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Tagosodes orizicolus is one of the main plagues of rice in tropical America causing two types of damages, the direct one, feeding and oviposition effect, and an indirect one, by the transmission of the "Rice hoja blanca virus". During 2006-2007 we carried out research under greenhouse conditions at Fundaci6n Danac, Venezuela, in order to determine the mechanisms of antixenosis, antibiosis and tolerance to T. orizicolus, which could be acting in commercial varieties and advanced lines of the rice genetic breeding programs of INIA and Fundaci6n Danac. The method of free feeding was used for the antixenosis evaluation, whereas the method of forced feeding was used for antibiosis evaluation (effect on survival and oviposition). Additionally, we used the indirect method based on biomass depression to estimate the tolerance. Some of the evaluated traits included: grade of damage, number of insects settling on rice plants, percentage of sogata mortality at the mature state, number of eggs in the leaf midrib and an index of tolerance. The results showed that rice genotypes possess different combinations of resistance mechanisms, as well as different grades of reactions. The susceptible control 'Bluebonnet 50' was consistently susceptible across experiments and the resistant control 'Makalioka' had high antixenosis and high antibiosis based on survival and oviposition. The rest of the genotypes presented lower or higher degrees of antixenosis and antibiosis for survival and oviposition. The genotype 'FD0241-M-17-6-1-1-1-1' was identified with possible tolerance to the direct damage of sogata.
Assuntos
Hemípteros/fisiologia , Interações Hospedeiro-Parasita , Oryza/parasitologia , Animais , Antibiose/fisiologia , Genótipo , Oryza/genética , VenezuelaRESUMO
Background: Reversible etiologies of cognitive impairment are common and treatable, yet the majority of mild cognitive impairment (MCI) and dementia research in Latin America has focused on irreversible, neurodegenerative etiologies. Objective: We sought to determine if thyroid dysfunction and vitamin B12 and folate deficiencies are associated with cognitive disorders among older adults with memory complaints in Lima, Peru. Methods: This was a retrospective review of patients who presented for cognitive evaluations to a multidisciplinary neurology clinic in Lima, Peru from January 2014 to February 2020. We included individuals aged ≥60 years, native Spanish-speakers, with at least a primary school educational level and a complete clinical assessment. Patients had either subjective cognitive decline (SCD), MCI, or dementia. One-way ANOVA and multiple logistic regression analyses were performed. Results: We included 720 patients (330 SCD, 154 MCI, and 236 dementia); the dementia group was significantly older [mean age SCD 69.7 ± 4.1, dementia 72.4 ± 3.7 (p = 0.000)] and had lower folate levels than SCD patients. The MCI group had higher free T3 levels compared with SCD patients. Those with lower TSH had greater dementia risk (OR = 2.91, 95%CI: 1.15-6.86) but not MCI risk in unadjusted models. B12 deficiency or borderline B12 deficiency was present in 34% of the dementia group, yet no clear correlation was seen between neuropsychological test results and B12 levels in our study. There was no association between MCI or dementia and thyroid hormone, B12 nor folate levels in adjusted models. Conclusion: Our findings do not support an association between metabolic and endocrine disorders and cognitive impairment in older Peruvians from Lima despite a high prevalence of B12 deficiency. Future work may determine if cognitive decline is associated with metabolic or endocrine changes in Latin America.
