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Introducción: Las charcas temporales son ecosistemas acuáticos variables en su estructura física y biótica, efímeros en el paisaje e importantes en el flujo de materia y energía. Los macroinvertebrados acuáticos constituyen el grupo más abundante y diverso en estos ecosistemas y requieren mayor estudio, particularmente en los trópicos. Objetivo: Evaluar la diversidad alfa y beta de las comunidades de macroinvertebrados acuáticos de seis charcas temporales durante dos épocas climáticas en el norte de Colombia. Métodos: En Magdalena, Colombia, hicimos seis arrastres aleatorios con redes manuales en la zona litoral, y seis arrastres en zigzag con redes tipo D en la zona lacustre; recolectamos macrofauna en tres lances con una draga Ekman; y muestreamos cada charca durante la alta precipitación (noviembre, 2020) y la baja precipitación (febrero, 2021). Resultados: Identificamos 3 358 individuos (13 órdenes, 39 familias y 68 géneros). La mayor abundancia y diversidad (N= 485, 0D= 32) durante la época de lluvia se presentó en Los Campanos, mientras que la charca Villa Leidy tuvo el mayor número de taxones comunes (18) y dominantes (14). En la época de sequía, la charca Los Trillizos presentó la mayor abundancia (533) y diversidad (43); mientras que Villa Leidy y El Miquito el mayor número de taxones dominantes (16). Las charcas tienen composiciones particulares (sin agrupamientos espaciales o temporales); el recambio de taxones es alto, y la correspondencia canónica se agrupa por temporada. Conclusiones: la composición de las comunidades de macroinvertebrados acuáticos de las charcas temporales son muy diversas, presentando alto recambio tanto espacial como temporal, reflejando altos valores de remplazo de taxones entre épocas climáticas. La zona litoral mantuvo una composición similar durante las dos temporadas.
Introduction: Temporary ponds are variable aquatic ecosystems in their physical and biotic structure, ephemeral in the landscape and important in the flow of matter and energy. Aquatic macroinvertebrates constitute the most abundant and diverse group in these ecosystems and need further study, particularly in the tropics. Objective: To evaluate the alpha and beta diversity of the aquatic macroinvertebrate communities of six temporary pools during two climatic seasons in Northern Colombia. Methods: In Magdalena, Colombia, we did six random trawls with hand nets in the coastal zone, and six zig zag trawls with D nets in the lacustrine zone; we collected macrofauna in three random hauls with an Ekman dredge; and sampled each pond in high rainfall (November 2020) and low rainfall (February 2021). Results: We identified 3 358 individuals (13 orders, 39 families and 68 genera). The highest rainy season abundance and diversity (N= 485, 0D= 32) were in Los Campanos, while Villa Leidy Pond had the highest number of common (18) and dominant (14) taxa. During the dry season, Los Trillizos Pond had the highest abundance (533) and diversity (43); while Villa Leidy and El Miquito had the largest number of dominant taxa (16). The pools have a particular composition (no spatial or temporal grouping); taxa turnover is high, and the canonical correspondence clustered by season. Conclusions: The aquatic macroinvertebrate communities of the temporary ponds are diverse and have high turnover in space and time, reflecting high replacement of taxa between climatic periods. The littoral zone had a similar composition in the two seasons.
