RESUMO
INTRODUCCIÓN: En Chile, los efectos maternos y perinatales de la pandemia por SARS-CoV-2 son aún desconocidos. GESTACOVID es un estudio multicéntrico que incluye embarazadas y puérperas hasta el día 42 con COVID-19. El objetivo de este estudio es presentar un informe preliminar, describiendo el impacto de la enfermedad en las embarazadas, factores de riesgo asociados y resultados perinatales. MÉTODOS: Estudio de cohorte descriptivo que incluye 661 pacientes enroladas entre el 7 de marzo y el 6 de julio de 2020, en 23 centros hospitalarios del país. Se analizaron variables demográficas, comorbilidades, características clínicas y del diagnóstico de COVID-19 y resultado materno y perinatal. RESULTADOS: Las pacientes hospitalizadas por COVID-19 tuvieron mayor prevalencia de hipertensión arterial crónica [10% vs 3%; OR=3,1 (1,5-6,79); p=0,003] y de diabetes tipo 1 y 2 [7% vs 2%; OR=3,2 (1,3-7,7); p=0,009] que las pacientes manejadas ambulatoriamente. Un IMC >40 kg/mt2 se asoció con un riesgo dos veces mayor de requerir manejo hospitalizado [OR=2,4 (1,2 - 4,6); p=0,009]. Aproximadamente la mitad de las pacientes (54%) tuvo un parto por cesárea, y un 8% de las interrupciones del embarazo fueron por COVID-19. Hasta la fecha de esta publicación, 38% de las pacientes continuaban embarazadas. Hubo 21 PCR positivas en 316 neonatos (6,6%), la mayoría (17/21) en pacientes diagnosticadas por cribado universal. CONCLUSIONES: Las embarazadas con COVID-19 y comorbilidades como diabetes, hipertensión crónica y obesidad mórbida deben ser manejadas atentamente y deberán ser objeto de mayor investigación. La tasa de transmisión vertical requiere una mayor evaluación para diferenciar el mecanismo y tipo de infección involucrada.
INTRODUCTION: In Chile, effects of the SARS-CoV-2 infection in pregnant women are unknown. GESTACOVID is a multicenter collaborative study including pregnant women and those in the postpartum period (until 42 days) who have had COVID-19. The purpose of this study is to report our preliminary results describing the clinical impact of COVID-19 in pregnant women, the associated risk factors and perinatal results. METHODS: Descriptive cohort study including 661 patients between April 7th and July 6th, 2020, in 23 hospitals. Demographical, comorbidities, clinical and diagnostic characteristics of COVID-19 disease and maternal and perinatal outcomes were analyzed. RESULTS: Pregnant women with COVID-19 admitted to the hospital were more likely to have chronic hypertension [10% vs 3%; OR=3.1 (1.5-6.79); p=0,003] and diabetes type 1 and 2 [7% vs 2%; OR=3.2 (1.3-7.7); p=0.009] than those with outpatient management. A body mass index of >40 kg/mt2 was associated with two-fold higher risk of hospitalization [OR=2.4 (1.2-4.6); p=0.009]. Almost half of patients (54%) were delivered by cesarean section, and 8% of the medically indicated deliveries were due to COVID-19. So far, 38% of the patients are still pregnant. Among 316 newborns, there were 21 positive PCR tests (6.6%), mostly from asymptomatic mothers undergoing universal screening. CONCLUSIONS: Pregnant women with COVID-19 and comorbidities such as diabetes, chronic hypertension and morbid obesity need a close follow up and should be a matter for further research. Vertical transmission of COVID-19 should be thoroughly studied to define the mechanisms and type of infection involved.
