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Adequate stem cell harvesting is required for autologous hematopoietic transplantation. In deficient mobilizer patients, the collection of stem cells can be challenging because of the impossibility of achieving satisfactory CD34 cell counts with GCSF + - chemotherapy. Plerixafor is a potent and expensive drug that promotes the release of stem cells from the medullary niche to the peripheral blood and allows satisfactory harvests. We performed a retrospective analysis of 370 patients with myeloma and lymphoma harvested at our institution. 99 % of patients achieved satisfactory apheresis using Plerixafor in 45 %. Satisfactory harvests were obtained in patients mobilized with GCSF or plerixafor. In patients who used plerixafor, it was necessary to perform fewer apheresis procedures (P = 0.05). In multivariate analysis, the only factor that predicted the need for plerixafor was the presence of less than 30,000 CD34 / ul on the day of apheresis (OR 0.3. p < 0.001). Since we adopted the plerixafor protocol guided by CD34 counts, the number of patients with harvest failure has decreased. In conclusion, the rational and standardized use of plerixafor favors satisfactory harvest in patients who require autologous transplantation in South-American patients.
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Remoção de Componentes Sanguíneos , Transplante Autólogo , Humanos , Feminino , Masculino , Remoção de Componentes Sanguíneos/métodos , Pessoa de Meia-Idade , Transplante Autólogo/métodos , Adulto , Estudos Retrospectivos , Transplante de Células-Tronco Hematopoéticas/métodos , Chile , Idoso , Ciclamos/farmacologia , Ciclamos/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/métodos , BenzilaminasRESUMO
In this work, we report the caloric effect for an electronic system of the antidot type, modeled by combining a repulsive and attractive potential (parabolic confinement). In this system, we consider the action of a perpendicular external magnetic field and the possibility of having an Aharonov-Bohm flux (AB-flux) generated by a current passing through a solenoid placed inside the forbidden zone for the electron. The energy levels are obtained analytically, and the model is known as the Bogachek and Landman model. We propose to control the caloric response of the system by varying only the AB-flux, finding that, in the absence of an external magnetic field, the maximization of the effect always occurs at the same AB-flux intensity, independently of the temperature, while fixing the external magnetic field at a non-zero value breaks this symmetry and changes the point where the caloric phenomenon is maximized and is different depending on the temperature to which the process is carried. Our calculations indicate that using an effective electron mass of GaAs heterostructures and a trap intensity of the order of 2.896 meV, the modification of the AB-flux achieves a variation in temperature of the order of 1 K. Our analysis suggests that increasing the parabolic confinement twofold increases the effect threefold, while increasing the antidot size generates the reverse effect, i.e., a strong decrease in the caloric phenomenon under study. Due to the great diversity in technological applications that have antidots in electronics, the possibility of controlling their thermal response simply by varying the intensity of the internal current inside the solenoid (i.e., the intensity of AB-flux) can be a platform of interest for experimental studies.
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Core-shell nanoparticles (CSNPs) are a class of functional materials that have received important attention nowadays due to their adjustable properties by a controlled tuning of the core or shell. Understanding the thermal response and structural properties of these CSNPs is relevant to carrying out an analysis regarding their synthesis and application at the nanoscale. The present work is aimed to investigate the shell thickness effect on thermal stability and melting behavior of Al@Fe CSNPs by using molecular dynamics simulations. The results are discussed considering the influence of the Fe shell on the Al nanoparticle and analyzing the effect of different shell thicknesses in Al@Fe CSNPs. In general, calorific curves show a smooth energy decline for temperatures greater than room temperature for different shell thicknesses and sizes, corresponding to the inward and outward atomic movement of Al and Fe atoms, respectively, that produce a mixed Al-Fe nanoalloy. Here, the thermal stability of the Al@Fe nanoparticle is gradually lost passing to a liquid-Al@solid-Fe configuration and reaching a mixed Al-Fe state by an exothermic mechanism. Combining quantities of the atomic diffusion and structural identification, a stepped structural transition of the system is subsequently observed, where the melting-like point was estimated. Furthermore, it is observed that the Al@Fe CSNPs with greater stability are obtained with a thick shell and a large size. The ability to control shell thickness and vary the size opens up attractive opportunities to synthesize a broad range of new materials with tunable catalytic properties.
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Doenças Autoimunes , Pancreatite Autoimune , Pancreatite , Pediatria , Humanos , Criança , Doenças Raras , Doenças Autoimunes/diagnósticoRESUMO
Resumen Las verrugas plantares son una patología común en la población. Estas lesiones son a menudo dolorosas y recidivantes. Entre los tratamientos más utilizados están las terapias tópicas destructivas y menos frecuentemente el tratamiento quirúrgico. Sin embargo, con frecuencia recurren, por lo que representan un desafío para el dermatólogo. Presentamos 3 casos de pacientes varones adultos con verrugas plantares recalcitrantes que fueron tratadas exitosamente con una sola sesión de láser PDL, sin recidiva luego de 8 a 12 meses de seguimiento.
Abstract Plantar warts are a common pathology in the population. These lesions are often painful and recurring. Among the most used treatments are topical destructive therapies, and less frequently, surgical treatment. However, they frequently recur, so they represent a challenge for the dermatologist. We present 3 adult males with a recalcitrant plantar wart that were successfully treated with a single PDL laser session, without relapse after 8-12 months of follow-up.
