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1.
Rev. chil. enferm. respir ; 39(2): 152-168, 2023. tab
Artículo en Español | LILACS | ID: biblio-1515115

RESUMEN

Las sibilancias recurrentes del preescolar son un problema prevalente. 50% de todos los niños tiene al menos un episodio de sibilancias en los primeros 6 años. Sin embargo, solo 4% de los menores de 4 años tiene diagnóstico de asma. Por este motivo es fundamental realizar una adecuada anamnesis y examen físico tendientes a descartar causas secundarias, lo que debe ser complementado con exámenes de laboratorio de acuerdo con la orientación clínica. En la actualidad se recomienda indicar tratamiento de mantención con corticoides inhalados en aquellos niños que tengan episodios repetidos de obstrucción bronquial y que tengan una alta probabilidad de respuesta favorable a esta terapia. Se ha demostrado que aquellos pacientes que tienen un recuento de eosinófilos en sangre > 300 células por mm3 o aquellos que presentan una prueba cutánea positiva o IgE específicas positivas para alergenos inhalados responderán adecuadamente al tratamiento con esteroides inhalados.


Recurrent wheezing in preschoolers has a high prevalence. 50% of all children have at least one wheezing episode in the first six years of life. However, only 4% of children under four years of age are diagnosed with asthma. Therefore it is essential to carry out an adequate medical history and physical examination to rule out secondary causes, which must be complemented with laboratory tests in accordance with clinical guidance. It is recommended to indicate maintenance treatment with inhaled corticosteroids to those children who have repeated episodes of wheezing and who have a high probability of a good response to this therapy. It has been demonstrated that those patients who have blood eosinophil count > 300 cells per mm3 or those who have a positive skin test or positive specific IgE for inhaled allergens will have a good response to inhaled corticosteroids.


Asunto(s)
Humanos , Preescolar , Asma/diagnóstico , Asma/tratamiento farmacológico , Ruidos Respiratorios , Fenotipo , Recurrencia , Índice de Severidad de la Enfermedad , Consenso
2.
Neumol. pediátr. (En línea) ; 18(3): 73-82, 2023. tab
Artículo en Español | LILACS | ID: biblio-1517019

RESUMEN

Las sibilancias recurrentes del preescolar son un problema prevalente. 50% de todos los niños tiene al menos un episodio de sibilancias en los primeros 6 años. Sin embargo, solo 4 % de los menores de 4 años tiene diagnóstico de asma. Por este motivo es fundamental realizar una adecuada anamnesis y examen físico tendientes a descartar causas secundarias, lo que debe ser complementado con exámenes de laboratorio de acuerdo con la orientación clínica. En la actualidad se recomienda indicar tratamiento de mantención con corticoides inhalados en aquellos niños que tengan episodios repetidos de obstrucción bronquial y que tengan una alta probabilidad de respuesta favorable a esta terapia. Se ha demostrado que aquellos pacientes que tienen un recuento de eosinófilos en sangre > 300 células por mm3 o aquellos que presentan una prueba cutánea positiva o IgE específicas positivas para alérgenos inhalados, responderán adecuadamente al tratamiento con esteroides inhalados.


Recurrent wheezing in preschoolers has a high prevalence. 50% of all children have at least one wheezing episode in the first six years of life. However, only 4% of children under four years of age are diagnosed with asthma. Therefore, it is essential to carry out an adequate medical history and physical examination to rule out secondary causes, which must be complemented with laboratory tests in accordance with clinical guidance. It is recommended to indicate maintenance treatment with inhaled corticosteroids to those children who have repeated episodes of wheezing and who have a high probability of a good response to this therapy. It has been demonstrated that those patients who have blood eosinophil count > 300 cells per mm3 or those who have a positive skin test or positive specific IgE for inhaled allergens will have a good response to inhaled corticosteroids.