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pacientes Ambulatoriais , Sinais e Sintomas , Resultado da Gravidez , Comorbidade , Cesárea/estatística & dados numéricos , Chile/epidemiologia , Programas de Rastreamento , Epidemiologia Descritiva , Fatores de Risco , Estudos de Coortes , Aborto Induzido/estatística & dados numéricos , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Cuidados Críticos , Diabetes Mellitus/epidemiologia , Betacoronavirus , Hospitalização , Hipertensão/epidemiologia , Obesidade/epidemiologiaRESUMO
Resumen Introducción: El cáncer de células escamosas (CCE) es el segundo cáncer de piel más frecuente. Sin embargo, no hay publicaciones en Chile sobre el tema. Objetivo: Investigar características sociodemográficas y clínicas del CCE en la Región de Coquimbo, Chile. Material y Métodos: Serie de casos de pacientes con diagnóstico de CCE de piel tratados en el hospital de Coquimbo, entre enero de 2006 y diciembre de 2015. Criterios de inclusión: diagnóstico histológico definitivo de CCE de piel. Criterio de exclusión: 1.- seguimiento posoperatorio menor de 12 meses; 2.- operado en otro hospital; 3.- sometido a otro tratamiento previo a la cirugía; 4.- metástasis cutáneas de un CCE mucoso; 5.- CCE con metástasis a distancia. Variables independientes: edad, género, localización, tamaño, linfonodos comprometidos, residencia costera-interior. Variables dependientes: recurrencia, factores de recurrencia, letalidad. Análisis estadístico: descriptivo y analítico con el programa SSPS. Resultados: Se registraron 2.202 casos de cáncer de piel, 1.487 basocelular (67,5%), 181 melanomas (8,2%) y 534 CCE (24,2%). 236 pacientes tienen datos completos y constituyen el informe, 153 hombres (64,8%) y 83 mujeres (35,2%). Edad: 75,5 años ± 11,7 (extremos 46-94). La localización es: cabeza 158 casos (66,9%), otras áreas expuestas 47 (20%) y no expuestas 31 (14,1%). En cabeza la localización más frecuente es mejilla 40 casos (25%), frente 29 casos (12,3%). En 119 casos (50,4%) el cáncer se presenta ulcerado y en 117, no ulcerado (49,6%); diámetro del tumor 22 milímetros (rango 3-100 mm). En 10 casos hay linfonodos clínicos (4,2%). En 12 casos (5,9%) se extirpa LNC, 2 positivos. 201 casos presentan bordes histológicos libres (85,2%) y en 35 casos, borde comprometido (14,8%). Tasa de recurrencia local 8,5% (20 casos) y ganglionar 2,1% (5 casos). Recidiva del cáncer se asocia a borde histológico comprometido: P = 0,001, IC 95% 3,12-12,19 y ulceración p = 0,01, OR 4,63; IC 1,59-13,50. Seguimiento de 36 meses (rango 12-228). Letalidad 2,56%. Conclusión: El CCE de piel extirpado precozmente con confirmación histológica de erradicación tiene buen pronóstico.
Introduction: Squamous skin cancer (SSC) is the second most frequent skin cáncer, nevertheless reports about this issue are not published in Chile. Objetive: To investigate social, demographics, and clinic characteristics of SSC in semidesertic Coquimbo Region, Chile. Material and Methods: serie of patients diagnosed and treated in Coquimbo hospital between January 2006 and December 2015. Inclussion criteria: 1.- histopathological confirmation of SSC. Exclusion criteria: 1.- follow up lesser than 12 months; 2.- operated in another hospital; 3.- submitted to another treatment prior to surgery; 4.- skin metastasis of mucous squamous carcinoma; 5.- patients with distant metástasis. Independent variables: age, gender, tumor site, tumor size, clinical lymph nodes, shore or valley residency. Dependent variable: recurrency frecuence, factors of recurrency, letality. Statistical analysis: descriptive and analytical by SSPS program. Results: 2.202 skin cancer cases were registered, 1.487 basal cells carcinoma (67.5%), 181 melanoma (8.2%) and 534 squamous cells carcinoma (24.2%). 236 patients with complete data are included in this report. There were 153 men (64.8%), and 83 women (35.2%). Mean age was 75.5 years old ± 11.7 (range 46-94). Primary site was: head 158 patients (66.9%), other sun exposed areas 47 patients (20%), and non exposed areas 31 patients. Cheek and front were the most frequents head site with 40 cases (25%) and 29 cases (12.3%), respectively. In 119 cases (50.4%) SCC was ulcerated, and 117 cases was not; primary tumor diameter was 22 millimeters (range 3-100). Clinical lymph nodes were primarily positives in 10 patients, (4.2%). In 12 cases with negative lymph nodes, sentinel limph node was resected. 2 were positives. Histological borders were tumor free in 201 patients (85.2%) and, 35 cases (14.8%) had positive histological borders. Local recurrence incidence was 8.5% (20 cases). Limph nodes recurrence was 2.1% (5 cases). Cancer recurrence was associated with histological positive borders P = 0.001, IC 95% 3.12-12.19, and ulcerated tumor p = 0.01, OR 4.63; IC 1.59-13.50. Letality was 2.56%. Mean follow up was 36 months (range 12-228 months). Conclusions: SSC has a good prognosis when primary tumor is resected early, with free histological borders resection.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Cutâneas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Cutâneas/cirurgia , Carcinoma de Células Escamosas/cirurgia , Chile/epidemiologia , Epidemiologia Descritiva , Incidência , Medição de Risco , Metástase Linfática , Recidiva Local de Neoplasia/epidemiologiaRESUMO