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INTRODUCCIÓN Y OBJETIVO Una enfermedad nueva, COVID-19, está afectando dramáticamente al mundo. Conocer los riesgos para la salud reproductiva es un imperativo para la práctica obstétrica y ginecológica. Esta investigación analiza los riesgos maternos y perinatales asociados a COVID-19, con el objetivo de identificar desafíos que la enfermedad plantea a la práctica de la matronería. MÉTODOS Revisión narrativa. Se consultaron artículos científicos de fuentes primarias indexados en las bases Scielo, Pubmed, Scope, WOS, mediante los siguientes términos de búsqueda: "embarazo" "transmisión vertical" "salud materna y perinatal", "riesgos maternos y perinatales" "lactancia materna", COVID-19", "Coronavirus". Se realizaron 3 fases de selección. Los tópicos de análisis fueron: Transmisión vertical, Riesgo materno y perinatal, Lactancia materna. RESULTADOS. En mujeres embarazadas las formas severas de COVID-19 se presentan en presencia de enfermedades crónicas. A nivel perinatal el riesgo mayor es el parto prematuro, generalmente por indicación médica y por cesárea. Aunque no hay evidencias de transmisión vertical, tampoco puede descartarse. Los riesgos neonatales se relacionan con el contagio por proximidad y con medidas restrictivas que pueden afectar la lactancia materna y la interacción madre-hija(o). CONCLUSIONES. La COVID-19 aporta varios desafíos para la práctica de la matronería: implementación de métodos de prevención del contagio a la gestante y a su entorno cercano; adecuación de la preparación al parto en caso de positividad; prevención del estrés y desgaste emocional materno desde el inicio de la gestación hasta el postparto; adecuación de cuidados al recién nacido; investigación aplicada en Latinoamérica, y evaluación de nuevos protocolos.
INTRODUCTION AND OBJECTIVE A new disease, COVID-19, is dramatically affecting the world. Knowing the risks for the reproductive health is an imperative for the obstetric and gynecological practice. This research analyzes the maternal and perinatal risks associated with COVID-19, with the aim of identifying challenges that the disease poses to the practice of midwifery. METHODS Narrative review. Scientific articles from primary sources indexed in Scielo, Pubmed, Scope, and WOS, are consulted by using the following search terms: "pregnancy" "vertical transmission" "maternal and perinatal health", "maternal and perinatal risks" "breastfeeding", COVID-19", "Coronavirus". Three selection phases were carried out. The topics of analysis were vertical transmission, maternal and perinatal risk, breastfeeding. RESULTS In pregnant women severe forms of COVID-19 occur in the presence of chronic diseases. At the perinatal level, the biggest risk is premature delivery, generally for medical indications and by cesarean section. Although there is no evidence of vertical transmission, it cannot be ruled out either. Neonatal risks are related to transmission by proximity and restrictive measures that may affect breastfeeding and mother-child interaction. CONCLUSIONS COVID-19 brings several challenges to the practice of midwifery: implementation of methods to prevent infection of the pregnant woman and her close environment; adaptation of birth preparation in case of positivity; prevention of maternal stress and emotional distress from the beginning of pregnancy to postpartum; adequacy of care for the newborn; research in Latin America, and evaluation of new protocols.
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Humanos , Feminino , Gravidez , Recém-Nascido , Pneumonia Viral/transmissão , Complicações Infecciosas na Gravidez , Infecções por Coronavirus/transmissão , Transmissão Vertical de Doenças Infecciosas , Betacoronavirus , Aleitamento Materno , Medição de Risco , Pandemias , TocologiaRESUMO
Few vaccine adjuvants have been approved for human use although several are currently being studied in preclinical and clinical trial. MPL is a toll-like receptor agonist able to trigger a high and persistent antibody response via-TLR-4 while QS-21 activates the NLRP3 inflammasome. Data suggest that there is a cross-talk between Notch and TLR signaling pathways modulating the polarization of the immune response in a MyD88-dependent manner. However, the role of Notch on the mechanism action of immunogenic adjuvants has not been addressed yet. This study aims to evaluate the in vitro toxicity and inflammatory response triggered by MPL and QS-21 using an in vitro human cell co-culture model and to determine whether NFκB or Notch signaling pathways are involved in their mechanism of immunotoxicity. In order to do this, we evaluated the effect of QS- 21/MPL alone or in combination using a co-culture of PBMC and HUVEC using cytotoxicity, surface expression of ECAMs, cell adhesion and cytokine release, NF-κB activation and NOTCH1 expression as observation endpoints. We found that both MPL and QS-21 were cytotoxic at concentrations over 5 µg/mL. Both adjuvants were able to trigger the expression of ECAMs and induce firm adhesion of PBMC to the endothelium. QS-21 and MPL combination demonstrated a synergistic effect on cellular recruitment and cytokine release generating a switch from Th2 to Th1 cytokine profile. Both MPL and QS-21 by themselves were able to generate significant NF-κB activation. However, this effect was not observed when both adjuvants were combined. On the contrary, the adjuvants alone and combined induced an overexpression of NOTCH-1. This is an important finding, as it provides new evidence that these adjuvants could modulate reactogenicity of vaccines through Notch signaling.
