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2.
Artigo em Inglês | MEDLINE | ID: mdl-37938921

RESUMO

Simultaneous bilateral quadriceps tendon ruptures are a rare occurrence commonly associated with a traumatic event or systemic disease. A 31-year-old man presented with simultaneous bilateral quadriceps tendon ruptures with associated hyperparathyroidism secondary to parathyroid carcinoma. The injury occurred after the patient attempted to lift a small wooden log from the ground. We discussed the multidisciplinary management of this patient resulting in bilateral quadriceps tendon repairs, tumor resection, and oncological and endocrinological restoration. Clinical follow-up is reported at 15 years after surgery. Parathyroid carcinoma is an extremely rare cancer and rarely the cause of hyperparathyroidism. The systemic effects of the tumor eventually lead to the rupturing of both quadriceps tendons. Orthopaedic physicians must remain vigilant in identifying the root cause of injuries that are atypical in nature.


Assuntos
Hiperparatireoidismo Secundário , Neoplasias das Paratireoides , Traumatismos dos Tendões , Masculino , Humanos , Adulto , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Ruptura/cirurgia , Ruptura/complicações , Tendões , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/cirurgia , Hiperparatireoidismo Secundário/complicações
3.
Rev Colomb Anestesiol ; 51(1)2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-37904840

RESUMO

Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.


Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organizacion Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

4.
Rev. cuba. med. mil ; 52(1)mar. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1521959

RESUMO

Introducción: La pandemia afectó el internado de estudiantes de salud en su asistencia hospitalaria, en la cual realizan las prácticas. Objetivo: Determinar los factores asociados a la percepción de repercusiones del internado hospitalario peruano durante la COVID-19. Métodos: Estudio transversal; se obtuvo estadística descriptiva, analítica bivariada y multivariada basado en una encuesta realizada de forma exploratoria, como parte de otra investigación mayor, a la cual se le asoció variables como edad, sexo, tipo de universidad, estrés, ansiedad, depresión y repercusiones del internado. Resultados: De los 121 encuestados, la mayoría pensó que su familia le hubiese apoyado si se enfermaba de gravedad, que pudo haber infectado a sus familiares o alguna amistad/conocido si acudían al hospital. Muchos estuvieron en desacuerdo con que el hospital o la universidad les darían los implementos de seguridad, por la falta de apoyo de estas entidades. Hubo asociación entre el pensar que se habría contagiado de la COVID-19 si iba al hospital versus el puntaje de ansiedad (p= 0,030), el sexo masculino, según la percepción de que la universidad les daría los materiales para cuidarse (p= 0,029) y el provenir de una universidad privada según el percibir que el hospital no le hubiese apoyado, si se enfermaba de gravedad (p= 0,049). Conclusión: Los factores asociados a la percepción de repercusiones del internado son el apoyo familiar, el poder contagiar a sus familiares, falta de materiales dados por las universidades y hospitales, la ansiedad, el sexo masculino y provenir de universidades privadas.


Introduction: The pandemic affected the internship of health sciences students when they attended the hospital. Objective: To determine the factors associated with the perceived impact of the Peruvian hospital internship during COVID-19. Methods: Cross-sectional; descriptive, bivariate analytical and multivariate statistics were obtained based on an exploratory survey conducted as part of a larger investigation, to which variables such as age, sex, type of university, stress, anxiety, depression, and repercussions of the internship were associated. Results: Of 121 respondents, most of them thought that family would have supported if they have gotten a severe disease. Also, they thought that they could have infected their families or friends/acquaintances if they have gone to the hospital. Many of them disagreed on the statement about the hospital or university providing them safety implements. There was an association between thinking that they could have gotten COVID-19 if they have gone to the hospital versus anxiety score (p= 0,030), being a male according to the perception that the university provided materials to take care of themselves (p= 0,029), and having studied in a private university according to perceiving that the hospital would not have supported them if they have gotten seriously ill (p= 0,049). Conclusion: The factors associated with the perception of repercussions of the boarding school are family support, being able to infect their acquaintances, lack of materials provided by universities and hospitals, anxiety, being male, and coming from private universities.

