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1.
Environ Pollut ; 346: 123654, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38402933

RESUMO

The seafloor is recognised as a major sink for marine litter. However, studies conducted in this compartment addressing marine litter densities and its interactions with fauna are scarce, mainly due to sampling constraints. In this paper, we assess marine litter density, composition and interactions with marine communities and evaluate its relationship with fishing activities at the "Banco de la Concepción" seamount (Canary Islands, Spain). We took advantage of underwater video records taken with a Remotely Operated Towed Vehicle in the framework of the LIFE IP INTEMARES project. A total of 56 video transects were analysed covering about 9 km with 19 h of video recording. Transects were categorised as high, low, and null fishing effort based on the Vessel Monitoring System (VMS) positional data registered between 2009 and 2017. Litter items were recorded in 70% of the transects with a mean density of 2122 (±2464) items km-2. There were significant differences in litter densities over the three levels of fishing pressure, with a density decrease from stations of high to stations of null fishing pressure. Regarding categories, plastic was by far the most abundant category found (83.1%), mainly consisting of fishing lines, both monofilaments and entangled longlines. The study of the interactions of marine litter with fauna showed that less than 20% of the items presented an interaction with benthic organisms either by causing or not a visible impact. The sponge Asconema setubalense accounted for more than half (57.4%) of all interactions, but only 5% of all A. setubalense specimens showed physical damage.


Assuntos
Monitoramento Ambiental , Plásticos , Espanha , Plásticos/análise , Resíduos/análise , Gravação em Vídeo
2.
Int J Hyg Environ Health ; 244: 114004, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35816847

RESUMO

Chlorination has historically provided microbiologically safe drinking water in public water supplies. Likewise, chlorine has also been introduced as a low-cost disinfection method in rural and marginalized communities, both at community and household level, as well as during emergencies. Although this practice is common and well established for use as a household water treatment technology in the Global South, several challenges in effective and efficient implementation still need to be addressed. Here, we explored these issues by a literature review and narrowed them to the status of three Latin American countries (Mexico, Colombia, and Brazil). Overall, it was found that although guidance on household-based chlorination includes information on health risks and hygiene, this may not create enough incentive for the user to adapt the method satisfactorily. Physicochemical quality of the water influences chlorination efficiency and it is found that variations in quality are rarely considered when recommending chlorine doses during implementation. These are far more often based on a few measurements of turbidity, thereby not considering dissolved organic matter, or seasonal and day-to-day variations. Other factors such as user preferences, chlorine product quality and availability also represent potential barriers to the sustainable use of chlorination. For chlorination to become a sustainable household water treatment, more focus should therefore be given to local conditions prior to the intervention, as well as support and maintenance of behavioural changes during and after the intervention.


Assuntos
Desinfecção , Purificação da Água , Cloro , Halogenação , América Latina , Abastecimento de Água
3.
Rehabilitacion (Madr) ; 56(3): 173-181, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34511255

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. MATERIAL AND METHODS: The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. RESULTS: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Realidade Virtual , Terapia por Exercício/métodos , Humanos , Projetos Piloto , Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade Superior
4.
Sci Total Environ ; 795: 148652, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34247086

RESUMO

Over the last decades global warming has caused an increase in ocean temperature, acidification and oxygen loss which has led to changes in nutrient cycling and primary production affecting marine species at multiple trophic levels. While knowledge about the impacts of climate change in cetacean's species is still scarce, practitioners and policymakers need information about the species at risk to guide the implementation of conservation measures. To assess cetacean's vulnerability to climate change in the biogeographic region of Macaronesia, we adapted the Marine Mammal Climate Vulnerability Assessment (MMCVA) method and applied it to 21 species management units using an expert elicitation approach. Results showed that over half (62%) of the units assessed presented Very High (5 units) or High (8 units) vulnerability scores. Very High vulnerability scores were found in archipelago associated units of short-finned pilot whales (Globicephala macrorhynchus) and common bottlenose dolphins (Tursiops truncatus), namely in the Canary Islands and Madeira, as well as Risso's dolphins (Grampus griseus) in the Canary Islands. Overall, certainty scores ranged from Very High to Moderate for 67% of units. Over 50% of units showed a high potential for distribution, abundance and phenology changes as a response to climate change. With this study we target current and future information needs of conservation managers in the region, and guide research and monitoring efforts, while contributing to the improvement and validation of trait-based vulnerability approaches under a changing climate.


