RESUMO
Resumen Introducción: El tinnitus se define como la percepción consciente de un sonido, en ausencia de un estímulo acústico externo correspondiente. Se ha relacionado a múltiples comorbilidades como hipertensión arterial (HTA), diabetes mellitus (DM) e hipoacusia, sin evidencia sólida en la actualidad. Hay diversas formas de experimentar el tinnitus, ya sea de comienzo unilateral o bilateral, intermitente o persistente, con deterioro de la calidad de vida, leve hasta formas invalidantes. El conocer las diversas patologías presentes en el tinnitus, en especial la hipoacusia, toma relevancia al momento de enfrentar a pacientes con dicha patología. Objetivo: Caracterizar el tinnitus y sus principales hallazgos audiométricos en pacientes atendidos en el Servicio de Otorrinolaringología del Hospital Clínico Herminda Martín de Chillán, Chile. Material y Método: Estudio retrospectivo. Se incluyeron pacientes mayores de 18 años con diagnóstico de tinnitus entre los años 2015-2017. Se obtuvo información epidemiológica, comorbilidades, presentación clínica del tinnitus en función de lateralidad y frecuencia, hipoacusia asociada y hallazgos audiométricos. Resultados: Se incluyeron en el estudio a 249 pacientes, la mayoría mujeres (70%) con una edad promedio de inicio de su tinnitus entre 60-79 años (52%). Entre las principales comorbilidades se encuentran la hipertensión arterial, diabetes mellitus y patologías autoinmunes; los síntomas otorrinolaringológicos acompañantes estuvieron en menos del 10% de los casos. En relación a la caracterización del tinnitus, el 52% fue de inicio unilateral y el 66% de forma continua. La hipoacusia objetivada en el audiograma estuvo presente en el 43% de los pacientes con tinnitus. Conclusión: El tinnitus es una patología compleja y multifactorial, en este sentido, la presencia de hipoacusia objetiva en la audiometría estuvo presente en un 43% de los pacientes, siendo una de las principales causas a descartar por el médico en el primer enfrentamiento del paciente.
Abstract Introduction: tinnitus is defined as the conscious perception of a sound, in the absence of a corresponding external acoustic stimulus. It has been related to multiple comorbidities such as high blood pressure, diabetes mellitus, hearing loss, with no solid evidence at present. There are various ways to experience tinnitus, whether it is unilateral or bilateral, intermittent or persistent onset, from mild quality of life deterioration to disabling forms. Knowing the various pathologies present in tinnitus, especially hearing loss, becomes relevant when confronting patients with this pathology. Aim: To characterize tinnitus and its main audiometric findings in patients treated at the Otorhinolaryngology Service of the Herminda Martin of Chillán Clinical Hospital in Chile. Material and Method: Retrospective study. Patients older than 18 years with a diagnosis of tinnitus between the years 2015-2017 were included. Epidemiological information, comorbidities, clinical presentation of tinnitus according to laterality and frequency, associated hearing loss and audiometric findings were obtained. Results: 249 patients were included. Most were women (70%), with an onset average age of tinnitus between 60 to 79 years (52%). The accompanying otorhinolaryngological symptoms were in less than 10% of the cases. The main comorbidities were high blood pressure, diabetes mellitus and autoimmune pathologies. 52% of tinnitus was unilateral presentation and in 66% it was continuous. 43% had hypoacusis objectified on the audiogram, regardless of whether they had the sensation of hearing loss. Conclusion: Tinnitus is a complex and multifactorial pathology, in this sense, the presence of objective hearing loss in audiometry was present in 43% of patients, being one of the main causes to be ruled out by the doctor in the patient's first confrontation.
