayunas (HOMA-IR, I0/G0, FIRI, ISI, Belfiore, Bennet, Quicki, Raynaud) y en la prueba de tolerancia a la glucosa oral (Belfiore2, Ribel, Ins2glu2, ATI, IITotal, DATI/DATG, Matsuda, BetaHOMA). Se emplearon las pruebas de Kruskal-Wallis, Mann-Whitney y Chi cuadrado. Resultados: Las mujeres con síndrome de ovario poliquístico tenían más obesidad global y central (p / 0,05), más nivel de glucemia a los 30, 120 y 180 minutos de la prueba de tolerancia a la glucosa oral (p / 0,05) y de insulinemia a los 30, 60 y 120 (p / 0,0001), lo que fue mayor en el grupo III. Se diagnosticó intolerancia en ayunas en una mujer de cada grupo y tolerancia alterada en una del II y III. No hubo diferencias significativas entre grupos para los índices de sensibilidad o resistencia a la insulina en ayunas; ni del HOMA entre mujeres normopeso vs. sobrepeso-obesidad (p / 0,05). La mediana de los índices de la prueba de tolerancia a la glucosa oral fue menor para los de sensibilidad (Belfiore2, Ribel) y mayor para los de resistencia a la insulina (Ins2glu2, ATI, IITotal) en el Grupo III. El DATI/DATG, Matsuda y BetaHOMA no tuvieron diferencias significativas. Conclusiones: Las mujeres con síndrome de ovario poliquístico tienen mayor respuesta glucémica, resistencia a la insulina e hiperinsulinismo postsobrecarga de glucosa que las mujeres con función ovárica normal, más manifiesta en el fenotipo clásico. Los índices de ayuno son menos sensibles, independientemente del peso corporal. Tienen mayor utilidad: insulinemia a los 60 minutos de la prueba de tolerancia a la glucosa oral, Belfiore2, ATI e IITotal(AU)
ABSTRACT Introduction: Insulin resistance is common in polycystic ovary syndrome, with differences between phenotypes and discrepancies on how to measure it. Objective: To identify disorders of insulin sensitivity and resistance in women with polycystic ovarian syndrome and determine if the latter is greater in the classic phenotype. Methods: The study included 152 women. 45 of them had no polycystic ovary syndrome (Group I), 46 had clinical polycystic ovary syndrome (Group II) and 61 had classic polycystic ovary syndrome (Group III). Oral glucose tolerance test was performed, fasting insulin sensitivity or resistance indices (HOMA-IR, I0 / G0, FIRI, ISI, Belfiore, Bennet, Quicki, Raynaud) were calculated and the tolerance test to oral glucose (Belfiore2, Ribel, Ins2glu2, ATI, IITotal, DATI / DATG, Matsuda, BetaHOMA) was also assessed. Kruskal-Wallis, Mann-Whitney and Chi square tests were used. Results: Women with polycystic ovarian syndrome had more global and central obesity (p /0.05), more blood glucose level at 30, 120 and 180 minutes of the oral glucose tolerance test (p /0.05 ) and insulinemia at 30, 60 and 120 (p /0.0001), which was higher in group III. Fasting intolerance was diagnosed in one woman in each group and altered tolerance in one of group II and group III, respectively. There were no significant differences between groups for fasting insulin sensitivity or resistance indices, nor for HOMA among normal weight women vs. overweight-obesity (p / 0.05). The median indexes of the oral glucose tolerance test were lower for those of sensitivity (Belfiore2, Ribel) and higher for those of insulin resistance (Ins2glu2, ATI, IITotal) in Group III. The DATI / DATG, Matsuda and BetaHOMA had no significant differences. Conclusions: Women with polycystic ovarian syndrome have higher glycemic response, insulin resistance and post-overload glucose hyperinsulinism than women with normal ovarian function, which is more evident in the classical phenotype. Fasting rates are less sensitive, regardless of body weight. Tests such as insulinemia 60 minutes after the oral glucose tolerance, Belfiore 2, ATI and IITotal are most useful(AU)
Assuntos
Humanos , Feminino , Adulto , Síndrome do Ovário Policístico/diagnóstico , Resistência à Insulina/fisiologia , Teste de Tolerância a Glucose/métodos , Hiperinsulinismo/etiologia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
Qualitative research of brigades and the family experience of congenital heart disease is of current interest and has been previously neglected. This study aimed to explore the social factors conditioning outcomes of paediatric cardiology care in the setting of Colombian medical brigades and to identify feasible strategies to improve the experience of the beneficiary populations. Participants were selected using purposeful sampling. Semi-structured interviews were conducted with members of logistic and health care teams, caregivers and custodians of beneficiary children of the Programme. The data collected provided an understanding of the health culture, social background, household and intrafamily dynamics. The outcomes of the Programme are influenced by sociocultural dynamics such as communication gaps and the socioeconomic status of the beneficiary populations. Findings may be specific to brigades, but also cross-relevant to any family experience of a new diagnosis of Congenital Heart Disease (CHD) communicating with healthcare professionals. It is important to foresee the role and further development of the Programme. Recommendations are provided suggesting innovative work by means of telemedicine and other sociocultural measures to reduce healthcare inequity and strengthen comprehensive healthcare programmes.