El surf es un deporte que ha incrementado su número de adeptos en Chile. Sin embargo, existen pocos estudios que describan las características antropométricas y físicas de estos deportistas en el medio nacional. Este estudio observacional descriptivo transversal, tuvo por objetivo describir las características antropométricas y físicas de surfistas experimentados chilenos. En 15 surfistas chilenos experimentados (edad: 27,1±5,2; talla: 1,77±0,04; peso: 74,1±6,3) se evaluó el somatotipo, control postural, los saltos Squat Jump (SJ) y Counter Movement Jump (CMJ), y el consumo máximo de oxígeno (VO2 Max.). El somatotipo promedio de la muestra fue endomorfo (2,7±0,5), mesomorfo (4,6±0,7) y ectomorfo (2,3±0,6). En la prueba de estabilidad postural se obtuvo un promedio de la velocidad y de área de desplazamiento del centro de presión de 7,2±1,3 mm/seg y 68,1±18,4 mm2 respectivamente. La altura promedio de los saltos SJ fue 33,2±5,3 cm y para el CMJ 35,8±5,1 cm. La media del VO2 Max. alcanzó los 47,2±5,6 (mL·min)/kg. Esta descripción reveló que el somatotipo de la muestra fue mesomórfico balanceado y que la capacidad aeróbica de estos deportistas fue alta en relación a la población general, pero intermedia en comparación a la de deportistas. Los surfistas de la muestra no presentan un gran desarrollo de la fuerza y fuerza-explosiva de los miembros inferiores, pero poseen un buen control postural.
Surfing is a sport that has been growing rapidly in popularity throughout Chile. However, there are very few studies that describe the anthropometric and physical characteristics of these athletes in this country. The objective of this study was to describe anthropometric and physical characteristics in Chilean surfers. The study design is a descriptive observational cross study. Somatotype, postural stability, Squat Jump (SJ) and Counter Movement Jump (CMJ) and maximal oxygen uptake (VO2 max) were evaluated in 15 experienced, Chilean surfers (age: 27.1±5.2; height: 1.77±0.04; weight: 74.1±6.3). Somatotype sample average was: endomorphism: 2.7±0.5, mesomorphism: 4.6±0.7 and ectomorphism: 2.3±0.6. In postural stability test, the average of the center of pressure displacement of speed and area was 7.2±1.3 mm/sec and 68.1±18.4 mm2 respectively. The height average of the jumps was 33.2±5.3 cm for SJ and 35.8±5.1 cm for CMJ. The average of VO2 max reached 47.2±5.6 (mL·min)/kg. This description reflects the sample´s somatotype was balanced mesomorph, their aerobic capacity was high-level in relation to the general population, but is middle level in comparison to other athletes. Surfers of this sample didn´t show a large force development or explosive strength in their lower limbs and hold a good postural control.
Assuntos
Humanos , Masculino , Adulto , Aptidão Física , Somatotipos , Esportes Aquáticos , Chile , Estudos Transversais , Movimento , Consumo de Oxigênio , Equilíbrio PosturalRESUMO
Introduction: At present, the relationship between diet, nutrition and HIV infection has been demonstrated. The scientific community recognizes that knowledge and nutritional care can help maintain health and reduce the effects of the infection. Objective: To assess the nutritional status of people living with HIV-AIDS treated in out-patient clinics of Plaza County. Subjects and Methods: A descriptive cross-sectional study in 87 people infected with HIV (66 males and 21 females). Fifty four asymptomatic infected people and 33 AIDS patients were studied. Nutritional assessment consisted of anthropometric measurements: weight, height, triceps skinfold and arm circumference to calculate the body mass index, and fat and arm muscle area; dietary assessment with frequency questionnaires and food consumption by food groups; measurement of biochemical parameters: hemoglobin, triglycerides, blood sugar and cholesterol. Values were compared with the Student t test and Spearman correlation. Results: The largest group was asymptomatic male between 30-49 years. Few cases of anemia were detected. Hypertriglyceridemia and discrete reductions in fat reserves were predominant. Half of people with AIDS presented bad eating habits. More than half presented sufficient level of knowledge and attitude. Conclusion: It is necessary to increase the attitude of these patients in relation to the care of their nutrition.