Asunto(s)
Humanos , Preescolar , Asma/diagnóstico , Asma/terapia , Ruidos Respiratorios/etiología , Terapia por Inhalación de Oxígeno , Fenotipo , Recurrencia , Administración por Inhalación , Inmunoglobulina E , Corticoesteroides/administración & dosificación , Eosinófilos
5.
Actas Dermosifiliogr ; 113(10): 930-937, 2022.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35963330

RESUMEN

INTRODUCTION: Folliculotropic mycosis fungoides is a variant that has poor prognosis and a variable clinical presentation. Concerns have been expressed that the current TNMB staging of this tumor may not be useful. A recently developed classification system based on clinical and histologic variables classifies this tumor as early or advanced, a distinction found to correlate with prognosis. The aim of this study was to compare survival in FMF in Colombia between patients with early versus advanced tumors. MATERIAL AND METHODS: Retrospective, observational study of clinical course and outcomes in patients with FMF treated at the National Cancer Institute of Colombia between 2008 and 2020. Survival was compared between early and advanced disease. RESULTS: Twenty-one patients (11 with early FMF and 10 with advanced FMF) were studied. Seven patients, all with advanced disease, died. Survival at 5 years was 62% overall and 40% for patients with advanced FMF. No differences were observed when survival was analyzed according to TNMB stage. CONCLUSIONS: TNMB staging is not useful in FMF. The new classification system based on clinicopathologic features appears to provide reliable information for assessing prognosis and guiding treatment decisions.


Asunto(s)
Micosis Fungoide , Neoplasias Cutáneas , Humanos , Estudios Retrospectivos , América Latina , Neoplasias Cutáneas/patología , Micosis Fungoide/diagnóstico , Micosis Fungoide/patología , Análisis de Supervivencia , Hospitales , Estadificación de Neoplasias
6.
Cell Tissue Bank ; 2022 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-35906514

RESUMEN

Tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. The aims of this work were to compare chemically and physically processed human Amniotic Membranes (hAM) and analyze the cytocompatibility and proliferation rate (PR) of two primary human mesenchymal stromal cell lines, from different sources and donor conditions seeded over these scaffolds. The evaluated hAM processes were: cold shock to obtain a frozen amniotic membrane (FEAM) with remaining dead epithelial cells, denudation of hAM with trypsin for 20/10 min (DEAM20/10) or treatment with sodium dodecyl sulfate to decellularized hAM (DAM). All samples were sterilized with gamma radiation. The selection of the treated hAM to then generate composites was performed by scanning and transmission electron microscopy and characterization by X-ray diffraction, selecting DEAM10 and FEAM as scaffolds for cell seeding. Two sources of primary human stromal cells were used, both developed by our researchers, human Dental Pulp Stem Cells (hDPSC) from living donors and human Mesenchymal Stromal Cells (hMSC) from bone marrow isolated from brain dead donors. This last line of cells conveys a novel source of human cells that, to our knowledge, have not been tested as part of this type of construct. We developed four in vitro constructs without cytotoxicity signs and with different PR depending on the scaffolds and cells. hDPSC and hMSC grew over both FEAM and DEAM10, but DEAM10 allowed higher PR.

7.
Morphologie ; 106(354): 169-176, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34384680

RESUMEN

OBJECTIVE: This study describes the cochlear morphometry of a mexican population analysed by laterality and sex. The objective is to compare Cochlear Length (CL) evaluation between Alexiades et al. formula and manual method described by Würfel et al. PATIENTS: Hispanic patients from Mexico, with an age of 18 years or older, were included. Morphometric examination was performed retrospectively on 200 subjects who underwent previously temporal bone imaging for clinical purposes. MATERIALS AND METHODS: Horos for Mac program was used to measure CL, cochlear height, distance A, and distance B. WorkStation AW Volume Share 2 was used to obtain volume. CL was measured in 400 temporal bones (228 females, 172 males). RESULTS: The mean CL was 34.02mm±2.15mm. A significant difference was found in all variables between sex (P=≤0.05) and laterality (P=≤0.05). The Alexiades equation was used for determining CL and compared with the manual formula, with no significant differences (κ=0.71). However, the time consumption was 5 times faster with the calculated method. The Alexiades formula was demonstrated to be a reliable method measurement. CONCLUSION: Preoperative Computed Tomography evaluation of the internal ear helps to plan the Cochlear Implants (CI) surgical approach and allows to choose an appropriate electrode length for each necessity. Our findings may be useful to facilitate and adapt preoperative management of CI surgery by considering the characteristics of cochlear morphology of Latin-American populations.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Adolescente , Cóclea/diagnóstico por imagen , Implantación Coclear/métodos , Femenino , Humanos , Masculino , México , Estudios Retrospectivos
8.
Pharmacol Res ; 178: 106028, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34896541