5.
Rev. colomb. anestesiol ; 51(1): 30, Jan.-Mar. 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1431763

RESUMO

Abstract Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.


Resumen Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organización Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

6.
J Surg Res ; 283: 127-136, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36403406

RESUMO

INTRODUCTION: The Lancet Commission on Global Surgery indicators for monitoring anesthetic and surgical care allow the identification of access barriers, evaluate the safety of surgeries, facilitate planning, and assess changes over time. The primary objective was to measure these indicators in all health facilities of a Peruvian region in 2020. METHODS: This was an ambispective observational study to measure the anesthetic and surgical care indicators in Piura, a region in Peru, between January 2020 and June 2021. Public and private health facilities in the Piura region that performed surgical care or had specialists from any surgical specialty participated in the study. Data were collected from all regional health facilities that provided surgical care to estimate the density of surgical workforce. Likewise, the percentage of the population with access to an operating room within 2 h was estimated using georeferenced tools. Finally, a public database was accessed to determine the surgical volume, the percentage of the regional population protected with health insurance. RESULTS: In 2020, 88.4% of the inhabitants of this Peruvian region had access to timely essential surgery. There were 18.4 surgical specialists and 1174 surgeries per 100,000 populations, and 91% of the population had health insurance. In addition, there was a rate of 2.1 working operating rooms per 100,000 inhabitants in 2021. CONCLUSIONS: This Peruvian region presented an increasing trend with respect to the population's access to essential and timely surgical care, and health insurance coverage. However, the workforce distribution was inequitable among the provinces of the region, the surgical volume was reduced, and timely access was hindered because of the SARS-CoV-2 pandemic.


Assuntos
Anestésicos , COVID-19 , Especialidades Cirúrgicas , Humanos , Peru , SARS-CoV-2 , Acessibilidade aos Serviços de Saúde
7.
Rev. colomb. anestesiol ; 50(4): e501, Oct.-Dec. 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1407955

RESUMO

Abstract The technical standards in anesthesiology govern the professional practice and allow for the provision of safer anesthesia and surgery. This article gives a historical perspective on the creation, main content, and consequences of the implementation of the Peruvian standards in anesthesiology.


Resumen Las normas técnicas de anestesiología rigen el ejercicio profesional y permiten ofrecer una anestesia y una cirugía más seguras. El presente artículo brinda una perspectiva histórica sobre la creación, el contenido principal y las consecuencias de la implementación de las normas de anestesiología peruanas.

8.
Molecules ; 27(19)2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36235158

RESUMO

The control of the duration of the dormancy phase is a significant challenge in the potato industry and for seed producers. However, the proteome landscape involved in the regulation of the length of the dormancy period over potato cultivars remains largely unexplored. In this study, we performed for the first time a comparative proteome profiling of potato cultivars with differential duration of tuber dormancy. More specifically, the proteome profiling of Agata, Kennebec and Agria commercial potato varieties with short, medium and medium-long dormancy, respectively, was assessed at the endodormancy stage using high-resolution two-dimensional electrophoresis (2-DE) coupled to reversed-phase liquid chromatography-tandem mass spectrometry (LC-TripleTOF MS/MS). A total of 11 proteins/isoforms with statistically significant differential abundance among cultivars were detected on 2-DE gels and confidently identified by LC-TripleTOF MS/MS. Identified proteins have known functions related to tuber development, sprouting and the oxylipins biosynthesis pathway. Fructokinase, a mitochondrial ADP/ATP carrier, catalase isozyme 2 and heat shock 70 kDa were the proteins with the strongest response to dormancy variations. To the best of our knowledge, this study reports the first candidate proteins underlying variable dormancy length in potato cultivars.