Assuntos
Golfinho Nariz-de-Garrafa , Baleias Piloto , Animais , Cetáceos , Mudança Climática , Espanha
5.
Phys Med Biol ; 66(4): 045011, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33339014

RESUMO

Collection efficiency is an important quantity in dosimetry with ionization chambers. It can be calculated by solving a hyperbolic system of partial differential equations. This system can be solved only in few, simple, idealized geometries, but for more realistic designs an analytical resolution is no longer possible. In the present work a Monte Carlo scheme that could permit to calculate the collection efficiency for any ionization chamber geometry is proposed. This scheme has been tested against Boag's approach for three chambers with plane-parallel, cylindrical and spherical geometries, operated in the recombination regime. The results obtained in the full Monte Carlo simulation closely agree with the Boag's ones for the three ideal geometries considered. The largest relative difference, ∼0.3%, has been found for the plane-parallel chamber in case of 50 V, the lowest potential difference investigated in this study. Results appear to be stable against changes in the chamber volume, the ion mobility and the recombination constant. The method proposed could be a useful tool to calculate collection efficiencies of ionization chambers, provided the electric field inside them is known.


Assuntos
Método de Monte Carlo , Radiometria/instrumentação , Simulação por Computador , Eletricidade
6.
Rev Neurol ; 70(12): 461-477, 2020 Jun 16.
Artigo em Espanhol | MEDLINE | ID: mdl-32500525

RESUMO

INTRODUCTION: Spinal cord injury is a traumatic or non-traumatic event that causes an alteration of sensory, motor or autonomic functioning and ultimately affects the physical, psychological and social well-being of the person who suffers it. A comprehensive approach to spinal cord injury requires many health resources and can place a considerable financial burden on patients, their families and the community. AIM: To review the literature published to date on the use of non-invasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcutaneous non-invasive spinal cord stimulation (tcSCS), as therapeutic strategies to improve the functionality of patients with spinal cord injury. The studies were grouped as addressing either non-invasive brain stimulation or non-invasive spinal cord stimulation. DEVELOPMENT: Altogether 32 studies were identified: 21 involving brain stimulation (14 in rTMS and 7 in tDCS) and 11 with spinal cord stimulation (tcSCS). All the studies were conducted in adult patients who had undergone a spinal cord injury. Despite significant variability in treatment protocols, patient characteristics and clinical assessment, the changes observed were reported in almost all the studies without producing any side effects and with motor or functional improvement. CONCLUSION: Non-invasive brain stimulation, as well as spinal cord stimulation, are promising techniques for the rehabilitation of patients with spinal cord injury due to their novelty, effectiveness and minimal side effects.


TITLE: Estimulación no invasiva cerebral y medular para la recuperación motora y funcional tras una lesión medular.Introducción. La lesión medular es un evento traumático o no traumático que causa una alteración de la función sensorial, motora o autonómica y, en última instancia, afecta a las características físicas, psicológicas y el bienestar social de la persona que lo sufre. El abordaje integral de la lesión medular requiere muchos recursos de salud y puede representar una considerable carga financiera para los pacientes, sus familias y la comunidad. Objetivo. Revisar la bibliografía publicada sobre el uso de la estimulación cerebral no invasiva, incluida la estimulación magnética transcraneal repetitiva (EMTr), la estimulación de corriente continua directa transcraneal (tDCS), así como la estimulación medular no invasiva transcutánea (tcSCS), como estrategias terapéuticas para mejorar la funcionalidad de los pacientes con lesión medular. Los estudios se agruparon bien como de estimulación no invasiva cerebral, bien como de estimulación medular no invasiva. Desarrollo. Se identificaron 32 estudios: 21 de estimulación cerebral (14 en EMTr y 7 en tDCS) y 11 de estimulación medular (tcSCS). Todos los estudios se realizaron en pacientes adultos que sufrieron una lesión medular. A pesar de la variabilidad significativa en los protocolos de tratamiento, las características de los pacientes y la evaluación clínica, los cambios observados se describieron en casi todos los estudios sin producir efectos secundarios con mejoría motora o funcional. Conclusión. La estimulación cerebral no invasiva, así como la estimulación medular, son técnicas prometedoras para la rehabilitación de pacientes con lesión medular debido a su novedad, su efectividad y mínimos efectos secundarios.


