RESUMO
Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
Assuntos
Neoplasias Cardíacas , Sarcoma , Humanos , Neoplasias Cardíacas/terapia , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Sarcoma/terapia , Sarcoma/patologia , PrognósticoRESUMO
External signs of disease are frequently used as indicators of disease susceptibility. However, immune profiling can be a more effective indicator to understand how host responses to infection may be shaped by host, pathogen and environmental factors. To better inform wildlife health assessment and research directions, we investigated the utility of a novel multivariate immunophenotyping approach examining innate and adaptive immune responses in differing climatic, pathogen co-infection and demographic contexts across two koala (Phascolarctos cinereus) populations in New South Wales: the Liverpool Plains (LP), and Southern Highlands to South-west Sydney (SHSWS). Relative to the comparatively healthy SHSWS, the LP had greater and more variable innate immune gene expression (IL-1ß, IL-6), and KoRV transcription. During extreme heat and drought, koalas from the LP displayed upregulation of a stress pathway gene and reduced adaptive immune genes expression, haematocrit and plasma protein, suggesting the possibility of environmental impacts through multiple pathways. In those koalas, KoRV transcription status, Chlamydia pecorum infection loads, and visible urogenital inflammation were not associated with immune variation, suggesting that immune markers were more sensitive indicators of real-time impacts than observed disease outcomes.
Assuntos
Infecções por Chlamydia , Chlamydia , Coinfecção , Phascolarctidae , Animais , Phascolarctidae/genética , Coinfecção/veterinária , Chlamydia/genética , Animais Selvagens , Suscetibilidade a DoençasAssuntos
Cistos , Doenças do Cão , Traumatismos Torácicos , Animais , Cistos/diagnóstico por imagem , Cistos/veterinária , Diagnóstico por Imagem , Doenças do Cão/diagnóstico por imagem , Cães , Pulmão , Traumatismos Torácicos/complicações , Traumatismos Torácicos/diagnóstico por imagem , Traumatismos Torácicos/veterináriaRESUMO
In cancer patients, depression causes suffering during the whole disease trajectory and it also influences the personal perception of well-being as well as treatment adherence. Consequently, its better definition is needed for planning more tailored supportive programmes. This study was aimed to provide information on depressive state intensity and prevalence in an heterogeneous sample of cancer inpatients. In addition, associations were studied between depressive state and different socio-demographic and clinical factors. A total of 1,147 consecutive adult cancer inpatients completed the Center for Epidemiologic Studies Scale on Depression together with a form for collecting socio-demographic and clinical data. The mean score of depression was 16.9 (SD = 9.3). There were differences in depression intensity associated with gender (p < .001), age (p = .001) and cancer type (p < .001), but not with education level (p = .282) or marital status (p = .436). Of the entire sample 13.9% had depressive states; this percentage raised to 26.2% if a less stringent criterion was used. These data reinforce the importance of a clinical and research focus on depression in oncology. As differences according to gender, age and diagnosis exist in depression prevalence and intensity, tailored supportive intervention should be planned and verified for effectiveness and efficacy.
Assuntos
Transtorno Depressivo/etiologia , Pacientes Internados/psicologia , Neoplasias/psicologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos Transversais , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Adulto JovemRESUMO
ANTECEDENTES: El año 2006, la Organización Mundial de la Salud definió a la "salud sexual" como un estado de bienestar físico, emocional, mental y social en relación a la propia sexualidad. De este modo, corresponde a un concepto más amplio que la ausencia de malestares, disfunciones o enfermedades, relacionándose con un nivel de bienestar general. Pese a la relevancia del concepto, aún es escasa la evidencia empírica al respecto a nivel local. OBJETIVOS: El artículo analiza el concepto de "salud sexual" a nivel de población general en Chile. MÉTODOS: Se diseñó una muestra probabilística, polietápica y estratificada en el Gran Santiago, encuestándose a 767 personas mayores de 18 años, siguiendo la metodología de autorreporte de hogares. RESULTADOS: El estudio evidencia diferencias según género y edad en la mayor parte de las variables relativas a la satisfacción sexual y a conductas sexuales seguras. CONCLUSIÓN: Se concluye que los hombres inician su vida sexual más tempranamente, tienen más parejas sexuales y reportan mayor satisfacción sexual que las mujeres, con excepción de la cohorte más joven. Ellas, a su vez, declaran mayores niveles de protección y cuidado de la vida sexual.
