RESUMO
BACKGROUND: Sclerotinia sclerotiorum is a necrotrophic fungus that causes Sclerotinia head rot (SHR) in sunflower, with epidemics leading to severe yield losses. In this work, we present an association mapping (AM) approach to investigate the genetic basis of natural resistance to SHR in cultivated sunflower, the fourth most widely grown oilseed crop in the world. RESULTS: Our association mapping population (AMP), which comprises 135 inbred breeding lines (ILs), was genotyped using 27 candidate genes, a panel of 9 Simple Sequence Repeat (SSR) markers previously associated with SHR resistance via bi-parental mapping, and a set of 384 SNPs located in genes with molecular functions related to stress responses. Moreover, given the complexity of the trait, we evaluated four disease descriptors (i.e, disease incidence, disease severity, area under the disease progress curve for disease incidence, and incubation period). As a result, this work constitutes the most exhaustive AM study of disease resistance in sunflower performed to date. Mixed linear models accounting for population structure and kinship relatedness were used for the statistical analysis of phenotype-genotype associations, allowing the identification of 13 markers associated with disease reduction. The number of favourable alleles was negatively correlated to disease incidence, disease severity and area under the disease progress curve for disease incidence, whereas it was positevily correlated to the incubation period. CONCLUSIONS: Four of the markers identified here as associated with SHR resistance (HA1848, HaCOI_1, G33 and G34) validate previous research, while other four novel markers (SNP117, SNP136, SNP44, SNP128) were consistently associated with SHR resistance, emerging as promising candidates for marker-assisted breeding. From the germplasm point of view, the five ILs carrying the largest combination of resistance alleles provide a valuable resource for sunflower breeding programs worldwide.
Assuntos
Ascomicetos/fisiologia , Resistência à Doença/genética , Helianthus/genética , Doenças das Plantas/imunologia , Alelos , Mapeamento Cromossômico , Estudos de Associação Genética , Genótipo , Helianthus/fisiologia , Repetições de Microssatélites/genética , Fenótipo , Melhoramento Vegetal , Doenças das Plantas/microbiologia , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
Sclerotinia head rot (SHR) is one of the most serious constraints to sunflower (Helianthus annuus L. var. macrocarpus) production worldwide. Here, we evaluated the response to SHR in a sunflower inbred panel from a large INTA germplasm collection, consisting of 137 inbred lines (ILs). Field trials were performed over five consecutive seasons using a twice-replicated randomized complete-block design. Disease incidence, disease severity, incubation period, and area under disease progress curve for disease incidence and severity were determined after controlled inoculation with the pathogen. Statistical analysis using mixed-effect models detected significant differences among ILs for all variables (P < 0.001). In addition, principal component analysis (PCA) and distance-based methods were used to classify the ILs according to their response to SHR, with ILs ALB2/5261 and 5383 emerging as the most resistant. Broad-sense heritability estimates ranged from 20.64% for disease severity to 10.58% for incubation period. The ample phenotypic variability of our collection, along with the moderate heritability estimates, highlight the importance of molecular breeding approaches to gain new insights into the genetic basis of sunflower resistance to SHR. The exhaustive phenotypic characterization presented here provides a reliable set of variables to comprehensively evaluate the disease and identifies two new sources of resistance to SHR.
Assuntos
Ascomicetos , Helianthus , Melhoramento Vegetal , Doenças das Plantas , Resistência à Doença/genética , Helianthus/microbiologia , Humanos , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controleRESUMO
Experts from six Latin American countries met to discuss critical issues and needs in the diagnosis and management of primary immunodeficiency diseases (PIDD). The diagnosis of PIDD is generally made following referral to an immunology centre located in a major city, but many paediatricians and general practitioners are not sufficiently trained to suspect PIDD in the first place. Access to laboratory testing is generally limited, and only some screening tests are typically covered by government health programmes. Specialised diagnostic tests are generally not reimbursed. Access to treatment varies by country reflecting differences in healthcare systems and reimbursement policies. An online PIDD Registry Programme for Latin America has been available since 2009, which will provide information about PIDD epidemiology in the region. Additional collaboration across countries appears feasible in at least two areas: a laboratory network to facilitate the diagnosis of PIDD, and educational programmes to improve PIDD awareness. In total, these collaborations should make it possible to advance the diagnosis and management of PIDD in Latin America.