Está demostrada la relación entre la alimentación, la nutrición y la infección por VIH. La comunidad científica reconoce que los conocimientos y el cuidado nutricional pueden contribuir a mantener la salud y a disminuir los efectos de la infección. Objetivo: Evaluar el estado nutricional de las personas con VIH-sida atendidas en la consulta de descentralización del municipio Plaza. Sujetos y Métodos: Se realizó un estudio descriptivo transversal en 87 personas infectados con el VIH, 66 del sexo masculino y 21 femenino. 54 portadores asintomáticos del virus y 33 pacientes sida. La evaluación nutricional consistió en mediciones antropométricas: peso, talla, pliegue tricipital, circunferencia braquial para calcular el índice de masa muscular, área grasa y muscular del brazo; evaluación dietética con encuestas de frecuencia de consumo de alimentos y por grupo de alimentos; medición de parámetros bioquímicos: hemoglobina, triglicéridos, glicemia y colesterol. Se comparó con la prueba t de Student así como correlación de Spearman entre indicadores. Resultados: Predominaron los asintomáticos masculinos entre 30-49 años. Se detectaron pocos casos de anemia. Predominó la hipertrigliceridemia y disminuciones discretas de las reservas de grasas. La mitad de personas con sida presentó comportamiento alimentario inadecuado. Más de la mitad presentó nivel de conocimientos y actitud suficiente. Conclusión: Es necesario incrementar la actitud de estos pacientes en relación al cuidado de su nutrición.
Assuntos
Humanos , Pacientes , Índice de Massa Corporal , Avaliação Nutricional , Antropometria , Estado Nutricional , Síndrome da Imunodeficiência Adquirida , HIV , Comportamento AlimentarRESUMO
Los embarazos múltiples se consideran una entidad de alto riesgo obstétrico. Su incidencia ha ido en aumento debido a la utilización de técnicas de reproducción asistida y el aumento de la edad materna. Se presentan 2 casos de embarazos triples monocoriales triamnióticos, de sexo femenino y masculino. En ambos embarazos se manifestaron complicaciones, principalmente fetales y neonatales, atribuidas a embarazos múltiples descritas en la literatura.
Multiple pregnancies are considered a high-risk obstetric entity. Their incidence has been increasing due to the use of assisted reproductive techniques and increased maternal age. Here, we describe two cases of triamniotic monochorionic triplet pregnancies, female and male respectively. Both pregnancies demonstrated complications, mainly fetal and neonatal, attributed to multiple pregnancies reported in the literature.
Assuntos
Humanos , Adulto , Complicações na Gravidez , Gravidez de Trigêmeos , Trigêmeos , Resultado da Gravidez , Gravidez MúltiplaRESUMO
BACKGROUND: Efficiency in the use of resources in health systems and hospitals has been a matter of interest for administrators as well as for policy makers. The growing costs due to higher levels of demand from the population require a better use and allocation of such costs. AIM: To assess the technical efficiency in 28 hospitals in Chile, considering the period from May to October, 2011. MATERIAL AND METHODS: The average number of available beds, the number of staff and the expenses on consumer and service goods were used as production inputs and, on the other hand, the expenditures adjusted by the Diagnosis-Related Groups (IR-DRG) were used as producís. To assess the technical efficiency, the Data Envelopment Analysis technique was used. RESULTS: The levéis of inefficiency fluctuóte from 20 to 23.3%. In other words, with a 20% increase in hospital discharges and maintaining fixed inputs, hospitals could become efficient. CONCLUSIONS: The incorporation of methodologies to determine efficiency allows gathering new knowledge for people who manage resources as well as for policy makers by optimizing practices and having better allocation criteria.