Assuntos
Disfunção Cognitiva , Deficiência de Ácido Fólico , Idoso , Disfunção Cognitiva/epidemiologia , Humanos , Peru/epidemiologia , Estudos Retrospectivos , Glândula Tireoide , Vitamina B 12RESUMO
Background: The accurate diagnosis of neurocognitive disorders in illiterate Peruvian populations is challenging, largely owing to scarcity of brief cognitive screening tools (BCST) validated in these diverse populations. The Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) is a BCST that relies minimally on educational attainment and has shown good diagnostic accuracy in an urban illiterate population in Peru, yet its psychometric properties in illiterate populations in rural settings of the country have not been previously investigated. Objectives: To establish the diagnostic accuracy of the RUDAS-PE compared to expert clinical diagnosis using the Clinical Dementia Rating (CDR) Scale in healthy and cognitively impaired illiterate persons living in two culturally and geographically distinct rural communities of Peru. Methods: A cross-sectional, population-based study of residents ≥ 50 years of age living in the Peruvian rural communities of Santa Clotilde and Chuquibambilla. A total of 129 subjects (76 from Santa Clotilde and 53 from Chuquibambilla) were included in this study. Gold standard diagnostic neurocognitive evaluation was based on expert neurological history and examination and administration of the CDR. Receiver operating characteristics, areas under the curve (AUC), and logistic regression analyses were conducted to determine the performance of RUDAS-PE compared to expert gold standard diagnosis. Results: Compared to gold standard diagnosis, the RUDAS-PE was better at correctly discriminating between MCI and dementia than discriminating between MCI and controls in both sites (97.0% vs. 76.2% correct classification in Chuquibambilla; 90.0% vs. 64.7% in Santa Clotilde). In Chuquibambilla, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.4% (optimal cutoff at <18), whereas between MCI and controls it was 82.8% (optimal cutoff at <22). In Santa Clotilde, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.1% (optimal cutoff at <17), whereas between MCI and controls it was 75.5% (optimal cutoff at <21). Conclusions: The RUDAS-PE has acceptable psychometric properties and performed well in its ability to discriminate MCI and dementia in two cohorts of illiterate older adults from two distinct rural Peruvian communities.
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Background: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegenerative diseases, such as Alzheimer's disease (AD), using brief cognitive tests. Combining brief socio-cognitive and behavioral evaluations with standard cognitive testing could better discriminate bvFTD from AD patients. We sought to evaluate the diagnostic accuracy of brief socio-cognitive tests that may differentiate bvFTD and AD patients with low educational levels. Methods: A prospective study was performed on 51 individuals over the age of 50 with low educational levels, with bvFTD or AD diagnosed using published criteria, and who were receiving neurological care at a multidisciplinary neurology clinic in Lima, Peru, between July 2017 and December 2020. All patients had a comprehensive neurological evaluation, including a full neurocognitive battery and brief tests of cognition (Addenbrooke's Cognitive Examination version III, ACE-III), social cognition (Mini-social Cognition and Emotional Assessment, Mini-SEA), and behavioral assessments (Frontal Behavioral Inventory, FBI; Interpersonal Reactivity Index-Emphatic Concern, IRI-EC; IRI-Perspective Taking, IRI-PT; and Self-Monitoring Scale-revised version, r-SMS). Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was performed to compare the brief screening tests individually and combined to the gold standard of bvFTD and AD diagnoses. Results: The AD group was significantly older than the bvFTD group (p < 0.001). An analysis of the discriminatory ability of the ACE-III to distinguish between patients with AD and bvFTD (AUC = 0.85) and the INECO Frontal Screening (IFS; AUC = 0.78) shows that the former has greater discriminatory ability. Social and behavioral cognition tasks were able to appropriately discriminate bvFTD from AD. The Mini-SEA had high sensitivity and high moderate specificity (83%) for discriminating bvFTD from AD, which increased when combined with the brief screening tests ACE-III and IFS. The FBI was ideal with high sensitivity (83%), as well as the IRI-EC and IRI-PT that also were adequate for distinguishing bvFTD from AD. Conclusions: Our study supports the integration of socio-behavioral measures to the standard global cognitive and social cognition measures utilized for screening for bvFTD in a population with low levels of education.
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Objectives: To evaluate the performance of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) in discriminating between controls and patients with mild cognitive impairment (MCI) and dementia in an illiterate population with low-levels of education. Methods: We compared the cognitive performance of 187 elderly subjects who were illiterate (controls n = 60; MCI n = 64; dementia n = 63). Neuropsychological measures included the RUDAS-PE, Mini-Mental State Examination (MMSE), INECO Frontal Screening (IFS), and Pfeffer Functional Activities Questionnaire (PFAQ). The results were compared to a neuropsychological evaluation (gold standard), including use of Clinical Dementia Rating (CDR) scores. Results: We found a Cronbach's alpha was 0.65; Spearman's correlation coefficient was 0.79 (p < 0.01). The area under the receiver operating characteristics curve for the RUDAS to discriminate dementia from MCI was 98.0% with an optimal cut-off <19 (sensitivity 95%, specificity 97%); whereas, to differentiate MCI and controls was 98.0% with an optimal cut-off <23 (sensitivity 89%, specificity 93%). Conclusions: Based on its excellent psychometric properties, we find the RUDAS-PE suitable to aid in the opportune detection of dementia in a geriatric illiterate population with low-levels of education.