Assuntos
Gerenciamento Clínico , Síndromes de Imunodeficiência/diagnóstico , Síndromes de Imunodeficiência/terapia , Alergia e Imunologia/educação , Conhecimentos, Atitudes e Prática em Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Imunoglobulinas Intravenosas/economia , Imunoglobulinas Intravenosas/uso terapêutico , Síndromes de Imunodeficiência/economia , Cobertura do Seguro , Reembolso de Seguro de Saúde , América Latina , Sistema de RegistrosRESUMO
Taxonomic literature contains information about virtually ever known species on Earth. In many cases, all that is known about a taxon is contained in this kind of literature, particularly for the most diverse and understudied groups. Taxonomic publications in the aggregate have documented a vast amount of specimen data. Among other things, these data constitute evidence of the existence of a particular taxon within a spatial and temporal context. When knowledge about a particular taxonomic group is rudimentary, investigators motivated to contribute new knowledge can use legacy records to guide them in their search for new specimens in the field. However, these legacy data are in the form of unstructured text, making it difficult to extract and analyze without a human interpreter. Here, we used a combination of semi-automatic tools to extract and categorize specimen data from taxonomic literature of one family of ground spiders (Liocranidae). We tested the application of these data on fieldwork optimization, using the relative abundance of adult specimens reported in literature as a proxy to find the best times and places for collecting the species (Teutamus politus) and its relatives (Teutamus group, TG) within Southeast Asia. Based on these analyses we decided to collect in three provinces in Thailand during the months of June and August. With our approach, we were able to collect more specimens of T. politus (188 specimens, 95 adults) than all the previous records in literature combined (102 specimens). Our approach was also effective for sampling other representatives of the TG, yielding at least one representative of every TG genus previously reported for Thailand. In total, our samples contributed 231 specimens (134 adults) to the 351 specimens previously reported in the literature for this country. Our results exemplify one application of mined literature data that allows investigators to more efficiently allocate effort and resources for the study of neglected, endangered, or interesting taxa and geographic areas. Furthermore, the integrative workflow demonstrated here shares specimen data with global online resources like Plazi and GBIF, meaning that others can freely reuse these data and contribute to them in the future. The contributions of the present study represent an increase of more than 35% on the taxonomic coverage of the TG in GBIF based on the number of species. Also, our extracted data represents 72% of the occurrences now available through GBIF for the TG and more than 85% of occurrences of T. politus. Taxonomic literature is a key source of undigitized biodiversity data for taxonomic groups that are underrepresented in the current biodiversity data sphere. Mobilizing these data is key to understanding and protecting some of the less well-known domains of biodiversity.
Assuntos
Biodiversidade , Mineração de Dados/estatística & dados numéricos , Filogenia , Aranhas/classificação , Animais , Sudeste AsiáticoRESUMO
Metabolons are dynamic associations of enzymes catalyzing consecutive reactions within a given pathway. Association results in enzyme stabilization and increased metabolic efficiency. Metabolons may use cytoskeletal elements, membranes and membrane proteins as scaffolds. The effects of glucose withdrawal on a putative glycolytic metabolon/F-actin system were evaluated in three Saccharomyces cerevisiae strains: a WT and two different obligate fermentative (OxPhos-deficient) strains, which obtained most ATP from glycolysis. Carbon source withdrawal led to inhibition of fermentation, decrease in ATP concentration and dissociation of glycolytic enzymes from F-actin. Depending on the strain, inactivation/reactivation transitions of fermentation took place in seconds. In addition, when ATP was very low, green fluorescent protein-labeled F-actin reorganized from highly dynamic patches to large, non-motile actin bodies containing proteins and enzymes. Glucose addition restored fermentation and cytoskeleton dynamics, suggesting that in addition to ATP concentration, at least in one of the tested strains, metabolon assembly/disassembly is a factor in the control of the rate of fermentation.