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Adjuvantes Imunológicos/toxicidade , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Leucócitos Mononucleares/efeitos dos fármacos , Lipídeo A/análogos & derivados , Receptor Notch1/genética , Saponinas/toxicidade , Adesão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Técnicas de Cocultura , Citocinas/metabolismo , Interações Medicamentosas , Células Endoteliais da Veia Umbilical Humana/fisiologia , Humanos , Leucócitos Mononucleares/fisiologia , Lipídeo A/toxicidade , NF-kappa B/metabolismoRESUMO
INTRODUCTION: Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implantable collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma. MATERIAL AND METHODS: A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg. Patients underwent surgery with conventional technique and three months after the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations. RESULTS: A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon. CONCLUSIONS: The effect of an ICL on IOP fluctuations, has been studied for the first time, which was found to be not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.
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Pressão Intraocular/fisiologia , Hipertensão Ocular/fisiopatologia , Lentes Intraoculares Fácicas/efeitos adversos , Complicações Pós-Operatórias/fisiopatologia , Adulto , Estudos Transversais , Feminino , Seguimentos , Glaucoma/etiologia , Humanos , Implante de Lente Intraocular/métodos , Masculino , México , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Tempo , Acuidade Visual , Adulto JovemRESUMO
Objetivo Medir la Calidad de Vida en el trabajo (CVT) y sus factores asociados en profesores de colegios públicos de Concepción, Chile. Método Investigación cuantitativa, transversal, descriptiva. Muestra: 92 profesores. Instrumentos: Se empleó CVT-GOHISALO para evaluar CVT (Alpha de Cronbach 0.952) y un cuestionario biosociodemográfico diseñado por el primer autor. El procesamiento de datos se realizó con SPPS, empleándose Rho-Spearman, Rho-Pearson, ANOVA y pruebas no-paramétricas. Se contó con las autorizaciones de los comités de ética involucrados, así como de la Dirección de Administración de Educación Municipal de Concepción (DAEM), y con el consentimiento informado de los participantes. Resultados Promedio CVT global: 215.8 (DE=43.3), que indica nivel medio de CVT. Promedios CVT por dimensiones: Soporte institucional para el trabajo (SIT)=44.6 (DE=10.2), Seguridad en el trabajo (ST)=30 (DE=11.7), Integración al puesto de trabajo (IPT)=33.4 (DE=6.1), Satisfacción por el trabajo (SPT)=34.9 (DE=6.8), Bienestar logrado a través del trabajo (BAT)=36.6 (DE=5.7), Desarrollo personal (DP)=23.3 (DE=6.4) y Administración del tiempo libre (ATL)=12.7 (DE=4.2). Clasificación CVT por dimensiones: SIT: nivel alto; ST, IPT, SPT y DP: nivel medio; BAT y ATL: nivel bajo. Anova para prexistencia de trastorno en salud mental y CVT global, dimensiones SIT, ST, IPT, SPT, BAT, DP y ATL con valor p=0.000; p=0.000; p=0.017; p=0.005; p=0.000; p=0.001 y p=0.046 respectivamente. Conclusiones Los maestros se encuentran medianamente satisfechos con su CVT; existe asociación entre prexistencia de trastornos en salud mental y baja percepción de CVT. Es fundamental que enfermería vele por adecuadas condiciones laborales de profesores y alumnos con el fin de asegurar una CVT satisfactoria así como mejorar la calidad de la educación impartida.
Objective To assess the Quality of Life at Work (QLW) and associated factors among professors of public colleges in Concepción, Chile. Method This is a quantitative, transversal, and descriptive study using a sample of 92 professors. The CVT-GOHISALO instrument was administered to assess QLW (Cronbach Alpha = 0.952) in addition to a bio-social-demographic questionnaire specifically designed by the first author. Data were analyzed with SPSS calculating Rho-Spearman, Rho-Pearson, ANOVA, and non-parametric tests. The corresponding authorizations from involved ethics committees and the Direction of Management of Municipal Education of Concepcion were obtained as well as the inform consent from all the participants. Results The global average QLW score was 215.8 (SD=43.3), indicating a medium level. The related average scores by dimension were as follows: Institutional Support for Work (ISW)=30 (SD=11.7); Work Security (WS)=30 (SD=11.7); Integration to the Work Position (IWP)=33.4 (SD=6.1); Work Satisfaction (WS)=34.9 (DS=6.8); Wellbeing Achieved from Work (WAW)=36.6 (DS=5.7); Personal Development (PD)=23.3 (SD=6.4); and Free Time Management (FTM)=12.7 (SD=4.2). The QLW classification by dimension is as follows: ISW=high; WS, IWP, WS, and PD=medium; WAW, and FTM=low. ANOVA for pre-existing mental health issues and global QLV, dimensions ISW, WS, IWP, WS, WAW, PD, FTM had p=0.000; p=0.000; p=0.017; p=0.005; p=0.000; p=0.001 and p=0.046 respectively. Conclusions Teachers are satisfied in a medium level regarding their QLW. An association between pre-existing mental health issues and a low perception of QLW was found. It is fundamental that nursing organizations promote adequate working conditions for professors and students in order to foster their satisfaction at work and thus the quality of the education they impart.