Assuntos
Terapia por Estimulação Elétrica/métodos , Traumatismos da Medula Espinal/terapia , Encéfalo , Humanos , Recuperação de Função Fisiológica , Estimulação da Medula Espinal/métodos
7.
J Environ Manage ; 254: 109743, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31706121

RESUMO

The Life-Cycle Assessment (LCA) is a standard approach for evaluating the environmental impacts of products and processes. This paper presents the LCA of Living Wall Systems (LWS), a new technology for greening the building envelope and improve sustainability. Impacts of manufacture, operation, and use of the systems selected, were evaluated through an LCA. LWS are closely related to several environmental benefits, including improved air quality, increased biodiversity, mitigation of heat island effects, and reduced energy consumption due to savings in indoor cooling and heating. Two prototypes have been selected, taking into account the modularity and the use of organic substrate as selection criteria. The systems evaluated were a plastic-based modular system and a felt-based modular system. The inventory data was gathered through the manufacturers. The LCA approach has been used to assess the impact of these solutions by focusing on the construction phase and its contribution to both the energy balance and the entire life cycle of a building. This approach has never been done before for LWS. The study found that out of the two systems through the manufacturing, construction, and maintenance stage of the LCA, the felt-based LWS has an impact on almost 100% of the impact categories analyzed, while plastic-based LWS has the lowest influence on the total environmental impact.


Assuntos
Poluição do Ar , Biodiversidade
8.
Int J Surg ; 29: 176-82, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27063856

RESUMO

BACKGROUND: F-flurodeoxyglucose positron emission tomography (FDG-PET) have been claimed to be an important prognostic tool in different malignancies. However, its predictive prognostic value on pancreatic neuroendocrine tumors (PNETs) is still under investigation. AIM: We study the prognostic impact of FDG-PET scan in neuroendocrine pancreatic tumors. METHODOLOGY: Between 2007 and 2012, 26 patients with no metastastatic histologically confirmed PNETs (mean age: 57 years) were examined with FDG-PET. We studied its captation in relation with the well established hystopathological prognostic markers assessed in the tumoral resected specimen according to the WHO 2004 and ENETS/WHO 2010 classification. RESULTS: FDG-PET captation was positive in 17 cases (65.4%). The median follow-up period was 34.4 months and recurrences occurred in 4 cases (15.4%). We found a significant correlation between this captation and Ki 67 index (p = 0.032), mitotic index (p = 0.002), tumor grade (p = 0.017) and tumor size (p = 0.01). CONCLUSIONS: FDG-PET provides a good prognostic value for PNETs. Present results must be further validated with larger sample studies.


Assuntos
Fluordesoxiglucose F18 , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/estatística & dados numéricos , Compostos Radiofarmacêuticos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Índice Mitótico , Gradação de Tumores , Recidiva Local de Neoplasia/etiologia , Tumores Neuroendócrinos/classificação , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/patologia , Tomografia por Emissão de Pósitrons/métodos , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Carga Tumoral , Organização Mundial da Saúde
9.
Public Health ; 134: 12-7, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26947312

RESUMO

OBJECTIVE: To investigate the consequences of including active commuting, compared with the leisure domain only, in the prevalence and sociodemographic factors associated with attending the physical activity recommendations, in Brazilian adults. STUDY DESIGN: Population-based cross-sectional study. METHOD: Adults between 20 and 59 years of age (n = 1720) were face-to-face interviewed from September 2009 to January 2010. Sociodemographic indicators and leisure-time and commuting physical activity were assessed by a validated questionnaire. Poisson regression was used to estimate crude and adjusted prevalence ratio (PR) and 95% confidence interval (95% CI). RESULTS: The prevalence of adherence to recommendations when only leisure-time physical activity was considered was 15.5% (95% CI: 13.6; 17.4) and was associated with men (PR: 1.57, 95% CI: 1.25; 1.96), adults without a partner (PR: 1.38 95% CI: 1.05; 1.81) and higher educational level and income. The prevalence of adherence to physical activity recommendations after the combination of leisure-time and commuting was 29.1% (95% CI: 26.5; 31.6). Percentages differences in favor of men, white adults and those with higher educational level and income were no longer significant after the inclusion of active commuting. CONCLUSION: The inclusion of active commuting expands the percentage of adults who achieved the health-related physical activity recommendations and reduced important sociodemographic differences derived from the analysis of leisure-time physical activity alone. Public health strategies should consider the different domains of physical activity in the monitoring and promotion of a more active lifestyle.