Assuntos
Solanum tuberosum , Difosfato de Adenosina/metabolismo , Trifosfato de Adenosina/metabolismo , Catalase/metabolismo , Frutoquinases/análise , Frutoquinases/metabolismo , Isoenzimas/metabolismo , Oxilipinas/metabolismo , Proteínas de Plantas/metabolismo , Tubérculos/química , Proteoma/metabolismo , Proteômica/métodos , Solanum tuberosum/química , Espectrometria de Massas em Tandem
9.
Rev. méd. hered ; 33(2): 133-138, abr.-jun. 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1409888

RESUMO

RESUMEN Se reporta el caso de una mujer quien a la edad de 54 años fue diagnosticada de leucemia mieloide crónica en fase crónica; inició tratamiento con inhibidor de tirosina cinasa de primera generación, y evidenció falla por ausencia de respuesta hematológica y citogenética. A pesar del cambio de tratamiento a un inhibidor de tirosina cinasa de segunda generación (dasatinib), no fue posible alcanzar niveles óptimos de respuesta, documentándose la positividad para la mutación T315I en dominio ABL de la tirosina cinasa desregulada BCR/ABL, frente a la cual el único medicamento que muestra actividad es ponatinib. Luego de iniciar tratamiento con ponatinib, se evidenciaron niveles óptimos de respuesta citogenética y molecular, así como una adecuada calidad de vida de la paciente.


SUMMARY We report the case of a woman who at the age of 54 years was diagnosed with chronic myeloid leukemia in chronic phase; she began treatment with a first-generation tyrosine kinase inhibitor, and evidenced failure due to the absence of a hematological and cytogenetic response. Despite changing treatment to a second-generation tyrosine kinase inhibitor (dasatinib), it was not possible to achieve optimal levels of response, documenting positivity for the T315I mutation in the ABL domain of the deregulated BCR/ABL tyrosine kinase, compared to ponatinib, the only drug that shows activity. After starting treatment with ponatinib, optimal levels of cytogenetic and molecular response were evidenced, as well as an adequate quality of life for the patient.

10.
Rev. mex. anestesiol ; 44(4): 300-304, oct.-dic. 2021. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1347757

RESUMO

Abstract: Introduction: Marfan syndrome is an inherited disorder that affects connective tissue. Case: We report the anesthetic management of a parturient with Marfan syndrome scheduled for an elective C-section. Successful use of a combined spinal-epidural technique was used to provide neuraxial anesthesia; however, she presented an unfavorable evolution due to maternal sepsis. Likewise, a literature review of combined spinal-epidural anesthesia for C-sections in Marfan syndrome pregnant women was performed. Conclusion: Anesthetic management of parturients affected by Marfan syndrome during the cesarean section can be challenging. Strict blood pressure control during the intraoperative period has cornerstone importance. Likewise, neuraxial techniques have a significant percentage of failure in these patients.


Resumen: Introducción: El síndrome de Marfan es un desorden hereditario que afecta el tejido conectivo. Caso: Reportamos el manejo anestésico de una parturienta con síndrome de Marfan programada para una cesárea electiva. Para administrar anestesia neuroaxial se utilizó un bloqueo combinado espinal-epidural; sin embargo, la paciente presentó una evolución desfavorable debido a sepsis materna. Asimismo, se realizó una revisión de la literatura del uso de esta técnica anestésica para cesárea en gestantes con síndrome de Marfan. Conclusión: El manejo anestésico de parturientas afectadas por este síndrome puede ser complicado. El control estricto de la presión arterial durante el intraoperatorio tiene importancia fundamental. Además, las técnicas neuroaxiales tienen un porcentaje significativo de fallo en estas pacientes.