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Several vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been approved for controlling the coronavirus disease 2019 (COVID-19) pandemic worldwide. Antibody response is essential to understand the immune response to different viral targets after vaccination with different vaccine platforms. Thus, the main aim of this study was to describe how vaccination with two distinct SARS-CoV-2 vaccine preparations elicit IgG antibody specific responses against two antigenically relevant SARS-CoV-2 viral proteins: the receptor-binding domain (RBD) and the full-length spike (S). To do so, SARS-CoV-2 protein specific in-house enzyme-linked immunosorbent assays (ELISAs) were standardized and tested against serum samples collected from 89 adults, recipients of either a single-dose of the Spike-encoding mRNA-based Pfizer/BioNTech (Pf-BNT) (70%, 62/89) or the Spike-encoding-Adenovirus-5-based CanSino Biologics Inc. (CSBIO) (30%, 27/89) in Merida, Mexico. Overall, we identified an IgG seroconversion rate of 88% (68/78) in all vaccinees after more than 25 days post-vaccination (dpv). Anti-RBD IgG-specific responses ranged from 90% (46/51) in the Pf-BNT vaccine at 25 dpv to 74% (20/27) in the CSBIO vaccine at 42 dpv. Compared to the S, the RBD IgG reactivity was significantly higher in both Pf-BNT (p < 0.004) and CSBIO (p < 0.003) vaccinees. Interestingly, in more than 50% of vaccine recipients, with no history of COVID-19 infection, antibodies against the nucleocapsid (N) protein were detected. Thus, participants were grouped either as naïve or pre-exposed vaccinees. Seroconversion rates after 25 and more dpv varies between 100% in Pf-BNT (22/22) and 75% (9/12) in CSBIO pre-exposed vaccinees, and 89% (26/29) and 73% (11/15) in Pf-BNT and CSBIO naïve vaccine recipients, respectively. In summary, observed seroconversion rates varied depending on the type of vaccine, previous infection with SARS-CoV-2, and the target viral antigen. Our results indicate that both vaccine preparations can induce detectable levels of IgG against the RBD or Spike in both naïve and SARS-CoV-2 pre-exposed vaccinees. Our study provides valuable and novel information about the serodiagnosis and the antibody response to vaccines in Mexico.
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Abstract Large branchiopods has been distributed in temporary waters around the world, but the knowledge about these organisms in Colombia is poorly known, especially leptesteriids, we report a new record of the Clam Shrimp Leptestheria venezuelica Daday, 1923 from the north of Colombia.
Resumen Los grandes branquiopodos se encuentran distribuidos en aguas temporales de todo el mundo, pero el conocimiento de estos en Colombia es poco sobre todo de los leptesteridos, en este trabajo presentamos un nuevo reporte del camaron almeja Leptestheria venezuelica Daday, 1923 para el norte de Colombia.
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PURPOSE: The LUME-Lung 1 study has brought consistent evidence of the effective use of nintedanib in lung adenocarcinoma as a second line of treatment; however, differences among ethnicities have been found in some studies. METHODS: This was a retrospective review among 21 medical centers of 150 patients with a confirmed diagnosis of lung adenocarcinoma, included in a compassionate use program of nintedanib from March 2014 to September 2015. The current study aimed to analyze the effectiveness of nintedanib in combination with docetaxel in the Mexican population, using progression-free survival rate and the best objective response to treatment by RECIST 1.1 as a surrogate of effectiveness. In addition, we examined the toxicity profile of our study population as a secondary end point. RESULTS: After exclusion criteria, only 99 patients met the criteria for enrollment in the current study. From the total study population, 53 patients (53.5%) were male and 46 (46.5%) were female, with an average age of 60 years and stage IV as the most prevalent clinical stage at the beginning of the compassionate use program. A total of 48 patients (48.5%) had partial response; 26 (26.3%), stable disease; 4 (4%), complete response; and 16 (16.2%), progression; and 5 (5%) were nonevaluable. We found a median progression-free survival of 5 months (95% CI, 4.3 to 5.7 months). The most common grade 3 or 4 adverse reactions were fatigue (14%) and diarrhea (13%). CONCLUSION: Nintedanib, as part of a chemotherapy regimen, is an effective option with an acceptable toxicity profile for advanced lung adenocarcinoma after first-line treatment progression.