BACKGROUND: In 2006, the World Health Organization endorsed the concept of "sexual health" as a state of physical, emotional, mental and social well-being in relation to sexuality. Thus, it corresponds to a broader concept that the absence of disease, dysfunction or infirmity, being related to a general level of well-being. Despite the relevance of the concept, locally, there is still scarce empirical evidence about it. AIMS: The article analyses the concept of "sexual health" among the Chilean general population. Methods: In order to achieve this objective, a probabilistic, polyphasic and stratified sample was designed for the province of Santiago, being surveyed 767 people over 18 years, through a self-reported method in their own households. RESULTS: The study shows differences by gender and age in both sexual satisfaction and safe sexual behaviours. CONCLUSION: It is possible to conclude that men begin their sexual life earlier, have more sexual partners and report higher sexual satisfaction than women, except for the youngest cohort. Women, in turn, report higher levels of protection and care of sexual life.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Satisfação Pessoal , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual , Orgasmo , Parceiros Sexuais , Chile/epidemiologia , Inquéritos e Questionários , Fatores Etários , Coito , Distribuição por Idade , Comportamento Contraceptivo , AutorrelatoRESUMO
La artroscopía de cadera es una técnica quirúrgica con un significativo crecimiento en el campo de la cirugía ortopédica en los últimos diez años. En el caso del pinzamiento femoroacetabular (PFA), con sus consecuentes lesiones labrales y condrales, el tratamiento artroscópico ha demostrado ser una alternativa exitosa, tanto en el alivio sintomático y mejoría funcional, como en la corrección de la alteración morfológica característica de esta patología. Sin embargo, en pacientes que se presentan con avanzado daño articular y artrosis de cadera secundaria al PFA,la artroscopía tiene resultados inferiores. El objetivo de este trabajo es presentar algunas herramientas clínicas e imagenológicas útiles, para distinguir entre los pacientes que son candidatos adecuados para un tratamiento artroscópico del PFA de aquellos que no lo son, debido a la presencia de daño articular avanzado.
Assuntos
Adulto , Artroscopia/métodos , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Quadril , Acetábulo/patologia , Fêmur/patologia , Osteoartrite do Quadril/etiologiaRESUMO
Objetivo: Determinar si la condición clínica periodontal materna, el índice de masa corporal (IMC) y su variación durante el embarazo, se asocian con marcadores de inflamación sistémica: interleuquina-6 (IL-6), factor de necrosis tumoral alfa (TNF-) y proteína C reactiva (PCR) a nivel plasmático. Material y Método: Estudio clínico que analizó una cohorte de 56 embarazadas entre 18 y 38 años de edad (promedio 27.9 +/- 7.04 años), derivadas de la unidad de medicina perinatal en el centro de salud docente asistencial (CESA) de la Universidad de los Andes. Todas ellas consintieron voluntariamente su participación en el estudio. En cada trimestre de embarazo, se les realizó un examen periodontal completo, consistente en la determinación de los niveles de inserción clínica, profundidad al sondaje, índice de higiene y sangrado en seis sitios por cada pieza dentaria, excluyendo terceros molares. Adicionalmente, en cada control se obtuvieron muestras de sangre periférica para la determinación de los mediadores proinflamatorios mediante técnica de ELISA. El diagnóstico periodontal y los niveles de mediadores inflamatorios fueron relacionados con la variación del IMC durante el embarazo. Resultados: Las embarazadas con periodontitis crónica presentaron una mayor variación y aumento del índice de masa corporal (p=0.039) y niveles de IL-6 (p=0.026) en comparación con las mujeres embarazadas con gingivitis. Conclusiones: En esta serie de pacientes, se demostró una asociación entre el diagnóstico clínico de periodontitis durante el embarazo con un aumento plasmático de IL-6, así como también una asociación entre un aumento del IMC con los niveles plasmáticos de PCR.