RESUMEN

BACKGROUND: Obesity and type 2 diabetes are chronic diseases characterized by insulin resistance, mitochondrial dysfunction and morphological abnormalities. OBJECTIVE: We have investigated if dysregulation of mitochondrial dynamics and biogenesis is involved in an animal model of obesity and diabetes. METHODS: The effect of short-term leptin and mdivi-1 - a selective inhibitor of Drp-1 fission-protein - treatment on mitochondrial dynamics and biogenesis was evaluated in epididymal white adipose tissue (WAT) from male ob/ob mice. RESULTS: An increase in Drp-1 protein levels and a decrease in Mfn2 and OPA-1 protein expression were observed with enhanced and sustained mitochondrial fragmentation in ob/ob mice compared to wt C57BL/6 animals (p < 0.05). The content of mitochondrial DNA and PGC-1α mRNA expression -both parameters of mitochondrial biogenesis- were reduced in ob/ob mice (p < 0.05). Treatment with leptin and mdivi-1 significantly increased mitochondrial biogenesis, improved fusion-to-fission balance and attenuated mitochondrial dysfunction, thus inducing white-to-beige adipocyte transdifferentiation. Measurements of glucose and lipid oxidation in adipocytes revealed that both leptin and mdivi-1 increase substrates oxidation while in vivo determination of blood glucose concentration showed decreased levels by 50% in ob/ob mice, almost to the wt level. CONCLUSIONS: Pharmacological targeting of Drp-1 fission protein may be a potential novel therapeutic tool for obesity and type 2 diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2 , Dinámicas Mitocondriales , Tejido Adiposo , Tejido Adiposo Blanco , Animales , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Leptina , Masculino , Ratones , Ratones Endogámicos C57BL , Obesidad/metabolismo
10.
Biochim Biophys Acta Biomembr ; 1863(1): 183489, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33075308

RESUMEN

Fluorescence spectroscopy and Molecular Dynamics results show that cholesterol reduces water along the chains in ether lipids by changing the water distribution pattern between tightly and loosely bound water molecules. Water distribution was followed by emission spectra and generalized polarization of 6-dodecanoyl-2-dimethyl aminonaphthalene (Laurdan) inserted in 1,2-dimiristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-di-O-tetradecyl-sn-glycero-3-phosphocholine (14: 0 Diether PC) membranes. Molecular Dynamics simulations indicate that the action of cholesterol could be different in ether PC in comparison to ester PC. In addition, Cholesterol seems to act "per se" as an additional hydration center in ether lipids. Regardless of the phase state, cholesterol both in DMPC and 14:0 Diether PC vesicles, changed the distribution of water molecules decreasing the dipole relaxation of the lipid interphase generating an increase in the non-relaxable population. Above 10% Cholesterol/14:0 Diether PC ratio vesicles' interphase present an environment around Laurdan molecules similar to that corresponding to ester PC.


Asunto(s)
Colesterol/química , Membrana Dobles de Lípidos/química , Fosfatidilcolinas/química , Espectrometría de Fluorescencia , Relación Estructura-Actividad
12.
Rev. chil. enferm. respir ; 36(3): 176-201, set. 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1138552