11.
Bol. malariol. salud ambient ; 61(4): 742-747, dic. 2021. tab., ilus.
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1399929

RESUMO

En el contexto de la llegada de las vacunas contra la COVID-19 al Perú, es importante conocer que rubros son los más dispuestos a realizarlo. El objetivo de este estudio fue determinar los factores socio-laborales asociados a la posibilidad de vacunación contra la COVID-19 si el trabajo se los exige. Estudio transversal analítico, que tuvo como pregunta principal si es que se vacunarían si es que es requisito para el trabajo, esto se comparó según el rubro laboral, el sexo y el grupo etario; se obtuvo estadística descriptiva y analítica. De los 6628 trabajadores encuestados, el 34% y 35% se vacunarían si es que el trabajo se los pide según el que aún no se enfermaran o que ya lo hubiesen hecho, respectivamente. En el análisis multivariado, hubo mayor frecuencia de estar de acuerdo con el vacunarse entre los que están en el sector de minería (RPa: 1,33; IC95%: 1,05-1,69; valor p=0,019), los que hacen labores domésticas (RPa: 1,14; IC95%: 1,01-1,29; valor p=0,036) y los hombres (RPa: 1,07; IC95%. 1,01-1,14; valor p=0,029); en cambio, a comparación de los más jóvenes, los del rango etario de 40-49 años (RPa: 0,82; IC95%: 0,71-0,95; valor p=0,010) los que pensaban en vacunarse menor frecuencia. Hubo una baja percepción a la posibilidad de vacunarse si es que el trabajo se los pide, siendo los principales factores asociados a la posibilidad de vacunarse el no haberse contagiado previamente de COVID-19, pertenecer al sector minería, realizar labores domésticas y ser hombre(AU)


In the context of the arrival of vaccines against COVID-19 in Peru, it is important to know which sectors are the most willing to be vaccinated. The objective of this study was to determine the socio-labor factors associated with the possibility of vaccination against COVID-19 if required by work. Analytical cross-sectional study, which had as its main question whether they would be vaccinated if it was a job requirement, this was compared according to work category, sex and age group; descriptive and analytical statistics were obtained. Of the 6628 workers surveyed, 34% and 35% would get vaccinated if required to do so by their job, based on whether they had not yet been sick or had already been sick, respectively. In the multivariate analysis, there was a higher frequency of agreement to be vaccinated among those in the mining sector (aPR: 1.33; 95%CI: 1.05-1.69; p-value=0.019), those doing domestic work (aPR: 1.14; 95%CI: 1.01-1.29; p-value=0.036) and men (aPR: 1.07; 95%CI. 1.01-1.14; p-value=0.029); in contrast, those in the younger age range 40-49 years (aPR: 0.82; 95%CI: 0.71-0.95; p-value=0.010) were less likely to be vaccinated than those in the younger age range (aPR: 0.82; 95%CI: 0.71-0.95; p-value=0.010). There was a low perception of the possibility of getting vaccinated if asked to do so at work, the main factors associated with the possibility of getting vaccinated being not having been previously infected with COVID-19, belonging to the mining sector, performing domestic work and being male(AU)


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Saúde Ocupacional , Vacinação/estatística & dados numéricos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Percepção , Peru , Estudos Transversais , Análise Multivariada , Mineração , Categorias de Trabalhadores
12.
Rev. salud pública ; 22(6): e207, nov.-dic. 2020. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1357407

RESUMO

RESUMEN Objetivo Determinar la asociación entre adherencia terapéutica (AT) y calidad de vida relacionada con la salud (CVRS). Materiales y Métodos Se llevó a cabo una investigación transversal en el programa de HTA de un hospital general. Se utilizó el cuestionario SF-36 y la versión española de la prueba de Morisky y Green. Se obtuvieron los puntajes de las dimensiones y componentes sumarios físico (PCS) y mental (MCS). Luego, se ejecutaron los respectivos análisis bivariante y multivariante. Resultados El 39% de los pacientes presentó AT. Los puntajes de todas las dimensiones presentaron asociación estadística con AT. La regresión de Poisson identificó las variables independientes asociadas a la obtención de un puntaje mayor de 50 en PCS [presencia de comorbilidad (factor de riesgo), estado laboral y AT (factores protectores)] y MCS (AT como factor protector). Conclusiones La AT, estado laboral y ausencia de comorbilidad presentaron asociación con una mejor calidad de vida relacionada con la salud.