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Cuidadores/normas , Cardiopatias Congênitas/diagnóstico , Equipe de Assistência ao Paciente/normas , Melhoria de Qualidade , Colômbia , Feminino , Humanos , Masculino , Observação , Pediatria , Pesquisa Qualitativa , Classe SocialRESUMO
This article explores the sociocultural aspects of a program of pediatric cardiology health brigades that provides care to children from low-income populations in peripheral regions of Colombia. We analyzed the brigades as a humanitarian strategy to close the gaps of inequity in access to health care, and as a particular context of the medical encounter, the experience of heart disease and the definition of care trajectories. Based on ethnographic observation of brigades and interviews with families receiving care and with health personnel, carried out in 2016 in five different cities, we looked at the dynamics that shape the medical encounter and questioned the mechanisms (medical and social) through which it is evaluated and decided which families can access care in Bogota. We conclude that the brigades, as initiatives that continue to be anchored in humanitarism instead of contributing to the transformation of the conditions that generate health inequities, reproduce and exacerbate such inequities by selecting which lives receive priority to be saved.
Este artículo explora aspectos socioculturales de un programa de brigadas de cardiología pediátrica para la atención de menores de poblaciones de escasos recursos que habitan en regiones periféricas de Colombia. Problematizamos las brigadas como estrategia humanitaria para cerrar las brechas de inequidad en el acceso a la atención en salud, y como contexto particular para el encuentro médico, la experiencia de la cardiopatía y la definición de las trayectorias de cuidado. A partir de la observación etnográfica de brigadas y de entrevistas a familias asistentes y personal de salud, realizadas durante el año 2016 en cinco ciudades diferentes, indagamos en las dinámicas que configuran el encuentro médico y cuestionamos los mecanismos (médicos y sociales) mediante los cuales se evalúa y decide qué familias pueden acceder a atención médica especializada en Bogotá. Se concluye que las brigadas, al ser iniciativas que continúan anclándose en el humanitarismo, en lugar de contribuir a la transformación de las condiciones que generan inequidades en salud acaban reproduciéndolas y exacerbándolas en la medida que seleccionan las vidas con prioridad para ser salvadas.
Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Cardiopatias Congênitas , Serviços de Saúde Rural/organização & administração , Determinantes Sociais da Saúde , Triagem/organização & administração , Adolescente , Altruísmo , Cardiologia , Criança , Pré-Escolar , Colômbia , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/etiologia , Cardiopatias Congênitas/terapia , Humanos , Lactente , Recém-Nascido , Pediatria , Saúde da População Rural , Triagem/métodos , Populações VulneráveisRESUMO
RESUMEN Objetivo Interpretar la percepción de hambre y escasez de alimentos en familias beneficiarias de Programas alimentarios MANA (Mejoramiento Alimentario y Nutricional de Antioquia) en Vigía del Fuerte. Método La investigación se orientó desde el enfoque cualitativo, usando la Etnografía Focalizada como método, para la recolección de la información se utilizaron entrevistas individuales y grupos de discusión. Resultados Las comunidades de la cuenca del río Murrí están protegidas del hambre física por la disponibilidad permanente del plátano; el hambre está asociada a la ausencia de carne o "liga" y al hecho de comer "plátano vacío"; así mismo se refieren al hambre como la sensación de desasosiego, debido al dolor de cabeza y de estómago que experimentan de manera permanente e intensa. Conclusiones A pesar de que las comunidades vigieñas disponen durante todo el tiempo de plátano, protegiéndolas del hambre física; estas no lo aprecian así, como alimento que calma su hambre y los libera, de cierta manera, de la escasez, porque su presencia como único alimento disponible, les recuerda, precisamente, que tienen carencia y hambre.(AU)
ABSTRACT Objective To analyze the perception of hunger and food shortage in families benefiting from MANA (Food and Nutritional Improvement) food programs in Vigía del Fuerte, Colombia. Methods Qualitative research, using focused ethnography as a method for collecting information. Individual interviews and discussion groups were used. Results Even though the communities that live by the Murrí River basin are protected from physical hunger due to the constant availability of plantain or musa, hunger is associated with the absence of meat or liga and the fact that they feel forced to eat empty musa. They also refer to hunger as the feeling of uneasiness caused by headache and stomachache. Conclusions Despite the fact that the communities of Vigía del Fuerte have access to plantain throughout the year, thus protecting them from physical hunger, they do not consider it as food that could calm their hunger and free them from scarcity. This happens because its presence as the only food available reminds them, precisely, that they lack certain conditions and feel hunger.(AU)
Assuntos
Humanos , Programas de Nutrição/organização & administração , Fome/fisiologia , Diversidade Cultural , Musa/fisiologia , Alimentos , Colômbia , Pesquisa QualitativaRESUMO
RESUMEN Este artículo explora aspectos socioculturales de un programa de brigadas de cardiología pediátrica para la atención de menores de poblaciones de escasos recursos que habitan en regiones periféricas de Colombia. Problematizamos las brigadas como estrategia humanitaria para cerrar las brechas de inequidad en el acceso a la atención en salud, y como contexto particular para el encuentro médico, la experiencia de la cardiopatía y la definición de las trayectorias de cuidado. A partir de la observación etnográfica de brigadas y de entrevistas a familias asistentes y personal de salud, realizadas durante el año 2016 en cinco ciudades diferentes, indagamos en las dinámicas que configuran el encuentro médico y cuestionamos los mecanismos (médicos y sociales) mediante los cuales se evalúa y decide qué familias pueden acceder a atención médica especializada en Bogotá. Se concluye que las brigadas, al ser iniciativas que continúan anclándose en el humanitarismo, en lugar de contribuir a la transformación de las condiciones que generan inequidades en salud acaban reproduciéndolas y exacerbándolas en la medida que seleccionan las vidas con prioridad para ser salvadas.
ABSTRACT This article explores the sociocultural aspects of a program of pediatric cardiology health brigades that provides care to children from low-income populations in peripheral regions of Colombia. We analyzed the brigades as a humanitarian strategy to close the gaps of inequity in access to health care, and as a particular context of the medical encounter, the experience of heart disease and the definition of care trajectories. Based on ethnographic observation of brigades and interviews with families receiving care and with health personnel, carried out in 2016 in five different cities, we looked at the dynamics that shape the medical encounter and questioned the mechanisms (medical and social) through which it is evaluated and decided which families can access care in Bogota. We conclude that the brigades, as initiatives that continue to be anchored in humanitarism instead of contributing to the transformation of the conditions that generate health inequities, reproduce and exacerbate such inequities by selecting which lives receive priority to be saved.
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/etiologia , Cardiopatias Congênitas/terapia , Pediatria , Cardiologia , Triagem/métodos , Colômbia , Serviços de Saúde Rural/organização & administração , Populações Vulneráveis , AltruísmoRESUMO
OBJECTIVE: To analyze the perception of hunger and food shortage in families benefiting from MANA (Food and Nutritional Improvement) food programs in Vigía del Fuerte, Colombia. METHODS: Qualitative research, using focused ethnography as a method for collecting information. Individual interviews and discussion groups were used. RESULTS: Even though the communities that live by the Murrí River basin are protected from physical hunger due to the constant availability of plantain or musa, hunger is associated with the absence of meat or liga and the fact that they feel forced to eat empty musa. They also refer to hunger as the feeling of uneasiness caused by headache and stomachache. CONCLUSIONS: Despite the fact that the communities of Vigía del Fuerte have access to plantain throughout the year, thus protecting them from physical hunger, they do not consider it as food that could calm their hunger and free them from scarcity. This happens because its presence as the only food available reminds them, precisely, that they lack certain conditions and feel hunger.