Objective: To determine if maternal periodontal clinical status, body mass index (BMI) and its variation during pregnancy are associated with increased levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-) and C-reactive protein (CRP) in plasma. Material and Methods: This clinical study included a total of 56 pregnant women between 18 and 38 years old (mean 27.9 +/- 7.04 years), referred from perinatal medicine unit at health care center Universidad de los Andes. All pregnant patients consented to voluntarily participate in the study. In each trimester of pregnancy, they underwent a complete periodontal examination, involving the determination of clinical attachment levels, probing depth, bleeding and hygiene index at six sites of each tooth, excluding third molars. Additionally, in each clinical check, peripheral blood samples were taken for determination of pro-inflammatory mediators with ELISA immunoassay. Periodontal diagnosis and inflammatory mediators were the variables analyzed in relation to changes in BMI during pregnancy. Results: Pregnant women with chronic periodontitis had an increase and more variation of BMI (p=0.039) and higher levels of IL-6 (p=0.026) in comparison with pregnant women with gingivitis. Conclusions: In this series of pregnant patients the clinical diagnosis of periodontitis, with an increase in BMI are associated with increased plasma levels of IL-6 and CRP.
Assuntos
Gravidez , Índice de Massa Corporal , Complicações na Gravidez/sangue , /sangue , Periodontite Crônica/sangue , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática , Fator de Necrose Tumoral alfa/sangue , Gengivite/sangue , Estado Nutricional , Proteína C-Reativa/análiseRESUMO
Objectives: To evaluate short-term clinical results of patients performed acetabular revision surgery using a Trabecular Tantalum coated modular acetabular cups. Materials and Methods: This is a retrospective and descriptive analysis of a serie of 32 consecutive patients (34 hips) with acetabular revision surgery (23 women, 9 men, mean age 70.7 years), mean follow-up 32 month (12-60). The Paprosky and the AAOS acetabular defects classifications were assessed. According to Paprosky acetabular defects classification, there were eleven type I, two IIA, three IIB, nine IIC, seven IIIA and two IIIB. According to AAOS acetabular defects classification there were thirteen patients with type 1, nine patients with type 2, ten type 3 and two type 4. The percentage of own acetabular bone in contact with the new cup was recorded for each patient at the time of surgery and was 45 percent (range from 20 to 80 percent), with 23 patients presenting less than 50 percent of bone contact (mean 35 percent). Postoperatively, osseous integration was radiographically assessed. Functional results were evaluated according to the Harris Hip Score (HSS). The complications related to the implant were also recorded. Results: In all radiographic assessments performed at 3, 6 and 12 month postoperatively an integrated cup without signs of migration or osteolysis was observed. Four patients (11.8 percent) presented recurrent hip dislocation that required a revision surgery without further cup revision. The final clinical assessment was performed at a mean of 26 month after surgery (12-60) with a mean HHS of 91.8 points. Conclusion: Trabecular tantalum coated modular acetabular cups in acetabular revision surgery shows good short term clinical results even with acetabular defects greater than 50 percent. No cup loosening was observed in these series.