RESUMO
Desde 1995 hasta la fecha la asociación entre patologías derivadas los embarazos hipertensivos y las enfermedades cardiovasculares ha generado un gran volumen de potentes evidencias epidemiológicas y clínicas. Los propósitos de esta revisión son varios. Mostrar la consistencia y magnitud de la evidencia científica. Integrar los riesgos/enfermedades cardiovasculares y los problemas obstétricos a través de la disfunción endotelial. Preconizar el seguimiento postparto de la hipertensa embarazada, como una ventana de oportunidad para beneficiar la salud de las mujeres y sus hijos. Incluir la historia obstétrica como factor de riesgo de enfermedad coronaria. Proponer cuestionarios adaptables a las prácticas locales para facilitar la pronta incorporación de los índices de riesgo obstétrico y cardiovascular en dos etapas de la vida de una mujer. Ha llegado el momento para que los equipos obstétricos, cardiológicos y las pacientes jueguen un rol en la prevención de los riesgos y enfermedades cardiovasculares.
From 1995 onwards the association between hypertensive pregnancies and cardiovascular disease has generated a great volume of epidemiologic and clinical evidence. The purposes of this review are several. To demonstrate the consistence and weight of the scientific evidence. To integrate cardiovascular risks/diseases and obstetric complications through the link of endothelial dysfunction. To advocate postpartum follow-up after a hypertensive pregnancy as a window of opportunity to benefit the health of mothers and offsprings. To include the obstetrical history as a risk factor for coronary disease. To propose questionnaires adaptable to local practices to incorporate cardiovascular and obstetrical indexes in two stages of a woman's lifetime. The time has come for obstetrical teams, cardiologists and patients to play a preventive role regarding cardiovascular risks and diseases.
Assuntos
Humanos , Feminino , Gravidez , Pré-Eclâmpsia/epidemiologia , Complicações Cardiovasculares na Gravidez/epidemiologia , Doenças Cardiovasculares/epidemiologia , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/fisiopatologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Complicações Cardiovasculares na Gravidez/prevenção & controle , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Fatores de RiscoRESUMO
Resumen Se describe el proceso para obtener un adhesivo sensible a la presión (PSA). Este PSA está formado por un copolímero de acrilato de 2-etilhexil (2-EHA) / metacrilato de metilo (MMA) en una relación 80:20 que se polimerizó mediante una técnica de polimerización en emulsión. Se añadieron nanopartículas de óxido de zinc (NPZnO) a este copolímero, que se sintetizaron previamente y se modificaron superficialmente con 3-aminopropil-3-toxisilano (APTES) y dimetilsulfóxido (DMSO) para mejorar su dispersión en la matriz de copolímero. Los nanocompuestos obtenidos se caracterizaron por espectroscopía infrarroja (FTIR), calorimetría diferencial de barrido (DSC) y pruebas de adhesión al delaminado. Además, se determinó la actividad antimicrobiana contra S. aureus y S. pyogenes, así como la citotoxicidad en células humanas (HeLa). Los resultados demostraron que la adición de las nanopartículas de NPZnO al copolímero incrementa la temperatura de transición vítrea (Tg) así como las propiedades antimicrobianas del adhesivo mejorando a su vez su adhesión superficial. Con respecto al comportamiento adhesivo, el PSA con NPZnO sin modificar mostró una mayor resistencia al delaminado, esto quiere decir que las nanopartículas incrementan la fuerza cohesiva y proporcionan resistencia a temperaturas elevadas, lo cual sería beneficioso a su aplicación final. Finalmente, los resultados de citotoxicidad mostraron que la incorporación de NPZnO al PSA disminuye la viabilidad celular, sin embargo no se considera tóxico acorde a la norma ISO 10993 test for in vitro cytotoxicity.
Abstract The process for obtaining a pressure sensitive adhesive (PSA) is described. This PSA is formed by an acrylate copolymer of 2-ethylhexyl (2-EHA) / methyl methacrylate (MMA) in an 80:20 ratio which was polymerized by emulsion polymerization technique. Zinc oxide nanoparticles (NPZnO) were added to this copolymer, which were previously synthesized, and surface modified with 3-aminopropyltretoxysilane (APTES) and dimethyl sulfoxide (DMSO) to improve its dispersion in the copolymer matrix. The obtained nanocomposites were characterized by infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and T-peel adhesion tests. In addition, the antimicrobial activity against S. aureus and S. pyogenes as well as the cytotoxicity in human cells (HeLa) were determined. The results demonstrated that the ZnO nanoparticles incorporation enhanced the glass transition temperature (Tg) and the antimicrobial activity of PSA copolymer as well as its surface adhesion. It was confirmed that NPZnO modification with APTES increased its antimicrobial activity. Regarding adhesive behavior, PSA with unmodified NPZnO showed a greater peel resistance. This indicates that these nanoparticles enhances the cohesive force and induces a better high temperature performance, which is beneficial for the final application. Finally, cytotoxicity results showed that the incorporation of NPZnO to PSA decreases the cell viability, however this PSA is not toxic according to the standard ISO 10993 test for in vitro cytotoxicity.