Assuntos
Citoesqueleto de Actina/ultraestrutura , Actinas/metabolismo , Citoesqueleto/enzimologia , Glicólise , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/metabolismo , Citoesqueleto/ultraestrutura , Fermentação , Glucose/metabolismo , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Proteínas dos Microfilamentos/metabolismo , Fosforilação Oxidativa , Fosfoglicerato Quinase/metabolismo , Saccharomyces cerevisiae/enzimologia , Saccharomyces cerevisiae/ultraestruturaRESUMO
The genus Wulfila O. Pickard-Cambridge 1895 belongs to the family Anyphaenidae Bertkau, 1878, commonly called ghost spiders. Wulfila is endemic to the Americas and currently has 43 valid species; here we describe five new: Wulfila conchamonile spec. nov., W. xilitlensis spec. nov., W. luisi spec. nov., W. unguis spec. nov. and W. phantasma spec. nov. Specimens were collected in Mexico as part of three biological inventories developed in Xilitla, San Luis Potosí, and Atotonilco and Xamaticpac, Veracruz, between 2011 and 2014. In addition, we provide an overview of Wulfila taxonomic literature with a discussion on the genus taxonomy, diagnostic characters, species placement, and novel genital characters.
Assuntos
Aranhas , Distribuição Animal , Animais , MéxicoRESUMO
Three new species of the spider genus Trachelas L. Koch, 1872 are described and included in the speciosus group based on the following features: embolus as a separate sclerite from the tegulum with no basal coils, legs with a conspicuous fringe of long trichobothria and narrow copulatory ducts coiled irregularly. The new species described are: T. crassus sp. n., T. ductonuda sp. n. and T. odoreus sp. n. A total of 46 specimens were collected in an oak forest near Pico de Orizaba Volcano, Mexico. Most individuals were collected on low vegetation using beating trays and direct collecting at night. Additional images are available at www.unamfcaracnolab.com.
Assuntos
Aranhas/anatomia & histologia , Aranhas/classificação , Distribuição Animal , Animais , Biodiversidade , Feminino , Florestas , Masculino , México , Quercus , Especificidade da Espécie , Aranhas/fisiologiaRESUMO
Resumen Introducción: La disección de la aurícula izquierda es una complicación infrecuente, pero potencialmente fatal de la cirugía cardíaca. Es frecuentemente asociada a cirugías de la válvula mitral, tanto su reparación el reemplazo, con una incidencia de 0,16%. Sin embargo, otros procedimientos como intervenciones percutáneas también presentan este riesgo. Objetivos: Presentar la resolución quirúrgica de un caso de disección de aurícula izquierda y aportar a la casuística nacional. Materiales y Método: Registro clínico, imagenológico y fotográfico del episodio clínico. Resultados: Una paciente que fue sometida a ablación por radiofrecuencia por vía retrógrada, y cursa durante el periodo postintervencional con insuficiencia cardíaca y su estudio identifica una disección auricular. Se realiza reparación del anillo mitral, plastía del aparato subvalvular y parche de pericardio, la paciente presenta evolución clínica y ecográfica favorable. Discusión: El tratamiento de esta entidad debe analizarse caso a caso, ya que la etiología relacionada a procedimientos percutáneos es diferente a la causada por cirugía valvular mitral. Conclusión: La reparación de una disección auricular con parche es una buena alternativa de tratamiento en estos casos.