Assuntos
Exercício Físico , Fidelidade a Diretrizes/estatística & dados numéricos , Atividades de Lazer , Meios de Transporte/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Guias como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
10.
Semergen ; 42(2): 103-9, 2016 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-25440966

RESUMO

Epilepsy is a chronic disease cursing with recurrent and paroxysmal crises due to anomalies in the electrical activity of brain, and is controllable in most of the patients by using antiepileptic drugs, in single or combination therapy. Probably one of the most complex aspects of epilepsy is the assessment of disability for work of the affected person. For this purpose, multiple factors need to be taken into account for homogeneous decision-making, and according to criteria of approval and within the principle of equity inherent in the granting of Social Security disability benefits. This requires the cooperation of all professionals involved in the different specialties, with reports using common criteria and taking into account the disease itself, as well as the effects of the prescribed treatments, the effects of which can contribute to the limitations in the performance of certain professions of risk.


Assuntos
Avaliação da Deficiência , Epilepsia/fisiopatologia , Saúde Ocupacional , Emprego , Humanos
11.
Transplant Proc ; 46(9): 3032-8, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25420816

RESUMO

BACKGROUND: In several countries, organ transplantation is limited. We describe the implementation of a model to perform kidney transplantation in a low-resource population through a financial mechanism sharing public, patient, and private foundations funds. METHODS: This was a cohort study of 100 low-resource patients undergoing renal transplantation at the Hospital General of México. The mean age of the transplanted population was 30.07 ± 11.4 years, from which 84% reported an income <400 USD/month. Ninety percent of grafts were obtained from live donors. RESULTS: The survival rate at 1 year after the procedure was 98%. Patient rehabilitation after transplantation included the incorporation of individuals into productive life and work. The economically active population increased from 8% to 40% after the transplant procedure. The model was successfully implemented as the result of (i) adequate incorporation of medical staff with solid experience in organ transplantation; (ii) institutional public policy and collaboration between diverse services to support donors and receptors; and (iii) financial collaboration to attract resources and funds to guarantee access to immunosuppressants. CONCLUSIONS: Our results led toward an operational, reproducible model for transplanting patients in developing and financial crisis countries, reflecting beneficial long-lasting effects on the patient from the therapeutic, clinical, and economic points of view.


Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Transplante de Rim , Adulto , Países em Desenvolvimento , Feminino , Hospitais Públicos/organização & administração , Humanos , Falência Renal Crônica/cirurgia , Transplante de Rim/economia , Transplante de Rim/mortalidade , Doadores Vivos , Masculino , México , Pessoa de Meia-Idade , Modelos Organizacionais , Desenvolvimento de Programas , Adulto Jovem
13.
Rev Gastroenterol Mex ; 78(2): 75-81, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23664428

RESUMO

BACKGROUND: Colorectal cancer is one of the most frequent cancers in both sexes and the most frequent in the developed countries, if men and women are considered together as a group. It has an important associated morbidity and mortality in all countries and constitutes a public health problem with a high direct and indirect economic cost. The number of workdays lost due to temporary disability (TD) is one of the quantifiable references of these indirect costs. AIMS: To determine the indirect cost associated with TD due to colorectal cancer in Spain during the year 2011, a cost that aids in the prevention cost/benefit estimation. METHODS: The number of TD processes, the number of workdays lost due to TD, and the mean duration of those processes, based on the CIE 9-MC codes related to this pathology, as well as the calculated cost, using the Spanish minimum wage as a reference, during the period of January to December 2011, were all reviewed. RESULTS: Colorectal cancer in Spain during 2011 represented 1,046 TD processes, 202,784 workdays lost, and a mean process duration of 194 days/year. The resulting cost of the pathology due to TD was 4,335,521.92 euros. CONCLUSIONS: These results are beneficial for evaluating the usefulness of implementing public health support strategies for a greater reduction in colorectal cancer prevalence and mortality, and an improvement in quality of life of the affected individuals and their families, together with an economic savings resulting from a reduction in TD as a consequence of this disease.


