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ABSTRACT Purpose: To describe the frequency, clinical characteristics, complications, and management of glaucoma in eyes that underwent keratoprosthesis implantation. Methods: Patients who underwent keratoprosthesis surgery between June 2010 and January 2020 were retrospectively evaluated for glaucoma association and prognoses. Results: Among 17 patients who underwent keratoprosthesis surgery, 9 (52.9%) were associated with underlying or keratoprosthesis-induced glaucoma. Five eyes (29.4%) had underlying glaucoma and underwent a glaucoma drainage device implantation at least 6 months before keratoprosthesis surgery. One eye (5.9%) with normal intraocular pressure had glaucoma drainage device implantation at the same session with keratoprosthesis surgery due to high-risk characteristics of anterior segment structures. Four eyes with preexisting glaucoma showed progression after keratoprosthesis surgery. Additional antiglaucomatous treatment was commenced in two eyes whereas implantation of 2nd glaucoma drainage device was performed in two eyes. Postoperative complications in three eyes (100%) with glaucoma drainage device implanted 6 months before or at the same session with aphakic type keratoprosthesis surgery with partial vitrectomy included rhegmatogenous retinal detachment in two eyes and bacterial endophthalmitis in one eye. Migration of silicone oil through the tube to the subconjunctival area was seen after pars plana vitrectomy in one eye. None of the three eyes (0%) that underwent glaucoma drainage device implantation years before keratoprosthesis surgery experienced a posterior segment complication other than glaucomatous progression. Out of 11 eyes with no previous history of glaucoma, 3 (27.3%) showed high intraocular pressure and glaucomatous disc changes after keratoprosthesis surgery, which could be pharmacologically controlled. Conclusions: In this cohort, eyes with preexisting glaucoma were more difficult to manage compared to eyes with de novo glaucoma after keratoprosthesis surgery. Retinal complications appeared more often when glaucoma drainage device implantation was performed no more than 6 months before aphakic type keratoprosthesis surgery with partial vitrectomy.
RESUMO Objetivo: Descrever a frequência, as características clínicas, as complicações e o manejo do glaucoma em olhos submetidos a implantes de ceratoprótese. Métodos: Pacientes submetidos à cirurgia de ceratoprótese entre junho de 2010 e janeiro de 2020 foram avaliados retrospectivamente em termos de glaucoma associado e prognóstico. Resultados: Dos 17 pacientes submetidos à cirurgia de ceratoprótese, em 9 (52,9%) foi constatado glaucoma subjacente ou induzido por ceratoprótese. Cinco olhos (29,4%) tinham glaucoma subjacente e receberam a implantação de um dispositivo de drenagem de glaucoma pelo menos 6 meses antes da cirurgia de ceratoprótese. Um olho (5,9%) com pressão intraocular normal teve implantado um dispositivo de drenagem de glaucoma na mesma sessão da cirurgia de ceratoprótese, devido às características de "alto risco" das estruturas do segmento anterior. Quatro dos olhos com glaucoma preexistente apresentaram progressão após a cirurgia de ceratoprótese. Foi iniciado um tratamento antiglaucomatoso adicional em 2 olhos, enquanto outros 2 olhos receberam o implante de um segundo dispositivo de drenagem de glaucoma. Foram observadas complicações pós-operatórias em 3 olhos (100%) com dispositivo de drenagem de glaucoma implantado 6 meses antes ou na mesma sessão da cirurgia de ceratoprótese tipo afácica com vitrectomia parcial, incluindo descolamento de retina regmatogênico em 2 olhos e endoftalmite bacteriana em 1 olho. Em 1 olho observou-se migração do óleo de silicone para a área subconjuntival através do tubo após vitrectomia via pars plana. Nenhum dos 3 olhos (0%) implantados com dispositivo de drenagem de glaucoma anos antes da cirurgia de ceratoprótese apresentou complicações do segmento posterior, exceto progressão glaucomatosa. Dos 11 olhos sem história prévia de glaucoma, 3 (27,3%) apresentaram alta pressão intraocular e alterações do disco glaucomatoso após cirurgia de ceratoprótese, condições que podem ser controladas clinicamente. Conclusões: Nesta coorte, os olhos com glaucoma pré-existente foram mais difíceis de manejar, comparados àqueles que desenvolveram glaucoma após a cirurgia de ceratoprótese. Apareceram mais complicações retinianas quando o implante do dispositivo de drenagem de glaucoma foi realizado no máximo 6 meses antes da cirurgia de ceratoprótese do tipo afácico com vitrectomia parcial.