Objetivo Medir a Qualidade de Vida no trabalho (CVT) e seus fatores associados em professores de escolas públicas de Concepción, Chile. Método Pesquisa quantitativa, transversal, descritiva. Amostra: 92 professores. Instrumentos: Empregou-se CVT-GOHISALO para avaliar CVT (Alpha de Cronbach 0.952) e um questionário biosociodemográfico desenhado pelo primeiro autor. O processamento de dados realizou-se com SPPS, empregou-se Rho-Spe arman, Rho-Pearson, ANOVA e provas não-paramétricas. Contou-se com as autorizações dos comités de ética envolvidos, assim como da "Dirección de Administración de Educación Municipal de Concepción" (DAEM), e com o consentimento informado dos participantes. Resultados Média CVT global: 215.8 (DE=43.3), que indica nível médio de CVT. Média CVT por dimensões: Suporte institucional para o trabalho (SIT)=44.6 (DE=10.2), Segurança no trabalho (ST)=30 (DE=11.7), Integração ao posto de trabalho (IPT)=33.4 (DE=6.1), Satisfação pelo trabalho (SPT)=34.9 (DE=6.8), Bem-estar atingido a través do trabalho (BAT)=36.6 (DE=5.7), Desenvolvimento pessoal (DP)=23.3 (DE=6.4) e Administração do tempo livre (ATL)=12.7 (DE=4.2). Classificação CVT por dimensões: SIT: nível alto; ST, IPT, SPT e DP: nível médio; BLT e ATL: nível baixo. Anova para preexistência de transtorno em saúde mental e CVT global, dimensões ST, IPT, SPT, BAT, DP e ATL com valor p=0.000; p=0.000; p=0.017; p=0.005; p=0.000; p=0.001 e p=0.046, respectivamente. Conclusões Os professores encontram-se medianamente satisfeitos com sua CVT; existe associação entre preexistência de transtornos em saúde mental e baixa percepção de CVT. É fundamental que a enfer magem garanta adequadas condições laborais de professores e alunos com o fim de segurar uma CVT satisfatória assim como melhorar a qualidade da educação ministrada.
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Humanos , Masculino , Feminino , Qualidade de Vida , Trabalho , Professores EscolaresRESUMO
Background: Atrophic gastritis (AG) and intestinal metaplasia (IM) are stages that appear in the process of gastric carcinogenesis. Their presence requires programmed endoscopic vigilance. Objectives: To determine the frequency of AG and IM in gastric biopsies (GB) taken according to Sydney Protocol and to correlate them with endoscopic findings. Methods: Retrospective descriptive analysis of 233 upper gastrointestinal endoscopies with GB per Sydney Protocol. OLGA (Operative Link for Gastritis Assessment) and OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) scores were calculated based on the GB description. Endoscopic findings were analyzed for atypical findings and compared to the GB report. Statistic analysis for Kappa and ANOVA was performed via Stata 12. Results: Mean age of patients was 58 ± 12 years. 69% were women. The frequency of AG and IM was 44% and 33% in the antrum, 31% and 20% in the angular incisure and 14% and 9% in the body, respectively. AG and IM were more frequent in the antrum (p < 0.05). AG and IM were more severe in the angular incisure and body (p < 0.05). We were unable to calculate OLGA and OLGIM in 6% and 9% of cases, respectively, due to absence of severity description in GB. 53% were OLGA 0, 42% OLGA I-II and 5% OLGA III-IV. 70% were OLGIM 0, 25% OLGIM I-II and 5% OLGIM III-IV. Agreement between endoscopic and histological findings was best for IM in the antrum (75.5%, Kappa 0.4). Sensitivity and specificity of endoscopic findings were 39% and 70% for AG, and 30% and 85% for IM, respectively. Conclusion: AG and IM are frequent findings in our patients. Due to the low endoscopic sensitivity for AG and IM, we suggest a systematic GB sampling using Sydney Protocol in patients over 40 years old.
Introducción: La gastritis crónica atrófica (GCA) y la metaplasia intestinal (MI) son etapas en el proceso de carcinogénesis gástrica, su presencia requiere control endoscópico programado. Objetivos: Determinar la frecuencia de GCA y MI en biopsias gástricas (BG) por protocolo de Sydney y relacionarlas con el hallazgo endoscópico. Métodos: Estudio descriptivo mediante revisión de 233 endoscopias digestivas altas con BG por Protocolo Sydney. Se graduó puntaje OLGA (Operative Link for Gastritis Assessment) y OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) según la descripción de la BG. Se definió el hallazgo endoscópico según su informe y se comparó con BG como patrón de referencia. Estadística: Stata 12 para Kappa y ANOVA. Resultados: Edad promedio 58 ± 12 años, 69% mujeres. La frecuencia de GCA y MI en antro fue de 44 y 33%, en ángulo 31 y 20% y en cuerpo 14 y 9%, respectivamente. Hubo mayor frecuencia de GCA y MI en antro (p < 0,05). La graduación de GCA y MI fue mayor en ángulo y cuerpo (p < 0,05). No se obtuvo OLGA en 6% y OLGIM en 9% por ausencia de graduación. La frecuencia de OLGA 0 fue de 53%, OLGA I-II 42%, OLGA III-IV 5%, OLGIM O 70%, OLGIM I-II 25% y OLGIM III-IV 5%. La mejor correlación se observó entre la MI antral endoscópica con la histológica (75,5%, Kappa 0,4). La sensibilidad y especificidad endoscópica fue de 39 y 70% para GCA y 30 y 85% para MI. Conclusión: GCA y MI son hallazgos frecuentes en nuestros pacientes. Por la baja sensibilidad endoscópica en la identificación de GCA y MI sugerimos la toma sistemática de BG por protocolo de Sydney en pacientes mayores de 40 años.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/epidemiologia , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/epidemiologia , Metaplasia/diagnóstico , Metaplasia/epidemiologia , Lesões Pré-Cancerosas/patologia , Biópsia/métodos , Chile/epidemiologia , Protocolos Clínicos , Programas de Rastreamento/métodos , Epidemiologia Descritiva , Prevalência , Estudos Retrospectivos , Análise de Variância , Endoscopia Gastrointestinal , Sensibilidade e Especificidade , Mucosa Gástrica/patologia , Gastrite Atrófica/patologia , Metaplasia/patologiaRESUMO