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Adenocarcinoma de Pulmão , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Docetaxel/efeitos adversos , Feminino , Humanos , Indóis , Pulmão , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxoides/efeitos adversos , Resultado do TratamentoRESUMO
BACKGROUND: The implementation of vector control interventions and potential introduction new tools requires baseline data to evaluate their direct and indirect effects. The objective of the study is to present the seroprevalence of dengue infection in a cohort of children 0 to 15 years old followed during 2015 to 2016, the risk factors and the role of enhanced surveillance strategies in three urban sites (Merida, Ticul and Progreso) in Yucatan, Mexico. METHODS: A cohort of school children and their family members was randomly selected in three urban areas with different demographic, social conditions and levels of transmission. We included results from 1,844 children aged 0 to 15 years. Serum samples were tested for IgG, NS1 and IgM. Enhanced surveillance strategies were established in schools (absenteeism) and cohort families (toll-free number). RESULTS: Seroprevalence in children 0 to 15 years old was 46.8 (CI 95% 44.1-49.6) with no difference by sex except in Ticul. Prevalence increased with age and was significantly lower in 0 to 5 years old (26.9%, 95% CI:18.4-35.4) compared with 6 to 8 years old (43.9%, 95% CI:40.1-47.7) and 9 to 15 years old (61.4%, 95% CI:58.0-64.8). Sharing the domestic space with other families increased the risk 1.7 times over the individual families that own or rented their house, while risk was significantly higher when kitchen and bathroom were outside. Complete protection with screens in doors and windows decreased risk of infection. Seroprevalence was significantly higher in the medium and high risk areas. CONCLUSIONS: The prevalence of antibodies in children 0 to 15 years in three urban settings in the state of Yucatan describe the high exposure and the heterogenous transmission of dengue virus by risk areas and between schools in the study sites. The enhanced surveillance strategy was useful to improve detection of dengue cases with the coincident transmission of chikungunya and Zika viruses.
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Anticorpos Antivirais/sangue , Dengue/sangue , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Dengue/epidemiologia , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/imunologia , Vírus da Dengue/fisiologia , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Estudos Soroepidemiológicos , Irmãos , Estudantes/estatística & dados numéricosRESUMO
The 2012 and 2013 annual influenza epidemics in Mexico were characterized by presenting different seasonal patterns. In 2012 the A(H1N1)pdm09 virus caused a high incidence of influenza infections after a two-year period of low circulation; whereas the 2013 epidemic presented circulation of the A(H1N1)pdm09 virus throughout the year. We have characterized the molecular composition of the Hemagglutinin (HA) and Neuraminidase (NA) genes of the A(H1N1)pdm09 virus from both epidemic seasons, emphasizing the genetic characteristics of viruses isolated from Yucatan in Southern Mexico. The molecular analysis of viruses from the 2012 revealed that all viruses from Mexico were predominantly grouped in clade 7. Strikingly, the molecular characterization of viruses from 2013 revealed that viruses circulating in Yucatan were genetically different to viruses from other regions of Mexico. In fact, we identified the occurrence of two genetic variants containing relevant mutations at both the HA and NA surface antigens. There was a difference on the temporal circulation of each genetic variant, viruses containing the mutations HA-A141T / NA-N341S were detected in May, June and July; whereas viruses containing the mutations HA-S162I / NA-L206S circulated in August and September. We discuss the significance of these novel genetic changes.
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Variação Genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/epidemiologia , Estações do Ano , Genes Virais , História do Século XXI , Humanos , Vírus da Influenza A Subtipo H1N1/genética , Influenza Humana/virologia , México/epidemiologiaRESUMO
BACKGROUND: Yucatán ranks first in the prevalence of urinary calculi (UL), and above the national average of obesity (OB). The aim of the study was to determine whether there is an association between obesity and metabolic disorders (MD) in patients with UL. METHODS: In a case-control design, 197 patients were studied with and without UL. Weight and height were measured; urine calcium, phosphate, magnesium, uric acid, oxalates, citrates and sodium were quantified. RESULTS: 197 subjects, 62 men and 135 women were studied; 114 subjects with UL and 83 without UL. Hyperuricosuria was more frequent in obese patients without UL. Hypocitraturia was the most frequent MD in patients both with and without OB, with and without UL. There was a positive trend towards a greater number of MD as weight increased. Urinary sodium excretion in patients with OB was significant. CONCLUSIONS: Obesity is a risk factor for MD in patients with UL. Strategies must be implemented to spread awareness on the influence of obesity on UL, and how it can be modified by diet.
Introducción: Yucatán ocupa el primer lugar en la prevalencia de litiasis urinaria (LU), y supera la media nacional de obesidad (OB). El objetivo del estudio fue conocer si existe una asociación entre la obesidad y las alteraciones metabólicas (AM) en pacientes con LU. Métodos: mediante un diseño de casos y controles, se estudiaron 197 pacientes con y sin LU. Se midió peso y talla; en orina se cuantificó calcio, fosfato, magnesio, ácido úrico, oxalatos, citratos y sodio. Resultados: se estudiaron 197 sujetos, 62 hombres y 135 mujeres; 114 sujetos con LU y 83 sin LU. La hiperuricosuria fue más frecuente en pacientes obesos sin LU. La hipocitraturia fue la AM de mayor frecuencia tanto en pacientes con, como sin OB, con y sin LU. Existió una tendencia positiva a un mayor número de AM en función del incremento de peso. Fue significativa la excreción de sodio urinario en los pacientes con OB. Conclusiones: la obesidad es factor de riesgo para AM en pacientes con LU. Deben implementarse estrategias que concienticen sobre la influencia de la obesidad en la LU, y como ésta puede ser modificada por la alimentación.