Assuntos
Neoplasias Colorretais/economia , Efeitos Psicossociais da Doença , Saúde Ocupacional , Licença Médica/estatística & dados numéricos , Idoso , Neoplasias Colorretais/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Fatores de Tempo
14.
Int J Obes (Lond) ; 36(9): 1158-64, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22689071

RESUMO

OBJECTIVE: To determine whether alcohol consumption is associated with incident overweight or obesity in normal-weight, postmenopausal women. DESIGN: Prospective cohort study considering baseline alcohol consumption and subsequent weight change over 7 years. SUBJECTS: 15,920 normal-weight (body mass index (BMI): 18.5 to <25 kg m(-2)), postmenopausal women enrolled in the Women's Health Initiative Clinical Trial. MEASUREMENTS: Body weight change, and incident overweight and obesity (BMI, 25.0 to <30 and ≥ 30 kg m(-2)) over 7 years. RESULTS: One-third of the 13,822 women included in the analytical cohort reported no alcohol consumption. BMI differed little between abstainers (22.8±1.58 kg m(-2)) and alcohol consumers in the upper quintile (22.7±1.53 kg m(-2)). Among normal-weight women, the risk of becoming overweight or obese over a 7-year follow-up period was 35% or 88% lower, respectively, for women in the upper quintile of alcohol intake relative to abstainers (hazard ratio (HR), 0.65; 95% confidence interval (CI), 0.58-0.73; or HR, 0.12; 95% CI, 0.05-0.25, respectively). Risk for overweight and obesity was not significantly modified by age. Wine consumption showed the greatest protective association for risk of overweight (HR, 0.75; 95% CI, 0.68-0.84), followed by liquor (HR, 0.85; 95% CI, 0.78-0.93) and beer (HR, 0.90; 95% CI, 0.82-1.00). CONCLUSION: Postmenopausal women of normal weight who report moderate alcohol intake have a reduced risk of becoming overweight or obese over time. Perhaps, weight control measures in this population should target behaviors other than reduction in alcohol for those of normal BMI consuming moderate amounts.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Obesidade/epidemiologia , Pós-Menopausa , Comportamento de Redução do Risco , Saúde da Mulher , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Índice de Massa Corporal , Estudos de Coortes , Feminino , Promoção da Saúde , Humanos , Incidência , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
15.
J Thromb Haemost ; 9(11): 2201-7, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21883882

RESUMO

BACKGROUND: Although previous studies have provided evidence that the majority of deaths following an acute pulmonary embolism (PE) directly relate to the PE, more recent registries and cohort studies suggest otherwise. METHODS: We assessed the cause of death during the first 30 days after the diagnosis of acute symptomatic PE in a consecutive series of patients. We also assessed the prognostic characteristics of the simplified Pulmonary Embolism Severity Index (sPESI) and cardiac troponin I (cTnI) obtained at the time of PE diagnosis. RESULTS: During the first 30 days after diagnosis, 127 of the 1291 patients died (9.8%; 95% confidence interval [CI], 8.2-11.5). Sixty patients (4.6%; 95% CI, 3.5-5.8) died from definite or possible PE, and 67 (5.2%; 95% CI, 4.0-6.4) died from other causes (cancer 25, infection 18, hemorrhage 7, heart failure 7, chronic obstructive pulmonary disease 5, renal failure 1, seizures 1, unknown 3). The sPESI predicted all-cause (odds ratio [OR], 5.97; 95% CI, 1.74-20.54; P < 0.01) and PE-associated mortality (OR, 8.79; 95% CI, 1.12-68.79; P = 0.04). cTnI only predicted PE-associated mortality (adjusted OR, 2.39; 95% CI, 1.25-4.57; P < 0.01). For all-cause mortality, the sPESI low-risk strata had a negative predictive value of 98.8% (95% CI, 97.4-100) in comparison with 91.3% (95% CI, 88.9-93.6) for the cTnI. CONCLUSIONS: Within the first 30 days after the diagnosis of acute symptomatic PE, death due to PE and death due to other causes occur in a similar proportion of patients. As cTnI only predicted PE-associated mortality, low-risk sPESI had a higher negative predictive value for all-cause mortality compared with cTnI.