Introduction: Left atrial dissection is an infrequent but potentially fatal complication of cardiac surgery. It is frequently associated with mitral valve surgery, both its repair and replacement, with an incidence of 0.16%. However, other procedures such as percutaneous interventions can also be predisposing factors. Objectives: To report the surgical resolution of a left atrial dissection case and contribute to the national casuistry. Materials and Method: Clinical, imaging and photographic record of the clinical episode. Results: A patient who underwent retrograde radiofrequency ablation during the post-interventional period with heart failure and whose study identifies an atrial dissection. Mitral ring repair, subvalvular apparatus repair and pericardial patch was performed, the patient evolves with favorable clinical and sonographic evolution. Discussion: The treatment of this entity should be analyzed case by case, the etiology related to percutaneous procedures is different to that caused by mitral valve surgery and this should be considered when choosing a therapeutic option. Conclusion: Repairing an atrial dissection with a patch is a good alternative in these cases.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Dissecção Aórtica/cirurgia , Dissecção Aórtica/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Doenças Raras , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Valva Mitral/cirurgiaRESUMO
BACKGROUND: Hepatocellular carcinoma is one of the most common tumors worldwide. Surgical resection has been the standard treatment but can only be applied to a small percentage of patients. In recent years, several other treatment options, including ablative procedures and transplantation, have been used in patients with hepatocellular carcinoma. METHODS: For 6 years, 110 patients with hepatocellular carcinoma were managed at the Medical College of Wisconsin. Fifty-five patients received only chemotherapy (n = 5) or palliative treatment (n = 50) because of advanced cirrhosis (P <.03) or tumor. Thirty-one patients had tumor ablation with percutaneous ethanol injection, cryoablation, radiofrequency ablation, or arterial chemoembolization. Twenty-eight patients underwent surgical resection (n = 18) or hepatic transplantation (n = 10). Relatively more patients (38%; P <.001) were treated with ablation in the second period of the study (1998-2000). RESULTS: Thirty-day mortality was 3% with ablation and 0% with resection. Median survival was 6 months with no treatment, 27 months with ablation (P <.001), and 35 months with resection (P <.001). Patients who underwent liver transplantation had the longest median survival (53 months). A multivariate analysis suggested that treatment modality (ablation or resection; P <.001) and Child-Pugh classification (P <.01) were the most important factors predicting outcome. CONCLUSIONS: This study suggests that treatment of hepatocellular carcinoma requires multidisciplinary expertise and that ablation and operation can be performed safely. Outcome is influenced most by treatment modality and Child-Pugh classification. Patients in Child-Pugh classes A and B should be treated with ablation, surgical resection, or liver transplantation.
Assuntos
Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Adulto , Carcinoma Hepatocelular/mortalidade , Quimioembolização Terapêutica , Terapia Combinada , Crioterapia , Etanol/administração & dosagem , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Terapia por RadiofrequênciaRESUMO
The recent introduction of cryotherapy and radiofrequency ablation of liver metastasis has expanded the indications for treatment. As technology has advanced, a percutaneous approach has been developed. Percutaneous treatment, however, requires accurate preoperative imaging. From 1993 to 1999, 179 patients underwent operative exploration for treatment of suspected hepatic metastases from colorectal carcinoma. One hundred seventy-seven patients were staged by preoperative CT, two patients were staged by MRI, and complete data were available in 176. Hepatic tumor count by preoperative imaging was compared to intraoperative tumor count obtained by inspection, palpation, ultrasonographic examination using a 3.5/7.5 MHz T probe, and careful gross sectioning of the resected specimen. Post hoc analysis was performed on 35 CT scans by two radiologists who specialize in abdominal CT. These radiologists were blinded to the intraoperative findings. Their interpretations were compared to the intraoperative counts and to each other. Thirty-four (19%) of 179 patients were deemed untreatable at operation because of unsuspected overwhelming liver involvement in 11 (6%) or extrahepatic metastases in 23 (13%). For the group, CT was accurate in 80 patients (45%), showed more lesions than were found in 16 (9%), and showed fewer metastases than were found in 80 (45%). When the preoperative scan predicted a solitary metastasis, it was correct in 45 (65%) of 69 patients and underestimated disease in 24 (35%). In the post hoc analysis, the mean numbers of lesions reported by the two radiologists did not differ from the mean number of tumors found; however, the radiologists' counts agreed on 16 (59%) and disagreed on 11 (41%) of the scans. The accuracy of CT decreased with increasing numbers of lesions. Regardless of the type of preoperative imaging, intraoperative findings altered the course of the operation in 96 (55%) of 176 patients. Preoperative imaging is not sufficiently accurate to permit adequate percutaneous treatment of hepatic metastases from colorectal carcinoma.
Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Imageamento por Ressonância Magnética/normas , Estadiamento de Neoplasias/métodos , Cuidados Pré-Operatórios/métodos , Tomografia Computadorizada por Raios X/normas , Viés , Ablação por Cateter , Criocirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Monitorização Intraoperatória/normas , Estadiamento de Neoplasias/normas , Cuidados Pré-Operatórios/normas , Sensibilidade e Especificidade , Método Simples-Cego , Fatores de Tempo , Ultrassonografia/normasRESUMO
Crustaceans exhibit a variety of overt circadian rhythms. Observations on intact animals suggest the existence of more than one circadian pacemaker in the nervous system. Ablation experiments so far have been inconclusive in pin-pointing the location of putative pacemakers. However, various structures, most notably the optic peduncle, have been shown to sustain circadian rhythmicity in vitro. Retinal sensitivity and neurosecretory activity display circadian rhythms in the isolated optic peduncle, but they are also responsive to synchronizing influences from other regions of the central nervous system, most notably the supraesophageal ganglion. A model based on a number of circadian pacemakers distributed in the central nervous system best fits the experimental results at present. Coupling of rhythmicity between independent circadian pacemakers is likely to occur, and a neuroendocrine stage of integration has been proposed for several rhythms. Various entraining agents have been identified, and more than one may play a part in the synchronization of a given rhythm.
Assuntos
Ritmo Circadiano/fisiologia , Crustáceos/fisiologia , Animais , Gânglios/fisiologia , Luz , Sistemas Neurossecretores/fisiologia , Fenômenos Fisiológicos Oculares , Retina/fisiologiaRESUMO
Caroli's syndrome comprises cystic dilatations of the intrahepatic bile ducts, which may be focal or diffuse. Partial hepatectomy, when possible, is the best current treatment. We report on two patients with Caroli's syndrome confined to one side of the liver, who were subjected to partial hepatectomy. Both patients had a previous history of biliary tract surgery. Transhepatic percutaneous cholangiography and abdominal CT scan were helpful in establishing the diagnosis and the extent of the disease. After hepatectomy, one patient developed an abdominal abscess that required surgical drainage, the other developed persistent fever, which resolved spontaneously. Both patients are asymptomatic three and five years post-hepatectomy, respectively, and there is no clinical evidence of recurrence of the disease. The diagnostic work-up and therapeutic choices for this rare entity are discussed.
Assuntos
Ductos Biliares Intra-Hepáticos , Cistos/congênito , Hepatectomia/métodos , Adolescente , Adulto , Doenças dos Ductos Biliares/congênito , Doenças dos Ductos Biliares/cirurgia , Cistos/cirurgia , Dilatação Patológica/congênito , Dilatação Patológica/cirurgia , Feminino , HumanosRESUMO
We present the case of a 23 years old female with chronic granulocytic leukemia and two intracranial tumors with all the radiological characteristics of intracranial meningiomas. Successful removal of the largest tumor was accomplished using the technique described for meningiomas. The recovery was very good and the histopathologic diagnosis was of granulocytic sarcoma. Radiotherapy of the second tumor reduced the tumor mass within one month leaving the patient neurologically intact. We recommended surgery in the future treatment of large chloromas.