RESUMO
OBJECTIVE: To analyze the impact of age on radiotherapy results based on cancer-specific survival (CSS), vaginal-cuff relapses (VCR) and complications analysis in 438 patients with endometrial carcinoma (EC) receiving postoperative radiotherapy (PRT) divided into three age groups for analysis. MATERIALS AND METHODS: From 2003 to 2015, 438 patients with EC were treated with PRT and divided into three age groups: Group-1: 202 patients < 65 years; Group-2: 210 patients ≥ 65 and < 80 years; Group-3: 26 patients ≥ 80 years. Vaginal toxicity was assessed using the objective LENT-SOMA criteria and RTOG scores were recorded for the rectum, bladder, and small bowel. STATISTICS: Chi square and Student's t tests, Kaplan-Meier survival study for analysis of CSS. RESULTS: The mean follow-up was 5.6 years in Group-1, 5.6 years in Group-2 and 6.3 years in Group-3 (p = 0.38). No differences were found among the groups in distribution of stage, grade, myometrial invasion, Type 1 vs. 2 EC and VLSI (p = 0.97, p = 0.52, p = 0.35, p = 0.48, p = 0.76, respectively). There were no differences in rectal, bladder and vagina late toxicity (p = 0.46, p = 0.17, p = 0.75, respectively). A better CSS at 5 years was found in Group-1 (p = 0.006), and significant differences were found in late severe small bowel toxicity in Group-3 (p = 0.005). VCR was increased in Group-3 (p = 0.017). CONCLUSIONS: Patients ≥ 65 years had a worse outcome in comparison to younger patients. Late vaginal, rectal and bladder toxicities were similar in the three groups, although an increase of severe late small bowel toxicity led to IMRT in patients ≥ 80 years. Further larger studies are needed including quality of life analysis in patients ≥ 80 years.
Assuntos
Envelhecimento/fisiologia , Carcinoma Endometrioide/radioterapia , Neoplasias do Endométrio/radioterapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Endometrioide/tratamento farmacológico , Carcinoma Endometrioide/mortalidade , Carcinoma Endometrioide/cirurgia , Terapia Combinada , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Neoplasias Vaginais/mortalidade , Neoplasias Vaginais/radioterapia , Neoplasias Vaginais/cirurgiaRESUMO
In Chile, high cost treatments required by selected medical conditions are financed by the State, according to Law 20.850. A bylaw under discussion by the Senate regulates clinical trials, posing complex issues that will endanger local interest in front-line research: 1. The exclusive and mandatory control bestowed to the Institute of Public Health during all stages of the trials and also the surveillance of institutions performing clinical trials, overriding their Clinical Research Review Boards; 2.The 10 year period during which any adverse event is assumed to have been caused by the medication or devise evaluated by the trial, unless the contrary is proven in a judicial process; 3. Individuals submitted to the trials are entitled to free post trial access to the treatment received during the study, financed by the trial supporting entities and as long as the drug or devise is considered to be useful. While agreeing with the need to have a National Registry of Clinical Trials, we predict that the mentioned critical issues in the bylaw will lead to difficulties and unnecessary judicial processes, thus limiting clinicians interest in performing research. We propose to modify the bylaw, excluding responsibilities on events associated with the natural evolution of the medical condition, with patients ageing or with comorbidities and clinical events considered unpredictable when the protocol was accepted. We recommend that the free post trial access should be a joint decision involving the patient and the attending physician, taking in consideration that the volunteer has been exposed to risks and burdens, or when discontinuation of treatment entails a vital risk until the treatment under study has been approved and becomes available in the national market.