Objetivo: Evaluar los resultados clínicos a corto plazo de pacientes sometidos a cirugía de revisión acetabular utilizando cotilos modulares con superficie de metal trabecular de tantalio. Material y Métodos: Estudio retrospectivo-descriptivo de una serie consecutiva de 32 pacientes (34 caderas) sometidos a cirugía de revisión acetabular (23 mujeres, 9 hombres, edad promedio 70,7 años), seguimiento promedio 32 meses (12-60). Se clasifican los defectos acetabulares de acuerdo ala clasificación de Paprosky y de la AAOS. Según la clasificación de Paprosky de los defectos acetabulares, 11 pacientes tenían categoría I, 2 categoría IIA, 3 categoría IIB, 9 categoría IIC, 7 categoría IIIA y 2 categoría IIIB. Según la clasificación de la AAOS, 13 pacientes correspondieron a nivel 1, 9 pacientes a nivel 2, 10 a nivel 3 y 2 a nivel 4. Se registra el porcentaje de hueso propio acetabular en contacto con el nuevo cotilo de cada paciente que fue en promedio 45 por ciento (20-80 por ciento), presentándose en 23 caderas un porcentaje < 50 por ciento, el cual fue en promedio 35 por ciento. En el postoperatorio se evalúa la integración ósea mediante radiografías de pelvis. Se evalúan los resultados funcionales mediante el HHS (Harris Hip Score) y las complicaciones postoperatorias relacionadas con el implante. Resultados: En todas las radiografías postoperatorias realizadas a los 3, 6 y 12 meses se evidenciaba el cotilo integrado, sin signos de migración ni osteolisis. Cuatro pacientes (11,8 por ciento) presentaron luxaciones recidivantes de cadera, las cuales requirieron de una cirugía de revisión sin recambio del cotilo. La última evaluación clínica fue en promedio 26 meses tras la cirugía (12-60 meses) constatándose un HHS promedio de 91,8 puntos. Conclusión: El uso de cotilos modulares con revestimiento de metal trabecular de tantalio en cirugías de revisión acetabular presenta buenos resultados clínicos a corto plazo incluso en defectos óseos acetabulares superiores...
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Acetábulo , Artroplastia de Quadril/instrumentação , Artroplastia de Quadril/métodos , Prótese de Quadril , Tantálio/uso terapêutico , Seguimentos , Osseointegração , Reoperação , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
Hip arthroscopy is a procedure which has significantly increased its frequency in recent years, especially due to the surgical treatment of femoroacetabular impingment. Cam type femoroacetabular impingement. Cam type femoroacetabular impingement results from abnormal head-neck junction, where a prominent anterior extension of the femoral head at the expected step off to the adjacent femoral neck can be seen. This femoral bump is typically located lateral to the physeal scar, causing damage of the acetabular rim, cartilage and labrum. The surgical treatment, also called osteochondroplasty of the femoral head-neck junction, consist of the complete resection of this femoral bump, in order to reduce pain, prevent further bone impaction and progressive articular damage. Prior to the arthroscopic resection of the femoral bump, it is recommended to identify important anatomic landmarks in the peripheral joint compartment (medial limit: medial synovial fold, central limit: acetabular labrum, lateral limit: synovial folds and retinacular vessels in the lateral limit of the peripheral joint compartment, a secure lateral bump resection can be performed, without risk of injuring these vessels. In this paper, we describe the detailed operative technique of an effective and secure arthroscopic femoral bump resection.
La artroscopía de cadera ha aumentado significativamente su frecuencia en los últimos años, especialmente debido al tratamiento quirúrgico del pinzamiento femoroacetabular (PFA). En el PFA tipo leva existe una anesfericidad de la cabeza femoral con la formación de una prominencia, resalte o giba ósea en la cara anterior de la unión cabeza-cuello femoral. El tratamiento quirúrgico consiste en la completa resección de esta giba para reducir el impacto óseo sobre el reborde y cartílago acetabular, prevenir un deterioro articular progresivo y lograr el alivio sintomático de los pacientes. Para realizar la completa resección artroscópica de la giba femoral se recomienda la identificación de los reparos anatómicos en el compartimiento articular periférico previo a la resección (límite medial: pliegue sinovial medial; límite central: labrum acetabular; límite lateral: pliegues sinoviales y vasos retinaculares; límite periférico y profundidad: cuello femoral). Más allá de la completa resección ésta debe ser segura sin lesionar los vasos retinaculares en la región lateral recomendándose la identificación de esos vasos previo a la resección de la giba en la región lateral. Se describen en este trabajo detalles de la técnica quirúrgica para una efectiva y segura resección artroscópica de la giba femoral en el pinzamiento femoroacetabular tipo leva.