Los profesionales de Enfermería conforman un cuantioso estamento profesional que, sin lugar a dudas, cumple un rol esencial en los servicios hospitalarios y de atención primaria. Sin embargo, poco se conoce en torno a sus condiciones laborales y los riesgos ocupacionales que estas implican. Objetivo: Identificar las condiciones de trabajo y las razones por las cuales enferman los profesionales de Enfermería en Chile. Método: Revisión sistematizada de carácter descriptivo y retrospectivo, realizada mediante la búsqueda sistemática según las recomendaciones de la Red en Salud Ocupacional. El universo lo conformaron artículos chilenos que respondieran a los descriptores: enfermería, trabajo, personal de enfermería, condiciones de trabajo, enfermedades laborales y riesgos laborales, cuya búsqueda se realizó en las bases de datos Web of Science, MEDLINE, La Biblioteca Cochrane, Scopus, SciELO y LILACS. La muestra quedó conformada por un total de 9 artículos, que trataban principalmente las temáticas de burnout , carga mental, malestar psicofisiológico y fatiga. El desarrollo de la presente publicación se enmarcó en los criterios establecidos por Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Resultados: Los profesionales de Enfermería en Chile se desenvuelven en condiciones laborales marcadas por la carencia de materiales, alta demanda laboral y limitados recursos. Conclusión: Las principales problemáticas asociadas al trabajo llevado a cabo por el personal de Enfermería corresponden a riesgos psicosociales como estrés, fatiga y burnout .
Nursing professionals make a large personnel segment which, doubtless, accomplishes an essential role in hospital and primary attention services. However, little is known about their working conditions and the implied occupational risks. Objective: To identify the working conditions and the reasons why nursing professionals in Chile become sick. Method: This is a systematic review with a descriptive and retrospective character performed through a systematic search in accordance to the Occupational Health Network. The universe was constituted by the Chilean articles which made references to the descriptor words nursing, work, nursing staff, working conditions, occupational diseases, and occupational risks, resulting from the web data searches in Web of Science, MEDLINE, Cochrane Library, Scopus, SciELO, and LILACS. The sample included a total of 9 articles which principally dealt with issues of burnout, mental burden, psycho-physiological discomfort, and fatigue. The development of this publication was framed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria checklist. Results: Nursing professionals in Chile practice in working conditions marked by the lack of materials, the high demand of services, and the limited resources. Conclusion: The principal problems associated to work among these nurses correspond to psychosocial risks such as stress, fatigue, and burnout.
Os profissionais de enfermagem conformam uma quantia elevada do setor profissional, que sem dúvida cumpre o rolo essencial nos serviços hospitalares e de atenção primária. Porém, pouco se conhece em volta a suas condições laborais e os riscos ocupacionais que estas envolvem. Objetivo: Identificar as condições de trabalho e as razões pelas quais adoecem os profissionais de Enfermagem no Chile. Método: Revisão sistematizada de caráter descritivo e retrospectivo, realizada mediante a busca sistemática segundo as recomendações da Rede em Saúde Ocupacional, o universo o conformaram artigos chilenos que responderam aos descritores: enfermagem, trabalho, pessoal de enfermagem, condições de trabalho, doenças ocupacionais e riscos ocupacionais, cuja busca realizou-se nas bases de dados Web of Science, MEDLINE, a Biblioteca Cochrane, Scopus, SciELO e LILACS. A amostra ficou conformada por um total de 9 artigos que tratavam principalmente das temáticas de burnout, carga mental, malestar psicofisiológico e fatiga. O desenvolvimento da presente publicação enquadrou-se nos critérios estabelecidos por Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Resultados: Os profissionais de Enfermagem no Chile desenvolveram-se em condições laborais marcadas pela carência de materiais, alta demanda laboral e limitados recursos. Conclusão: As principais problemáticas associadas ao trabalho realizado pelas enfermeiras/os correspondem a riscos como estresse, fatiga e burnout.
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Humanos , Masculino , Feminino , Esgotamento Profissional , Enfermagem , Papel do Profissional de EnfermagemRESUMO
Background: The prevalence of cervicovaginal infections during pregnancy has been associated with adverse perinatal outcomes however, the actual approach used for diagnosis is not effective. The aim of this study was to compare the diagnosis of vaginal infections in pregnant women using clinical, molecular diagnostic and traditional microbiological culture in a pilot study, to determine the prevalence and association with the development of preterm labor. Materials and methods: We performed a nested cross-sectional study composed by 54 women in a cohort of pregnant women in Mexico City. Cervicovaginal infections were evaluated by clinical methods, microbiology culture and a commercially available molecular biology test. Results: Prevalence of cervicovaginal infections during pregnancy was estimated between 28% and 50% according to methodologies. Considering the clinical diagnosis of preterm labor as the gold standard, all diagnostic tests were poor as predictors of preterm labor. Conclusion: Traditional approaches to establish the significance of cervicovaginal infection in pregnancy are exhausted, so be sought new ways to understand this complex relationship. Meanwhile it is recommended to continue to use traditional methods to identify infections during pregnancy in both knowledge of new methods aimed at understanding these relationships are sophisticated.