Assuntos
Academias e Institutos/legislação & jurisprudência , Ensaios Clínicos como Assunto/legislação & jurisprudência , Legislação de Medicamentos , Legislação de Dispositivos Médicos , Chile , HumanosRESUMO
In Chile, high cost treatments required by selected medical conditions are financed by the State, according to Law 20.850. A bylaw under discussion by the Senate regulates clinical trials, posing complex issues that will endanger local interest in front-line research: 1. The exclusive and mandatory control bestowed to the Institute of Public Health during all stages of the trials and also the surveillance of institutions performing clinical trials, overriding their Clinical Research Review Boards; 2.The 10 year period during which any adverse event is assumed to have been caused by the medication or devise evaluated by the trial, unless the contrary is proven in a judicial process; 3. Individuals submitted to the trials are entitled to free post trial access to the treatment received during the study, financed by the trial supporting entities and as long as the drug or devise is considered to be useful. While agreeing with the need to have a National Registry of Clinical Trials, we predict that the mentioned critical issues in the bylaw will lead to difficulties and unnecessary judicial processes, thus limiting clinicians interest in performing research. We propose to modify the bylaw, excluding responsibilities on events associated with the natural evolution of the medical condition, with patients ageing or with comorbidities and clinical events considered unpredictable when the protocol was accepted. We recommend that the free post trial access should be a joint decision involving the patient and the attending physician, taking in consideration that the volunteer has been exposed to risks and burdens, or when discontinuation of treatment entails a vital risk until the treatment under study has been approved and becomes available in the national market.
Assuntos
Humanos , Ensaios Clínicos como Assunto/legislação & jurisprudência , Academias e Institutos/legislação & jurisprudência , Legislação de Dispositivos Médicos , Legislação de Medicamentos , ChileRESUMO
Zinc oxide (ZnO) nanoparticles (NPs) have received considerable attention in the medical field because of their antibacterial properties, primarily for killing and reducing the activity of numerous microorganisms. The purpose of this study was to determine whether surface-modified ZnO NPs exhibit different properties compared with unmodified ZnO. The antimicrobial and cytotoxic properties of modified ZnO NPs as well as their effects on inflammatory cytokine production were evaluated. ZnO NPs were prepared using a wet chemical method. Then, the surfaces of these NPs were modified using 3-aminopropyltriethoxysilane (APTES) and dimethyl sulfoxide (DMSO) as modifying agents via a chemical hydrolysis method. According to infrared spectroscopy analysis (FTIR), the structure of the ZnO remained unchanged after modification. Antibacterial assays demonstrated that APTES modification is more effective at inducing an antimicrobial effect against Gram-negative bacteria than against Gram-positive bacteria. Cytotoxicity studies showed that cell viability was dose-dependent; moreover, pristine and APTES-modified ZnO exhibited low cytotoxicity, whereas DMSO-modified ZnO exhibited toxicity even at a low NP concentration. An investigation of inflammatory cytokine production demonstrated that the extent of stimulation was related to the ZnO NP concentration but not to the surface modification, except for IFN-γ and IL-10, which were not detected even at high NP concentrations.
Assuntos
Antibacterianos/toxicidade , Nanopartículas Metálicas/toxicidade , Óxido de Zinco/toxicidade , Antibacterianos/química , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Citocinas/metabolismo , Dimetil Sulfóxido/química , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/crescimento & desenvolvimento , Humanos , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Nanopartículas Metálicas/química , Propilaminas/química , Silanos/química , Propriedades de Superfície , Óxido de Zinco/químicaRESUMO
El presente trabajo intenta reflexionar acerca del uso actual que dan los niños a los videojuegos y a internet. Se ha observado que algunos niños empiezan a jugar muy tempranamente, de manera solitaria y adictiva con atractivos juegos que provienen de programas computacionales, logrando desplazar el interés de los antiguos juguetes a estos programas. Es sabido que la concretud de los juguetes tradicionales, facilita que los pequeños los puedan oler, tocar, maniobrar, maltratar, trasladando sus conflictos a ellos. Estas figuras inanimadas están siempre disponibles a ocupar el lugar que la imaginación del chico/a les quiera asignar. Al parecer los cambios culturales han influido en la conformación de la estructura familiar y en la internalización de los padres, unido a los inconmensurables avances de la tecnología computacional. Estos y otros factores han facilitado que muchos niños presenten adicción, en algún grado, a estas nuevas formas de entretención.