Assuntos
Eficiência Organizacional/normas , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Recursos em Saúde/estatística & dados numéricos , Hospitais/normas , Benchmarking , Chile , Grupos Diagnósticos Relacionados , Eficiência Organizacional/estatística & dados numéricos , Alocação de Recursos para a Atenção à Saúde/normas , Recursos em Saúde/normas , Hospitais/estatística & dados numéricos , Humanos , Modelos Teóricos , Qualidade da Assistência à Saúde/estatística & dados numéricosRESUMO
BACKGROUND: The knowledge of variables influencing hospital efficiency is of paramount importance to carry out initiatives of management improvement and optimization. AIM: To explore on the hospital technical efficiency factors. MATERIAL AND METHODS: Data from 255,439 hospital discharges from 28 hospitals from May to October 2011 were analyzed. The efficiency index developed by Santelices et al was calculated. Proxy variables of hospital practices, human resource productivity, strategic performance, financing mechanisms, geographical territory and specialization, were considered. The analysis was carried out estimating econometric models. RESULTS: The most significant variables to explain efficiency are the length of stay adjusted by complexity, the discharges per nurse and midwife and the performance of the Hospital Balancea Score Card. CONCLUSIONS: The suggested analysis contributes to identify hospital efficiency causes. The results suggest ways to improve performance of hospitals.
Assuntos
Eficiência Organizacional , Administração Hospitalar , Chile , Economia Hospitalar , Humanos , Tempo de Internação , Modelos EconométricosRESUMO
Background: The knowledge of variables influencing hospital efficiency is of paramount importance to carry out initiatives of management improvement and optimization. Aim: To explore on the hospital technical efficiency factors. Material and Methods: Data from 255,439 hospital discharges from 28 hospitals from May to October 2011 were analyzed. The efficiency index developed by Santelices et al was calculated. Proxy variables of hospital practices, human resource productivity, strategic performance, financing mechanisms, geographical territory and specialization, were considered. The analysis was carried out estimating econometric models. Results: The most significant variables to explain efficiency are the length of stay adjusted by complexity, the discharges per nurse and midwife and the performance of the Hospital Balancea Score Card. Conclusions: The suggested analysis contributes to identify hospital efficiency causes. The results suggest ways to improve performance of hospitals.
Assuntos
Humanos , Eficiência Organizacional , Administração Hospitalar , Chile , Economia Hospitalar , Tempo de Internação , Modelos EconométricosRESUMO
Background: Efficiency in the use ofresources in health systems and hospitals has been a matter ofinterestfor administrators as well asforpolicy makers. The growing costs due to higher levéis of demand from the population require a better use and allocation ofsuch costs. Aim: To assess the technical efficiency in 28 hospitals in Chile, considering the period from May to October, 2011. Material and Methods: The average number ofavailable beds, the number ofstaffand the expenses on consumer and service goods were used as production inputs and, on the other hand, the expenditures adjusted by the Diagnosis-Related Groups (IR-DRG) were used as producís. To assess the technical efficiency, the Data Envelopment Analysis technique was used. Results: The levéis of inefficiency fluctuóte from 20 to 23.3%. In other words, with a 20% increase in hospital discharges and maintainingfixed inputs, hospitals could become efficient. Conclusions: The incorporation of methodologies to determine efficiency allows gathering new knowledge for people who manage resources as well asforpolicy makers by optimizing practices and having better allocation criteria.
