RESUMO
Background: The sinking skin syndrome (SSS) is a particular complication after a decompressive craniectomy (DC). It still remains a poorly understood and underestimated entity. Methods: Retrospective case series of craniectomized patients with and without SSS. Clinical and radiological features (DC diameter, shape of craniectomy flap, and midline deviation) were described and relative volumes of intracranial loss were quantified. Results: Twenty-seven patients (63% with SSS). The most common indication for DC was traumatic brain injury: 48.15%. The p50 diameter of DC was 12.8 cm for patients with SSS and 11.1 cm for patients without (Z score = 0.32). DC area was 81.5 cm2 for patients with SSS and 71.43 cm2 for patients without the syndrome (Z score = 0.61). According to the shape of the craniectomy flap, we classified our patients as: «same level¼ (51.8%), «sunken¼ (25.9%), and «extracranial herniation¼ (14.8%). Two patients (7.4%) had paradoxical herniation. Midline deviation was present in 12 (70.6%) patients with SSS. The 3rd ventricle volume average was 1.2 cc for patients with SSS versus 2.35 cc for patients without (Z score = 0.04). About 94.11% of patients (16 out of 17) clearly improved after replacement of the cranial defect. Conclusion: In our series, low 3rd ventricle volumes had a good relation with SSS. The presence of a sunken flap does not guarantee SSS per se and we propose the following radiologic description: A = sunken, B = same level, C = extracranial herniation, and D = paradoxical. Replacement of the skull defect is the main treatment.
RESUMO
Chronic inflammation plays a role in the development of chronic lymphocytic leukaemia (CLL), and diet might modulate chronic inflammation. This study aims to evaluate the association between the dietary inflammatory index (DII®) and CLL. A total of 366 CLL cases and 1643 controls of the Spanish multicase-control (MCC) Spain study were included. The inflammatory potential of the diet was assessed using the energy-adjusted dietary inflammatory index (E-DII) based on 30 items from a validated semi-quantitative food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models controlling for potential confounders. Overall, a modest, non-statistically significant, positive association was observed between CLL and E-DII scores (OR for a one-unit increase in E-DII: 1.05 (CI 95%: 0.99, 1.12), p-value = 0.09 and by tertiles: ORT2vsT1: 1.20 (CI 95%: 0.90, 1.59); OR T3vsT1: 1.21 (CI 95%: 0.90, 1.62), p trend = 0.21). These results were independent from disease severity (p-het: 0.70), time from diagnosis (p-het: 0.67) and CLL treatment received (p-het: 0.56). No interactions were detected. In conclusion, the consumption of a diet with high pro-inflammatory components was not significantly associated with CLL. Changes towards a more pro-inflammatory dietary pattern in younger generations not included here warrant future research.
Assuntos
Dieta/efeitos adversos , Inflamação/epidemiologia , Leucemia Linfocítica Crônica de Células B/epidemiologia , Idoso , Estudos de Casos e Controles , Registros de Dieta , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologiaAssuntos
Antibacterianos/uso terapêutico , Estado Terminal/terapia , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Sepse/tratamento farmacológico , Adolescente , Criança , Pré-Escolar , Estado Terminal/mortalidade , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica/normas , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Sepse/diagnóstico , Sepse/mortalidade , Choque Séptico/diagnóstico , Choque Séptico/tratamento farmacológico , Choque Séptico/mortalidade , Fatores de TempoRESUMO
Debido a la importancia que la contaminación de los alimentos entraña para la salud Pública, se procuró determinar la contaminación microbiológica de los alimentos que consumen los usuarios de los comedores populares del distrito de Hunter-Arequipa. Así como sus características sanitarias (estructura física, higiene organización). Se trata de un estudio transversal Analítico, donde se analizaron 8 comedores del mencionado distrito. La información se recolectó por medio de cuestionarios, observaciones directas y análisis microbiológicos de los alimentos servidos. Los análisis de los alimentos se ajustaron, respectivamente a las recomendaciones de la dirección de Dirección General de Salud Ambiental de nuestro país y del Código Alimentario Español y el estudio de las características sanitarias de los comedores se basaron en el Código y Reglamento Sanitario de nuestro país. Los hallazgos encontrados fueron que 6 (75 por ciento) de los comedores presentaban comida contaminada. En los alimentos cocidos fueron los Coliformes Fecales los wue predominaron, en las ensaladas E. coli fue la bacteria patógena que se encontró con mayor frecuencia en los refrescos predominaron los Mesófilos aerobicos viables. Así mismo se Halló que la organización, la higiene de la cocina, manipulador, vajilla y la disposición de las basuras son las características que tienen mayor grado de relación (diámetro: 0,5961) con la contaminación de los alimentos.
Assuntos
Humanos , Contaminação de Alimentos , Alimentos , Ingestão de Alimentos , Microbiologia de Alimentos , Ciências da NutriçãoRESUMO
Foi efetuado inquérito sorológico, através da soroaglutinaçäo para leptospirose, em soro de 50 trabalhadores da zona rural de Turvo, município situado no sul de Santa Catarina. Destes 50 trabalhadores, 38 trabalham na agricultura de arroz e cana-de-açucar, 3 säo caminhoneiros, 6 säo domésticas, 1 é professora e dois säo comerciantes. Foram encontrados seis soros de agricultores com soroaglutinaçäo positiva sendo dois para canícola, um deles com coaglutinaçäo para bataviae, um para bataviae, um para grippotyphosa com coaglutinaçäo para wolffi e dois para sorotipo de triagem patoc . Todas as soroaglutinaçöes ocorreram na diluiçäo de 1:100