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OBJECTIVES: To assess the psychometric properties of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) to discriminate controls from patients with mild cognitive impairment (MCI) and early dementia (ED) in a population with a mid-level education. METHODS: A total of 133 patients from a memory clinic were administered the RUDAS-PE, INECO Frontal Screening, Addenbrooke's Cognitive Examination, and Mini-Mental State Examination. Results were compared against a neuropsychological evaluation (gold standard). Validity measures, internal consistency, and concurrent validity were calculated. RESULTS: Cronbach's α was 0.68; Pearson's ratio was 0.79 (P < .01). The area under the receiver-operating characteristics curve of the RUDAS to discriminate between ED and MCI was 89.0% (optimal cutoff at <21), whereas between MCI and controls, it was 99.0% (optimal cutoff at <24). CONCLUSIONS: The RUDAS-PE has acceptable psychometric properties performing well in its ability to discriminate controls from patients with MCI and ED.
Assuntos
Escolaridade , Transtornos Neurocognitivos/diagnóstico , Testes Neuropsicológicos/normas , Psicometria/normas , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Humanos , Pessoa de Meia-Idade , PeruRESUMO
Distance learning can be enhanced with the use of virtual reality; this paper describes the design and initial validation of a Web Environment for Surgery Skills Training on Otolaryngology (WESST-OT). WESST-OT was created aimed to help trainees to gain the skills required in order to perform the Functional Endoscopic Sinus Surgery procedure (FESS), since training centers and specialist in this knowledge are scarce in Colombia; also, it is part of a web based educational cycle which simulates the stages of a real procedure. WESST-OT is one from the WESST family of telesimulators which started to be developed from an architecture proposed at the Medicine Meets Virtual Reality conference 2002; also, it is a step towards the use of virtual reality technologies in Latin America.
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Simulação por Computador , Educação a Distância , Otolaringologia , Telemedicina/métodos , Interface Usuário-Computador , Colômbia , InternetRESUMO
Objetivo: Estimar el costo del manejo de cada uno de los estadios del cáncer de mama en Colombia. Métodos: La estimación de costos se realizó usando la metodología de un estudio de caso, dividida en tres etapas: identificar el consumo de recursos asociados a las diferentes fases de la enfermedad, cuantificar el consumo físico de recursos y valorizar el consumo de estos. La cantidad, frecuencia de uso y cumplimiento de los procedimientos y medicamentos se obtuvo mediante opinión de expertos de centros de oncología de cinco regiones el país (Bogotá, Barranquilla-Cartagena, Cali, Medellín y Bucaramanga). Los costos de los medicamentos se calcularon con base en el Sistema de Información de Precios de Medicamentos (SISMED) 2010 y la Resolución 4316 de 2011. Los costos de los procedimientos fueron obtenidos de los manuales ISS 2001 + 30%, SOAT y la información del estudio de suficiencia de la UPC. Resultados: Los estadios más costosos para el cáncer fueron el metastásico con un costo total de $144.400.865, seguido del cáncer de mama regional que alcanzó un costo total de $65.603.537. Se observó una contribución importante de la quimioterapia en el costo total para los diferentes estadios y en la recaída sistémica y local. Conclusiones: La diferencia en los costos del cáncer de mama entre estadios está altamente influenciada por el valor de los costos asociados al tratamiento de quimioterapia.