Assuntos
Leucemia Mieloide/diagnóstico por imagem , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico por imagem , Adulto , Angiografia Cerebral , Diagnóstico Diferencial , Dura-Máter , Feminino , Lobo Frontal , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva , Leucemia Mieloide/complicações , Leucemia Mieloide/radioterapia , Leucemia Mieloide/cirurgia , Neoplasias Meníngeas/irrigação sanguínea , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/radioterapia , Neoplasias Meníngeas/cirurgia , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Pseudotumor Cerebral/etiologiaRESUMO
We analyzed 82 cases of hepatobiliary fibropolycystic disease (FPD) that were seen at the Instituto Nacional de la Nutrición "Salvador Zubirán" in Mexico City in the thirty-year period comprised from 1956 to 1986. The different entities that compose FPD were distributed as follows: 61 (74%) cases of polycystic liver disease, 13 (16%) cases of choledochal cyst, and 8 (10%) cases of congenital hepatic fibrosis; there were 5 (6%) cases of Caroli's disease, 3 associated with congenital hepatic fibrosis and 2 with choledochal cyst. Polycystic liver disease predominated in females (67%) and presented at 54 +/- 12 years (mean +/- SEM) with pain, a mass, symptoms related to renal insufficiency or incidentally; polycystic kidneys were present in 61%. Liver function tests were normal in 94%. Choledochal cyst also predominated in females and presented at a mean age of 19 years with cholangitis. Liver function tests were abnormal in 69%. Congenital hepatic fibrosis (50% male) presented with variceal hemorrhage or cholangitis (in 3 patients associated with Caroli's disease). Polycystic kidneys were present in five patients. Four of the five patients with Caroli's disease were female and presented at a mean age of 19 years with cholangitis. It never presented as an isolated disease, but was associated more frequently to congenital hepatic fibrosis. The diseases that are part of the hepatobiliary polycystic disease vary in severity and thus the prognosis in an individual patient is determined by the type of fibropolycystic disease present. This is the largest series of this disease published in our country.
Assuntos
Ductos Biliares Intra-Hepáticos/patologia , Doenças do Ducto Colédoco/patologia , Cistos/patologia , Cirrose Hepática/congênito , Hepatopatias/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças dos Ductos Biliares/patologia , Doenças do Ducto Colédoco/diagnóstico por imagem , Feminino , Humanos , Cirrose Hepática/patologia , Hepatopatias/diagnóstico por imagem , Masculino , México , Pessoa de Meia-Idade , RadiografiaRESUMO
OBJETIVO: Determinar predictores de buena respuesta con el uso de prótesis en la estenosis traqueobronquial. MATERIALES Y MÉTODO: Estudio retrospectivo descriptivo de una serie de casos entre junio de 2014 y junio de 2016. Se revisaron registros clínicos, protocolos operatorios, estudios histopatológicos y de imagen. Se consignaron antecedentes demográficos y clínicos al ingreso y luego del procedimiento, etiología de la estenosis traqueal, necesidad de oxígeno en litros, estadía hospitalaria, morbilidad asociada al procedimiento, indicación de terapia complementaria posterior y sobrevida. Se analizaron los datos con estadística descriptiva y analítica. RESULTADOS: Se realizaron 68 procedimientos, en 44 pacientes, 24 mujeres, el diagnóstico principal fue estenosis traqueal con 40 casos. La etiología neoplásica fue el 88% de los casos. El Performance status (PS) de ingreso fue mayor o igual a 2 en el 68% y posterior al procedimiento disminuyó a 22% p < 0,05. En 36 casos los pacientes requerían al menos 1 L de oxígeno lo que disminuyó en 13 casos posterior a la intervención p < 0,05. El tiempo de hospitalización promedio fue 6,2 días (1-60). En 13 pacientes con patología neoplásica se indicó terapia paliativa complementaria. La morbilidad asociada al procedimiento fue de 2,9% dado por prótesis desplazada y lesión iatrogénica. La sobrevida fue de 27% a un año. CONCLUSIONES: La etiología benigna, el PS previo a la intervención menor o igual a 3, requerimiento de oxígeno de 1 litro y obstrucción tumoral menor al 70% del lumen fueron elementos de buena respuesta.