This paper attempts to reflect on current use that give children to video games and Internet. It has been observed that some children start to play very early, lonely and addictively attractive games that come from computer programs, managing to shift the interest of old toys to these programs. It is known that the concreteness of traditional toys, enables the little ones can smell, touch, maneuver, mistreat, in a way that they can transfer their internal conflict to them. These inanimate figures are always available to take the place of the boy's imagination want to assign them. Apparently cultural changes have influenced the shaping of the family structure and the internalization of parents, joined the immeasurable advances in computer technology. These and other factors have made it easier for many children to present addiction or some degree these new forms of entertainment.
Assuntos
Humanos , Masculino , Psicanálise , Jogos de Vídeo/psicologia , Dependência Psicológica , Atitude Frente aos Computadores , Família , Relações Familiares , Relações Pai-FilhoRESUMO
The Prosopis alba seed is a waste material in the process to produce pod flour. To suggest a potential use of these seeds it is necessary to determine the nutritional, phytochemical and functional quality of cotyledon flour from Prosopis alba. This flour showed high level of proteins (62%), low content of total carbohydrate and fat. Free polyphenol (1150±20mg GAE/100g flour) and carotenoids (10.55±0.05mg ß-CE/100g flour) compounds were the dominant compounds. The main identified constituents in the polyphenolic extracts were C- glycosyl flavones, including schaftoside, isoschaftoside, vicenin II, vitexin and isovitexin. The extract enriched in polyphenolic compounds exhibited ABTS(+) reducing capacity and scavenging activity of H2O2; and was able to inhibit phospholipase, lipoxygenase and cyclooxygenase, three pro-inflammatory enzymes. According to our results, the P. alba cotyledon flour could be considered as a new alternative in the formulation of functional foods or food supplements.
Assuntos
Cotilédone/química , Farinha/análise , Compostos Fitoquímicos/análise , Prosopis/química , Antioxidantes/química , Apigenina/análise , Carotenoides/análise , Glucosídeos/análise , Polifenóis/análise , Sementes/químicaRESUMO
BACKGROUND: During the years 2008 and 2009, 1,191 biomedical articles authored by Chilean investigators working in Chile were indexed in PubMed. AIMS: To evaluate the potential visibility of those articles, according to scientometric indexes of the journals where they were published. METHODS: Those journals where the articles had been published were identified and each journals Impact Factor (JIF), 5-year JIF, SCImago Journal Rank (SJR), SCImago Quartiles (Q) for 2010 and the Source Normalized Impact per Paper (SNIP) for 2008-2009 were identified. RESULTS: Three hundred and twelve articles (26,2%) were dedicated to experimental studies in animals, tissues or cells and they were classified as Biomedicine, while 879 (73,8%) were classified as Clinical Medicine; in both areas the main type of articles were original reports (90% and 73.6%, respectively). Revista Médica de Chile and Revista Chilena de Infectología concentrated the greater number of publications. Articles classified in Biomedicine were published more frequently in English and in journals with higher scientometric indexes than those classified in Clinical Medicine. CONCLUSIONS: Biomedical articles dealing with clinical topics, particularly case reports, were published mostly in national journals or in foreign journals with low scientometric indexes. It can be partly attributable to the authors interest in reaching local readers. The evaluation of research productivity should combine several scientometric indexes, selected according to the field of research, the institution's and investigators interests, with a qualitative and multifactorial assessment.