Assuntos
Humanos , Acetábulo/cirurgia , Acetábulo/lesões , Artroscopia/métodos , Lesões do Quadril/cirurgia , Acetábulo , Articulação do Quadril/cirurgia , Articulação do Quadril , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Tomografia Computadorizada por Raios XRESUMO
Objective: To assess the complication rate in bilateral total hip arthroplasty (THA) performed in one stage, and to evaluate the patient satisfaction after the surgery. Methods: We analyzed the pen-operative data from 40 patients who underwent bilateral total hip arthroplasty in one stage, between November 2002 and December 2008 in our institution. We registered the operative risk, based on the American Society of Anesthesiologists (ASA) risk score classification system, the type of anesthesia and postoperative complications. All patients completed a questionnaire by telephone regarding the level of satisfaction after the surgery. Results: Forty patients (80 THAs), 26 females and 14 males were evaluated. The average age was 50.7 years (19-76 years). Twenty-five patients (62.5 percent) had ASA 1 operative risk, 12 (30 percent ) ASA 2 and 3 patients (7.5 percent) had ASA 3. Thirty-eight (95 percent) patients received combined anesthesia and 25 patients (62.5 percent) hypotensive anesthesia. Twelve patients (30 percent) received blood transfusion during or after the surgery. The average length of stay was 7.8 days. One patient (2.5 percent) had an intraoperative incomplete calcar fracture and another patient (2.5 percent) had local wound infection. No other complications were reported. Thirty-nine (97.5 percent) patients answered the telephonic questionnaire on July 2009, after a mean follow up of 33.6 months (6-78 months). Thirty-eight (97.4 percent) of them were very satisfied after the surgery. Conclusion: A bilateral total hip arthroplasty performed in one stage is a controlled low risk procedure in ASA 1 and 2 patients, with a high level of patient satisfaction after a short term follow up.
Objetivo: Evaluar la incidencia de complicaciones al realizar una artroplastia bilateral de cadera en un tiempo quirúrgico. Evaluar además el grado de satisfacción de los pacientes a corto plazo. Métodos: Análisis retrospectivo de 40 pacientes (26 mujeres, 14 hombres, edad promedio 50,7 años) operados de una artroplastia bilateral de cadera en un tiempo quirúrgico entre noviembre de 2002 y diciembre de 2008. Se revisaron los protocolos operatorios, las fichas clínicas realizándose además una encuesta telefónica para evaluar grado de satisfacción de los pacientes operados. Resultados: De los 40 pacientes, en relación al riesgo quirúrgico 25 pacientes (62,5 por ciento) correspondieron a ASA 1, 12 (30 por ciento) a ASA 2y3 (7,5 por ciento) a ASA 3. Veinticinco pacientes (62,5 por ciento) recibieron anestesia hipotensiva. Doce pacientes (30 por ciento) requirieron transfusión de glóbulos rojos durante la cirugía o en el postoperatorio. El tiempo de estadía hospitalaria fue de promedio 7,8 días. Un paciente (2,5 por ciento) presentó como complicación intraoperatoria una fractura incompleta del calcar y 1 (2,5 por ciento) como complicación local una infección superficial de herida operatoria. Ninguno presentó alguna complicación sistémica. Treinta y nueve pacientes se contactaron vía telefónica en junio de 2009 (tiempo de evolución 6-78 meses), 38 de estos (97,4 por ciento) manifestaron una alta satisfacción con la cirugía. Conclusión: La artroplastia bilateral de cadera en un tiempo quirúrgico es un procedimiento de bajo riesgo en pacientes seleccionados (ASA 1 y 2) y con un alto grado de satisfacción por parte de éstos a corto plazo.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Artroplastia de Quadril/métodos , Complicações Pós-Operatórias/epidemiologia , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/estatística & dados numéricos , Chile/epidemiologia , Coleta de Dados , Incidência , Satisfação do Paciente , Estudos Retrospectivos , Medição de Risco , Resultado do TratamentoRESUMO
Although intra-articular lesions after hip trauma are frequent, reports of patients treated with hip arthroscopy are limited. The most common indications for this procedure are loose bodies, labral lesions and chondral lesions. Some of these patients may have preexisting femoroacetabular impingement. We present in this article two case reports of intra-articular lesions after traumatic hip dislocation. The first is a case of a man with an anterior labral lesion and loose bodies after closed hip reduction. The second case is a man with a large anterior labral lesion with a previous femoroacetabular impingement. Both of them were treated by debridement of unstable labrum. Additionally loose bodies removal was performed in the first patient and femoral head-neck osteochondroplasty in the second one with excellent clinical results. Hip arthroscopy has proven to be a safe and effective surgical technique for treating specific posttraumatic lesions and previous femoroacetabular impingement.