ABSTRACT Objective To determine the association between treatment adherence and health-related quality of life. Methods and Materials A cross-sectional investigation was performed in an arterial hypertension program of a general hospital. The Spanish version of the Short Form-36 Health Survey and the Spanish version of the Morisky-Green test. The scores of the subscales and Physical Component (PCS) and Mental Component (MCS) summaries of the SF-36 survey were obtained, then the respective bivariate and multivariate analyzes (Poisson regression) were executed. Results 39% of patients had therapeutic adherence. All the dimensions of the SF-36 survey presented a statistical association with adherence to antihypertensive treatment. Poisson regression was executed to identify the independent variables associated with obtaining a score higher than 50 in the PCS [presence of comorbidity (risk factor), work status, and therapeutic adherence (protective factor)] and MCS (therapeutic adherence as a protective factor). Conclusions Therapeutic adherence, work status, and absence of comorbidity were associated with a better health-related quality of life.

13.
Arch. cardiol. Méx ; 90(4): 498-502, Oct.-Dec. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1152825

RESUMO

Abstract Objectives: Left atrial disease is an independent risk factor for ischemic stroke and can be used to predict atrial fibrillation (AF). We examine whether left atrial enlargement (LAE) could predict stroke recurrence in patients with embolic stroke of undetermined source (ESUS). Materials and methods: Sixty-four patients with a confirmed diagnosis of ESUS were followed for a median of 22 months. Clinical data and echocardiogram findings were recorded. The echocardiogram interpretation was performed centrally and blindly. The Brown ESUS – AF score was used to categorize patients into high (human resource planning [HRP]: score > 2) and low-risk patients (non-HRP score 0-1). Stroke recurrence was the primary outcome. Results: The median age was 62 years (range: 22-85 years); and 33 (51.6%) were men. The median initial NIHSS score was three points (range: 0-27). Twelve (18.8%) patients were categorized as HRP. We found a significant tendency toward recurrence among HRP versus non-HRP patients. Three (25%) HRP versus 2 (3.8%) non-HRP experienced recurrence (OR: 8.3 95% CI 1.2-57; p=0.042); this association was related to severe atrial dilatation (OR: 14.5 95% CI 0.78-277, p = 0.02) and age > 75 years (OR: 12.7 95% CI 1.7-92.2, p = 0.03). We found no differences in recurrence in a univariate analysis. Conclusions: Patients with severe LAE who are 75 years old or older have a significant tendency to experience stroke recurrence.


Resumen Objetivos: La patología atrial izquierda es factor de riesgo independiente para infarto cerebral y puede utilizarse para predecir fibrilación auricular. Examinamos si el crecimiento aurícular izquierdo puede predecir recurrencia en pacientes con infarto embolico de origen indeterminado (ESUS). Materiales y métodos: Sesenta y cuatro pacientes con diagnóstico confirmado de ESUS fueron seguidos por una mediana de seguimiento de 22 meses. Registramos los datos clínicos y ecocardiográficos. La interpretación ecocardiográfica fue centralizada y cegada. La escala de Brown ESUS – AF fue utilizada para categorizar a los pacientes en riesgo alto (HRP puntaje > 2) y bajo riesgo (no-HRP: puntaje 0-1). El descenlace primario fue recurrencia de infarto cerebral. Resultados: Mediana de edad fue de 62 años (rango: 22-85 años); 33 (51.6%) fueron hombres. La mediana inicial de la escala de NIHSS fue de 3 putnos (rango de 0 a 27). 12 (18.8%) pacientes fueron de alto riesgo (HRP) y 52 (81.3%) de bajo riesgo (non- HRP). El grupo HRP mostró tendencia significatica hacia mayor recurrencia. Tres (25%) HRP versus 2 (3.8%) no-HRP experimentaron recurrencia (OR: 8.3 IC 95% 1.2-57; p = 0.042); esta asociación se relacionó con dilatación auricular severa (OR: 14.5 IC 95% 0.78-277, p = 0.02) y edad > 75 años (OR: 12.7 IC 95% 1.7-92.2, p = 0.03). En el análisis multivarioado, no encontramos significativas. Conclusiones: El crecimiento auricular izquierdo severo y la edad mayor de 75 años mostraron tendencia significativa a recurrencia de infarto cerebral.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Cardiomegalia/complicações , AVC Embólico/epidemiologia , Átrios do Coração/diagnóstico por imagem , Recidiva , Índice de Gravidade de Doença , Ecocardiografia , Fatores de Risco , Seguimentos , Fatores Etários , Cardiomegalia/diagnóstico por imagem , AVC Embólico/etiologia , Átrios do Coração/patologia
14.
Rev. colomb. anestesiol ; 48(3): 174-176, July-Sept. 2020. tab
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1126300

RESUMO

It was with significant interest that I reviewed the Chapter entitled "Anesthesia and Analgesia in the Global Context," published in the last edition of the book Miller's Anesthesia. The article makes a practical review of the practice of anesthesiology in Colombia and Paraguay, under the South American section.1 However, the intro duction claims that Peru has the lowest density of anesthesia specialists in South America (1.7 per every 100,000 inhabitants). Such rate was estimated using a global survey conducted between 2015 and 2016. The survey was addressed to the National Societies of Anesthesiology in 150 countries (see third column, Table 1)


Con gran interés revisé el capítulo titulado "Anestesia y Analgesia en el Contexto Global", publicado en la última edición del libro Miller's Anesthesia. El artículo hace una revisión práctica de la práctica de la anestesiología en Colombia y Paraguay, en la sección de América del Sur.1 Sin embargo, la intro ducción afirma que Perú tiene la menor densidad de especialistas en anestesia en América del Sur (1,7 por cada 100.000 habitantes). Dicha tasa fue estimada mediante una encuesta global realizada entre 2015 y 2016. La encuesta fue dirigida a las Sociedades Nacionales de Anestesiología de 150 países (ver tercera columna, Tabla 1)


Assuntos
Humanos , Sociedades/estatística & dados numéricos , Anestesiologistas , Peru , Demografia
15.
Adv Food Nutr Res ; 92: 127-185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32402443

RESUMO

There is a growing concern about chronic diseases such as obesity, diabetes, hypertension, hypercholesterolemia, cancer and cardiovascular diseases resulting from profound changes in the western lifestyle. Aquaculture by-products are generated in large quantities and they can be profitably recycled through their bioactive compounds used for health or food supplements. Improving waste utilization in the field of aquaculture is essential for a sustainable industry to prevent or minimize the environmental impact. In this sense fish by-products are a great source of protein and omega-3 polyunsaturated fatty acids which are particularly studied on Atlantic salmon or rainbow trout. Fish protein hydrolysate (FPH) obtained from chemical, enzymatical and microbial hydrolysis of processing by-products are being used as a source of amino acids and peptides with high digestibility, fast absorption and important biological activities. Omega-3 polyunsaturated fatty acids, eicosapentaenoic (EPA) and docosahexaenoic (DHA) from fish discards have been reported to decrease postprandial triacylglycerol levels, reduction of blood pressure, platelet aggregation and the inflammatory response. Crustacean by-products can also be used to produce chitosan with antioxidant and antimicrobial activity for food and pharmaceutical industries and carotenoids with important biological activity. Seaweeds are rich in bioactive compounds such as alginate, carrageenan, agar, carotenoids and polyphenols with different biological activities such as antioxidant, anticancer, antidiabetic, antimicrobial or anti-inflammatory activity. Finally, regarding harvest microalgae, during the past decades, they were mainly used in the healthy food market, with >75% of the annual microalgal biomass production, used for the manufacture of powders, tablets, capsules or pills. We will report and discuss the present and future role of aquaculture by-products as sources of biomolecules for the design and development of functional foods/beverages. This chapter will focus on the main bioactive compounds from aquaculture by-products as functional compounds in food and their applications in biomedicine for the prevention and treatment of diseases.


Assuntos
Aquicultura , Produtos Pesqueiros , Proteínas de Peixes , Peixes , Animais
16.
Rev. colomb. anestesiol ; 48(1): 3-11, Jan.-Mar. 2020. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1092914

RESUMO

Abstract Introduction: Postoperative nausea and vomiting (PONV) are common issues arising after general anesthesia, for which several independent risk factors (RF) have been described. Objective: To determine the accumulated incidence of PONV during the first 24hours of the postoperative period. Methods: A cohort observational, prospective study was conducted that included all the adults undergoing cholecystectomy under balanced general anesthesia at the EsSalud Talara Hospital from October 2014 until December 2016. The presence of PONV during the first 24hours after surgery was assessed, and univariate, bivariate, and logistic regression analyses were conducted. Results: A total of 244 patients were included, most of them with 2 RFs in the Apfel scale, that represented an accumulated incidence of PONV of 0.51 (95% confidence interval [CI] 0.45-0.57) during the observation period, notwithstanding the fact that 85.25% received antiemetic prophylaxis. The logistic regression analysis identified that being a female (odds ratio [OR] 3.30,95% CI 1.66-6.55, P = 0.0007) and previous PONV or motion sickness (OR 2.67, 95% CI 1.25-5.68, P = 0.011) were independent RFs for PONV. The administration of antiemetic prophylaxis and the presence of PONV (P = 0.92) were found to be independent. Conclusion: The high cumulative incidence of PONV could be the result of the type of surgery, the use of volatile anesthetic agents, and errors in the antiemetic pharmacological prophylaxis.


Resumen Introducción: Las náuseas y vómitos posoperatorios (NVPO) son problemas comunes que aparecen luego de la anestesia general, para los que se han descrito varios factores independientes de riesgo. Objetivo: Determinar la incidencia acumulada de NVPO durante las primeras 24 horas del periodo posoperatorio. Métodos: Se realizó un estudio observacional prospectivo de cohorte que incluyó a todos los adultos sometidos a colecistectomía bajo anestesia general balanceada en el Hospital EsSalud Talara desde octubre de 2014 hasta diciembre de 2016. Se evaluó la presencia de NVPO durante las primeras 24 horas posoperatorias y se ejecutaron análisis univariado, bivariado y de regresión logística. Resultados: Se incluyeron 244 pacientes, la mayoría con dos factores de riesgo en la escala de Apfel, que presentaron una incidencia acumulada de NVPO de 0.51 (IC 95% 0.45-0.57) en el periodo de observación, a pesar de que el 85.25% recibió profilaxis antiemética. El análisis de regresión logística identificó la presencia de sexo femenino (OR 3.30, IC 95% 1.66-6.55, p = 0.0007) y la historia de NVPO previos o cinetosis (OR 2.67, IC 95% 1.25-5.68, p = 0.011) como factores de riesgo independientes para NVPO. Se halló independencia entre la presencia de profilaxis antiemética y la presencia de NVPO (p=0.92). Conclusiones: La alta incidencia acumulada de NVPO pudiera ser ocasionada por el tipo de cirugía, uso de anestésicos volátiles y falencias en la profilaxis farmacológica antiemética.


Assuntos
Humanos , Adulto , Colecistectomia , Análise de Regressão , Fatores de Risco , Náusea e Vômito Pós-Operatórios , Anestesia Geral , Período Pós-Operatório , Enjoo devido ao Movimento , Estudos Prospectivos , Estudos de Coortes , Anestésicos , Antieméticos
17.
J Sci Food Agric ; 100(1): 218-224, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31512242

RESUMO

BACKGROUND: Nowadays, fat replacement in meat products is a matter of concern in the meat industry. The objective of this study was to evaluate the replacement of pork backfat with two oleogels of linseed in dry-cured sausages. RESULTS: Five batches of dry-cured sausages were prepared with two oleogels, a mixture of γ-oryzanol and ß-sitosterol (SO) and beeswax (B), at two levels of replacement (20% and 40%) (SO-20, SO-40, B-20, and B-40, respectively) and a control batch. The fatty acid profile improved in terms of nutrition: the polyunsaturated fatty acid / saturated fatty acid (PUFA/SFA) and n-6/n-3 ratio was about 1.41 and 0.93 for the higher levels of replacement, SO-40 and B-40, respectively. Quality parameters such as pH and color also changed with the inclusion of oleogels, resulting in changes in the sensory quality. CONCLUSION: Oleogels based on linseed enabled the replacement of pork backfat in fermented sausages. Depending on the level of fat substitution, such oleogels could replace fat in dry-cured sausages at the industrial level. © 2019 Society of Chemical Industry.


Assuntos
Substitutos da Gordura/análise , Manipulação de Alimentos/métodos , Óleo de Semente do Linho/análise , Produtos da Carne/análise , Animais , Ácidos Graxos/análise , Fermentação , Humanos , Compostos Orgânicos/análise , Suínos , Paladar
18.
Rev. colomb. cir ; 35(3): 363-372, 2020.
Artigo em Espanhol | LILACS | ID: biblio-1123140

RESUMO

Este consenso presenta las recomendaciones de la División de Educación de la Asociación Colombiana de Cirugía para los programas de especialización en cirugía general del país, con el fin de enfrentar la pandemia de la COVID-19 en los próximos años. Las recomendaciones se formularon mediante un método informal de consenso de expertos conformado por todos los directores de los programas de especialización en cirugía general en Colombia. Las principales recomendaciones se relacionan con los procesos de selección en los programas, investigación, bioseguridad, vigilancia de volumen operatorio, evaluación, simulación y virtualidad, rotaciones especiales, esquemas de trabajo y evaluación de la calidad programática


This consensus presents the recommendations of the División de Educación of the Asociación Colombiana de Cirugía for the Colombian surgical residency programs, in order to face the COVID-19 pandemic in the coming years. The recommendations were formulated using an informal method of consensus of experts made up of all program directors of residency programs in the country. The main recommendations are related to the selection processes in the programs, research, biosecurity, surveillance of operative volume, evaluation, simulation and virtual education, special rotations, work schemes and evaluation of program quality.


Assuntos
Humanos , Infecções por Coronavirus , Cirurgia Geral , Educação Médica , Programas de Pós-Graduação em Saúde
20.
Foods ; 8(9)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31455030

RESUMO

Different health institutions from western countries ha-ve recommended a diet higher in polyunsaturated fats, especially of the n-3 family. However, this is not a trivial task, especially for meat-processing sectors. The objective of this work was to assess the influence of replacing pork backfat with linseed oleogel on the main quality parameters of frankfurters. The frankfurters were formulated by the pork backfat replacement of 0% (control), 25% (SF-25), and 50% (SF-50), using a linseed oleogel gelled with beeswax. The determination of quality parameters (pH, colour, chemical composition, and texture parameters), the fatty acid profile, and the sensory evaluation was carried out for each batch. The fatty acid profile was substantially improved, and the saturated fatty acid (SFA) content was reduced from 35.15g/100g in control sausages to 33.95 and 32.34g/100 g in SF-25 and SF-50, respectively, and more balanced ratios n-6/n-3 were achieved. In addition, the sausages with linseed oleogel also decreased the cholesterol content from 25.08 mg/100 g in control sausages to 20.12 and 17.23 mg/100 g in SF-25 and SF-50, respectively. It may therefore be concluded that these innovative meat products are a healthier alternative. However, sensory parameters should be improved in order to increase consumer acceptability, and further research is needed.

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