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Doenças Metabólicas/etiologia , Obesidade/complicações , Urolitíase/complicações , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
BACKGROUND: Obesity is a risk factor for renal damage. This study aimed to determine the relationship between body fat percent and creatinine clearance in adult patients with and without type 2 diabetes mellitus (T2DM). METHODS: An observational prospective cross-correlation study was carried out among adults with and without T2DM between 18 and 60 years of age. It was determined the time of evolution with T2DM, as well as fat percentage (FP), body mass index (BMI), creatinine clearance (Cockroft-Gault [CrCCG]), glycemia and micro/macroalbuminuria. The correlation between CrCCG and FP was determined by Spearman's test. RESULTS: 174 subjects were included in this study. Obesity by BMI and FP in subjects with and without T2DM was similar. Of the studied subjects, 12.6 % didn't have kidney damage and 50.7 % had increased risk of renal disease; the frequencies for stages 1-4 of kidney damage were 12.0, 20.1, 4.0 and 0.6 %, respectively. Spearman's test showed a direct relationship between FP and CrCCG, higher in diabetics (r = 0.418, p < 0.0001) than in non-diabetics (p = 0.327, p < 0.0001). CONCLUSIONS: The FP was correlated directly with the CrCCG in subjects with and without T2DM; therefore, we can conclude that the greater the kidney damage, the smaller the fat porcentage in the study sample.
Introducción: la obesidad es un factor de riesgo para daño renal. El objetivo del estudio fue conocer la relación entre el porcentaje de grasa corporal (PG) y la depuración de creatinina en pacientes adultos con y sin diabetes mellitus 2 (DM2). Métodos: estudio observacional, prospectivo, transversal de correlación. Se evaluaron adultos entre 18 y 60 años, con y sin DM2. Se determinó el tiempo de evolución con DM2, el PG, el índice de masa corporal (IMC), la depuración de creatinina (Cockroft-Gault [DCrCG]), la glicemia y la micro/macroalbuminuria. Mediante la prueba de Spearman se determinó la correlación entre DCrCG y PG. Resultados: se incluyeron 174 sujetos. La frecuencia de obesidad por IMC y PG en sujetos con y sin DM2 fue similar. El 12.6 % no tuvo daño renal y el 50.7 % tuvo riesgo aumentado de enfermedad renal. Las frecuencias para los estadios 1 a 4 fueron 12.0, 20.1, 4.0 y 0.6 %, de forma respectiva. La prueba de Spearman mostró relación directa entre PG y DCrCG, mayor en diabéticos (r = 0.418 frente a r = 0.327, p < 0.0001). Conclusiones: el PG corporal se correlacionó en forma directa con la DCrCG en sujetos con y sin DM2; se infiere que a mayor daño renal, menor grasa tiene la población evaluada.
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Adiposidade/fisiologia , Creatinina/sangue , Diabetes Mellitus Tipo 2/complicações , Obesidade/fisiopatologia , Insuficiência Renal/etiologia , Adolescente , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Estudos Prospectivos , Insuficiência Renal/sangue , Insuficiência Renal/diagnóstico , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Chronic kidney disease (CKD) is a public health problem; more than 6 % of worldwide population suffers from it. Low education and socioeconomic status, as well as limited access to medical care increase the probability of kidney damage. The objective was to evaluate and classify renal function in Yucatan's marginalized population. METHODS: A transversal descriptive survey was carried out among non-hospitalized adults of a general hospital. The study population included marginalized subjects (confirmed by socioeconomic survey), without oedema, pregnancy or diabetes mellitus. Renal function was evaluated by glomerular filtration rate. Patients were staged according to KDOQI guidelines. Likewise, weight, height, body mass index (BMI), fat percentage and blood pressure were measured. The results were compared between gender groups as well as rural and urban population. RESULTS: 165 subjects were included (83 % female). High risk of kidney damage was observed in 44.2 % of patients; 1.8 %, 49.1 %, and 4.8 % were in stages 1 to 3, respectively. There was no difference when comparing data between different groups. CONCLUSIONS: This study found high prevalence of CKD in Yucatan's marginalized population.