Objective: To estimate the cost of managing each of the stages of breast cancer in Colombia. Methods: The estimation of costs was performed using case study methodology, divided into three stages: the identification of the use of resources associated with the different stages of the disease, the quantification of the resource use, and the evaluation of this use. The quantity, frequency of use, and the percentage of compliance with procedures and medications were obtained by expert opinion in the cancer centres in five regions of the country (Bogotá, Barranquilla-Cartagena, Cali, Medellin and Bucaramanga). The drug costs were calculated using prices reported in the Price of Medications Information System (SISMED) 2010, and Resolution 4316 of 2011. The procedure costs were obtained from the ISS 2001 manuals + 30%, SOAT and information from the UPC sufficiency study. Results: The most expensive stages of breast cancer were metastatic cancer at a cost of COP $144,400,865 and regional cancer with COP $65,603,537 (D 56 million). A significant contribution by chemotherapy was observed in the total cost for the different stages and systemic and local recurrence. Conclusion: The difference in costs between the stages of breast cancer is highly influenced by the value of the costs associated with chemotherapy treatment.
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Humanos , Feminino , Terapêutica , Neoplasias da Mama , Custos e Análise de Custo , Atenção , Custos de Medicamentos , Colômbia , Recursos em SaúdeRESUMO
Tagosodes orizicolus is one of the main plagues of rice in tropical America causing two types of damages, the direct one, feeding and oviposition effect, and an indirect one, by the transmission of the “Rice hoja blanca virus”. During 2006-2007 we carried out research under greenhouse conditions at Fundación Danac, Venezuela, in order to determine the mechanisms of antixenosis, antibiosis and tolerance to T. orizicolus, which could be acting in commercial varieties and advanced lines of the rice genetic breeding programs of INIA and Fundación Danac. The method of free feeding was used for the antixenosis evaluation, whereas the method of forced feeding was used for antibiosis evaluation (effect on survival and oviposition). Additionally, we used the indirect method based on biomass depression to estimate the tolerance. Some of the evaluated traits included: grade of damage, number of insects settling on rice plants, percentage of sogata mortality at the mature state, number of eggs in the leaf midrib and an index of tolerance. The results showed that rice genotypes possess different combinations of resistance mechanisms, as well as different grades of reactions. The susceptible control ‘Bluebonnet 50’ was consistently susceptible across experiments and the resistant control ‘Makalioka’ had high antixenosis and high antibiosis based on survival and oviposition. The rest of the genotypes presented lower or higher degrees of antixenosis and antibiosis for survival and viposition. The genotype ‘FD0241-M-17-6-1-1-1-1’ was identified with possible tolerance to the direct damage of sogata.
Tagosodes orizicolus es una de las principales plagas del cultivo del arroz en América tropical causando dos tipos de daños a la planta, el directo, por efecto de la alimentación y oviposición; el indirecto, por la transmisión del virus de la hoja blanca del arroz. Durante el período 2006-2007 se llevó a cabo una investigación bajo condiciones de umbráculo en la Fundación Danac, Venezuela, con el objeto de determinar los mecanismos de resistencia de antixenosis, antibiosis y tolerancia a T. orizicolus que pudieran estar actuando en líneas avanzadas y cultivares del programa de mejoramiento enético de arroz de las instituciones INIA y Fundación Danac. Para la evaluación de antixenosis se utilizó el método de libre elección, para antibiosis (efecto sobre sobrevivencia y oviposición de los insectos) el de alimentación forzada, adicionalmente se usó un método indirecto para estimar la tolerancia. Dentro de los principales parámetros determinados se encontraban: grado de daño, número de insectos posados sobre plantas de arroz, porcentaje de mortalidad de sogata en estado adulto, número de huevos y se calculó un índice de tolerancia con base en la biomasa. Los resultados mostraron que los genotipos de arroz evaluados poseen diferentes combinaciones en cuanto a los mecanismos de resistencia, así como el grado de su efecto. El testigo ‘Bluebonnet 50’ se mantuvo consistentemente susceptible en las evaluaciones y el testigo resistente ‘Makalioka’ fue el único genotipo que presentó alta antixenosis y alta antibiosis para sobrevivencia y oviposición. El resto de los genotipos presentaron un menor o mayor grado de resistencia de tipo antixenosis y antibiosis para sobrevivencia y oviposición. Se identificó el genotipo ‘FD0241-M-17-6-1-1-1-1’ con posible tolerancia al daño directo de sogata.