Son frecuentes las lesiones intraarticulares post-fractura o luxación de cadera siendo escasos los reportes de tratamiento artroscópico de estas lesiones. Las principales indicaciones son cuerpos libres intraarticulares, lesiones del labrum o lesiones condrales. Puede coexistir además una deformidad preexistente como el pellizcamiento femoroacetabular. Se presentan 2 casos clínicos de pacientes con lesiones intraarticulares después de una luxación de cadera. El primer caso con una lesión del labrum anterior y cuerpos libres intraarticulares después de la reducción cerrada. El segundo caso con una extensa lesión del labrum anterior además de un pellizcamiento femoroacetabular. Ambos fueron tratados mediante artroscopía de cadera realizándose la estabilización del labrum. Además, se realizó la extracción de los fragmentos libres y una osteocondroplastía femoral respectivamente, con una excelente evolución clínica. La artroscopía de cadera es una técnica efectiva y segura para el tratamiento de estas lesiones traumáticas y corrección de la deformidad preexistente en casos de pellizcamiento femoroacetabular.
Assuntos
Humanos , Masculino , Adulto , Artroscopia/métodos , Fraturas do Quadril/cirurgia , Luxação do Quadril/cirurgia , Resultado do TratamentoRESUMO
Purpose: Acetabular labral tears are a frecuent cause of hip pain in nonarthritic young patients. We present our experience in the arthroscopic treatment of acetabular labral tears. Material and Methods: This is a retrospective study of45 patients operated by hip arthroscopy between December 2002 and March 2006. We analized the etiology and the location of the labral tears, the presence of associated chondral lesions and clinical short term results. In all the patients we perform the resection of the damaged part of the labrum, in 13 of this cases we perform a resection off the underlying bone deformity. Results: The most frecuent etiology was the femoroacetabular impingement (28 patients), less frecuent are traumatic, displastic and degenerative causes. In 36 patients the lesion was located anterosuperior, in 35 cases chondral lesions of the articular surface were present. The clinical result were excellent and good in 39, poor or fair in 6 patients. Conclusion: In our group the labral tear was the most frecuent cause of hip arthroscopy. Associated chondral lesions are highly frecuent. The main etiology is the femoroacetabular impingement which must be treated simultaneously. With a selective patient selection and an accurate surgical technique good clinical results can be achieved.