INTRODUCCIÓN: la enfermedad renal crónica (ERC) es un problema de salud pública. A nivel mundial, más del 6 % de la población la padece. Tener un nivel educativo y socioeconómico bajo, así como acceso limitado a los servicios médicos incrementan la probabilidad de daño renal. Los objetivos de esta investigación fueron evaluar y clasificar la función renal de la población marginada de Yucatán. MÉTODOS: estudio observacional, prospectivo, transversal, descriptivo, en una muestra no probabilística consecutiva, en adultos del área de consulta externa de un hospital general. Se incluyeron sujetos marginados (confirmado por encuesta socioeconómica), sin edema, embarazo ni diabetes mellitus. Se realizaron pruebas de función renal; se calculó filtrado glomerular y se estadificaron las enfermedades de los pacientes, según guías KDOQI. Se determinó peso, talla, índice de masa corporal (IMC), porcentaje de grasa y presión arterial. Se compararon los resultados entre grupos por sexo y por población rural y urbana. RESULTADOS: se incluyeron 165 sujetos (83 % mujeres). El 44.2 % presentó un riesgo alto de daño renal; 8, 49.1 y 4.8 % estuvieron en estadios del 1 al 3, respectivamente. No hubo diferencia cuando se compararon los datos entre los diferentes grupos estudiados. CONCLUSIONES: se encontró alta prevalencia de ERC en la población marginada de Yucatán.
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Insuficiência Renal Crônica/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Testes de Função Renal , Masculino , México , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Insuficiência Renal Crônica/fisiopatologia , Marginalização Social , Fatores SocioeconômicosRESUMO
OBJECTIVE: To know the relationship between total body composition and the stage of kidney damage, according to the K/DOQI classification, in patients with type 2 diabetes mellitus (T2DM). METHODS: Under a correlation design, adults with T2DM were studied. Age, evolution time, fat and lean mass, fat percentage, total water, body index mass (BMI), creatinine clearance by Cockroft-Gault (CrCCG), glucose, HbA1c, proteinuria and microalbuminuria were determined. T test to compare independent means and Spearman correlation were used. RESULTS: The study included 60 men (23.4%) and 196 women (76.6%). There were no differences by gender when comparing age, BMI, duration of T2DM, blood glucose and HbA1c. The analysis showed a direct relationship between BMI (r = 0.281), the amount of fat mass (r = 0.360), lean tissue (r = 0.158), and water (r = 0.176) with the CrCCG (p < 0.0001). The biggest change in body composition, due to fat mass, was observed in chronic kidney disease stages 1-3, in which BMI had a good correlation with fat mass (r = 0.80, p < 0.001). CONCLUSIONS: Fat mass is inversely related to the stage of kidney damage in patients with T2DM.
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Composição Corporal , Complicações do Diabetes/etiologia , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Insuficiência Renal/etiologia , Insuficiência Renal/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
El objetivo de esta investigación fue describir los elementos semánticos delsignificado de la violencia para una muestra de jóvenes estudiantes de bachillerato. Medianteanálisis de redes semánticas naturales encontramos como principal asociación con la violencia:manifestaciones físicas, golpes, agresión, maltrato y abuso, con mayor peso semántico para lasmujeres. Las definidoras fueron agrupadas en ocho categorías de análisis (tipos, manifestaciones,influencia social, coerción, atributos descriptivos, calificativos, y simbólicos); de éstas, las quecuentan con mayor significancia fueron las de influencia social y atributos emocionales para mujeres.Para los hombres las definidoras están más asociadas con factores externos como desencadenantesde conducta violenta, y para las mujeres las relativas a vulnerabilidad y debilidad ante situacionesviolentas.