RESUMEN

El asma bronquial es la enfermedad crónica más frecuente en la infancia. Sin embargo, en Chile existe un importante subdiagnóstico. Es fundamental estar atentos a los síntomas y signos que nos hacen sospechar el diagnóstico para iniciar un tratamiento oportuno, que asegure un buen control de la enfermedad. Debemos sospechar asma en todo escolar que presente cuadros repetidos de obstrucción bronquial. El diagnóstico debe confirmarse con pruebas de función pulmonar que demuestren obstrucción variable al flujo aéreo y respuesta broncodilatadora positiva. El tratamiento se basa en dos pilares fundamentales: la educación y el tratamiento farmacológico. Las actividades educativas deben incluir contenidos acerca de la enfermedad y su tratamiento, se debe monitorizar constantemente la adherencia al tratamiento de mantención, enseñar la técnica inhalatoria correcta y revisar en cada control, entregar un plan de acción escrito personalizado frente al inicio de una crisis y realizar controles médicos periódicos. Con respecto al tratamiento farmacológico, el estándar de oro es el uso de corticoides inhalados permanentes, en la mínima dosis posible que logre el control de la enfermedad. El objetivo del tratamiento es la supresión de los síntomas diarios y de las crisis. El tratamiento se irá incrementando en la medida que no haya una respuesta adecuada, pero antes de aquello se debe evaluar la adherencia al tratamiento de mantención, la técnica inhalatoria, presencia de comorbilidades asociadas y exposición ambiental. En el paciente leve, que esté sin tratamiento permanente, el rescate debe realizarse con broncodilatadores asociados siempre a un corticoide inhalado. Este consenso es una guía de apoyo para mejorar el diagnóstico oportuno, tratamiento y control del asma en el escolar.


Bronchial asthma is the most prevalent chronic condition among children, however, in Chile, it is underdiagnosed. This may be due to medical professionals failing to recognize the disease. It is essential to be aware of the symptoms and signs that are suggestive of the disease in order to begin an appropriate treatment to achieve disease control. Asthma must be suspected in school age children who present repeated episodes of bronchial obstruction. The diagnosis should be confirmed with lung function tests that demonstrate variable airflow obstruction with a positive bronchodilator response. Treatment is based on two fundamental pillars: education and pharmacological treatment. Educational activities must include: information about the disease and its treatment, regular monitoring of treatment adherence, teaching and reviewing the correct inhalation technique at every checkup, developing a personalized written action plan and scheduling regular follow-up appointments. The gold standard for treatment is maintenance inhaled corticosteroids, in the lowest possible dose that enables disease control. The goal of the treatment is to eliminate daily symptoms and asthma crisis. Therapy should be increased if control is not achieved, but before starting it, adherence to maintenance treatment, inhalation technique, presence of associated comorbidities and environmental exposure should be evaluated. In the mild patient, who is not receiving maintenance therapy, rescue treatment should be done with bronchodilators, always associated with inhaled corticosteroids. This consensus is a guide to improve the diagnosis, treatment and control of asthma in schoolchildren


Asunto(s)
Humanos , Niño , Asma/diagnóstico , Asma/terapia , Terapia por Inhalación de Oxígeno , Pruebas de Función Respiratoria , Asma/clasificación , Asma/tratamiento farmacológico , Vitamina D/sangre , Índice de Severidad de la Enfermedad , Nebulizadores y Vaporizadores , Radiografía Torácica , Factores Desencadenantes , Chile , Consenso , Diagnóstico Diferencial
13.
Neumol. pediátr. (En línea) ; 15(3): 381-401, sept. 2020. tab, ilus
Artículo en Español | LILACS | ID: biblio-1127611

RESUMEN

Bronchial asthma is the most prevalent chronic condition among children, however, in Chile, it is underdiagnosed. This may be due to medical professionals failing to recognize the disease. It is essential to be aware of the symptoms and signs that are suggestive of the disease in order to begin an appropriate treatment to achieve disease control. Asthma must be suspected in school age children who present repeated episodes of bronchial obstruction. The diagnosis should be confirmed with lung function tests that demonstrate variable airflow obstruction with a positive bronchodilator response. Treatment is based on two fundamental pillars: education and pharmacological treatment. Educational activities must include: information about the disease and its treatment, regular monitoring of treatment adherence, teaching and reviewing the correct inhalation technique at every checkup, developing a personalized written action plan and scheduling regular follow-up appointments. The gold standard for treatment is maintenance inhaled corticosteroids, in the lowest possible dose that enables disease control. The goal of the treatment is to eliminate daily symptoms and asthma crisis. Therapy should be increased if control is not achieved, but before starting it, adherence to maintenance treatment, inhalation technique, presence of associated comorbidities and environmental exposure should be evaluated. In the mild patient, who is not receiving maintenance therapy, rescue treatment should be done with bronchodilators, always associated with inhaled corticosteroids. This consensus is a guide to improve the diagnosis, treatment and control of asthma in schoolchildren.