OBJETIVO: Interpretar la percepción de hambre y escasez de alimentos en familias beneficiarias de Programas alimentarios MANA (Mejoramiento Alimentario y Nutricional de Antioquia) en Vigía del Fuerte. MÉTODO: La investigación se orientó desde el enfoque cualitativo, usando la Etnografía Focalizada como método, para la recolección de la información se utilizaron entrevistas individuales y grupos de discusión. RESULTADOS: Las comunidades de la cuenca del río Murrí están protegidas del hambre física por la disponibilidad permanente del plátano; el hambre está asociada a la ausencia de carne o "liga" y al hecho de comer "plátano vacío"; así mismo se refieren al hambre como la sensación de desasosiego, debido al dolor de cabeza y de estómago que experimentan de manera permanente e intensa. CONCLUSIONES: A pesar de que las comunidades vigieñas disponen durante todo el tiempo de plátano, protegiéndolas del hambre física; estas no lo aprecian así, como alimento que calma su hambre y los libera, de cierta manera, de la escasez, porque su presencia como único alimento disponible, les recuerda, precisamente, que tienen carencia y hambre.
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The general lack of well-preserved juvenile skeletal remains from Caribbean archaeological sites has, in the past, prevented evaluations of juvenile dietary changes. Canímar Abajo (Cuba), with a large number of well-preserved juvenile and adult skeletal remains, provided a unique opportunity to fully assess juvenile paleodiets from an ancient Caribbean population. Ages for the start and the end of weaning and possible food sources used for weaning were inferred by combining the results of two Bayesian probability models that help to reduce some of the uncertainties inherent to bone collagen isotope based paleodiet reconstructions. Bone collagen (31 juveniles, 18 adult females) was used for carbon and nitrogen isotope analyses. The isotope results were assessed using two Bayesian probability models: Weaning Ages Reconstruction with Nitrogen isotopes and Stable Isotope Analyses in R. Breast milk seems to have been the most important protein source until two years of age with some supplementary food such as tropical fruits and root cultigens likely introduced earlier. After two, juvenile diets were likely continuously supplemented by starch rich foods such as root cultigens and legumes. By the age of three, the model results suggest that the weaning process was completed. Additional indications suggest that animal marine/riverine protein and maize, while part of the Canímar Abajo female diets, were likely not used to supplement juvenile diets. The combined use of both models here provided a more complete assessment of the weaning process for an ancient Caribbean population, indicating not only the start and end ages of weaning but also the relative importance of different food sources for different age juveniles.
Assuntos
Osso e Ossos/química , Dieta/história , Isótopos de Nitrogênio/análise , Desmame , Adulto , Teorema de Bayes , Aleitamento Materno/história , Pré-Escolar , Cuba , Feminino , História Antiga , Humanos , Lactente , Recém-Nascido , Modelos BiológicosRESUMO
Dental modifications in the Caribbean are considered to be an African practice introduced to the Caribbean archipelago by the influx of enslaved Africans during colonial times. Skeletal remains which exhibited dental modifications are by default considered to be Africans, African descendants, or post-contact indigenous people influenced by an African practice. Individual E-105 from the site of Canímar Abajo (Cuba), with a direct 14C AMS date of 990-800 cal BC, provides the first unequivocal evidence of dental modifications in the Antilles prior to contact with Europeans in AD 1492. Central incisors showing evidence of significant crown reduction (loss of crown volume regardless of its etiology) were examined macroscopically and with a scanning electron microscope (SEM) to determine if the observed alterations were due to deliberate modification or other (unintentional) factors considered: postmortem breakage, violent accidental breakage, non-dietary use of teeth, and wear caused by habitual or repeated actions. The pattern of crown reduction is consistent with deliberate dental modification of the type commonly encountered among African and African descendent communities in post-contact Caribbean archaeological assemblages. Six additional individuals show similar pattern of crown reduction of maxillary incisors with no analogous wear in corresponding mandibular dentition.