AIM: Determine good response predictors in use of stent in benign and malignant tracheobronchial stenosis. MATERIAL AND METHODS: We retrospectively reviewed medical records of patients submitted to the procedure in the period 2014 to 2016. Clinical records, operative protocols, and histopathological and imaging studies were reviewed. Demographic and clinical data, performance status (PS) at admission and after the procedure, etiology of tracheal stenosis, need for oxygen in liters (L) Post-intervention, hospital stay, procedure-related morbidity, indication of therapy (Chemotherapy and/or Radiotherapy) and survival. Data were analyzed with descriptive and analytics statistics. RESULTS: A total of 68 procedures were performed in 44 patients, 24 women. Tracheal stenosis 40 cases were diagnosed. The malignant etiology was 88%. The admission PS was greater than or equal to 2 in 68% and 22% after the procedure. The oxygen requirements prior to the procedure were at least 1 L in 36 cases and decreased in 13 cases after the procedure. The average hospitalization period was 6.2 days (1-60). Complementary therapy was indicated in 13 patients; the morbidity associated with the procedure was 2.9%, displaced installation and iatrogenic injury. The one year survival was 27%. CONCLUSIONS: Benign etiology, el PS minor than or equal to 3, oxygen requirements prior to the procedure of 1 L and tumoral obstruction less than 75% were good response predictors in our study.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Estenose Traqueal/cirurgia , Broncopatias/cirurgia , Stents , Próteses e Implantes , Estenose Traqueal/complicações , Broncopatias/complicações , Análise de Sobrevida , Estudos Retrospectivos , Resultado do Tratamento , Obstrução das Vias Respiratórias/etiologia , Tempo de InternaçãoRESUMO
Introducción: Los nacimientos prematuros permanecen como un problema perinatal, afectan entre 5 y 12% de los nacimientos, la principal condición clínica asociada a estos es el Síndrome de Dificultad Respiratoria (SDR), inicia inmediatamente al nacimiento con dificultad respiratoria progresiva que requiere asistencia ventilatoria e ingreso a Unidades de Cuidados Intensivos Neonatales (UCIN). Se presenta el abordaje de manera integral a una recién nacida de 32 SDG con SDR, en un hospital de segundo nivel de atención, en este se aplicó el proceso enfermero. Objetivo: Brindar atención integral e individualizada con cuidados específicos al neonato prematuro, con base en la Teoría General del Autocuidado. Método Selección de paciente a conveniencia en UCIN, aplicación de la metodología del proceso enfermero, valoración basada en los requisitos universales de autocuidado. La información obtenida fue a través del expediente clínico, entrevista a la madre y valoración de la recién nacida. Se analizaron los datos, se emitieron diagnósticos enfermeros, se ejecutó plan de cuidados fundamentados por artículos científicos y guías de práctica clínica. Resultados: Se realizaron 12 diagnósticos de enfermería, 10 reales y 2 de riesgo de acuerdo con los requisitos de autocuidado universal, se identificaron los más alterados: mantenimiento de un aporte suficiente de aire, agua y alimentos, y provisión de cuidados asociados con los procesos de excreción. Conclusiones: Se lograron intervenciones independientes e interdependientes; sin embargo, el neonato permaneció en UCIN debido a que su atención es compleja y requiere personal capacitado con conocimientos y habilidades fundamentadas para el cuidado. La asistencia al prematuro debe ser inmediata para la detección precoz y manejo de patologías frecuentes.
Introduction: Premature births remain a perinatal problem affecting between 5% and 12% of cases. The main clinical condition associated is the Neonatal Respiratory Distress Syndrome (NRDS), which onsets right after birth, and which is characterized by a progressive respiratory difficulty which requires ventilation assistance at the Neonatal Intensive Care Units (NICU). This study presents the integral handling of the case of a newly born with 32 gestational weeks and NRDS at a second level of attention hospital. The Nursing Process was applied. Objective: To provide integral and individualized attention with specific care to this premature neonate, based on the General Theory of Self-Care. Method The patient was selected by convenience from the NICU applying the methodology of the nursing process, and with an assessment based on the universal requirements of self-care. The related information was obtained through the clinical record, an interview to the mother, and the assessment of the patient. Data were analyzed and nursing diagnoses were generated. The care plan was executed with the support of scientific articles and clinical practice guides. Results: 12 nursing diagnoses were emitted, 10 real and 2 of risk, including: maintenance of enough air, water, and feeding supply, and excretion related associated care. Conclusions: Independent and inter-dependent interventions were achieved, however, the premature neonate remained at the NICU because of the complexity of the needed care, which requires constant supervision from experienced and skillful personnel. The attention to these cases must be immediate in order to handle the frequent associated pathologies.