El asma bronquial es la enfermedad crónica más frecuente en la infancia. Sin embargo en Chile existe un importante subdiagnóstico. Es fundamental estar atentos a los síntomas y signos que nos hacen sospechar el diagnóstico para iniciar un tratamiento oportuno, que asegure un buen control de la enfermedad. Debemos sospechar asma en todo escolar que presente cuadros repetidos de obstrucción bronquial. El diagnóstico debe confirmarse con pruebas de función pulmonar que demuestren obstrucción variable al flujo aéreo y respuesta broncodilatadora positiva. El tratamiento se basa en dos pilares fundamentales: la educación y el tratamiento farmacológico. Las actividades educativas deben incluir contenidos acerca de la enfermedad y su tratamiento, se debe monitorizar constantemente la adherencia al tratamiento de mantención, enseñar la técnica inhalatoria correcta y revisar en cada control, entregar un plan de acción escrito personalizado frente al inicio de una crisis y realizar controles médicos periódicos. Con respecto al tratamiento farmacológico, el estándar de oro es el uso de corticoides inhalados permanentes, en la mínima dosis posible que logre el control de la enfermedad. El objetivo del tratamiento es la supresión de los síntomas diarios y de las crisis. El tratamiento se irá incrementando en la medida que no haya una respuesta adecuada, pero antes de aquello se debe evaluar la adherencia al tratamiento de mantención, la técnica inhalatoria, presencia de comorbilidades asociadas y exposición ambiental. En el paciente leve, que esté sin tratamiento permanente, el rescate debe realizarse con broncodilatadores asociados siempre a un corticoide inhalado. Este consenso es una guía de apoyo para mejorar el diagnóstico oportuno, tratamiento y control del asma en el escolar.


Asunto(s)
Humanos , Niño , Asma/diagnóstico , Asma/terapia , Respiración Artificial , Pruebas de Función Respiratoria , Asma/clasificación , Asma/fisiopatología , Estado Asmático/etiología , Nebulizadores y Vaporizadores , Chile , Antiasmáticos/uso terapéutico , Consenso , Cumplimiento y Adherencia al Tratamiento
14.
Rev. méd. Chile ; 148(6): 852-857, jun. 2020.
Artículo en Español | LILACS | ID: biblio-1139381

RESUMEN

Telemedicine partially resolved inequalities in access to health care, especially in geographical areas with a low number of doctors and in places with absent or insufficient specialists. Currently, Chile has a National Telehealth Program, but there are no specific laws on digital medicine that recognize remote medical acts and it is uncertain if they really are medical acts. The goal of a medical act is the well-being of a patient, requiring a therapeutic alliance based on the doctor's knowledge of the needs, expectations and fears of such a patient. This article tries to determine if patient care by telemedicine can be considered a medical act. For this purpose, the conception of a medical act defined by P. Laín Entralgo, M. Besio and the main medical and professional associations is analyzed in depth. It is concluded that although direct physical contact between doctor and patient largely supports the therapeutic alliance, telemedicine has been successful, particularly in its synchronous modality. Taking the necessary precautions, in most cases distant medical acts can be carried out allowing a humanized and respectful care of people.


Asunto(s)
Humanos , Telemedicina , Chile , Atención a la Salud
15.
Langmuir ; 36(10): 2644-2653, 2020 03 17.
Artículo en Inglés | MEDLINE | ID: mdl-32073276

RESUMEN

The lack of carbonyl groups and the presence of ether bonds give the lipid interphase a different water organization around the phosphate groups that affects the compressibility and electrical properties of lipid membranes. Generalized polarization of 1,2-di-O-tetradecyl-sn-glycero-3-phosphocholine (14:0 diether PC) in correlation with Fourier transform infrared (FTIR) analysis indicates a higher level of polarizability of water molecules in the membrane phase around the phosphate groups both below and above Tm. This reorganization of water promotes a different response in compressibility and dipole moment of the interphase, which is related to different H bonding of water molecules with phosphates (PO) and carbonyl (CO) groups.