Assuntos
Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Medicina Clínica/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , PubMed/estatística & dados numéricos , Animais , Chile , Humanos , Internacionalidade , Fator de Impacto de Revistas , Publicações Periódicas como Assunto/normasRESUMO
Background: During the years 2008 and 2009, 1,191 biomedical articles authored by Chilean investigators working in Chile were indexed in PubMed. Aims: To evaluate the potential visibility of those articles, according to scientometric indexes of the journals where they were published. Methods: Those journals where the articles had been published were identified and each journals Impact Factor (JIF), 5-year JIF, SCImago Journal Rank (SJR), SCImago Quartiles (Q) for 2010 and the Source Normalized Impact per Paper (SNIP) for 2008-2009 were identified. Results: Three hundred and twelve articles (26,2%) were dedicated to experimental studies in animals, tissues or cells and they were classified as Biomedicine, while 879 (73,8%) were classified as Clinical Medicine; in both areas the main type of articles were original reports (90% and 73.6%, respectively). Revista Médica de Chile and Revista Chilena de Infectología concentrated the greater number of publications. Articles classified in Biomedicine were published more frequently in English and in journals with higher scientometric indexes than those classified in Clinical Medicine. Conclusions: Biomedical articles dealing with clinical topics, particularly case reports, were published mostly in national journals or in foreign journals with low scientometric indexes. It can be partly attributable to the authors interest in reaching local readers. The evaluation of research productivity should combine several scientometric indexes, selected according to the field of research, the institution's and investigators interests, with a qualitative and multifactorial assessment.
Assuntos
Animais , Humanos , Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Medicina Clínica/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , PubMed/estatística & dados numéricos , Chile , Internacionalidade , Fator de Impacto de Revistas , Publicações Periódicas como Assunto/normasRESUMO
Introducción: La Displasia del desarrollo de la cadera (DDC) es un espectro de enfermedades que abarca desde la luxación franca de la cadera hasta la displasia acetabular leve. El screening de detección de DDC se realiza de rutina en nuestro país, mediante una radiografía de pelvis a los 3 meses. El índice acetabular medido en estas radiografías se utiliza para evaluar la cadera displásica, tanto en la presentación inicial como durante el seguimiento posterior. Objetivo: Evaluar la variabilidad tanto intra como inter observador en la medición del índice acetabular, entre profesionales médicos. Material y Métodos: Cuatro evaluadores (un cirujano-ortopédico infantil, un médico general, un pediatra y un radiólogo) realizaron la medición del índice acetabular en 100 radiografías de screening (200 caderas), en tres ocasiones, separadas por un mes cada una (600 mediciones totales). Un observador independiente evaluó la reproductibilidad en la medición. Se utilizó el coeficiente de correlación intraclase para determinar diferencias significativas. Resultados: La variabilidad intra observador fue menor que la interobservador. La variabilidad intra observador fue similar para los diferentes evaluadores, +/- 1,5°. La variabilidad inter observador fue de +/- 3,4°. Conclusiones: Demostramos una alta concordancia entre las mediciones, determinando una alta reproductibilidad del índice acetabular. El índice acetabular es un método seguro para el diagnóstico y seguimiento de displasia acetabular.
Developmental dysplasia of the hip (DDH) is a spectrum of diseases ranging from frank dislocation of the hip to mild acetabular dysplasia. DDH screening for detection is performed routinely in our country using pelvic x-ray at 3 months of age. The radiographic measured acetabular index is used to evaluate the dysplastic hip, at initial presentation and during follow-up. Objective: Evaluation of the intra- and inter-observer variability, among medical professionals, when measuring acetabular index. Methods: Four reviewers (a children orthopedic surgeon, a general practitioner, a pediatrician and a radiologist) performed acetabular index measurement in 100 radiographs (200 hips), on three occasions, separated each by one month (600 total measurements). An independent observer evaluated the measurement reproducibility. The intra-class correlation coefficient to determine significant differences was used. Results: The intra-observer variability was less than the inter-observer variability. The intra-observer variability was similar among the different assessors, +/- 1.5 degrees. The inter-observer variability was +/- 3.4 degrees. Conclusions: A high concordance among measurements was reported, evidencing a high reproducibility of the acetabular index; this index is a reliable method for the diagnosis and follow-up of acetabular dysplasia.