Assuntos
População Negra , Dente/anatomia & histologia , Cuba/etnologia , Feminino , Humanos , Incisivo/anatomia & histologia , MasculinoRESUMO
OBJECTIVE: To analyze the epidemiology, treatment and outcome of a series of adult patients with Monteggia lesion treated in Uruguayan institutions. METHODS: This is a retrospective article, we retrospectively identified from two Uruguayan institutions 44 adult patients with Monteggia lesion and analyzed their characteristics including Bado classification, associated injuries, treatment modality and outcome (Morrey score). RESULTS: Using Bado classification, 23 cases (52%) were type II, 12 (27%) type I, seven (16%) type IV and two cases (5%) type III. Associated lesions were radial head fractures, found in 15 patients, coronoid ipsilateral fractures in seven patients, and neurological injuries in four. Radial head dislocation was reduced in 93% of the cases with closed maneuvers. Ulna fractures underwent open reduction and internal fixation in all 30 cases using 3.5 mm DCP plates. Complications after surgery occurred in 21 cases. Revision surgery was done in 15 cases. Outcomes after primary and revision surgery were good or excellent in 37 cases. CONCLUSIONS: In our series we observed that Monteggia lesion in adults is a serious injury with a high number of complications that often require revision surgeries. Level of Evidence IV, Retrospective Study, Case Series.
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ABSTRACT Objective: To analyze the epidemiology, treatment and outcome of a series of adult patients with Monteggia lesion treated in Uruguayan institutions. Methods: This is a retrospective article, we retrospectively identified from two Uruguayan institutions 44 adult patients with Monteggia lesion and analyzed their characteristics including Bado classification, associated injuries, treatment modality and outcome (Morrey score). Results: Using Bado classification, 23 cases (52%) were type II, 12 (27%) type I, seven (16%) type IV and two cases (5%) type III. Associated lesions were radial head fractures, found in 15 patients, coronoid ipsilateral fractures in seven patients, and neurological injuries in four. Radial head dislocation was reduced in 93% of the cases with closed maneuvers. Ulna fractures underwent open reduction and internal fixation in all 30 cases using 3.5 mm DCP plates. Complications after surgery occurred in 21 cases. Revision surgery was done in 15 cases. Outcomes after primary and revision surgery were good or excellent in 37 cases. Conclusions: In our series we observed that Monteggia lesion in adults is a serious injury with a high number of complications that often require revision surgeries. Level of Evidence IV, Retrospective Study, Case Series.
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Introducción: Evidencias sugieren que la testosterona interviene en la regulación del metabolismo de la glucosa y los lípidos.Objetivo: determinar la relación entre los niveles de testosterona y la sensibilidad a la insulina, la adiposidad y los parámetros del metabolismo lipídico en hombres.Métodos: estudio transversal y descriptivo en 225 hombres, entre 35 y 60 años, con y sin trastornos de la tolerancia a la glucosa. Se midieron: talla, peso, circunferencias de la cintura y de la cadera. Se realizaron determinaciones de insulina, glicemia, testosterona, colesterol, HDL-colesterol, LDL-colesterol y triglicéridos. Se determinaron índices de sensibilidad y resistencia a la insulina.Resultados: se encontró una correlación negativa entre los niveles de testosterona y la resistencia a la insulina, y los parámetros de adiposidad explorados (índice de masa corporal, circunferencias abdominal y de la cadera, índice cintura/cadera). El nivel de testosterona fue menor en los sujetos con hipertrigliceridemia. En los sujetos con trastornos de la tolerancia, se encontró un aumento significativo de la frecuencia de obesidad abdominal en presencia de valores bajos de testosterona.Conclusiones: existe una asociación directa entre los niveles de testosterona y la sensibilidad a la insulina en la población estudiada. La disminución de los niveles de testosterona en presencia de los desórdenes asociados al síndrome metabólico, sugiere la indicación de una evaluación metabólica temprana a los pacientes con hipogonadismo(AU)