16.
Rev Med Chil ; 148(6): 852-857, 2020 Jun.
Artículo en Español | MEDLINE | ID: mdl-33480386

RESUMEN

Telemedicine partially resolved inequalities in access to health care, especially in geographical areas with a low number of doctors and in places with absent or insufficient specialists. Currently, Chile has a National Telehealth Program, but there are no specific laws on digital medicine that recognize remote medical acts and it is uncertain if they really are medical acts. The goal of a medical act is the well-being of a patient, requiring a therapeutic alliance based on the doctor's knowledge of the needs, expectations and fears of such a patient. This article tries to determine if patient care by telemedicine can be considered a medical act. For this purpose, the conception of a medical act defined by P. Laín Entralgo, M. Besio and the main medical and professional associations is analyzed in depth. It is concluded that although direct physical contact between doctor and patient largely supports the therapeutic alliance, telemedicine has been successful, particularly in its synchronous modality. Taking the necessary precautions, in most cases distant medical acts can be carried out allowing a humanized and respectful care of people.


Asunto(s)
Telemedicina , Chile , Atención a la Salud , Humanos
17.
Neurologia (Engl Ed) ; 35(3): 185-206, 2020 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31003788

RESUMEN

BACKGROUND AND OBJECTIVES: Steinert's disease or myotonic dystrophy type 1 (MD1), (OMIM 160900), is the most prevalent myopathy in adults. It is a multisystemic disorder with dysfunction of virtually all organs and tissues and a great phenotypical variability, which implies that it has to be addressed by different specialities with experience in the disease. The knowledge of the disease and its management has changed dramatically in recent years. This guide tries to establish recommendations for the diagnosis, prognosis, follow-up and treatment of the complications of MD1. MATERIAL AND METHODS: Consensus guide developed through a multidisciplinary approach with a systematic literature review. Neurologists, pulmonologists, cardiologists, endocrinologists, neuropaediatricians and geneticists have participated in the guide. RECOMMENDATIONS: The genetic diagnosis should quantify the number of CTG repetitions. MD1 patients need cardiac and respiratory lifetime follow-up. Before any surgery under general anaesthesia, a respiratory evaluation must be done. Dysphagia must be screened periodically. Genetic counselling must be offered to patients and relatives. CONCLUSION: MD1 is a multisystemic disease that requires specialised multidisciplinary follow-up.


Asunto(s)
Asesoramiento Genético , Distrofia Miotónica/diagnóstico , Distrofia Miotónica/genética , Guías de Práctica Clínica como Asunto/normas , Trastornos de Deglución , Estudios de Seguimiento , Humanos , Distrofia Miotónica/complicaciones
18.
Epidemiol Infect ; 147: e71, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30869023

RESUMEN

We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41-64 years) compared with older adults (⩾65 years) (38.6% vs. 23.2%; P < 0.0001). The prevalence of undernutrition was lower among those with DM, and higher in communities with high indigenous presence. Immigrants only comprised 2% of all TB cases, but were more likely to have unfavourable TB treatment outcomes (treatment failure, death and default) when compared with those born in Chiapas (29.5% vs. 11.1%; P < 0.05). Unfavourable TB outcomes were also more prevalent among the TB patients with undernutrition, HIV or older age, but not DM (P < 0.05). Our study in Chiapas illustrates the challenges of other regions worldwide where social (e.g. indigenous origin, poverty, migration) and host factors (DM, undernutrition, HIV, older age) are associated with TB. Further understanding of these critical factors will guide local policy makers and health providers to improve TB management.