Assuntos
Humanos , Lactente , Acetábulo/patologia , Acetábulo , Luxação Congênita de Quadril/patologia , Luxação Congênita de Quadril , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Programas de Rastreamento/métodosRESUMO
BACKGROUND: Biomedical research is a fundamental tool for the development of a country, requiring human and financial resources. AIM: To define some current characteristics of biomedical research, in Chile. METHODS: Data on entities funding bio-medical research, participant institutions, and the number of active investigators for the period 2007-2009 were obtained from institutional sources; publications indexed in PubMed for 2008-2009 were analysed. RESULTS: Most financial resources invested in biomedical research projects (approximately US$ 19 million per year) came from the "Comisión Nacional de Investigación Científica y Tecnológica" (CONICYT), a state institution with 3 independent Funds administering competitive grant applications open annually to institutional or independent investigators in Chile. Other sources and universities raised the total amount to US$ 26 million. Since 2007 to 2009, 408 investigators participated in projects funded by CONICYT. The main participant institutions were Universidad de Chile and Pontificia Universidad Católica de Chile, both adding up to 84% of all funded projects. Independently, in 2009,160 research projects -mainly multi centric clinical trials- received approximately US$ 24 million from foreign pharmaceutical companies. Publications listed in PubMed were classified as "clinical research" (n = 879, including public health) or "basic biomedical research" (n = 312). CONCLUSIONS: Biomedical research in Chile is mainly supported by state funds and university resources, but clinical trials also obtained an almost equivalent amount from foreign resources. Investigators are predominantly located in two universities. A small number of MD-PhD programs are aimed to train and incorporate new scientists. Only a few new Medical Schools participate in biomedical research. A National Registry of biomedical research projects, including the clinical trials, is required among other initiatives to stimulate research in biomedical sciences in Chile.
Assuntos
Pesquisa Biomédica/tendências , Pesquisa Biomédica/economia , Pesquisa Biomédica/organização & administração , Chile , Humanos , Publicações Periódicas como AssuntoRESUMO
Background: Biomedical research is a fundamental tool for the development of a country, requiring human and financial resources. Aim: To define some current characteristics of biomedical research, in Chile. Methods: Data on entities funding bio-medical research, participant institutions, and the number of active investigators for the period 2007-2009 were obtained from institutional sources; publications indexed in PubMedfor2008-2009 were analysed. Results: Mostfinancial resources invested in biomedical research projects (approximately US$ 19 million per year) came from the "Comisión Nacional de Investigación Científica y Tecnológica" (CONICYT), a state institution with 3 independent Funds administering competitive grant applications open annually to institutional or independent investigators in Chile. Other sources and universities raised the total amount to US$ 26 million. Since 2007 to 2009, 408 investigators participated in projects funded by CONICYT. The main participant institutions were Universidad de Chile and Pontificia Universidad Católica de Chile, both adding up to 84% of all funded projects. Independently, in 2009,160 research projects -mainly multi centric clinical trials- received approximately US$ 24 million from foreign pharmaceutical companies. Publications listed in PubMed were classified as "clinical research" (n = 879, including public health) or "basic biomedical research" (n = 312). Conclusions: Biomedical research in Chile is mainly supported by state funds and university resources, but clinical trials also obtained an almost equivalent amount from foreign resources. Investigators are predominantly located in two universities. A small number of MD-PhD programs are aimed to train and incorporate new scientists. Only a few new Medical Schools participate in biomedical research. A National Registry of biomedical research projects, including the clinical trials, is required among other initiatives to stimulate research in biomedical sciences in Chile.
Assuntos
Humanos , Pesquisa Biomédica/tendências , Pesquisa Biomédica/economia , Pesquisa Biomédica/organização & administração , Chile , Publicações Periódicas como AssuntoRESUMO
BACKGROUND: In Brazil, a mixture of cereals known as "Human Ration" (HR) has been consumed as a substitute for meals due to effects in satiation and weight loss. METHODS: This paper evaluated the effect of HR consumption for 45 days as a breakfast replacement, on body composition, biochemical profile and eating behavior in women (n = 20) between 18-45 years old and with BMI between 27-35 kg/m². RESULTS: The intake of HR did not promote significant changes in the body composition as well as in the mean serum values of glucose, HDL, VLDL, TC/HDL, AST and ALT. However, a significant change was noticed in the levels of TC, LDL and triglycerides (p < 0.05). Average daily intake of calories and macronutrients of the volunteers during the period of HR consumption did not differ from their habitual ingestion (p > 0.05). Regarding the consumption of total fibers, there was a significant increase (p < 0.05) in intake at breakfast during the period of HR consumption when compared to the usual intake. The consumption of HR did not intervene in the sensations of satiation, hunger and prospective intake among the subjects, presenting only instantaneous significant alterations throughout the study. CONCLUSION: The results are clinically relevant, since they may contribute to the reduction of risk factors for chronic noncommunicable diseases.