Assuntos
Humanos , Eficiência Organizacional/normas , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Recursos em Saúde/estatística & dados numéricos , Hospitais/normas , Benchmarking , Chile , Grupos Diagnósticos Relacionados , Eficiência Organizacional/estatística & dados numéricos , Alocação de Recursos para a Atenção à Saúde/normas , Recursos em Saúde/normas , Hospitais/estatística & dados numéricos , Modelos Teóricos , Qualidade da Assistência à Saúde/estatística & dados numéricosAssuntos
Feminino , Humanos , Recém-Nascido , Lactente , Aleitamento Materno , Fertilidade , Recém-Nascido , Saúde da Criança , Leite Humano/fisiologiaRESUMO
BACKGROUND: There is little information on the influence of body mass index (BMI) on mortality in patients with acute venous thromboembolism (VTE). PATIENTS AND METHODS: RIETE is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We examined the association between BMI and mortality during the first 3 months of therapy. RESULTS: Of the 10 114 patients enrolled as of March 2007: 153 (1.5%) were underweight (BMI < 18.5); 2882 (28%) had a normal weight (BMI 18.5-24.9); 4327 (43%) were overweight (BMI 25.0-30); and 2752 (27%) were obese (BMI > 30). The overweight and obese patients were significantly older, and were less likely to have had cancer, recent immobility or renal insufficiency. After 3 months of therapy their death rates were 28%, 12%, 6.2% and 4.2%, respectively. In multivariate analysis, the relative risks for death after adjusting for confounding variables including age, cancer, renal insufficiency or idiopathic VTE were: 2.1 (95% CI, 1.5-2.7); 1.0 (reference); 0.6 (95% CI, 0.5-0.7); and 0.5 (95% CI, 0.4-0.6), respectively. The rates of fatal pulmonary embolism (2.0%, 2.1%, 1.2% and 0.8%, respectively) also decreased with BMI. There were no differences in the rate of fatal bleeding, but patients who were underweight had an increased incidence of major bleeding complications (7.2% vs. 2.7%; odds ratio, 2.7; 95% CI, 1.4-5.1). CONCLUSIONS: Obese patients with acute VTE have less than half the mortality rate when compared with normal BMI patients. This reduction in mortality rates was consistent among all subgroups and persisted after multivariate adjustment.
Assuntos
Índice de Massa Corporal , Sistema de Registros/estatística & dados numéricos , Tromboembolia Venosa/mortalidade , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Argentina/epidemiologia , Comorbidade , Europa (Continente)/epidemiologia , Feminino , Hemorragia/induzido quimicamente , Hemorragia/mortalidade , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Obesidade/epidemiologia , Estudos Prospectivos , Embolia Pulmonar/tratamento farmacológico , Embolia Pulmonar/mortalidade , Insuficiência Renal/epidemiologia , Tromboembolia Venosa/tratamento farmacológicoRESUMO
La tasa de cesáreas en Chile se ubicó entre las más altas del mundo en el año 2000: 39 por ciento a 83 por ciento en la práctica privada y 20 por ciento a 28 por ciento en los hospitales públicos. El objetivo de nuestro estudio es comunicar el impacto que ha tenido en la tasa de cesáreas y el resultado neonatal la aplicación de Guías Clínicas para el manejo del trabajo de parto y monitoreo fetal. Entre el 1 de enero de 1999 y el 31 de diciembre de 2004, la tasa global de cesáreas del período fue de 23,2 por ciento y la tasa de fórceps osciló entre 7,5 y 9,7 por ciento. La incidencia de encefalopatía hipóxico-isquémica (EHI) para el período de estudio fue de 3,5/1.000 nacidos vivos, con una progresiva tendencia a la disminución. Las tasas de cesárea y de EHI son comparables a las reportadas en la literatura internacional. Luego de revisar la literatura, ésta es la primera comunicación nacional sobre el impacto de Guías Clínicas en la atención del parto.
Assuntos
Feminino , Gravidez , Adulto , Humanos , Cesárea/estatística & dados numéricos , Cesárea/normas , Hipóxia-Isquemia Encefálica/prevenção & controle , Trabalho de Parto , Chile , Monitorização Fetal , Forceps Obstétrico/estatística & dados numéricos , Hipóxia-Isquemia Encefálica/diagnóstico , Hipóxia-Isquemia Encefálica/epidemiologia , Incidência , Parto Obstétrico/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Fatores SocioeconômicosRESUMO
OBJECTIVES: To assess the safety-efficacy balance of low-dose inhaled nitric oxide (iNO) in hypoxemic premature infants because no sustained beneficial effect has been demonstrated clearly and there are concerns about side effects. STUDY DESIGN: Eight hundred and sixty infants <32 weeks were randomized at birth to receive 5 ppm iNO or placebo when they presented with hypoxemic respiratory failure (HRF) defined by a requirement for mechanical ventilation, fraction of inspired oxygen (FIO 2 ) >40%, and arterio-alveolar ratio in oxygen (aAO 2 ) <0.22. The primary end point was intact survival at 28 days of age. RESULTS: Sixty-one of 415 infants presented with HRF and were compared with 84 of 445 controls who presented with HRF. There was no difference in the primary end point (61.4% in infants [23% with HRF who were treated with iNO] vs 61.1% in controls [21.4% in controls with HRF]; P = .943). For the infants with HRF who were treated with iNO, there was no significant difference from controls for intraventricular hemorrhage (IVH) (6% vs 7%), necrotizing enterocolitis (8% vs 6 %), or patent ductus arteriosus (PDA) (34% vs 37%). Compared with nonhypoxemic infants, the risk of bronchopulmonary displasia (BPD) increased significantly in HRF controls (OR = 3.264 [CI 1.461-7.292]) but not in infants with HRF who were treated with iNO (OR = 1.626 [CI 0.633-4.178]). CONCLUSIONS: iNO appears to be safe in premature infants but did not lead to a significant improvement in intact survival on day 28.