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Adolescente , Semântica , Violência , Identidade de GêneroRESUMO
BACKGROUND: Interventional closure of patent arterial duct has become an accepted alternative to surgical closure. Clinical trial with "Nit-Occlud® PDA-R". METHODS AND RESULTS: To assess the safety and efficacy of the device, we performed a prospective clinical study between June, 2009 and December, 2010 in La Paz, Bolivia. In all, 29 - 22 female patients and 7 male patients - out of 59 patients were selected on the basis of inclusion criteria. The procedures were performed under sedation at an age and weight of 5.7 years and 22.7 kilograms, respectively, with 4-6 French arterial sheaths and 5-7 French venous sheaths. The minimal diameter of the duct was 3.5 millimetres. The procedure, fluoroscopy, and hospitalisation times were 96.4 minutes (55 to 145), 13.1 minutes (3 to 25.2), and 24 hours, respectively. The "Nit-Occlud® PDA-R" was successfully deployed in all patients. Immediate, 24-hour, 1-, 3-, and 6-month closure rates were 65.5%, 79.3%, 96.5%, and 100%, respectively. The systolic pulmonary pressure diminished from 37 millimetres of mercury (21 to 57) before the intervention to 31 millimetres of mercury (21 to 45) after the intervention. No early or late embolisation, haemolysis, left pulmonary artery, or descending aorta obstruction occurred. CONCLUSIONS: We conclude that the "Nit-Occlud® PDA-R" device is safe and effective in closing patent arterial duct up to a diameter of 8 millimetres.
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Cateterismo Cardíaco/métodos , Permeabilidade do Canal Arterial/terapia , Próteses e Implantes , Adolescente , Adulto , Ligas , Bolívia , Criança , Pré-Escolar , Doença Crônica , Permeabilidade do Canal Arterial/complicações , Feminino , Fluoroscopia , Humanos , Hipóxia/complicações , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Patent ducti arteriosi (PDAs) are more frequent and larger at high altitude than at sea level. A novel PDA closure device, the Nitocclud PDA-R, is designed specifically for both large and medium size PDAs. The initial clinical experience with a new nitinol-based device in high altitude patients with large PDAs is described. METHODS: The Nitocclud PDA-R is a self-expandable, self-centering, repositionable occluder made of one nitinol wire without use of welding. It contains several polyester membranes, is delivered with a central guide wire and is released by retraction of the central wire into the delivery catheter. The efficacy of this device was evaluated at several high altitude centers. RESULTS: Fifty-one patients without other congenital cardiac defects underwent transcatheter closure of PDA. Complete occlusion of the PDA was achieved in 98% of the patients. Nearly 49% of the patients had no shunt immediately after device implantation. Echocardiography revealed a complete closure rate by Doppler interrogation of 69% after 24 hr, 96% after 6 months, and 98% after 1 year. In two cases, device embolization was observed after release, and in both cases the device was easily retrieved with standard interventional techniques. There have been no episodes of delayed device migration, endocarditis, hemolysis, wire fracture, device disruption, or death. CONCLUSIONS: The Nitocclud PDA-R device is safe and effective and can easily close very large PDAs. This device has a high rate of complete occlusion within 1 year and is easily retrieved if embolized.
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Ligas , Altitude , Cateterismo Cardíaco/instrumentação , Permeabilidade do Canal Arterial/terapia , Adolescente , Adulto , Argentina , Bolívia , Cateterismo Cardíaco/efeitos adversos , Criança , Pré-Escolar , Remoção de Dispositivo , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/fisiopatologia , Ecocardiografia Doppler em Cores , Desenho de Equipamento , Feminino , Migração de Corpo Estranho/etiologia , Migração de Corpo Estranho/terapia , Hemodinâmica , Humanos , Lactente , Masculino , Membranas Artificiais , Poliésteres , Estudos Prospectivos , Terapêutica , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Chromosome aberrations (CA) are the main etiology of multiple congenital malformations, recurrent abortions and intellectual disability (ID) specifically of moderate and severe degree. They account for 0.3 to 1% of newborns (NB) and 6 of 10,000 NB have chromosome imbalances with submicroscopic deletions or duplications smaller than 10 MB that are overlooked by conventional cytogenetic studies. AIM: To report the results of cytogenetic and molecular studies performed in patients with a congenital malformation disease or ID with or without dysmorphic features, attended in a regional hospital. PATIENTS AND METHODS: One hundred and eighty patients, 27 with a clinical diagnosis of Down syndrome, derived for the suspicion of a genetic disease, were studied. A karyogram was performed in all of them and in 30 cases additional molecular studies, such as fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR) were carried out. RESULTS: Among the 153 patients without Down syndrome, 20 (13%) had a genetic abnormality responsible for the altered phenotype. Sixteen had a chromosome aberration (structural and numerical aberrations in 75 and 25% respectively) and four had genetic molecular alterations. Additional studies were performed to confirm or better characterize the chromosome aberration in 13 of the 30 patients in whom these were requested. CONCLUSIONS: Chromosome and specific genetic molecular studies in selected cases help to characterize patients with genetic diseases. The collaboration between academic and health care facilities is crucial.