Assuntos
Técnicas de Diagnóstico Molecular/métodos , Complicações Infecciosas na Gravidez/diagnóstico , Doenças do Colo do Útero/diagnóstico , Doenças Vaginais/diagnóstico , Adolescente , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , México , Trabalho de Parto Prematuro/epidemiologia , Projetos Piloto , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez , Doenças do Colo do Útero/microbiologia , Doenças Vaginais/microbiologia , Adulto JovemRESUMO
Background: In Mexico, the prevalence of caesarean section is 40.9% in the health sector, the techniques used are the traditional Pfannenstiel-Kerr and Kerr-half infraumbilical and little experience with this new technique Misgav-Ladach modified. Objetive: To compare pregnancy outcomes (surgical and fetal extraction time, bleeding, postoperative pain, surgical wound infection, maternal and fetal death) caesarean section techniques modified Misgav-Ladach, Pfannenstiel-Kerr and infraumbilical. Material and method: Clinical trial in primiparous women with term pregnancy treated at the Medical Unit of High Specialty 23 of the Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico. Misgav-Ladach caesarean Caesarean modified and Kerr, the latter subdivided into two groups: infraumbilical Pfannenstiel incision and incision half-Kerr two groups patients were randomized. Results: 137 gilts were studied, with term pregnancy and BMI between 19 and 24.9 kg / m2. Caesarean modified Misgav-Ladach 68 patients and 69 classical Kerr (35 Pfannenstiel-Kerr and 34 infraumbilical) was performed. The surgical time in minutes was lower with modified Misgav-Ladach: 27.8 ± 8.0, Pfannenstiel-Kerr recorded 51.7 ± 12.1 and 12.0 ± infraumbilical media48.3 (p = 0.000). The time in seconds fetal extraction was lower in modified Misgav-Ladach: 96.2 ± 68.3, 474.9 ± Pfannenstiel-Kerr 294.1 and 423.2 ± 398.6 infraumbilical (p = 0.000). The trasoperatory milliliters bleeding was lower with modified Misgav-Ladach: 298.5 ± 57.3, 354.3 ± Pfannenstiel-Kerr 98.0 and 355.9 ± 110.6 infraumbilical (p = 0.001). Postoperative pain assessed with the visual analog scale in the first 24 hours was lower with modified Misgav-Ladach: 4.4 ± 1.9, 5.7 ± Pfannenstiel-Kerr and IK 2.1 6.1 ± 2.0 (p = 0.000). The start of the oral route and ambulation Nwas soon comparing modified Misgav-Ladach against Pfannenstiel-Kerr and Kerr-infraumbilical (p = 0.000). The prevalence of fever was 5.9% with modified Misgav-Ladach, 5.9% Pfannenstiel-Kerr and 32.4% withinfraumbilical-Kerr (p = 001). The discharge in hours was modified Misgav-Ladach ± 45.8 to 12.1 h, Pfannenstiel-Kerr 49.3 ± 12.3 h and 58.5 infraumbilical-Kerr ± 21.5 h (p = .000). In this study no maternal or fetal deaths were observed. Conclusion: Surgical time, bleeding, postoperative pain, better postoperative recovery and shorter hospital stays and less infection were significantly lower than with conventional techniques of caesarean Nsection or infraumbilical-Kerr technique.
Assuntos
Cesárea/métodos , Dor Pós-Operatória/epidemiologia , Resultado da Gravidez , Infecção da Ferida Cirúrgica/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Tempo de Internação , México , Duração da Cirurgia , Medição da Dor , Gravidez , Adulto JovemRESUMO
Background: Live Donor Laparoscopic Nephrectomy (LDLN) has substantial benefits when compared with open nephrectomy such as shorter hospital stay, prompt return to work, less post-operative pain, better cosmetic results, less blood loss and less surgical wound infections. It is the mode of choice for safely harvesting a kidney for organ transplantation. Aim: To describe the surgical results of LDLN in a pioneer renal transplant center in Chile. Material and Methods: Review of clinical records of 75 subjects aged 27 to 60 years (37 males) subjected to a LDLN in a public hospital between 1998 and 2013. Information about clinical and surgical data and perioperative complications was retrieved. Results: No subject died. All kidneys were satisfactorily implanted in their receptors. The mean operative time was 116 minutes. Mean hospital stay was 1.6 days, warm ischemia time was 6.8 minutes, and cold ischemia time was 31.5 minutes. Operative adverse events occurred in 8 percent. The conversion and reoperation rates were 4 and 1.3 percent, respectively. Among receptors, 1.5 percent evolved with Acute Tubular Necrosis and 2.2 percent required graft excision. Conclusions: LDLN is a safe and pioneering surgical technique in Chile. Its results are satisfactory and comparable to those obtained with classic lumbotomy.