Assuntos
Broncodilatadores/administração & dosagem , Hipóxia/tratamento farmacológico , Doenças do Prematuro/terapia , Óxido Nítrico/administração & dosagem , Insuficiência Respiratória/terapia , Administração por Inalação , Displasia Broncopulmonar/epidemiologia , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/etiologia , Feminino , Humanos , Hipóxia/mortalidade , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/mortalidade , Masculino , Análise Multivariada , Respiração Artificial , Insuficiência Respiratória/mortalidade , Estudos Retrospectivos , Fatores de Risco , SegurançaRESUMO
The antiviral activity of butanol- and acetic acid-soluble fractions, prepared from the leaves and stems of Phyllanthus orbicularis H.B.K., has been investigated against acyclovir-sensitive or -resistant herpes simplex virus type 1 (HSV-1) strains, using human foreskin fibroblast (HFF) and green ape kidney (Vero) cell lines. Both fractions showed antiviral selectivity indexes (SI) from 10.3 to 22.8, while their extracellular virucidal activities reached SI values ranging from 371 to 1,040. Time-addition experiments suggested that the active compounds present in the studied fractions acted on early steps of the virus replication cycle.
Assuntos
Antivirais/farmacologia , Herpesvirus Humano 1/efeitos dos fármacos , Phyllanthus , Fitoterapia , Extratos Vegetais/farmacologia , Aciclovir/farmacologia , Animais , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Chlorocebus aethiops , Fibroblastos/efeitos dos fármacos , Humanos , Extratos Vegetais/administração & dosagem , Extratos Vegetais/uso terapêutico , Células Vero/efeitos dos fármacosRESUMO
BACKGROUND: Fully breastfeeding women experience an amenorrhoea of variable duration. Our aim was to identify in pregnancy, endocrine markers that could predict the duration of subsequent lactational amenorrhoea. METHODS: We studied 17 healthy women at 34 and 38 weeks gestation, and 1 and 3 months post-partum. The women fully breastfed until 6 months post-partum. During pregnancy, prolactin (PRL), oestrogens (total oestradiol, unconjugated oestrone, unconjugated oestriol), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEA-S), progesterone and placental lactogen, and during post-partum PRL, oestrogens and SHBG, were measured. Free oestradiol in pregnancy and post-partum was calculated. RESULTS: Ten women experienced long (>6 months) and seven experienced short (<6 months) lactational amenorrhoea. At 38 weeks gestation, the women who experienced a long lactational amenorrhoea had twice as much PRL, about half the total oestradiol, lower SHBG concentration (P < 0.05, Student's t-test, Bonferroni modification) and similar free oestradiol concentration, compared with those who experienced short lactational amenorrhoea. The difference in PRL concentration persisted in post-partum postsuckling samples. CONCLUSION: At 38 weeks gestation, the ratio PRL/oestradiol identified all individual women according to the subsequent duration of their lactational amenorrhoea, suggesting that duration of lactational amenorrhoea is conditioned during pregnancy.