Introduction: Evidence suggests that testosterone participates in the regulation of glucose and lipid metabolism.Objective: determine the relationship between testosterone levels and insulin sensitivity, adiposity and metabolism parameters in men.Methods: a descriptive cross-sectional study was conducted of 225 men aged 35-60 with and without glucose tolerance disorders. The variables measured were height, weight, and waist and hip circumference. Determinations were made for insulin, glycemia, testosterone, cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Insulin sensitivity and resistance were also determined.Results: a negative correlation was found between testosterone levels/insulin resistance and the adiposity parameters considered (body mass index, waist and hip circumference and waist to hip ratio). Testosterone levels were lower in subjects with hypertriglyceridemia. Patients with tolerance disorders showed a significant increase in the frequency of abdominal obesity in the presence of low testosterone values.Conclusions: a direct relationship was found between testosterone levels and insulin sensitivity in the population studied. Reduced testosterone levels in the presence of disorders associated to metabolic syndrome suggest the need for an early metabolic assessment of patients with hypogonadism(AU)
Assuntos
Humanos , Masculino , Testosterona/metabolismo , Resistência à Insulina/imunologia , Adiposidade/imunologia , Metabolismo dos Lipídeos/imunologia , Hipogonadismo/epidemiologia , Epidemiologia Descritiva , Estudos Transversais/métodosRESUMO
Objetivos: analizar la relación existente entre la influencia barométrica lunar y la ruptura prematura de membranas en parturientas del Hospital Materno-infantil German Urquidi de la provincia Cercado del Departamento de Cochabamba, Bolivia. Métodos: se realizó un estudio de tipo observacional, correlacional de corte transversal en 964 registros de pacientes obstétricas, a través de una tabla de levantamiento de datos elaborado en base a objetivos, para registrar los datos requeridos considerando una seguridad del 95%, con una precisión d=0,049%. El análisis estadístico se realizó con el Software PASS2008. Resultados: observamos que el 31% de las RPM ocurren durante el cuarto menguante y el 29% en la fase de Luna Nueva; el 29% de los nacimientos (por cualquiera de las vías) se realizaron en el cuarto menguante, el 22% en Cuarto Creciente, 32% en la fase lunar de Luna Nueva y el 17% en Luna llena. Conclusiones: no existe una relación entre la influencia barométrica lunar y la ruptura prematura de membranas.
Objectives: analyze the characteristics and outcomes of percutaneous vertebroplasty in the treatment of fractures or spinal injuries, transmit our experience of the advantages of this technique and its applications in surgery. Methods: we performed a study of observational and cross-sectional, in 18 patients, 10 were female, of which 8 were for osteoporotic fractures, trauma and 2, and 8 male patients of which 6 were for trauma, and only two consequence of osteoporosis. Results: according to the study and monitoring of the cases it was found that the technique of vertebroplasty with hydroxyapatite promotes the development and treatment of patients with vertebral fracture, reducing their symptoms and ensuring the stability of the patient. Conclusions: the technique of vertebroplasty with hydroxyapatite is an important contribution to vertebral fracture cases in which they quickly resolved indication, hydroxyapatite is a natural phosphate bone tissue which ensures in many cases bone reformation facilitating patient outcomes.
Assuntos
Ruptura Prematura de Membranas FetaisRESUMO
Objetivos: analizar las características epidemiológicas del trauma abdominal en pacientes de 18 a 78 años atendidos en el Complejo Hospitalario Viedma de la ciudad de Cochabamba, durante el periodo de enero del 2011 a julio del 2012. Métodos: se realiza un estudio de tipo observacional y de corte transversal en 31 registros de pacientes con diagnóstico confirmado de trauma abdominal, considerando una seguridad del 95%, a=0,05 y Z1-a =0,76; seleccionados por muestreo aleatorio no probabilístico sistémico. Resultados: el grupo más vulnerable son los varones (71%), el mecanismo más frecuente son los accidentes automovilísticos (32%); el diagnóstico de ingreso y egreso más frecuente fué trauma abdominal cerrado (65%). La técnica quirúrgica más empleada fue laparotomía exploratoria y rafia de viscera hueca (87%y52%), la complicación más frecuente el hemoperitoneo (16%). Conclusiones: existe una relación directa y estadísticamente significativa entre el tiempo demorado para el ingreso a quirófano y la estadía intrahospitalaria en pacientes ingresados por trauma abdominal independientemente de su tipología (COVAR=22,24 y R²=0,5335).