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Aberrações Cromossômicas , Transtornos Cromossômicos/genética , Análise Citogenética/métodos , Deficiência Intelectual/genética , Adolescente , Adulto , Criança , Pré-Escolar , Chile , Feminino , Humanos , Hibridização in Situ Fluorescente , Recém-Nascido , Masculino , Fenótipo , Reação em Cadeia da PolimeraseRESUMO
Background: Chromosome aberrations (CA) are the main etiology of múltiple congenital malformations, recurrent abortions and intellectual disability (ID) specifically of modérate and severe degree. They accountfor 0.3 to 1 percent of newborns (NB) and 6 of 10,000 NB have chromosome imbalances with submicroscopic deletions or duplications smaller than 10 MB that are overlooked by conventional cytogenetic studies. Aim: To report the results of cytogenetic and molecular studies performed in patients with a congenital malformation disease or ID with or without dysmorphic features, attended in a regional hospital. Patients and Methods: One hundred and eighty patients, 27 with a clinical diagnosis ofDown syndrome, derivedfor the sus-picion of a genetic disease, were studied. A karyogram was performed in all ofthem and in 30 cases additional molecular studies, such as fluorescence in situ hybridization (FISH) orpolymerase chain reaction (PCR) were carried out. Results: Amongthe 153 patients without Down syndrome, 20 (13 percent) had a genetic abnormality responsible for the altered phenotype. Sixteen had a chromosome aberration (structural and numerical aberrations in 75 and 25 percent respectively) andfour had genetic molecular alterations. Additional studies were performed to confirm or better characterize the chromosome aberration in 13 ofthe 30 patients in whom these were requested. Conclusions: Chromosome and specific genetic molecular studies in selected cases help to characterize patients with genetic diseases. The collaboration between academic and health care facilities is crucial.
Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Masculino , Aberrações Cromossômicas , Transtornos Cromossômicos/genética , Análise Citogenética/métodos , Deficiência Intelectual/genética , Chile , Hibridização in Situ Fluorescente , Fenótipo , Reação em Cadeia da PolimeraseRESUMO
Experiencia local en la técnica de angioplastía con catéter-balón, realizada en siete pacientes con edad que oscila entre 1 mes a 27 años, siendo 5 varones y 2 mujeres, con diagnostico de coartación aórtica nativa. Una vez realizada la sedación, se colocó un introductor en la arteria femoral y se procedió al avance de guías y catéteres hasta la aorta transversa, con el objetivo de obtener imágenes angiografícas y medir presiones invasivas en todos los segmentos. El gradiente de presión pre intervención fue de 41.5mmHg en promedio (rango:21-69mmHg) disminuyó post intervención a 10mmHg en promedio (rango:0-20mmHg). El diámetro de la coartación pre dilatación en promedio fue de 4.3mm (rango: 2.3 a 9.4mm) y aumentó post dilatación a 8.4 mm (rango: 5.5 a 13.5mm). El resultado final fue satisfactorio, pues disminuyó significativamente el gradiente de presión, el diámetro aórtico coartado aumentó y los pulsos en las cuatro extremidades se tornaron simétricos. Se alcanzó estabilidad clínica y el procedimiento se demostró como favorable en todos los pacientes. Los controles postintervención hasta un año después mostraron que el gradiente se mantiene en el tiempo, salvo en el caso de la niña de un mes, que desarrolló recoartación aórtica y fue operada en condiciones electivas, como es usual para este grupo de edad.