Assuntos
Amenorreia , Estradiol/sangue , Idade Gestacional , Período Pós-Parto , Prolactina/sangue , Adulto , Sulfato de Desidroepiandrosterona/sangue , Estriol/sangue , Estrona/sangue , Feminino , Humanos , Lactogênio Placentário/sangue , Gravidez , Progesterona/sangue , Globulina de Ligação a Hormônio Sexual/análise , Fatores de TempoRESUMO
The aim of the present study was to determine the presence of Borrelia burgdorferi antibodies in horses from the metropolitan area of Monterrey, Nuevo León, México. Blood serum was obtained from a total of 100 horses residing at different counties in the area. From each animal data was obtained on age, sex, county of residence, presence of ectoparasites and clinical signs. All sera samples were analyzed by indirect immunofluoresence and the sera that resulted positive to this test was analyzed by Western blot. The serological test yielded 34 positive sera at 1:64 dilution, and from them 6 were positive at 1:128 dilution, 3 at 1:256, and only one at 1:512. Confirmation of the infection by Western blot was obtained only in the sample positive at the 1:512 dilution. These results shown a low frequency of seropositivity to B. burgdorferi of the horses in the area, confirming previous studies indicating that in northeast Mexico Lyme disease is present in different animal species.
Assuntos
Anticorpos Antibacterianos/sangue , Borrelia burgdorferi/imunologia , Doenças dos Cavalos/diagnóstico , Doença de Lyme/veterinária , Animais , Vetores Aracnídeos/microbiologia , Mordeduras e Picadas/complicações , Mordeduras e Picadas/microbiologia , Western Blotting , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Doenças dos Cavalos/epidemiologia , Doenças dos Cavalos/transmissão , Cavalos/imunologia , Cavalos/parasitologia , Ixodes/microbiologia , Doença de Lyme/diagnóstico , Doença de Lyme/epidemiologia , Doença de Lyme/transmissão , Masculino , México/epidemiologia , Infestações por Carrapato/veterináriaRESUMO
An analysis was made on the incidence of Culicidae in Boyeros municipality, City of Havana from 1994 to 1996 based on the requirements of the national program for eradication of Aedes aegypti. A total of 13 species was detected in which Aedes mediovittatus predominated during 3 years of study, followed by Culex quinquefasciatus whereas for the first time Aedes albopictus species was found in the territory. People's Councils Wajay, Santiago de las Vegas and Armada exhibited the highest values of infestation by Culicidae in the municipality, therefore, they required that anti-Aedes program, operators paid more attention to this situation. It was found that depots preferred by Culicidae for breeding were larval traps followed by low tanks in 1994 and 1995 and by other reservoirs in 1996. A mediovittatus preferred larval traps whereas Cx. quinquefasciatus preferred low tanks except in 1996 when this species was mostly found in other tanks. 93% of all test-positive reservoirs found were colonized by only one species, whereas 7% presented larvae from 2 species or more. A. mediovittatus and C. quinquefasciatus were the most related, above all in low tanks.
Assuntos
Aedes , Anopheles , Culex , Ecossistema , Insetos Vetores , Animais , Distribuição de Qui-Quadrado , Intervalos de Confiança , Cuba , Larva , Dinâmica PopulacionalRESUMO
The results of the entomologic surveillance carried out from 1991 to 1996 in Boyeros municipality, City of Havana within the Program for Eradication of Aedes aegypti were analyzed. Data on mosquitoes fauna collected in the municipality by various sampling methods, larval survey, human bait, capture at rest and larval traps. Culex quinquefasciatus, Aedes mediovittatus and Aedes aegypti species were the most found by the different methods. It was proved that water tanks, man-made deposits, other kinds of tanks and low tanks were the most exploited resources by mosquitoes for their breeding in this municipality whereas larval surveys were the most sensitive method for detecting species since it contributed a greater variety of species. Reference is made to the search for a mechanism that help estimate adult populations from larval indices provided by surveys and the method of capture at rest is stressed as the most sensitive method for adult mosquitoes, particularly for dengue vector within the surveillance system aimed at this species.
Assuntos
Aedes , Anopheles , Culex , Insetos Vetores , Animais , Cuba , Dengue/transmissão , Ecossistema , Humanos , Larva , Densidade Demográfica , Estações do Ano , Estatísticas não ParamétricasRESUMO
Se presentan los resultados del manejo de fractura del pilón tibial en el Servicio de Traumatología Adultos y Unidad de Emergencia adultos del Hospital. Todos los pacientes fueron intervenidos por el mismo equipo de cirujanos y controlados al final del estudio mediante entrevista personal o por encuesta telefónica, con el protocolo de Marsh y cols