Assuntos
Composição Corporal/fisiologia , Peso Corporal/fisiologia , Grão Comestível , Lipídeos/sangue , Sobrepeso/sangue , Sobrepeso/dietoterapia , Adolescente , Adulto , Antropometria , Desjejum , Dieta , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Atividade Motora , Adulto JovemRESUMO
This review analyses the changes in immunological tolerance, and the systemic and local hemodynamic changes observed along human pregnancy. To underscore the conceptual importance of tolerance and adaptation the background is provided by the two main advocates of these ideas: Gandhi and Darwin. The cognate factors that determine immunological tolerance (IT), systemic (SA) and local adaptation (LA) are multiple; IT = desensitisation to paternal antigens, absence of HLA-A, roles of HLA-G, natural killer cells and their receptors; SA = decreased vascular resistance, plasma volume expansion, increased cardiac output and plasma renin activity; LA = prostacyclin, nitric oxide, kallikrein-kinin system, vasodilator arm of the renin angiotensin system, vascular endothelial growth factor (VEGF). A possible role of vasodilators in the crucial process of trophoblast invasion and uterine artery transformation is supported. The relevance of an adequate adaptation to pregnancy is highlighted not only by the intragestational complications derived from a defective process, such as intrauterine growth restriction, preterm birth, and preeclampsia -its foremost expression- but also by the long term cardiovascular complications of the mother and her offspring.
Assuntos
Adaptação Fisiológica/fisiologia , Hemodinâmica/fisiologia , Tolerância Imunológica/fisiologia , Gravidez/fisiologia , Endotélio Vascular/fisiologia , Feminino , HumanosRESUMO
This review analyses the changes in immunological tolerance, and the systemic and local hemodynamic changes observed along human pregnancy. To underscore the conceptual importance of tolerance and adaptation the background isprovided by the two main advocates ofthese ideas: Gandhi and Darwin. The cognate factors that determine immunological tolerance (IT), systemic (SA) and local adaptation (LA) are múltiple; IT = desensitisation to paternal antigens, absence of HLA-A, roles of HLA-G, natural killer cells and their receptors; SA = decreased vascular resistance, plasma volume expansión, increased cardiac output and plasma renin activity; LA = prostacyclin, nitric oxide, kallikrein-kinin system, vasodilator arm of the renin angiotensin system, vascular endothelial growth factor (VEGF). A possible role of vasodilators in the crucial process of trophoblast invasión and uterine artery transformation is supported. The relevance ofan adequate adaptation to pregnancy is highlighted not only by the intragestational complications derivedfrom a defective process, such as intrauterine growth restriction, preterm birth, and preeclampsia -its foremost expression- but also by the long term cardiovascular complications ofthe mother and her offspring.
Assuntos
Feminino , Humanos , Adaptação Fisiológica/fisiologia , Hemodinâmica/fisiologia , Tolerância Imunológica/fisiologia , Gravidez/fisiologia , Endotélio Vascular/fisiologiaRESUMO
Ambulatory blood pressure monitoring (ABPM) is a valuable tool to evaluate the blood pressure pattern, to identify hypertensive patients, to diagnose white coat and masked hypertension and in situations in which a tight control of hypertension is crucial. This is an update of 1999 consensus recommendations about the use to ABPM, considering that there is new evidence concerning its benefits, and the clinical experience with its application has increased. Equipment programming, its installation, the interpretation and analysis of the data are described, and a report sheet for patients is included. New recommendations have been added to the accepted indications. Normal blood pressure ranges for children and pregnant women have been replaced by new data.