Introdução: Os nascimentos prematuros permanecem como um problema perinatal, afeitam entre 5 e 12% dos nascimentos, a principal condição clínica associada a estresse é a Síndrome de Dificuldade Respiratória (SDR), inicia imediatamente no nascimento com dificuldade respiratória progressiva que requer assistência ventilatória e ingresso a Unidades de Cuidados Intensivos Neonatal (UCIN). Apresenta-se a abordagem de maneira integral a uma recém-nascida de 32 SDG com SDR, em um hospital de segundo nível de atenção, neste aplicou-se o processo enfermeiro. Objetivo: Proporcionar atenção integral e individualizada com cuidados específicos no neonato prematuro, com base na Teoria General do Autocuidado. Método Seleção de paciente a conveniência em UCIN, aplicação da metodologia do processo enfermeiro, valoração baseada nos requerimentos universais de autocuidado. A informação obtida foi a través do expediente clínico, entrevista à mãe e valoração da recém-nascida. Analisaram-se os dados, emitiram-se diagnósticos enfermeiros, executou-se o plano de cuidados fundamentados por artigos científicos e guias de prática clínica. Resultados: Realizaram-se 12 diagnósticos de enfermagem, 10 reais e 2 de risco conforme com os requerimentos de autocuidado universal, identificaram-se os mais alterados: mantimento de um aporte suficiente de ar, água e alimentos, e provisão de cuidados associados com os processos de excreção. Conclusões: Conseguiram-se intervenções independentes e interdependentes; porém, o neonato permaneceu em UCIN devido a que sua atenção é complexa e requer pessoal capacitado com conhecimentos e habilidades fundamentadas para o cuidado. A assistência no prematuro deve ser imediata para a detecção precoce e manejo de patologias frequentes.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Síndrome do Desconforto Respiratório do Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva NeonatalRESUMO
Resumen Introducción: Prolongar la permeabilidad de los injertos utilizados en bypass coronario es un desafío constante. Objetivo: Comparar anatomofuncionalmente venas safenas humanas (VSH) extraídas con técnica convencional (TC) vs técnica "no-touch" (NT). Material y Método: Estudio experimental. Se diseccionó VSH con TC y NT en el pabellón de cirugía cardiaca del Hospital Regional de Antofagasta. Las muestras de VSH fueron seccionadas en anillos de 3 mm y conservados en cámaras de órganos aislados con solución Ringer-Krebs. Para evaluar la vasomotilidad se administró norepinefrina (10-6M), papaverina (10-4M), acetilcolina (10-6M) y nitroprusiato de sodio (10-5M). Un segmento de las muestras fue fijado en formalina al 10%, procesado con técnica histológica y analizado bajo microscopía óptica. Las muestras fueron teñidas con hematoxilina-eosina, Verhoeff y orceína. El análisis estadístico fue realizado mediante el software Prism Graphad. Resultados: Reactividad vascular: La vasoconstricción inducida por noradrenalina fue significativamente superior en anillos del grupo NT vs TC (p < 0,0001). La vasodilatación producida por papaverina y acetilcolina fue superior en el grupo NT (p < 0,004) y (p < 0,0003), respectivamente. Estudio morfométrico: El grupo NT presentó túnica muscular (0,755 vs 0,680 mm), adventicia (0,5600 vs 0,4663 mm) y pared total (1,344 vs 0,962 mm) más gruesa que el grupo TC. No hubo diferencias significativas respecto el número de vasa vasorum. Conclusión: El grupo NT responde significativamente mejor a estímulos vasoconstrictores y vasodilatadores. Los resultados se asocian con las diferencias morfométricas.
Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted "No touch" (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceína. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences.