RESUMO
Persistent organic pollutants (POPs) pose a significant global threat to human health and the environment, and require continuous monitoring due to their ability to migrate long distances. Active biomonitoring using cloned mosses is an inexpensive but underexplored method to assess POPs, mainly due to the poor understanding of the loading mechanisms of these pollutants in mosses. In this work, Fontinalis antipyretica (aquatic moss) and Sphagnum palustre (terrestrial moss) were evaluated as potential biomonitors of hexachlorocyclohexanes (HCHs: α-, ß-, γ-, δ-HCH), crucial POPs. Moss clones, grown in photobioreactors and subsequently oven-dried, were used. Their lipid composition and distribution were characterized through molecular and histochemical studies. Adsorption experiments were carried out in the aqueous phase using the repeated additions method and in the gas phase using an active air sampling technique based on solid-phase extraction, a pioneering approach in moss research. F. antipyretica exhibited greater lipid content in the walls of most cells and higher adsorption capacity for all HCH isomers in both gaseous and liquid environments. These findings highlight the need for further investigation of POP loading mechanisms in mosses and open the door to explore other species based on their lipid content.
Assuntos
Monitoramento Ambiental , Hexaclorocicloexano , Hexaclorocicloexano/análise , Monitoramento Ambiental/métodos , Adsorção , Briófitas/química , Poluentes Ambientais/análise , Monitoramento Biológico/métodos , Sphagnopsida/químicaRESUMO
INTRODUCTION: At least 20% of paediatric patients with epilepsy present resistance to multiple anti-crisis drugs in trials, which has a negative impact on their neuropsychological state, quality of life and prognosis; it is therefore necessary to document their neuropsychological profile in order to improve the clinical approach to them. AIMS: To describe the neuropsychological profile (cognitive, academic, behavioural, emotional, adaptive, sleep disturbances and quality of life) of paediatric patients with drug-resistant focal epilepsy in the frontal, temporal and occipital lobes, and to compare performance between patients with frontal and temporal foci, and to assess the link between the duration of the condition, the frequency of seizures and the amount of anti-crisis drugs and the neuropsychological profile. PATIENTS AND METHODS: The neuropsychological profile of 19 paediatric patients with a diagnosis of pharmacoresistant epilepsy with a mean age of 10.89 years was evaluated. RESULTS: 57.9% of the 19 patients were men. 63.2% presented frontal focus; 26.3% presented temporal focus; and 10.5% presented occipital focus. Deficiencies in attention, comprehension, verbal memory, working memory and processing speed, in addition to adaptive difficulties were observed. When the patients with frontal and temporal focus were compared, the former were found to present greater deficits in planning, while the patients with temporal focus presented more severe symptoms of anxiety. Patients with a longer disease duration were found to present greater impairment to their intelligence quotient and adaptive behavioural skills. CONCLUSIONS: Pharmacoresistant epilepsy in paediatric patients affects intelligence quotient and adaptive skills, as well as attention, memory and executive functions, and neuropsychological intervention programmes must therefore be implemented to improve these patients' quality of life.
TITLE: Perfil neuropsicológico de pacientes pediátricos mexicanos con epilepsia focal farmacorresistente.Introducción. Al menos el 20% de los pacientes pediátricos con epilepsia muestra resistencia a los ensayos de múltiples fármacos anticrisis, que impactan negativamente en su estado neuropsicológico, calidad de vida y pronóstico; por tal motivo, es necesario documentar ampliamente su perfil neuropsicológico para mejorar su abordaje clínico. Objetivos. Describir el perfil neuropsicológico (cognitivo, académico, conductual, emocional, adaptativo, alteraciones del sueño y calidad de vida) de pacientes pediátricos con epilepsia focal farmacorresistente de los lóbulos frontal, temporal y occipital, así como comparar el desempeño entre los pacientes con foco frontal y temporal, y evaluar la asociación entre la duración del padecimiento, la frecuencia de las crisis y la cantidad de fármacos anticrisis con el perfil neuropsicológico. Pacientes y métodos. Se evaluó el perfil neuropsicológico de 19 pacientes pediátricos con diagnóstico de epilepsia farmacorresistente, con una edad promedio de 10,89 años. Resultados. De los 19 pacientes, el 57,9% fueron hombres. El 63,2% presentó foco frontal; el 26,3%, temporal; y el 10,5%, occipital. Se encontraron deficiencias en atención, comprensión, memoria verbal, memoria de trabajo y velocidad de procesamiento, además de dificultades adaptativas. Al comparar a los pacientes con foco frontal y temporal, se encontró que los primeros presentaron mayores deficiencias en planificación, mientras que los pacientes con foco temporal presentaron mayores síntomas de ansiedad. Con respecto a la duración de la enfermedad, se encontró que los pacientes con mayor duración del padecimiento presentaron mayor afectación en el cociente intelectual y en las habilidades en la conducta adaptativa. Conclusiones. La epilepsia farmacorresistente en pacientes pediátricos afecta el cociente intelectual y las habilidades adaptativas, así como a la atención, la memoria y las funciones ejecutivas, por lo que es necesaria la implementación de programas de intervención neuropsicológica para mejorar la calidad de vida de estos pacientes.
Assuntos
Epilepsia Resistente a Medicamentos , Epilepsias Parciais , Testes Neuropsicológicos , Humanos , Masculino , Criança , Feminino , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Epilepsia Resistente a Medicamentos/psicologia , Epilepsias Parciais/tratamento farmacológico , Epilepsias Parciais/psicologia , México , Adolescente , Qualidade de Vida , Pré-EscolarRESUMO
AIM: To analyze stress in a metal-ceramic, zirconia and lithium disilicate implant-supported unitary fixed partial prosthesis in the first lower premolar through finite element analysis at a 500 N force. MATERIALS AND METHODS: Three study models were carried out, metal-ceramic, lithium disilicate and zirconium implant-supported crowns in the first lower premolar. The dental implant was made of titanium grade 5 based on the Bolt® model of UniDentalDirect with internal grooved connection (18 grooves) and the implant had a size of 11,0 x 4,5 mm, preformed abutment and integrated screw. The three designs had vertical and oblique (45°) forces applications at 500 N. The geometric modeling was performed with the SolidWorks® 2017 program and the results were obtained through the Von mises analysis using the CosmoWorks®2017 program. RESULTS: The lowest value of maximum stress on crown level, under vertical and oblique forces, was found in the lithium disilicate crown with 21,9 MPa and 33,2 MPa, and with a minimum difference with the zirconium crown with 22,1 MPa and 35,1 MPa; on the abutment level, the zirconium crown had the lowest value of maximum stress with 18,6 MPa and 28,1 MPa; at the screw level, there were no significant differences. CONCLUSION: Metal-ceramic, lithium disilicate, and zirconia crowns proved to be materials of good compressive and tensile strength, but it was concluded that the zirconia crown design generated lower overall stress.
RESUMO
Studies have suggested that total energy intake and diet composition affect lifespan and ageing. A high-fat diet induces oxidative stress and affects the development of diseases. In contrast, antioxidants are capable of reducing its harmful effects. Yerba mate beverages are an important source of antioxidants, but there is scarce knowledge about their effects on suppressing fat accumulation. Here, we investigated the compounds present in yerba mate extracts and assessed their effects on Drosophila melanogaster given a high cholesterol diet. LS-ESI-MS analysis showed the presence of matesaponins, phenolic compounds and methylxanthines in all of the examined extracts. In Drosophila, under extract treatment conditions, the mean lifespan was significantly extended from 38 to 43 days, there was an increase in the ability to support induced stress and decrease in lipid peroxidation products. Moreover, yerba mate extracts recovered the glutathione S-transferases (GST) activity and reduced the cholesterol level. Taken together, our results support that extracts can extend lifespan by reducing the detrimental effect of a high-fat diet in D. melanogaster, and this outcome can be associated with the compound content in the extracts. This study improves the understanding of natural interventions that reduce stress-induced oxidative damage, which is fundamental in promoting healthy ageing.
Assuntos
Animais , Extratos Vegetais/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Ilex paraguariensis/química , Drosophila melanogaster/fisiologia , Longevidade/efeitos dos fármacos , Antioxidantes/farmacologia , Estresse Oxidativo/fisiologia , Drosophila melanogaster/crescimento & desenvolvimento , Dieta Hiperlipídica , Longevidade/fisiologiaRESUMO
Sida tuberculata (Malvaceae) is a medicinal plant traditionally used in Brazil as an antimicrobial and anti-inflammatory agent. Here, we aimed to investigate the different extractive techniques on phytochemical parameters, as well as to evaluate the toxicity and antioxidant capacity of S. tuberculata extracts using in silico and in vitro models. Therefore, in order to determine the dry residue content and the main compound 20-hydroxyecdysone (20E) concentration, extracts from leaves and roots were prepared testing ethanol and water in different proportions. Extracts were then assessed by Artemia salina lethality test, and toxicity prediction of 20E was estimated. Antioxidant activity was performed by DPPH and ABTS radical scavenger assays, ferric reducing power assay, nitrogen derivative scavenger, deoxyribose degradation, and TBARS assays. HPLC evaluation detected 20E as main compound in leaves and roots. Percolation method showed the highest concentrations of 20E (0.134 and 0.096 mg/mL of extract for leaves and roots, respectively). All crude extracts presented low toxic potential on A. salina (LD50 >1000 µg/mL). The computational evaluation of 20E showed a low toxicity prediction. For in vitro antioxidant tests, hydroethanolic extracts of leaves were most effective compared to roots. In addition, hydroethanolic extracts presented a higher IC50 antioxidant than aqueous extracts. TBARS formation was prevented by leaves hydroethanolic extract from 0.015 and 0.03 mg/mL and for roots from 0.03 and 0.3 mg/mL on egg yolk and rat tissue, respectively (P<0.05). These findings suggest that S. tuberculata extracts are a considerable source of ecdysteroids and possesses a significant antioxidant property with low toxic potential.
Assuntos
Animais , Masculino , Extratos Vegetais/química , Malvaceae/química , Antioxidantes/química , Simulação por Computador , Extratos Vegetais/toxicidade , Cromatografia Líquida de Alta Pressão/métodos , Ratos Wistar , Testes de Toxicidade , Raízes de Plantas/química , Folhas de Planta/química , Malvaceae/toxicidade , Ecdisterona/toxicidade , Antioxidantes/toxicidadeRESUMO
Recurrent upper abdominal pain is a condition that requires clinical capabilities for treatment, because its diagnosis has a wide spectrum, going from functional pathologies to potentially lethal diseases. Occasionally, the gastroenterologist sees patients that have already gone upper endoscopic procedure and Computed Tomography. Correct clinical assessment is key for diagnosis with an appropriate characterization of the symptoms and systematic exploration of the alarm signs. Reliability of the tests performed must be reviewed. Among the etiologies, the clinician must consider functional conditions, biliar lithiasis, food allergies, abdominal wall pain, metabolic disorders and secondary to drugs.
El dolor abdominal alto recurrente es un cuadro que exige habilidades clínicas, dado que el diagnóstico diferencial es amplio, desde patologías funcionales, hasta enfermedades graves potencialmente letales. Ocasionalmente, el gastroenterólogo es consultado por pacientes que han sido estudiados con endoscopía alta y tomografía computada. La correcta evaluación clínica es clave para orientar el diagnóstico con una adecuada caracterización del síntoma y la exploración sistemática de signos de alarma. Se debe revisar la confiabilidad de los exámenes realizados. Dentro de las etiologías, el médico debe considerar cuadros funcionales, litiasis biliar, alergias alimentarias, dolor originado en la pared abdominal, trastornos metabólicos y secundarios a drogas.
Assuntos
Humanos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Dor Crônica , Diagnóstico Diferencial , RecidivaRESUMO
Cytomegalovirus (CMV) is considered an agent involved in reactivation of inflammatory bowel disease (IBD). In our country there are no studies or guidelines to standardize CMV search in that setting. Objective: To describe the prevalence of CMV infection in hospitalized patients with IBD. Methods: Retrospective analysis of patients hospitalized due to IBD crisis from June 2007 to June 2009 at a university health center. Electronic cards, laboratory data, and endoscopic study were reviewed. CMV reactivation was diagnosed by means of antigenemia assay, and/or histopathology. Results: 88 IBD crises were identified (74 patients), in 52 a CMV study was requested (47 with antigenemia assay). Mean age was 38.5 years-old, 54 percent female, ulcerative colitis 67.3 percent, Crohn disease 32.7 percent. IBD crisis were classified as follows; severe 57.7 percent, moderate or mild 42.3 percent. The CMV diagnosis test was positive in 5 cases (9.6 percent), all of them were severe crisis (16.6 percent in severe crisis versus 0 percent in moderate/mild crisis, p = 0.055). In the group of steroid resistant disease the CMV antigenemia was positive in 66.6 percent versus 2.17 percent of non-steroid resistant patients (p = 0.0002). Test to detect CMV performed after the third day of hospitalization were positive in 36.36 percent versus those performed earlier, which were positive in 2.43 percent (p = 0.004). Conclusion: High prevalence of CMV infection in cases of severe IBD crisis was detected, specifically in a subgroup of steroid-resistant patients and three days after hospital admission. These findings suggest the importance to search CMV in this subgroup of patients.
Introducción: El citomegalovirus (CMV) puede participar en la reactivación de la enfermedad inflamatoria intestinal (EII). En nuestro medio no se ha estudiado el rol de CMV en pacientes hospitalizados por crisis de EII. Objetivo: Estimar la prevalencia de la reactivación de CMV en crisis de EII que requirieron hospitalización. Métodos: Análisis retrospectivo de pacientes hospitalizados en un centro de salud universitario por EII entre junio de 2007 y junio de 2009. Se revisaron registros clínicos electrónicos, laboratorio y estudio endoscópico. La reactivación de CMV se diagnosticó mediante antigenemia y/o histología. Resultados: Se identificaron 88 crisis de EII (74 pacientes), en 52 se solicitó estudio de CMV (47 con antigenemia). 67,3 por ciento fueron colitis ulcerosa; 32,7 por ciento enfermedad de Crohn. Edad promedio 38,5 años, 54 por ciento sexo femenino. La exacerbación fue catalogada como grave en 57,7 por ciento de los casos, moderada o leve en 42,3 por ciento. Se detectó reactivación de CMV en 5 pacientes (9,6 por ciento), los que se caracterizaron por presentar crisis grave (16,6 por ciento en crisis grave versus 0 por ciento en crisis leve/moderada, p = 0,055), refractariedad a corticoides (66,6 por ciento en corticorrefractarios versus 2,17 por ciento en sensibles a corticoides, p = 0,0002) y hospitalización mayor de 3 días (36,36 por ciento en hospitalización > 3 días versus 2,43 por ciento en estudio temprano, p = 0,004). Conclusión: En pacientes hospitalizados por crisis de EII es frecuente detectar evidencia de reactivación de CMV, la que se concentra en las crisis graves, corticorrefractarias y con hospitalización mayor de 3 días. Estos datos sugieren que la búsqueda de CMV debiera ser dirigida a este subgrupo de pacientes.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Citomegalovirus/fisiologia , Doenças Inflamatórias Intestinais/complicações , Infecções por Citomegalovirus/epidemiologia , Colite Ulcerativa/complicações , Doença de Crohn/complicações , Doenças Inflamatórias Intestinais/virologia , Prevalência , Recidiva , Estudos Retrospectivos , Fatores de Risco , Ativação ViralRESUMO
Omega and unusual fatty acids were evaluated from ethanol extracts of roots and leaves ofPlukenetia volúbilis L. were evaluated. Seed oil was obtained by soxhlet and bioreactor; the fatty acids were determined and characterized by gas chromatography coupled to mass spectrometry (GLC-MS). Also, antioxidant activity was evaluated using ABTS/HRP enzymatic. Fatty acid in seed oil was beyond 80%. Meanwhile, the main unusually fatty acids in leaves and roots are ciclopropenic acids. The phytocompounds, omega and functional fatty acids could be responsible for the lipophilic antioxidant activity in leaves.
A partir de extractos etanólicos de hojas y raíces de Plukenetia volúbilis L, se evaluó la presencia de ácidos grasos omega (FAc) y funcionales. El aceite de las semillas de la planta, extraído por Soxhlet y a través de un biorreactor, fue caracterizado físicamente, se le determinó el perfil lipídico mediante cromatografía de gases acoplada a espectrometría de masas (CG-EM) y, se evaluó el potencial antioxidante (ABTS-HRP). El análisis dejó ver que el aceite del vegetal contiene ácidos grasos poliinsaturados en una proporción mayor al 80%. Los extractos de hojas y raíces mostraron principalmente ácidos de tipo ciclo-propénico. Tanto los fitocompuestos como los ácidos grasos omega y funcionales parecen estar asociados con la actividad antioxidante de las hojas.
Assuntos
Arachis , Fenômenos Químicos , Ácidos Graxos , AntioxidantesRESUMO
O presente trabalho teve como objetivo fazer uma análise comparativa da qualidade de preparações extrativas obtidas de Passiflora alata Curtis, além de descrever esse processo. O extrato líquido foi obtido por refluxo utilizando água como solvente em proporção 1:10. A preparação líquida foi submetida à secagem em spray dryer utilizando aerosil® e fosfato de cálcio como adjuvantes tecnológicos. A eficiência de extração foi avaliada através da determinação do resíduo seco e do teor de flavonoides totais por técnica de espectrofotometria no UV. O extrato seco foi avaliado quanto à viabilidade tecnológica a partir da determinação das características de granulometria e da estabilidade em ambientes de umidade relativa controlada. O teor de flavonoides totais para o extrato seco apresentou redução quando comparado à solução extrativa, indicando possível influência do processo de secagem na composição do material. Os resultados de caracterização tecnológica demonstraram que o processo de secagem utilizado garante uma uniformidade de tamanho particular, embora seja observada uma tendência de higroscopicidade do material em ambientes de elevada umidade relativa. As técnicas empregadas se mostraram viáveis para uso em ensaios quali-quantitativos aplicados à determinação da qualidade dos extratos desenvolvidos.
This paper describes a process to prepare liquid and dried aqueous extracts from aerial parts of Passiflora alata Curtis (sweet passionfruit) and reports a comparative analysis of the extractive preparations obtained. The extractive solution was obtained by refluxing the plant material with water in the proportion 1:10 (w/v). The aqueous extract was dried in a spray-dryer, with Aerosil® and calcium phosphate as processing aids. The extraction efficiency was assessed by weighing the dry residue and assaying the total flavonoid content by UV spectrophotometry. The particle size and hygroscopicity of the spray-dried powder were determined in order to assess its technological viability. In the solid state, the total flavonoid content was reduced, relative to the aqueous extract, which indicates a possible influence of the drying process on its composition. The technological characterization demonstrated that this drying process leads to particle size uniformity, though a tendency to hygroscopicity can be observed under conditions of high relative humidity. The analytical techniques employed proved to be viable for qualitative and quantitative assays used for quality control of the extracts developed in this study.
Assuntos
Flavonoides/farmacologia , Passiflora , Plantas MedicinaisRESUMO
Subepithelial lesions are a frequent finding in the upper gatrointestinal tract. Endoscopic ultrasound (EUS) is the preferred procedure to characterize these lesions, but in case of a hypoechogenic image, this technique does not differentiate between leiomyoma and a potentially malignant gastrointestinal stromal tumor (GIST). The diagnosis is determined by histological study and immunohistochemistry (IHC), but endoscopic sampling and EUS-guided techniques have efficiency below 60 percent. Objective: To assess the performance of submucous resection and Jumbo biopsy forceps technique, to access esophageal subepithelial lesions and sampling for histology and IHC. Methods: Endosonographic assessment of the subepithelial lesion. Biopsy samples of tissue were obtained with Jumbo biopsy forceps for histology and IHC. Results: Seven patients were evaluated. Age: 54.8 years (range 32-69), 5 esophageal lesions and 2 gastric lesions, maximum diameter of 15.6 mm (range 10-20). The procedure was successful in all patients, no complications were seen. Histology showed that all esophageal lesions were leiomyomas, CD 117 and CD 34 were negative in the selected patients (4 of 4). Gastric lesions corresponded to a heterotopic pancreas and one GIST with positive reaction to CD 117 and CD 34. Discussion: The described technique is useful to obtain histology and IHC diagnosis of esophageal subepithelial lesions. Prospective studies are necessary to compare these techniques with EUS-guided techniques.
Las lesiones subepiteliales son un hallazgo frecuente en el tubo digestivo alto. La ultrasonografía endoscópica (USE) es el examen de elección para caracterizarlas, pero frente a una imagen hipoecogénica no diferencia entre un leiomioma y un tumor estromal gastrointestinal (GIST) potencialmente maligno. El diagnóstico se establece con estudio histológico e inmunohistoquímica (IHQ) pero la obtención de muestra por vía endoscópica y las técnicas guiadas por USE tienen un rendimiento que no supera el 60 por ciento. Objetivo: Evaluar el rendimiento de la técnica de incisión submucosa y biopsia con pinza jumbo, para acceso a lesiones subepiteliales esofágicas o gástrricas y obtención de muestras para estudio histológico e IHQ. Métodos: Se realiza evaluación endosonográfica de la lesión subepitelial seguido de incisión de mucosa y submucosa con papilótomo de punta para acceso a la lesión. Se toman muestras de tejido con pinza Jumbo, para estudio histológico e IHQ. Resultados: Se evaluaron 7 pacientes, edad 54,8 años (32-69), 5 lesiones esofágicas y 2 gástricas, diámetro máximo de 15,6 mm (rango 10-20). El procedimiento fue exitoso en todos los pacientes, sin complicaciones. En el estudio histológico todas las lesiones esofágicas correspondieron a leiomiomas, CD 117 y Cd 34 negativo en los pacientes en que fue solicitado (4 de 4). Las lesiones gástricas correspondieron a un páncreas heterotópico y un GIST con reacción positiva para CD 117 y CD 34. Discusión: La técnica descrita es útil para obtener diagnóstico histológico e IHQ de lesiones esofagogástricas subepiteliales. Estudios prospectivos son necesarios para compararlas con técnicas guiadas por USE.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Leiomioma/patologia , Leiomioma , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal , Biópsia , Endoscopia Gastrointestinal , Endossonografia , Imuno-Histoquímica , Mucosa Gástrica/patologia , Mucosa Gástrica , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas , Neoplasias Gastrointestinais/patologia , Neoplasias GastrointestinaisRESUMO
DRESS syndrome is an infrequent adverse drug reaction but in some cases may be life-threatening. It is characterized by cutaneous rash, systemic symptoms and eosinophilia. It is usually caused by aromatic anticonvulsants, sulfonamides and some antiviral drugs, among others. In this article we present two cases of drug induced hypersensitivity syndrome with rash, systemic symptoms (DRESS) associated to lamotrigine therapy with hepatic involvement and a review of the literature. The first case is a 78 year-old woman, presenting with myalgia, fever, abdominal pain and skin rash on her face and extremities. Labora¬tory tests revealed alteration of hepatic profile with hepatocellular pattern. After ruling out other causes, she recognized recent use of lamotrigine. The drug was withdrawn and she had a favourable evolution. The second case is a 30 year-old woman being treated for depression who presented with rash, adenopathies, fever and alteration of hepatic profile twenty four days after starting lamotrigine. Infectious causes were ruled out and she had a good response to corticosteroid treatment.
El síndrome de DRESS es una reacción adversa a medicamentos, poco frecuente pero potencialmente letal. Se caracteriza por eritema cutáneo, síntomas sistémicos y eosinofilia. Suele ser producido por los anticonvulsivantes aromáticos, sulfonamidas y algunos fármacos antivirales, entre otros. En este artículo presentamos dos casos de DRESS secundario a lamotrigina con compromiso hepático y revisión de la literatura. El primero de ellos, una mujer de 78 años, consulta por mialgias, fiebre, dolor abdominal y eritema maculopapular en cara y extremidades. Los exámenes de laboratorio revelaron alteración de pruebas de función hepática con patrón hepatocelular. Luego de descartar otras causas, la paciente reconoció uso reciente de lamotrigina. Se suspendió la droga y evolucionó favorablemente. El segundo caso es una mujer de 30 años en tratamiento por trastorno depresivo quien, veinticuatro días post-inicio de lamotrigina, comienza con eritema, adenopatías, fiebre y alteración de pruebas de función hepática, excluyéndose etiologías infecciosas; se inicia tratamiento corticoesteroidal con buena respuesta.
Assuntos
Humanos , Feminino , Adulto , Idoso , Anticonvulsivantes/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Triazinas/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Eritema/induzido quimicamente , Toxidermias/etiologia , Febre/induzido quimicamente , Testes de Função Hepática , SíndromeRESUMO
Introducción: en esta 2ª parte se presentan los aprendizajes que alcanzaron los alumnos de tres especialidades del Plan Único de Especialización en Enfermería (PUEE); Cultura física y deporte; Neurológica y Salud mental; desde la opinión de los egresados; en la idea de identificar el impacto que tienen los procesos de formación en este nivel. En un artículo previo; se presentaron los casos de las especialidades de Enfermería en Salud Pública; Perinatal; Cardiovascular e Infantil. Objetivo: identificar los aprendizajes que se consolidan en los alumnos de las especialidades de Enfermería del PUEE; desde la perspectiva del egresado. Metodología: estudio descriptivo; longitudinal que abarca tres cohortes generacionales de alumnos 2006; 2007 y 2008; que cursaron las especialidades mencionadas dentro del PUEE. Se aplicó un cuestionario de preguntas abiertas; con carácter anónimo; aplicado al concluir los estudios de la especialidad. El instrumento analiza: los conocimientos y habilidades fundamentales que proporcionó la especialidad; los conocimientos más relevantes que propiciaron los espacios de prácticas y la opinión que tienen los egresados respecto a recomendar a otras personas el estudio de la especialidad. Resultados: los resultados obtenidos; se analizaron y agruparon en cuadros; a partir del mayor consenso mostrado Discusión: existen aspectos constantes en el aprendizaje y la formación de las diversas especialidades y cohortes generacionales; así como diferencias que se observan de manera más clara en la especialidad de Enfermería en Salud Mental. Las diferencias pueden atribuirse a las características diversas que reúne cada grupo y que lleva a los docentes a realizar ajustes en su enseñanza; ponderando unos aspectos sobre otros; sin que esto implique perder de vista el referente curricular.
Introduction: in order to identify the impacts of the academic forming proceses from the opinion of the graduates, in this 2nd part, we show the learning objectives reached by alumni enrolled in other specialization studies of the Nursing Specialization Unique Plan. In the previous part, we showed the results corresponding to the nursing specialization studies in Public Health, Perinatal, Cardiovascular and Pediatric. Objetive: identify the consolidated learning in the alumni enrolled in the specialization studies of the Nursing Specialization Unique Plan, from the perspective of its graduates. Methodology: descriptive and longitudinal study corresponding to the 2006, 2007 and 2008 alumni generations enrolled in differente specialization studies of the Nursing Specialization Unique Plan. After finishing their nursing specialization studies, graduates were given an anon ymous open question survey to analyze their knowledge and skills, including those acquired from clinical practice, and to explore their opinions about recommending other nurses these specialization studies. Results: results were classified into different levels of consensus. Discussion: related to the learning processes we found constant issues, but also varying differences. This last was more apparent in the Mental Health nursing specialization. Differences can be attributed to the groups specific characteristics which simultaneously encourage professors adjusted their teaching protocols according ly but within the Nursing Speciliaztion Unique Plan curriculum.
Assuntos
Humanos , Masculino , Feminino , Aprendizagem , Especialização , Saúde MentalRESUMO
Con el objetivo de conocer las principales característicasepidemiológicas de la mortalidad por suicidio en el Uruguay,se realizó un estudio descriptivo. Uruguay se ubicó en elprimer tercio de los países con las tasas de suicidio máselevadas del mundo, en el tercer lugar de América y en elprimero de Sudamérica. Presentó para el año 2000 unatasa del 18.76 por cien mil, ocurriendo un promedio de 1.7suicidios por día, representando la novena causa de muerte.Las tasas más elevadas se presentaron en el sexo masculino;entre divorciados/as y viudos/as y el método más usadofue el disparo por arma de fuego. Para el Departamento deMontevideo, el promedio de AVPP por suicidio fue de 28 y29 años para el sexo femenino y masculino respectivamente,se destaca las mayores tasas en el nivel de instrucciónterciaria, en desocupados y jubilados; y en nivelessocioeconómicos medios o bajos. El suicidio es consideradoun problema de Salud Pública.
Assuntos
Humanos , Saúde Pública , Suicídio , Suicídio/estatística & dados numéricos , MortalidadeRESUMO
Presentamos el caso de un hombre de 61años ingresado al servicio de urgencia por hematemesis y síncope. Previamente había sido tratado por cáncer anal espinocelular sin evidenciade recidiva. Al examen físico destacaba palidez, taquicardia y sudoración. Se realizó endoscopia alta que evidenció lesiones no significativas. El paciente evolucionó con shock hipovolémico y coagulación intravascular diseminada.La tomografía computarizada de abdomen demostró líquido libre intrabdominal y tumor hepático con signos de ruptura. Se realizó laparotomía de urgencia, posteriormente se efectuó embolización selectiva de arteria hepática derecha con buen resultado clínico. La biopsia del tumor hepático resultó compatible con metástasis de cáncer anal espinocelular.
A 61 years old man was admitted in emergency room by syncope and hematemesis. He has been treated by spinocellular carcinoma of the anus without evidence of relapse. At physical examination pallor, sweet and tachycardia, were observed. Upper endoscopy showed no significant lesions. The patient progressed to a hypovolemic shock and intravascular disseminated coagulation. The Abdominal CT revealed massive hemoperitoneum and a single hepatic mass with signs of rupture. The initial treatment was emergency surgery. In a second time selective hepatic artery embolization was done with successful clinical outcome. Biopsy o the liver tumor revealed hepatic metastasis of anal cancer.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/patologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Neoplasias do Ânus/patologia , Ruptura Espontânea/etiologia , Embolização Terapêutica , Hemoperitônio/etiologia , Hemoperitônio/terapia , Laparotomia , Ruptura Espontânea/terapiaRESUMO
La unidad morfológica y funcional de la glándula tiroides es el folículo, estructura ovoide cerrada, constituida por una capa de células cúbicas (tirocitos) que encierran un lumen lleno del coloide secretado por ellas. En cultivo, tanto la estructura como la función del folículo se pierden rápidamente en las primeras 24 horas. Sin embargo, si se cultivan folículos cerrados de tiroides de rata conservan la arquitectura folicular, la morfología del tirocito y la función hasta la síntesis de hormonas tiroides de manera similar a la glándula in vivo. En este trabajo describimos el aislamiento y cultivo de folículos porcinos cerrados y su análisis morfológico. Los folículos se aíslan por digestión enzimática y disociación mecánica del parénquima tiroideo, luego se cultivan sobre agarosa con y sin hormona tirotrópica o tirotropina (1 mU/ml, TSH). El tejido de tiroides porcino obtenido tiene las mismas características de una glándula hipotiroidea in vivo, un epitelio casi plano, retículo endoplásmico rugoso (RER) exiguo, complejo de Golgi (CG), y microvellosidades escasas y cortas. Los folículos cultivados sin TSH conservan la forma ovoide y el coloide en su interior, y la misma ultra-estructura del tejido in vivo, RER y CG muy escasos, pero con el tiempo de cultivo aumenta la longitud de la microvellosidades y el espesor del epitelio. En presencia de TSH el epitelio se hipertrofia desde el primer día y las cavidades foliculares se reducen considerablemente. Se demuestra que folículos cerrados de tiroides durante ocho días (d) de cultivo conservan su morfología con y sin TSH. Además, estos responden al estímulo de TSH disminuyendo su cavidad folicular y aumentando el espesor del epitelio folicular.
The morphological and functional unit of the thyroid gland is the follicle - an ovoid closed-structure, constituted by a layer of cubical cells (thyrocytes) that lock up a full lumen of the colloid secreted by themselves. In culture, the structures as well as the function of the follicles are lost rapidly in the first 24 hours. However, if the rat thyroid follicles closed are seeded since the beginning of the culture, these conserve the follicular structure, the thyrocyte morphology and the function even as the thyroid hormone synthesis in a similar way to the gland in vivo. This work describes the isolation and the culture of closed swine thyroid follicles and its morphological analysis. The follicles are isolated by enzymatic and mechanic digestion of the thyroid, then they are cultured in agarose with and without thyrotropin (1 mU/ml, TSH). The swine thyroid tissue obtained has the same characteristics of an in vivo hypothyroid gland, an almost flat epithelium, low quantity of Rough Endoplasmic Reticulum (RER) and Golgi complex (GC), short and very scarce microvillus. The isolated and closed follicles cultivated without TSH preserve the ovoid form and the colloid in the lumen, and the same ultrastructure of the thyroid tissue in vivo, RER and GC, but the length of the microvillus as well as the thickness of the epithelium were increased with the culture time. In the presence of TSH the thickness of the epithelium increases from the first day and the follicular cavities reduce considerably. The isolated and closed follicles preserve their morphology in the long term (8 days) of culture with and without the TSH. Besides, they responded to the stimulus of the TSH reducing the follicular cavity.
RESUMO
Introducción, identificar los aprendizajes que las alumnas adquieren en su trayecto de formación como enfermeras especialistas, es una manera de reconocer el impacto que tienen los procesos de formación de recursos humanos que se llevan a cabo a través del Plan Único de Especialización en Enfermería (PUEE). Objetivo, Identificar los aprendizajes que se consolidan en los alumnos que transitan por el PUEE, en sus diversas ramas a su egreso. Metodología, estudio descriptivo longitudinal que abarca tres cohortes generacionales de alumnos 2006, 2007 y 2008- que cursaron alguna especialidad de enfermería dentro del PUEE. Se aplicó un cuestionario de preguntas abiertas, con carácter anónimo en el que se interrogó a los alumnos, sobre los principales conocimientos y habilidades que fueron desarrollados en la especialidad, las bondades y debilidades que estuvieron presentes en las sedes de prácticas y la recomendación del estudio de la especialidad a sus conocidos. Resultados se presentan cuadros que concentran las respuestas de mayor frecuencia, considerando los rubros mencionados. Discusión los resultados muestran en todos los casos puntos de encuentro a los largo de las tres generaciones, respecto a los conocimientos y habilidades que fueron adquiridos. Los aprendizajes señalados se vinculan con los propósitos curriculares del PUEE. Conclusiones. La presencia de aprendizajes específicos que son significativos para alguna cohorte generacional en particular, puede explicarse como aspectos sobre los que los tutores y docentes, así como la sede de prácticas, tuvieron oportunidad de hacer énfasis en la generación en turno.
Introduction: Identify students learning during their schooling in nursing special fields; it is useful to recognize the influence of the training process in the Plan Único de Especialización en Enfermería (PUEE).Objective: Identify learning students acquire while enrolled in PUEE, in its several special fields, until the end of their studies. Methodology: a longitudinal and descriptive study, over three generations of students 2006, 2007 and 2008- that studied some nursing special field in PUEE. An anonymous, open questions questionnaire was applied to the students who were asked about main knowledge and skills they developed during the special course, the assets and weaknesses they found at the practice facilities and if they would recommend to someone going through the special course. Results: concentrated answers are presented, according to their frequency about the mentioned aspects. Argument: the results show, in every case, points of agreement throughout generations, regarding the knowledge and skills that were acquired. Included learning are related with curricular objectives of the PUEE. Conclusions: specific learning that are meaningful for some specific generation can be explained as being topics that counselors, teachers and the practice facilities, had a chance to focus on in that generation
Assuntos
Humanos , Masculino , Feminino , Aprendizagem , Enfermagem , EspecializaçãoRESUMO
La resistencia antimicrobiana es codificada por algunos elementos genéticos que generan un flujo horizontal, particularmente, en ambientes que están sometidos a una fuerte presión selectiva, como ocurre en el ambiente hospitalario. En tal sentido, los bacilos gramnegativos, en el último tiempo, han cobrado importancia como agentes de infección nosocomial. Objetivo. Investigar la presencia de integrones en aislados clínicos de bacilos gramnegativos y su relación con el fenotipo de resistencia, Material y Métodos. Se analizaron 88 aislados clínicos de distintos servicios del Hospital Torres Galdames, durante el período: junio a diciembre de 2004. Fueron identificadas de acuerdo con su perfil bioquímico y se determinó la susceptibilidad a antimicrobianos mediante el método de difusión en agar. La presencia de integrones se detectó mediante RPC. Se realizó un análisis de cluster para estudiar la relación entre el fenotipo de resistencia y la presencia de integrones. Las cepas fueron genotipificadas mediante ERIC-PCR. Resultados. Dieciocho por ciento de las cepas aisladas correspondió a Proteus mirabilis, 17 por ciento a Escherichia coli y 32 por ciento a bacilos gramnegativos no fermentadores. La mayoría de los aislados presentó una elevada resistencia a los antimicrobianos evaluados: ampicilina 83 por ciento, cefalotina 82 por ciento, ceftriaxona 82 por ciento, ciprofloxacina 81 por ciento, gentamicina 81 por ciento y cotrimoxazol 82 por ciento. De las 88 cepas, 75 por ciento presentó integrones, siendo más común la clase 2. Los resultados del análisis de cluster no revelaron una clara relación entre la presencia de éstos y el perfil de resistencia para los antimicrobianos ensayados. Con la información disponible no fue posible relacionar la presencia de integrones con un determinado patrón de resistencia. Los patrones de bandas obtenidos con la técnica de ERIC-PCR revelaron una gran variedad genética entre las cepas analizadas, definiendo...
The antimicrobial resistance is coded in genetic elements which generate a horizontal flow of information, particularly in conditions that are under strong selective pressure like the nosocomial environment. In that sense, in the last decades, gram negative bacilli have become important agents of nosocomial infection. In order to investigate the presence of integrons among clinical isolates of gram negative bacilli and their relationship with their resistance profile, we studied 88 strains isolated from clinical specimens of different wards of the Hospital Torres Galdames, during the June-December period, 2004. They were identified according to biochemical tests. The antimicrobial susceptibility was evaluated by agar diffusion method. The integron presence was investigated by polymerase chain reaction (PCR). A cluster analysis was carried out to study the relationship between the presence of integrons and the resistance profile. The genotyping of the isolates was carried out by ERIC-PCR technique. Results: Of the isolated strains, 18 percent corresponded to Proteus mirabilis, 17 percent to Escherichia coli, and 32 percent to Non Fermentative Gram Negative bacilli. Most isolates presented high resistance to the antibiotics studied: 83 percent to ampicillin, 85 percent to cephalotin, 82 percent to ceftriaxone, 82 percent to ciprofloxacin, 81 percent to gentamycin and 82 percent to cotrimoxazole. Seventy-five percent of the 88 strains presented integrons. Class 2 integrons were found to be the most common. The results of the cluster analysis did not show a clear relationship among the presence of the integrons and the resistance profile. With the available information it is not possible to relate the integron presence with a certain resistance pattern. The patterns of bands obtained with the technique ERIC-PCR revealed a great genetic variety among the analyzed isolations, defining diverse genotypes, distributed in the different services...