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Animais , Interações Hospedeiro-Parasita , Hemípteros/fisiologia , Oryza/parasitologia , Antibiose/fisiologia , Genótipo , Oryza/genética , VenezuelaRESUMO
Justificación: fenazopiridina es un medicamento analgésico urinario oral; cuenta con una amplia experiencia histórica de uso y, bajo el paradigma de medicina basada en evidencia, tiene poco fundamento de alta calidad para sustentar su valor terapéutico. Objetivo: analizar el perfil de la utilización de la fenazopiridina en la práctica clínica habitual dentro de la Seguridad Social, a nivel de consulta ambulatoria, en los tres niveles de atención y por un periodo de 30 días. Procedimientos: en enero de 2011, en una unidad de cada nivel de atención: Área de Salud de Santa Bárbara, Clínica Dr. Carlos Durán y Hospital Dr. Calderón Guardia, se analizó el reporte de despacho por farmacia de la fenazopiridina, con el fin de preparar un perfil cuantitativo. En el análisis cualitativo de la prescripción, se revisó una muestra al azar de 30 expedientes de pacientes atendidos durante ese periodo en cada unidad, con un formulario prediseñado para el efecto. Resultados: durante 1 mes, tres unidades despacharon 381 prescripciones a los pacientes, mayormente mujeres. La prescripción varió entre 3 y 90 tabletas; la mayoría (60,43%) con solo 10 tabletas para tratamiento. Se documentó la anotación del medicamento y la dosis en un 54,55% de los expedientes. La dosis diaria prescrita (DDP) fue 100 mg TID, equivalente a 300 mg/d, en la mitad de los pacientes, y en las unidades del primer y segundo nivel de atención; seguida de 100 mg BID (33,33%). Un 54,55% de los pacientes tenían diagnóstico de infección del tracto urinario (89% mujeres); de estos, un 89,89% recibió también antibióticos. La duración varió entre 1 y 30 días, y se prolongó más en unidades del segundo y tercer nivel. Conclusión: la utilización es parcial y razonablemente adecuada, apoya el supuesto de efectividad seguridad, sobre todo en el contexto de la atención médica en el primero y segundo niveles de atención. La diversidad en los hábitos de prescripción requiere mejorar su empleo y desarrollar ...
Background: Phenazopiridine is an oral urinary tract analgesic; an extensive historical experience of use and, under the paradigm of evidence-based medicine, its therapeutic value is not supported by high quality explanations. Aim: To analyze the use of phenazopiridine in everyday clinical practice, at an ambulatory level, in the three different levels of attention in the Costa Rican social security during a period of 30 days. Methods: In January 2011, electronic pharmacy records from a first, second and third level health center; Health Area of Santa Barbara, Dr. Carlos Durán Clinic and Dr. Calderón Guardia Hospital, respectively, were obtained to establish the quantitative characteristics of the prescription of phenazopiridine. For the qualitative analysis of the prescription, a random sample of 30 medical records of patients treated during that period in each unit was considered using an instrument previously designed for said task. Results: During one month, three study units prescribed phenazopiridine to 381 patients, mostly females. Prescription varied from 3 to 90 tablets; most patients (60.43%) received only 10 tablets for their treatment regime. In 54.55% of the medical records, the diagnosis and prescription was documented. The daily-prescribed dose (DPD) was 100mg thrice a day, equivalent to 300mg per day in half of the patients; and in the first and second level of attention followed by 100mg twice a day (33.3%). A total of 55.4% of the patients had been diagnosed with urinary tract infection (89% female); of these an 89.9% received also antibiotic treatment. The duration of treatment varied between 1 to 30 days, with more prolonged use in the second and third level of attention. Conclusion: The use of phenazopiridine is partial and reasonably adequate, thus supporting the efficacy-safety criteria in the context of first and second level attention centers. The diversity in the prescription patterns requires improvement in ...