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ABSTRACT Introduction: Medical improvements are needed to prevent ischemia-reperfusion injury in thoracoabdominal aortic surgery. The aim of this study was to determine the antioxidant effects of thymoquinone, silymarin, and curcumin against ischemia-reperfusion injury associated with abdominal aorta. Methods: Twenty-five Wistar albino rats were included in the study. Sham, control, and treatment (thymoquinone, silymarin, and curcumin) groups were set in equal numbers. Ischemia-reperfusion was applied by clamping (120 minutes) and de-clamping (60 minutes) the infrarenal aorta of all groups, except the sham group. Before reperfusion, thymoquinone, silymarin, and curcumin were given intraperitoneally to the treatment groups. After reperfusion, blood samples were taken from the right ventricle. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were studied in serum samples and histopathological examination was performed on the gastrocnemius muscle. Results: There was a significant difference in TOS and OSI values between the control and sham groups. Both values were found higher in the control group than in the sham group (P<0.05). OSI values were found to be lower in the thymoquinone group compared to the control group (P<0.05). All three parameters were found to be lower in the silymarin group than in the control group (P<0.05). TAS and TOS levels were found to be higher in the curcumin group than in the control group (P<0.05). There was no histopathological difference between the groups. Conclusion: Silymarin and thymoquinone administration decreases oxidative stress in experimental aortic ischemia-reperfusion injury. Antioxidant effect of curcumin was lower than silymarin and thymoquinone.
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Introducción. El cáncer colorrectal (CCR) es la tercera causa de muerte a nivel mundial, constituyendo la cirugía la piedra angular de tratamiento. El abordaje abierto inicialmente era el más utilizado, situación que ha cambiado en los últimos años con el avance de las técnicas laparoscópicas. En nuestra población no encontramos estudios que comparen los resultados del abordaje laparoscópico versus abierto. Objetivo. Mostrar los resultados de los pacientes con CCR primario intervenidos quirúrgicamente con intención curativa según el abordaje laparoscópico versus abierto. Metodología. Se analizaron los datos recogidos de forma retrospectiva de 159 pacientes sometidos a cirugía programada por CCR en el servicio de coloproctología del Hospital Santo Tomás del 2014 al 2017. Resultados. En las variables preoperatorias, solamente el antígeno carcinoembrionario mostró diferencia significativa (p<0.001) con mediana de 2.37 en laparoscopia versus 4.9 con abordaje abierto. Las variables operatorias tiempo y sangrado quirúrgico resultaron menores por laparoscópica ambas con (p<0.001). No se encontraron diferencias en: número de ganglios resecados (p=0.366), márgenes distales (p=0.786). En el postoperatorio la estancia hospitalaria fue menor por laparoscopía (p<0.001); complicaciones (p=0.425) e intervalo libre de enfermedad (p=0.575) fueron similares en ambos grupos. Conclusiones. Este estudio muestra resultados equiparables de la técnica laparoscópica vs la técnica abierta en cuanto a estándares de calidad intraoperatorios como la cosecha ganglionar y márgenes libres, sin diferencia en el grado de complicaciones en el postoperatorio inmediato. (provisto por Infomedic International)
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INTRODUCTION: Exposure to mercury, a toxic metal, occurs primarily from inhaling mercury vapors or consuming methylmercury-contaminated fish. One third of all anthropogenic mercury emissions worldwide are from artisanal gold mining, which uses mercury to extract gold. Although recent reports suggest that the Madre de Dios region in Peru (with >30,000 artisanal miners) has extensive mercury contamination, residents had never been assessed for mercury exposure. Thus, our objective was to quantify mercury exposure among residents of an artisanal mining town in Madre de Dios and to assess risk factors for exposure. METHODS: We conducted a cross-sectional assessment of 103 residents of an artisanal gold mining town in July 2010. Each participant provided a urine and blood sample and completed a questionnaire assessing potential exposures and health outcomes. We calculated geometric mean (GM) urine total mercury and blood methylmercury concentrations and compared log-transformed concentrations between subgroups using linear regression. RESULTS: One third (34.0 %) of participants were gold miners. All participants had detectable urine total mercury (GM, 5.5 µg/g creatinine; range, 0.7-151 µg/g creatinine) and 91 % had detectable blood methylmercury (GM, 2.7 µg/L; range, 0.6-10 µg/L); 13 participants (13 %) reported having kidney dysfunction or a neurological disorder. Urine total mercury concentrations were higher among people who heated gold-mercury amalgams compared with people who never heated amalgams (p < 0.05); methylmercury concentrations were higher among fish consumers compared with nonfish consumers (p < 0.05). CONCLUSION: Our findings suggest that mercury exposure may be widespread in Huaypetue.