Asunto(s)
Diabetes Mellitus/epidemiología , Migración Humana/estadística & datos numéricos , Indígenas Norteamericanos/estadística & datos numéricos , Pueblos Indígenas/estadística & datos numéricos , Desnutrición/epidemiología , Tuberculosis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Alcoholismo/epidemiología , Alcoholismo/etiología , Comorbilidad , Estudios Transversales , Diabetes Mellitus/etiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Humanos , Masculino , Desnutrición/etiología , México/epidemiología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Tuberculosis/microbiología , Adulto Joven
19.
Transplant Proc ; 50(2): 433-435, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29579821

RESUMEN

BACKGROUND: Hand-assisted laparoscopic nephrectomy (HALDN) is currently the procedure of choice for obtaining living donor kidneys for transplantation. In our institution, it has been the standard procedure for 5 years. Previous studies have shown the same function of the graft as that obtained by open surgery, with a lower rate of bleeding and no differences in complications. We sought to demonstrate the experience and safety of HALDN compared with open donor nephrectomy in healthy donors for kidney transplantation. METHODS: A retrospective analytical observational study was conducted, reviewing the records of the living donors for kidney transplant undergoing open donor nephrectomy or HALDN in our center from March 1, 2009, to March 1, 2016. Renal function was assessed by the estimated glomerular filtration rate by the Modification of Diet in Renal Disease method before and after donation, as well as bleeding (mL), and complications (according to Clavien), performing a comparative analysis between the two techniques using parametric or nonparametric tests. RESULTS: A total of 179 living donor nephrectomies were performed during the study period-31 open donor nephrectomy (17.3%) and 148 HALDN (82.7%)-without relevant baseline differences, except for creatinine. HALDN has a shorter surgical time (156,473 ± 87.75 minutes vs 165,484 ± 69.95 minutes) and less bleeding (244.59 ± 416.08 mL vs 324.19 ± 197.986 mL) and a shorter duration of hospital stay (3.74 ± 1.336 days vs 4.75 ± 1.226 days). There were no significant differences in surgical complications at 30 days, or graft loss reported; there were 3 conversions (1.7%) from the HALDN to the open technique. There were no differences in renal function in the donors or recipients at the 5th day or the month after surgery. CONCLUSIONS: Laparoscopic nephrectomy has replaced open surgery as the gold standard for living kidney donors. HALDN is a safe and feasible procedure when compared with open donor nephrectomy, achieving a shorter surgical time with less bleeding, and no difference in the number of complications. This procedure lowers costs by decreasing the duration of the hospital stay, making is feasible to perform it at any institution with appropriately trained personnel.


Asunto(s)
Laparoscópía Mano-Asistida/métodos , Trasplante de Riñón/métodos , Donadores Vivos , Nefrectomía/métodos , Recolección de Tejidos y Órganos/métodos , Adulto , Femenino , Humanos , Tiempo de Internación , Masculino , Tempo Operativo , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Tiempo
20.
Trop Biomed ; 35(2): 365-372, 2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33601810

RESUMEN

Neurocysticercosis is a leading cause of seizures in adults, but in paediatric patients, the diagnosis is controversial. The aim of this study was to search for antibodies to Taenia solium cysticerci in paediatric patients with seizures. We retrospectively studied a cohort of 41 serum samples from paediatric patients and 40 serum samples from healthy children. Antibodies were analysed by ELISA (vesicular fluid) and by Western blot (glycoproteins). Clinical, image and socio-demographic data were obtained from the medical records. The frequency of positive by ELISA was of 12% (n=5) in patients with seizures, while no positive samples were found in the healthy group. Results of Western blot were negatives. The analysis of the medical records showed a cyst of unknown origin in 2/5 ELISA positive samples. According to the diagnostic criteria for neurocysticercosis, three minor criteria (positive serology, active seizures and compatible image) were associated to an epidemiological condition (Mexico is endemic for neurocysticercosis); thus, the probable frequency of neurocysticercosis in the studied sample of patients with seizures was 4.9% (2/41 patients). The three remaining positive samples were associated with problems of noninfectious origin. The positivity was associated with the identification of cysts by magnetic resonance imaging (p = 0.047; chi-square), but found no association with the socio-economic characteristics of the patients, family history or to clinical symptoms. In conclusion, scarce frequency of antibodies to T. solium cysticerci was determined in paediatric patients with seizures. The low prevalence of antibodies detected in children is an indirect indicator of the interruption of T. solium transmission. Further studies are needed to design an algorithm for the conclusive diagnosis of seizures.

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