La lesión del labrum acetabular es causa frecuente de coxalgia en pacientes jóvenes sin artrosis. En este trabajo se presenta el análisis de sus causas y nuestra experiencia en el tratamiento artroscópico. Material y Métodos: Se analizan retrospectivamente 45 pacientes operados entre Diciembre 2002 y Marzo 2006. Se analiza la etiología, localización de las lesiones, presencia de lesiones condrales asociadas y la evolución clínica. En todos se efectuó la resección parcial del labrum dañado, en 13 se efectuó además la resección artroscópica de la deformidad ósea subyacente. Resultados: La etiología más frecuente fue un pellizcamiento femoroacetabular (28 pacientes), menos frecuente la causa degenerativa, displasia o traumática. En 36 pacientes la lesión del labrum era anterosuperior, 35 presentaban lesiones condrales asociadas. En 13 casos de pellizcamiento se efectuó la resección de la deformidad ósea. Los resultados clínicos fueron excelentes y buenos en 39 pacientes, regulares y malos en 6. Conclusiones: La lesión del labrum es la indicación más frecuente de artroscopia de cadera. Son muy frecuentes las lesiones condrales asociadas. La principal etiología fue el pellizcamiento femoroacetabular el cual idealmente debe ser tratado en forma simultánea. Con una indicación selectiva y adecuada técnica quirúrgica se obtienen resultados clínicos satisfactorios.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Acetábulo/cirurgia , Artroscopia/métodos , Lesões do Quadril/cirurgia , Lesões do Quadril/etiologia , Acetábulo/lesões , Cartilagem Articular/cirurgia , Cartilagem Articular/lesões , Satisfação do Paciente , Complicações Pós-Operatórias , Estudos RetrospectivosAssuntos
Cefalosporinas/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Resistência beta-Lactâmica , beta-Lactamases/metabolismo , Chile , Farmacorresistência Bacteriana , Humanos , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Sensibilidade e Especificidade , beta-Lactamases/efeitos dos fármacosRESUMO
BACKGROUND: The resistance of Shigella flexneri to antimicrobial agents can be associated to the presence of integrons that may contain and express antimicrobial resistance gene cassettes. AIM: To study antimicrobial resistance and the presence of integrons and antimicrobial gene cassettes in Shigella flexneri strains. MATERIAL AND METHODS: In vitro susceptibility to 27 antimicrobials was studied in twenty four Shigella flexneri strains isolated from stools. The presence of integrons class 1, 2 and 3 and antimicrobial resistance gene cassettes was investigated by polymerase chain reaction (PCR) using specific primers for each gene. RESULTS: Most strains were resistant to one of the following antimicrobials: ampicillin, sulphonamide, trimethoprim, tetracycline, streptomycin, sulfamethoxazole-trimethoprim or chloramphenicol. Twenty nine percent were simultaneously resistant to all these antimicrobials. Integrons class 1 and 2 were found in 19 strains (79 per cent). Class 3 integrons were not found. Gene cassettes dfrA1 and ant(3")I were associated to integrons class 2 in most strains (15/20, 75 per cent). Genes cat, tetB and blarTEM were detected in 18/24 (75 per cent), 7/24 (29 per cent) and 4/24 (17 per cent) of the strains, respectively and were not associated to any of the studied integrons. Genes that codify enzymes AAC(6')Ib and APH(3')VI were not detected in any strain. CONCLUSIONS: The high frequency of integrons found in the studied strains, could partly explain the increasing antimicrobial resistance of Shigella flexneri strains, isolated in Chile.
Assuntos
Humanos , Genes Bacterianos/efeitos dos fármacos , Integrons/genética , Farmacorresistência Bacteriana/genética , Shigella flexneri/efeitos dos fármacos , Dados de Sequência Molecular , Genes Bacterianos/genética , Oligonucleotídeos/genética , Reação em Cadeia da Polimerase , Farmacorresistência Bacteriana Múltipla/genética , Sequência de Aminoácidos , Shigella flexneri/genética , Testes de Sensibilidade MicrobianaRESUMO
Members of the family Enterobacteriaceae are responsible for a variety of nosocomial infections, treatment of which is limited due to their increasing resistance to antibiotics. Some bacterial genes encoding antibiotic resistance comprise the major part of gene cassettes, most of which are associated with integrons. In this work, the carriage of class 1, 2 and 3 integrons was investigated in 191 Enterobacteriaceae isolates from clinical specimens of hospitalized patients. Class 1 integrons were found to be the most common, whereas no class 3 integrons were detected. The variable regions of 13 class 1 integrons were characterized and four types were found. Type 1 harbours only ant(3")I, type 2 harbours ant(2")I and ant(3")I, type 3 harbours aac(6')Ib and ant(3")I and type 4 lacks inserted gene cassettes.