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Ouro , Compostos de Metilmercúrio/sangue , Compostos de Metilmercúrio/urina , Mineração , Exposição Ocupacional , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Biomarcadores/urina , Criança , Pré-Escolar , Creatinina/urina , Estudos Transversais , Monitoramento Ambiental/métodos , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Peru , Fatores de Risco , Adulto JovemRESUMO
Se realizó un estudio experimental en los consultorios 15, 16, 17 y 18 correspondientes al área de salud del Policlínico Gaspar con el objetivo de evaluar la respuesta a diferentes regímenes terapéuticos en el período comprendido desde junio del 2007 al 2008. La muestra estuvo comprendida por 200 pacientes con edades comprendidas entre 0 y 14 años con complementarios de heces fecales directos o seriados positivos de giardiasis y sin tratamiento anterior. Los pacientes fueron distribuidos de forma aleatoria a cada uno de los grupos de tratamiento garantizando la homogeneidad de la muestra. Al finalizar el tratamiento se realizó la evaluación final en relación con los síntomas clínicos y los resultados de heces fecales. El grupo de edades comprendida entre 10 a 14 años y el sexo femenino predominaron en el universo de pacientes estudiados, el dolor abdominal y las diarreas fueron los síntomas más frecuentemente encontrados, estos desaparecieron en más de la mitad de los niños que fueron tratados con tinidazol y metronidazol. Los mejores resultados en el análisis de las heces fecales después de culminado el tratamiento correspondieron a los grupos tratados con estos dos medicamentos.
An experimental study was conducted in 15, 16, 17 and 18 clinics for the health area of Gaspar Polyclinic in order to evaluate the response to different treatment regimens from June 2007 to 2008. The sample consisted of 200 patients aged between 0 and 14 years with fecal specimens or positive serial of giardiasis and without prior treatment. Patients were randomly assigned to each of the treatment groups by ensuring the homogeneity sample. After treatment the final evaluation was conducted in relation to clinical symptoms and fecal specimens results. The age group between 10 and 14 years and female predominance in the studied group of patients, abdominal pain and diarrhea were the most frequently found symptoms; they disappeared in more than half of children who were treated with tinidazole and metronidazole. The best results in the analysis of feces after the treatment completion corresponded to the groups treated with these two drugs.
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Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Giardíase/tratamento farmacológico , Giardíase/epidemiologia , Giardíase/fisiopatologiaRESUMO
Se presenta un caso de dos años de evolución con síntomas principales de incontinencia urinaria, alucinaciones visuales llamativas, pérdida de la conciencia transitoria, dificultad para reconocer el lugar, rigidez muscular con inestabilidad en la marcha y fluctuaciones del rendimiento cognitivo en el transcurso del día. Se concluye que coincide con los criterios.
A case of two years of evolution that fit with the diagnoses criteria of Dementia with Lewy bodies (DLB) is presented being the main symptoms urinary incontinence, showy visual allucinations, loss of transitory consciousness, difficulty to recognize place, muscular rigidity with instability to walk and fluctuations of the mental performance as day went by.
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Humanos , Feminino , Idoso de 80 Anos ou mais , Doença por Corpos de Lewy/diagnósticoRESUMO
Se presenta un caso de cicladores rápidos como modalidad del Trastorno Afectivo Bipolar de un año de evolución con más de seis episodios de manía, depresión o hipomanía, sin períodos eutímicos con agudización de los síntomas sobre todo maníacos alrededor del ciclo menstrual, resistente a la terapéutica convencional y evolución favorable a la terapia anticonvulsinante
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Humanos , Masculino , Feminino , Transtorno BipolarRESUMO
Se realizó un estudio observacional descriptivo en los casos de Tentativa de Suicidio por Quemaduras ingresados en el servicio de Quemaduras del Hospital General Docente Roberto Rodríguez, Morón Ciego de Avila durante el período comprendido del 1ro de enero al 31 de diciembre del 2000, con finalidad de conocer las características psicosociales de los mismos. El universo de trabajo estuvo comprendido por todos los casos que sufrieron lesiones por dicha conducta. A los cuales se les aplicó una encuesta confeccionada al efecto. Los datos se procesaron computadoras medianteestadística descriptiva con el MICROSTAT. Exponiéndose en forma de tablas, se obtuvo un predominio de casos con intento suicida por quemaduras en las edades comprendidas entre 15 y 34 años, sexo femenino, amas de casa, casados o acompañados y los de un nivel educacional de enseñanza media. El alcohol constituyó el agente más utilizado para realizar este acto. En la casuística predominan los críticos extremos.