Assuntos
Causas de Morte , Embolia Pulmonar/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Embolia Pulmonar/mortalidade , Índice de Gravidade de Doença , Troponina I/análise
16.
Int J Tuberc Lung Dis ; 15(9): 1206-10, i, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21943847

RESUMO

SETTING: The national TB reference laboratory and four health care units connected to the national laboratory network in Honduras, Central America. OBJECTIVE: To evaluate the performance of the direct nitrate reductase assay (NRA) for rapid, low-cost detection of multidrug-resistant tuberculosis (MDR-TB) in a resource-limited setting. DESIGN: Consecutive smear-positive samples (n = 185) were prospectively analysed with NRA and compared to the proportion method on Löwenstein Jensen medium (PM-LJ) to detect resistance to isoniazid (INH) and rifampicin (RMP). RESULTS: The NRA sensitivity, specificity, positive and negative predictive values for INH and RMP were respectively 100%, 99%, 91%, 100% and 80%, 100%, 100%, 99%. Good agreement was observed between NRA and PM-LJ (κ > 0.8). CONCLUSION: The direct NRA is a reliable alternative for rapid and low-cost identification of MDR-TB cases in resource-limited settings.


Assuntos
Antituberculosos/farmacologia , Nitrato Redutase/metabolismo , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Honduras , Humanos , Isoniazida/farmacologia , Testes de Sensibilidade Microbiana , Valor Preditivo dos Testes , Estudos Prospectivos , Rifampina/farmacologia , Sensibilidade e Especificidade , Escarro/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/enzimologia
17.
Actas Dermosifiliogr ; 102(1): 39-47, 2011 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-21315860

RESUMO

BACKGROUND AND OBJECTIVE: an increasing number of patients seek emergency treatment for dermatologic complaints. The aim of this study was to assess the characteristics of skin complaints seen in an emergency department prior to establishment of specialist dermatology cover. MATERIALS AND METHODS: a retrospective, descriptive study was undertaken using data on urgent dermatology cases seen by nonspecialist physicians in the emergency department of Hospital General Universitario de Albacete, Spain, in 2008. RESULTS: a total of 3662 patients with skin diseases were seen (2.59% of all emergency cases; approximately 10 patients per day). The mean age was 27.73 years and there was a slight predominance of female patients. Children and adolescents accounted for 5.85% of cases. A total of 96 different conditions were diagnosed and 84% of cases corresponded to one of 21 different diagnostic entities, urticaria being the most frequent (19.27%). The 96 diagnoses were grouped into 16 categories to facilitate analysis. According to this classification, most patients had infectious diseases (47.49%), followed by urticaria and angioedema (20.13%), "nonspecific diagnosis" (11.93%), and "descriptive diagnosis" (6.49%). In 4.8% of cases, the patient was admitted, most frequently for cellulitis. CONCLUSIONS: in nonspecialist emergency services, the number of different diagnoses is small in relation to the number of patients seen and the proportion of nonspecific and descriptive diagnoses is relatively large. In our opinion, an on-call dermatologist should be made available within emergency departments in order to offer a higher quality of care to patients with skin conditions.


Assuntos
Dermatologia/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Hospitais Gerais/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Encaminhamento e Consulta/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Atenção à Saúde/organização & administração , Grupos Diagnósticos Relacionados , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Corpo Clínico Hospitalar/organização & administração , Pessoa de Meia-Idade , Estudos Retrospectivos , Dermatopatias/diagnóstico , Adulto Jovem
18.
Actas Dermosifiliogr ; 102(3): 193-8, 2011 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-21300325

RESUMO

BACKGROUND AND OBJECTIVE: Skin diseases account for a large number of consultations in primary care. The objective of this study was to determine the characteristics and cost of referrals from primary care to a dermatology clinic. MATERIAL AND METHODS: Descriptive cross-sectional study of referrals from a primary care health center to a dermatology clinic. The dermatology clinic was situated in the same health center and was attended by a dermatologist from Complejo Hospitalario Universitario in Albacete, Spain. The study was performed on 10 days selected at random between April 21, 2009, and June 26, 2009. The data gathered included age, sex, use of cryotherapy, and diagnostic group. Patients were divided into 4 diagnostic groups: A) benign degenerative disease or trivial disorders whose treatment may not merit involvement of the national health service, B) diseases resolved with a single dermatology consultation at the health center, C) diseases requiring evaluation in hospital-based dermatology outpatients, and D) diseases referred for surgical treatment. RESULTS: Data were gathered on 257 patients with a mean age was 41.18 years and there was a slight female predominance. The majority of patients were in diagnostic group B (53.7%), followed by groups A (19.1%), C (19.1%), and D (8.2%). The total estimated cost of these 257 visits was €29 750.32, of which €5672.24 was for trivial disorders. CONCLUSIONS: The current high prevalence of trivial disorders in the caseload of dermatology clinics by trivial disorders makes it necessary to control referrals from primary care more strictly.


Assuntos
Dermatologia/estatística & dados numéricos , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Ambulatório Hospitalar/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Estudos Transversais , Crioterapia/economia , Crioterapia/estatística & dados numéricos , Dermatologia/economia , Grupos Diagnósticos Relacionados , Feminino , Controle de Acesso/economia , Controle de Acesso/estatística & dados numéricos , Mau Uso de Serviços de Saúde/economia , Hospitais Universitários/economia , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/economia , Visita a Consultório Médico/economia , Visita a Consultório Médico/estatística & dados numéricos , Ambulatório Hospitalar/economia , Atenção Primária à Saúde/estatística & dados numéricos , Encaminhamento e Consulta/economia , Dermatopatias/classificação , Dermatopatias/economia , Dermatopatias/epidemiologia , Dermatopatias/cirurgia , Espanha , Carga de Trabalho/economia , Carga de Trabalho/estatística & dados numéricos
19.
Minerva Stomatol ; 58(11-12): 577-84, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20027128

RESUMO

AIM: The aim of this study was to compare the polymerization contraction stress of composites photoactivated by two light sources: quartz tungsten halogen light (QTH) and light emitting diode (LED). METHODS: Glass rods were fabricated (5.0 mm X 5.0 cm) and one of the surfaces was air abraded with aluminum oxide. An adhesive was applied to this surface and photoactivated by LED. The glass rods were assembled to a Universal Testing machine (Instron - 5565) and the composite were applied to the lower rod using a manual instrument. The upper rod was placed closer, at 2 mm, and an extensometer was attached to the rods. The twenty composites were polymerized by either by QTH (N.=10) or LED (N.=10). Polymerization was carried out using two apparatuses positioned in opposite sides, which were simultaneously activated for 30 seconds. Contraction stress was analyzed twice: shortly after polymerization (t30s) and 30 minutes later (t30min). RESULTS: The contraction stress for all composites was higher at t30min than at t30s, regardless of the activation source. Z100 showed lower contraction stress values (P<0.05) compared to the other composites. Regarding to Charisma and TPH, the photoactivation source had no influence on contraction stress, except for Z100 at t30min. CONCLUSIONS: It was concluded that composite composition is the factor that most influence the polymerization contraction stress.


Assuntos
Resinas Compostas/efeitos da radiação , Lâmpadas de Polimerização Dentária , Cura Luminosa de Adesivos Dentários/métodos , Luz , Cimentos de Resina/efeitos da radiação , Dióxido de Silício/efeitos da radiação , Zircônio/efeitos da radiação , Técnicas In Vitro , Teste de Materiais , Processos Fotoquímicos , Estresse Mecânico
20.
Rev Esp Med Nucl ; 28(6): 295-8, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19864049

RESUMO

Neurolymphomatosis is a rare neurological manifestation of non-Hodgkin's lymphoma (NHL) and it may be its first and sole manifestation. Diagnosis is often difficult and nerve biopsy is generally required. However, this it is not always possible to perform or is not conclusive. We present the case of a 66-year-old woman diagnosed with giant B-cell NHL. After 6 cycles of chemotherapy, imaging and molecular biology techniques showed complete remission. At four months after treatment, the patient complained of low back pain of radicular distribution. CT and MRI imaging showed signs of lymphoproliferative activity of L5 and also lesions to thoracic nerve roots. A PET-CT was requested in order to complete the diagnosis and plan the treatment. Imaging confirmed the presence of tumor recurrence with neurolymphomatosis and also indicated lesions on the chest and abdominal level. Thus, it was decided to start a new line of chemotherapy, without performing the histological study through biopsy. This case illustrates the important role played by PET-CT imaging in neurolymphomatosis diagnosis. This technique can help the patient avoid more aggressive procedures, such as a biopsy, and can also be useful in the follow-up and assessment of the treatment response to NHL-diagnosed patients.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Nervos Periféricos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Raízes Nervosas Espinhais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Murinos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Citarabina/administração & dosagem , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Evolução Fatal , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Metilprednisolona/administração & dosagem , Nervos Periféricos/patologia , Prednisona/administração & dosagem , Recidiva , Indução de Remissão , Rituximab , Nervo Isquiático/diagnóstico por imagem , Nervo Isquiático/patologia , Raízes Nervosas Espinhais/patologia , Vincristina/administração & dosagem
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