Local experience in the technique of balloon catheter angioplasty, performed in seven patients aged between 1 month and 27 years, 5 males and 2 females, diagnosed with native aortic coarctation. After the sedation, the introducer was collocated in the femoral artery, and guide wires and catheters were pushed forward until the transverse aorta in order to obtain angiographic images and to measure invasive pressures in all the segments. The mean pressure gradient before the intervention was 41.5mmHg (range:21-69mmHg) and decreased post intervention to 10mmHg (range:0-20mmHg). The mean diameter of the coarctation pre dilatation was 4.3mm (range:2.3-9.4mm) and increased post dilation to 8.4mm(range:5.5-13.5mm). The final result was satisfactory because the pressure gradient was significantly reduced, the aortic diameter increased and the pulses in all four extremities symmetrical. Clinical stability was achieved and the procedure proved to be favorable for all the patients. Controls until one year post intervention showed that the gradient did not change over the time, except in the case of a one month old girl, who developed recoarctation and was operated in elective conditions, as it is usual for this group of age.
Assuntos
AngioplastiaRESUMO
Objetivo: Determinar el efecto de la histerectomía con preservación de uno o dos ovarios sobre el nivel de estradiolen mujeres premenopáusicas. Material y métodos: Se incluyeron en el estudio 40 mujeres premenopáusicas del Hospital Nacional Arzobispo Loayza; se les realizó una medición de estradiol antes de la histerectomía y la otra medición luego de un tiempo equivalente a tres ciclos menstruales después de la cirugía. Además se les realizó una encuesta de síntomas climatéricos en ambas oportunidades. Resultados: No hubo diferencia significativa entre los niveles de estradiol antes y después de la histerectomía. La comparación de las medias según el tipo de histerectomía, número de ovarios conservados y el diagnóstico preoperatorio, no alcanzó valores estadísticamente significativos. No hubo diferencia estadísticamente significativa entre los síntomas climatéricos antes y después de la cirugía. Conclusiones: El tipo de histerectomía, el número de ovarios conservados y el diagnóstico preoperatorio no alterarían los niveles de estradiol, ni favorecerían la aparición de síntomas climatéricos.
Objective: To determinate the effect of hysterectomy with preservation of one or two ovaries on estradiol concentration in premenopausal women. Materials and methods: 40 premenopausal patients of the Hospital Nacional Arzobispo Loayza were recruited; the first blood sample was taken one day before the hysterectomy and the second sample in an equivalent time to three menstrual cycle length after the surgery. We also conducted a survey about climacteric symptoms in both interviews. Results: There was no significant difference between levels of estradiol, before and after hysterectomy. Comparison of means by type of hysterectomy, number of preserved ovaries and diagnosis before surgery were not statistically significant. The climacteric symptoms were not statiscally significant before or after the hysterectomy. Conclusions: Type of hysterectomy, the number of preserved ovaries and diagnosis before surgery will not affect the estradiol level and will not favor the beginning of climacteric symptoms.
Assuntos
Feminino , Humanos , Estradiol , Histerectomia , Ovariectomia , Pré-MenopausaRESUMO
OBJECTIVE: to describe clinical data, metabolic profile, treatment and evolution of a nursing children cohort with urolithiasis. METHODS: using a descriptive, prospective and longitudinal design, were registered all patients with urolithiasis, of Pediatric Division at the Hospital General "Agustín O'Horán," in Yucatan, Mexico. We included all patients who were 36 months old and younger. We did not include children with malformations or associated disease which causes urolithiasis. Clinical and metabolic profiles, evaluation of the applied treatment as well as an evolution by four years period were done. RESULTS: 63 patients were recruited with ages ranging from 2 to 36 months; 39 (61.9 %) were male. The most common clinical signs were crying upon urination (49.2 %), urinary retention (31.7 %), hematuria (30.2 %), and pollakiuria (28.6 %). Calculus were most frequently located in the kidney (58.7 %). The most common complications were acute urinary tract infection (61.9 %), malnutrition (47.6 %) and acute renal failure (12.7 %). Documented metabolic alterations included hyperuricosuria (57.1 %), hypomagnesiuria (11.1 %) and hypercalciuria (9.5 %). CONCLUSIONS: urolithiasis should be suspected in children with crying upon urination and urinary symptoms; it should be considered among the different causes of renal failure; hyperuricosuria was the most frequent metabolic alteration.