Objectives: to analyze the epidemiological characteristics of abdominal trauma in patients 18 to 78 years treated at the Hospital Viedma city of Cochabamba, during the period January 2011 to July 2012. Methods: we performedis a study of observational and cross-sectional records in 31 patients with confirmed diagnosis of abdominal trauma, considering a 95% confidence, a = 0.05 and Z1-a = 0.76, selected by non-probability random sampling systemic. Results: the most vulnerable group are men (71%), the most common mechanism are motor vehicle accidents (32%), the diagnosis of most frequent entry and exit was closed abdominal trauma (65%). The surgical technique used was exploratory laparotomy and raffia hollow viscera (87% Y52%), the most common complication hemoperitoneum (16%). Con-clusions: there is a statistically significant relationship between the time elapsed for admission to the operating room and hospital stay in patients admitted for abdominal trauma regardless of their type (COVAR = 22.24 and R2 = 0.5335).
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Avaliação Sonográfica Focada no TraumaRESUMO
Objetivos: analizar la relación del estado nutricional de los niños menores de 5 años con los diferentes pisos ecológicos en el municipio de Vinto. Métodos: se realiza un estudio observacional y de corte transversal; a través de la evaluación antropométrica de niños menores de 5 años, de acuerdo a los indicadores estandarizados de la OMS y analizados mediante el software Antrho v. 3.1. Resultados: se determinaron las siguientes prevalencias para cada una de las variable de desnutrición; Desnutrición Crónica=30,7%; Desnutrición Aguda=7,1%; Desnutrición Global=2,2%; Déficit de Reserva energética< -2DE=2,5%. Observamos que el 61,9% (DE=1,38) de los niños y niñas de la Zona Alta son pequeños para su edad. En relación al Peso/Talla, la mediana del z-score es menor en la zona Media (m=0,25) En relación al indicador Peso/Edad, la mayor prevalencia se encuentra en la zona media con 10,2% DE=1,02 (m=-0,64). En relación al Perímetro Meso Braquial o MUAC; para la cuali-cuantificación de la reserva energética y la respuesta ante patologias carenciales; el Z-score es inferior a la media en la Zona Alta (m=-2) y en la zona Media (m= - 2,5). Conclusiones: la prevalencia de desnutrición varía en relación al piso ecológico en el que habitan los niños menores de 5 años, pero por si sola, no es un factor que defina la misma, mas por el contrario depende de otros factores asociados. La desnutrición crónica es directamente proporcional a la altura de la población de origen del niño o niña. La residencia en la zona alta representa una mayor prevalencia de desnutrición crónica en este grupo de riesgo.
Objectives: to analyze the relationship of nutritional status of children under 5 years with the different ecological zones in the municipa-lity of Vinto. Methods: We performed an observational, correlational and cross sectional through anthropometric assessment of children under 5 years, according to standardized WHO indicators and analyzed using software Antrho v 3.1. Results: we identified the following prevalence's for each of the variables of malnutrition, chronic malnutrition = 30.7% = 7.1% Acute Malnutrition, Malnutrition Global = 2.2%, Energy reserve deficit <-2SD = 2, 5%. We observed that 61.9% (SD = 1.38) of the Boys and Girls High zone are small for their age. In relation to weight / height, the median z-score is lower in the Media (m = 0.25) in relation to the indicator weight / age, the highest pre-valence is in the middle with 10.2% SD = 1.02 (m = -0.64) regarding Meso Brachial Perimeter or MUAC, for the qualitative measurement of the energy reserve and response to deficiency pathologies, the Z-score is below average in the Zone Alta (m = -2) and in the Media (m = - 2.5). Conclusions: the prevalence of malnutrition varies in relation to the ecological level in living children under 5 years, but by itself is not a factor that defines the same, but instead depends on other associated factors. Chronic malnutrition is inversely proportional to the height of the source population of the child. The residence in the high risk associated represents a double for the presence of chronic malnutrition in children under the age 5.