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Assistência Ambulatorial , Fenazopiridina/uso terapêuticoRESUMO
Objetivo: En algunos Servicios de Emergencias de la CCSS, a los pacientes con infarto agudo de miocardio se les administra una dosis alta aunque variables de lovastatina en las primeras horas de evolución de los síndromes coronarios agudos, con la expectativa de lograr efectos pleiotrópicos, un resultado positivo sobre el endotelio y la disminución de mediadores inflamatorios. Analizar la evidencia científica que sustenta el beneficio de esta intervención farmacológica y clarificar la posible dosis oral y el potencial intervalo idóneo. Búsqueda vías electrónicas en sistemas secundarios de información científica y análisis de fuentes primarias, con énfasis en ensayos clínicos aleatorizados que evalúen la eficacia de las estatinas en los eventos coronarios agudos; también de fuentes terciarias , específicamente revisiones sistemáticas y guías de consenso para prácticas clínicas basadas en evidencia y revisiones por instancias evaluadoras de tecnología con reconocimiento internacional. Resultados: Cuatro ensayos clínicos aleatorizados controlados con placebo, no demostraron diferencias significativas ni clínicamente relevantes en la variable primaria combinada: evento cardiaco mayor, muerte, IAM recurrente fatal, AVC fatal u otra causa de muerte cardiovascular, ninguno usó dosis de carga, ni se inició la administración en las 24hs del inicio de la sintomatología. Conclusión: Ante la falta de evidencia que permita proyectar con claridad un papel beneficioso para las estatinas en el manejo inicial del síndrome coronario agudo, esta práctica desequilibra la relación beneficio/riesgo y se aleja de los principios del uso racional de medicamentos y la aplicación del paradigma de la medicina basada en evidencia.
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Humanos , Anomalias dos Vasos Coronários/tratamento farmacológico , Doença das Coronárias/tratamento farmacológico , LovastatinaRESUMO
National and Global Health have dramatically improved since the end of WWII. This has been primarily the result of public health actions. Public health is information transfer. The information superhighway can markedly improve public health, but public health and prevention have been neglected. Tele medicine, but it should. We have outlined a global health network to address this. The global health network consists of 1) connectivity of all people in public health worjdwide. 2)tele-monitoring of disease, the use telecommunication for disease monitoring. 3)establishment of a global health network university, a health network through the internet, 4)connecting health related non-government organizations, 5)establishment of a global health network research server to replace biomedical journals, 6)the training of cyberdocs, individual trained in public health and networking (AU)
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Redes de Comunicação de Computadores , Saúde Pública , Sistemas de Informação , Telecomunicações , TelemedicinaRESUMO
Desde hace 6 años colocamos los implantes mamarios en un plano subfascial (subaponeurótico) reemplazando el plano subglandular(SG). Este artículo considera 150 pacientes implantados en este plano.
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Humanos , Feminino , Implantes de Mama , Músculos Peitorais , Tela SubcutâneaRESUMO
Reportamos en este trabajo el caso de mujer multípara, embarazada con diagnóstico serológico Rh negativo y antígeno Du positivo, con antecedentes de haber recibido antiglobulina anti-D en sus dos embarazos anteriores cuyos productos resultaron ser positivos en sistema Rh, y en la que el control prenatal inicial de su último embarazo fue empleado un algoritmo encaminado a prevenir isoinmunización. Este trabajo enfatiza la necesidad de la determinación del Du en pacientes Rh d y la comprensión del manejo de este tipo serológico durante el embarazo.
We report the case of a multipara pregnant woman with serologic diagnosis of negative Rh and positive Du Antigen, with antecedents of have received anti-D antiglobulin in her two previous pregnancies with Rh system positive products. In the last pregnancy, an algorithm routed to prevent isoinmunization was used as an initial prenatal control. This work emphasize the necessity of determination of Du in Rh D patients and the comprehension of its management during pregnancy.
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Feminino , Gravidez , Incompatibilidade de Grupos Sanguíneos , Complicações na Gravidez , Isoimunização Rh , Eritroblastose Fetal , Imunoglobulina GRESUMO
El concepto de la terapia invasiva fetal guiada por ecografía para corrección de defectos congénitos y adquiridos ha cambiado de lo teórico a lo práctico. Por esta razón, se disminuye la morbi-mortalidad perinatal. Presentamos un caso de diagnóstico prenatal de hidrotórax + hipoplasia pulmonar fetal de una gestante de 33 semanas. La paciente es transferida del Seguro Campesino al Hospital Teodoro Maldonado Carbo. Se realizan exámenes y rastreo ecográfico revelando embarazo de +/- 31 semanas de gestación + derrame pleural fetal izquierdo + polihidramnios. Se realiza con éxito drenaje del hidrotórax, mediante punción transabdominal. Luego de realizar cesárea segmentaria se obtiene producto único vivo, pretérmino, sexo femenino.