Introducción: El trasplante renal es en la actualidad el tratamiento de elección de la Insuficiencia Renal Crónica Terminal. La Nefrectomía Laparoscópica del Donante Vivo (NLDV) tiene ventajas sustanciales en relación a la Nefrectomía Clásica. Entre estas se destacan una menor estancia hospitalaria, pronto regreso a la actividad laboral, disminución del dolor post-operatorio, mejores resultados cosméticos, menor pérdida de volumen sanguíneo y una disminución de infecciones de heridas operatorias, consolidándose como la primera prioridad como forma de obtener un órgano para trasplante renal. El presente trabajo tiene como objetivo mostrar la casuística y complicaciones en el Hospital Barros Luco-Trudeau (HBLT), como centro pionero en NLDV en nuestro país. Material y Método: Estudio retrospectivo de corte transversal. Se realiza una revisión de registros clínicos de 75 NLDV realizadas entre 1998-2013, seleccionando datos demográficos, clínicos y quirúrgicos de donantes y receptores, con un especial énfasis en relación a complicaciones peri-operatorias. Resultados: Sin mortalidad. Todos los riñones fueron implantados satisfactoriamente en sus respectivos receptores. Cirugía con duración promedio de 116 min, estadía hospitalaria promedio de 1,6 días, isquemia caliente promedio de 6,8 min e isquemia fría promedio de 31,5 min. Incidentes operatorios 8 por ciento y 4 por ciento conducentes a conversión. Tasa de reoperación de 1,3 por ciento. En cuanto a receptores, un 1,5 por ciento desarrolla Necrosis Tubular Aguda. 2,2 por ciento requiere transplantectomía. Discusión: La NLDV representa una técnica segura, que ha llegado a constituir el 100 por ciento de las nefrectomías de donantes vivos realizadas durante los últimos tres años. Los resultados son satisfactorios y plenamente comparables a los resultados obtenidos por lumbotomía clásica y de otros centros de alto volumen laparoscópico a nivel internacional.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Transplante de Rim , Laparoscopia , Doadores Vivos , Nefrectomia/estatística & dados numéricos , Nefrectomia/métodos , Estudos Transversais , Tempo de Internação , Complicações Pós-Operatórias , Estudos RetrospectivosRESUMO
Chikungunya fever is an emerging infection in our country due to travelers to endemic areas. It presents acutely with high fever, fatigue, headache, myalgia, skin rash and arthritis, usually as a symmetric polyarthritis compromising the interphalangeal and metacarpophalangeal joints, wrist, elbow, ankle and knee. While most of the symptoms last about a week, arthralgias may become chronic and generate significant functional impairment. Chikungunya has been postulated as a triggering factor for rheumatoid arthritis because of the presence of positive rheumatoid factor. We present the three confirmed cases in Almirante Nef Naval Hospital with the review of the published literature...
La fiebre de Chikungunya es una infección novedosa en nuestro país pues su contagio se produce por viajeros en zonas endémicas. Se presenta generalmente en forma aguda con fiebre alta, astenia, cefalea, mialgia, rash cutaneo y artritis, mayoritariamente como poliartritis simétrica comprometiendo las articulaciones interfalángicas, metacarpofalángicas, muñecas, codos, tobillo y rodillas. Si bien la mayoría de los síntomas duran aproximadamente una semana, las artralgias pueden hacerse crónicas y generar un importante deterioro funcional. Se ha postulado que podría ser un factor gatillante de artritis reumatoide ante la presencia de factor reumatoideo positivo. A continuación se presentan los tres casos confirmados del Hospital Naval Almirante Nef junto a la revisión de la literatura publicada hasta el momento...
Assuntos
Humanos , Masculino , Adulto , Artrite/virologia , Febre de Chikungunya/complicações , Febre de Chikungunya/epidemiologia , Artralgia/virologia , Chile , Evolução Clínica , Diagnóstico Diferencial , Febre de Chikungunya/terapia , Imunoglobulina G , Estudos RetrospectivosRESUMO
BACKGROUND: Dermatomycoses are superficial fungal infections of the skin, hair and nails that affect more than 20-25% of the people worldwide. These infections can be caused by yeasts, dermatophytes and non-dermatophyte filamentous fungi (NDFF) and are considered a public health problem. Despite this, few studies have investigated the prevalence and antifungal susceptibility of causative agents of dermatomycoses in the developing world. OBJECTIVES: The aims of this study were to identify and determine the antifungal susceptibility profile of yeast and filamentous fungi isolated from dermatomycoses in Uberaba, Minas Gerais, Brazil. METHODS: Specimens were obtained from patients with clinically diagnosed and laboratory confirmed dermatomycosis between July 2009 and July 2011. Fungal identification was based on classical methods and antifungal susceptibility testing was performed by broth microdilution method. RESULTS: Of the 216 fungal isolates, 116 (53.8%) were yeasts, 70 (32.4%) dermatophytes and 30 (13.8%) NDFF. Onychomycosis was the most common clinical condition. Candida parapsilosis (24.1%) and Trichophyton rubrum (17.1%) were the fungi most frequently isolated. Voriconazole, ketoconazole and itraconazole were the most potent antifungal agents against yeast, whereas terbinafine, voriconazole and itraconazole had a high in vitro activity against dermatophytes. Overall, the antifungal agents had little or no activity against NDFF and the highest minimum inhibitory concentrations were those against Fusarium spp. CONCLUSION: Yeasts, particularly C. parapsilosis, play an important role as causative agents of dermatomycosis in our region. Our results suggest that the antifungal susceptibility testing coupled with proper identification of the fungi may be useful to assist clinicians in determining the appropriate therapy for dermatomycoses.
Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Fungos/efeitos dos fármacos , Antifúngicos/farmacologia , Dermatomicoses/microbiologia , Fungos/classificação , Humanos , Testes de Sensibilidade MicrobianaRESUMO
Group B Streptococcus (GBS) is the leading cause of neonatal infections. Our purpose was to characterize GBS colonization in pregnant women, current serotypes, resistance phenotypes and genes associated with virulence. In Misiones, Argentina, there are no previous data on this topic. Vaginal-rectal swabs from 3125 pregnant women were studied between 2004 and 2010. GBS strains were identified by conventional and serological methods (Phadebact Strep B Test, ETC International, Bactus AB, Sweden). Serotypes were detected using Strep-B Latex (Statens Serum Institut, Denmark). Resistance phenotypes were determined by the double-disk test. Genes were studied by PCR. Maternal colonization was 9.38%. Resistance to erythromycin was 11.6%, and the constitutive phenotype was the predominant one. Serotype Ia was the most frequent, whereas serotypes IV, VI, VII and VIII were not detected. The lmb, bca and hylB genes were detected in more than 79% of the strains. In this study, the colonization rate with GBS and the serotype distribution were compared with studies reported in other areas of the country. The high resistance to erythromycin in Misiones justifies performing antibiotic susceptibility testing. The serotype distribution, the genes encoding putative virulence factors, and the patterns of resistance phenotypes of GBS may vary in different areas. They thus need to be evaluated in each place to devise strategies for prevention.
RESUMO
Group B Streptococcus (GBS) is the leading cause of neonatal infections. Our purpose was to characterize GBS colonization in pregnant women, current serotypes, resistance phenotypes and genes associated with virulence. In Misiones, Argentina, there are no previous data on this topic. Vaginal-rectal swabs from 3125 pregnant women were studied between 2004 and 2010. GBS strains were identified by conventional and serological methods (Phadebact Strep B Test, ETC International, Bactus AB, Sweden). Serotypes were detected using Strep-B Latex (Statens Serum Institut, Denmark). Resistance phenotypes were determined by the double-disk test. Genes were studied by PCR. Maternal colonization was 9.38%. Resistance to erythromycin was 11.6%, and the constitutive phenotype was the predominant one. Serotype Ia was the most frequent, whereas serotypes IV, VI, VII and VIII were not detected. The lmb, bca and hylB genes were detected in more than 79% of the strains. In this study, the colonization rate with GBS and the serotype distribution were compared with studies reported in other areas of the country. The high resistance to erythromycin in Misiones justifies performing antibiotic susceptibility testing. The serotype distribution, the genes encoding putative virulence factors, and the patterns of resistance phenotypes of GBS may vary in different areas. They thus need to be evaluated in each place to devise strategies for prevention.(AU)
Assuntos
Infecções/veterinária , Fenótipo , Virulência , Streptococcus/ultraestruturaRESUMO
Group B Streptococcus (GBS) is the leading cause of neonatal infections. Our purpose was to characterize GBS colonization in pregnant women, current serotypes, resistance phenotypes and genes associated with virulence. In Misiones, Argentina, there are no previous data on this topic. Vaginal-rectal swabs from 3125 pregnant women were studied between 2004 and 2010. GBS strains were identified by conventional and serological methods (Phadebact Strep B Test, ETC International, Bactus AB, Sweden). Serotypes were detected using Strep-B Latex (Statens Serum Institut, Denmark). Resistance phenotypes were determined by the double-disk test. Genes were studied by PCR. Maternal colonization was 9.38%. Resistance to erythromycin was 11.6%, and the constitutive phenotype was the predominant one. Serotype Ia was the most frequent, whereas serotypes IV, VI, VII and VIII were not detected. The lmb, bca and hylB genes were detected in more than 79% of the strains. In this study, the colonization rate with GBS and the serotype distribution were compared with studies reported in other areas of the country. The high resistance to erythromycin in Misiones justifies performing antibiotic susceptibility testing. The serotype distribution, the genes encoding putative virulence factors, and the patterns of resistance phenotypes of GBS may vary in different areas. They thus need to be evaluated in each place to devise strategies for prevention.
Assuntos
Humanos , Feminino , Resistência Microbiana a Medicamentos , Eritromicina/análise , Eritromicina/isolamento & purificação , Técnicas In Vitro , Fenótipo , Gestantes , Infecções Estreptocócicas , Streptococcus agalactiae/genética , Streptococcus agalactiae/patogenicidade , Genótipo , Metodologia como Assunto , Sorotipagem , VirulênciaRESUMO
The trophic interactions between the scyphozoan medusa Chrysaora plocamia and the palm ruff Seriolella violacea were investigated off northern Chile and showed that large numbers of hyperiid amphipods parasitizing the medusa may channel energy back to the fishes, which feed on the parasites. The biomass of hyperiids eaten by the fish was a function of the biomass of hyperiids parasitizing the medusa. This temporally available food supply may enhance fish recruitment. The large number of hyperiids parasitizing diverse jellyfish species represents a missing trophic link in current efforts to understand the effects of jellyfish blooms on marine food webs.