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Transtornos da Nutrição InfantilRESUMO
This paper discusses parents' narratives on cochlear implantation in Bogotá, Colombia using a qualitative approach. The main research objective was to identify how parents perceived the processes of diagnosis of their child's hearing loss, making the decision for cochlear implantation and the post-surgery period. All participants were hearing couples (n = 13) with similar socio-cultural backgrounds whose children had undergone cochlear implant surgery. Results show why cochlear implants are a very highly valued technological device with great symbolic power for parents. The study also deals with how perceptions about oral/sign language and disability, as well as social expectations for their children's lifetime opportunities, determine how the parents themselves have experienced their journey through the process of their children's cochlear implantation.
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Implante Coclear/psicologia , Surdez/psicologia , Relações Pais-Filho , Pais/psicologia , Adaptação Psicológica , Adulto , Atitude Frente a Saúde , Criança , Pré-Escolar , Colômbia , Características Culturais , Surdez/etnologia , Saúde da Família , Feminino , Humanos , Masculino , Narração , Pesquisa Qualitativa , Inquéritos e QuestionáriosRESUMO
En este número de la Revista Cubana de Endocrinología, así como en muchos de los anteriores, aparecen trabajos dedicados al tema de la metodología analítica para el estudio de la sensibilidad a la insulina. Este tema, por su actualidad e importancia, merece una especial atención y unos comentarios que sirvan para estimular a nuestros colegas a estudiarlo e incorporarse a su investigación.El concepto de resistencia a la insulina (RI) se propuso desde 1936 para describir el trastorno de las personas con diabetes que requerían dosis exageradamente grandes de insulina para mantener la glucemia en un rango aceptable,1 pero su papel como factor patogénico de diversas enfermedades solo se pudo estudiar a partir de los años 60, cuando el radioinmunoanálisis permitió realizar, de forma simple y segura, la determinación de insulina en un gran número de muestras, y se pudieron realizar estudios que demostraron la coincidencia de altos niveles circulantes de insulina, con niveles normales o elevados de glucosa en un gran número de sujetos, especialmente en obesos, personas con diabetes mellitus tipo 2 (DM 2), con síndrome de ovarios poliquísticos o con enfermedad hepática no alcohólica. Posteriormente, en los años 80, Reaven planteó que la RI era un factor de riesgo para el desarrollo de la diabetes mellitus y de las enfermedades cardiovasculares, lo que llevó a la definición del llamado síndrome metabólico.2 El conocimiento actual de la relación de los trastornos de la sensibilidad a la insulina y de la secreción de insulina por el páncreas, se basa en un enorme volumen de investigaciones que han utilizado como herramienta fundamental la determinación de insulina en plasma en humanos y en modelos experimentales sometidos a diversas pruebas de estimulación, con el fin de evaluar la sensibilidad a la insulina y la capacidad funcional del páncreas endocrino.3Por otra parte, grandes estudios poblacionales que han utilizado indicadores alternativos para el diagnóstico...
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Humanos , Resistência à Insulina , Síndrome Metabólica/etiologia , Diabetes Mellitus/diagnóstico , Fatores de RiscoRESUMO
Actualmente se define la PD como la situación de riesgo de padecer DM 2 y complicaciones vasculares en las personas con tolerancia a la glucosa alterada (TGA) o glicemia en ayunas alterada (GAA). Se conoce que en la progresión de la PD hacia la DM 2 ocurren paralelamente cambios de la TG, de la sensibilidad a la insulina, modificaciones de los patrones de secreción de esta hormona ante los cambios de los niveles de la glucosa en el plasma, trastornos tisulares y fenómenos aterogénicos y trombogénicos, que dependen de estos trastornos. Las intervenciones para la prevención de la DM no deben dirigirse solamente a las personas con hiperglucemia en ayunas o posprandial, pues la heterogeneidad del cuadro clínico y metabólico de esta etapa obliga a ampliar la exploración a toda la población con factores personales o antecedentes familiares que potencialmente lo colocan en una situación de riesgo