The concept of ultrasound-guided invasive fetal therapy for correction of acquired and congenital defects has moved from the theory to a routine application. In this condition, it appears to be effective in reducing both mortality and morbidity. We report the case of prenatal diagnosis of hydrothorax + fetal lung hypoplasia in a 33 weeks pregnant woman, who was admitted at Teodoro Maldonado Carbo Hospital. Ultrasound controls were performed assesing the presence of a +/- 31 pregnancy weeks + left fetal pleural effusion + polyhydramnios. Hydrothorax drainage was successfully realized with transabdominal punction. After segmentary c-section, we obtained a unique, preterm, female product.
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Feminino , Gravidez , Adulto Jovem , Quilotórax , Drenagem , Derrame Pleural/cirurgia , FetoRESUMO
En medicina se escriben aproximadamente 2 millones de artículos nuevos cada año, por lo que permanecen al tanto de los descubrimientos y nuevos conocimientos médicos constituye una real tarea para los profesionales de hoy. El uso de computadoras personales para ganar acceso directo (on-line) a los bancos de datos de la Biblioteca Nacional de Medicina en Washington (NLM) se ha convertido en un método alterno para manejar esta explosión de información. Sin embargo, para los países latinoamericanos, el obstáculo más importante es de carácter económico por lo costoso de la llamada internacional. Desde 1981, instituciones académicas de EE.UU y Europa pueden comunicarse entre sí mediante el uso de correo electrónico a través de una red de telecomunicaciones denominada BITNET. Dicho medio de comunicación, que permite el envío de mensajes, datos, resultados, o archivos completos a un relativo bajo costo, requiere de la instalación de infraestructuras de acceso, o nodos. Un sistema que permite la utilización de los bancos de datos de la NLM mediante correo electrónico, denominado BITNIS, ha sido posible mediante un esfuerzo internacional entre médicos e ingenieros chilenos y el auspicio de la Oficina Panamericana de la Salud, la NLM y el Instituto Nacional de Salud (NIH). Una gestion ante el centro de computación de la Universidad de Yale con el objeto de permitir la utilización del nodo BITNET de esta universidad ha permitido que Venezuela se incorpore a este novedoso sistema de informática médica. Mediante el apoyo de IBM se espera que Venezuela y otros países latinoamericanos cuenten pronto con nodos BITNET propios y redes internas..
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Automação de EscritórioRESUMO
Durante el período de este estudio se encontró que en relación a la característica sociodemográfica de grupos etáreos predominantes fue de 14-16 años 40.7 porciento seguidos del grupo de adolescentes de 17-19años 36.7 porciento. La escolaridad que predominó fue la secundaria 60.7 porciento seguido de la primaria 37.3 porciento. En relación al consumo de sustancias alguna vez en la vida hubo una prevalencia de casos de 73.3 porciento y los tipos de sustancias que predominaron fue el tabaco 60.7 porciento, seguido del alcoholismo 53.7 porciento y las drogas 26.7 porciento, las bebidas que más predominaron fueron el licor y la cerveza en 52 porciento, drogas consumida laMarihuana para 10 porciento seguido de inhalantes (pega) para un 6 porciento la cocaína para un 5.3 porciento. La edad para el inicio de consumo de alcohol fue de 14-16 años. La causa que motivó al cosumo de estas drogas fue por curiosidad seguido de presión de compañeros. En relación a la combinación de tabaco-alcohol se presentó 56 porciento de casos, alcohol-drogas 13.3 porciento, la combinación tabaco-alcohol-droga del 18.7 porciento. En ralación algún familiar se encontró que el papá consumió algún tipo de sustancias fue 75 porciento, y de las mamá en un 38 porciento consumen algun tipo