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1.
Br J Nutr ; 110(9): 1639-47, 2013 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-23789921

RESUMO

Changes in paraoxonase 1 (PON1) activities have been observed in a variety of diseases involving oxidative stress, such as CVD. However, its role in obesity has not been fully established. In the present study, we aimed (1) to genotype sixteen PON1 SNP, (2) to measure serum PON1 activities and (3) to correlate these findings with the incidence of childhood obesity and related traits. We conducted a case-control study of 189 normal-weight and 179 obese prepubertal children, and we measured four different PON1 activities: lactonase; paraoxonase; arylesterase; diazoxonase. Although none of these activities was significantly different between the obese and normal-weight children, lactonase activity was found to be positively correlated with HDL-cholesterol and ApoA1 levels and negatively correlated with myeloperoxidase and fatty acid-binding protein 4 levels. Among the sixteen genotyped PON1 SNP, only the intronic SNP rs854566 exhibited a significant association with obesity (OR 0·61, 95 % CI 0·41, 0·91; P= 0·016). This genetic variant was also associated with increased diazoxonase, lactonase and arylesterase activities and decreased paraoxonase activity. Other genetic variants exhibited different association patterns with serum activities based on their location within the PON1 gene, and SNP that were located within the promoter were strongly associated with lactonase, arylesterase and diazoxonase activities. The functional variant Q192R exhibited the greatest effect on paraoxonase activity (P= 5·88 × 10(-42)). In conclusion, SNP rs854566 was negatively associated with childhood obesity and with increased serum PON1 activities in prepubertal children. We determined that lactonase is a reliable indicator of PON1 activities and should be included in future studies of PON1 function.


Assuntos
Arildialquilfosfatase/genética , Hidrolases de Éster Carboxílico/sangue , Genótipo , Obesidade Infantil/genética , Polimorfismo de Nucleotídeo Único , Apolipoproteína A-I/sangue , Arildialquilfosfatase/sangue , Estudos de Casos e Controles , Criança , HDL-Colesterol/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Feminino , Humanos , Masculino , Razão de Chances , Obesidade Infantil/enzimologia , Obesidade Infantil/metabolismo , Peroxidase/sangue , Regiões Promotoras Genéticas
2.
Int J Obes (Lond) ; 36(12): 1558-63, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22310475

RESUMO

BACKGROUND: The 11ß-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) enzyme catalyses the regeneration of active cortisol from inert cortisone and plays a critical role in tissue-specific corticosteroid reactions; therefore, 11ß-HSD1 is a key molecule associated with the development of obesity. Despite evidence for its role in obesity, no genetic polymorphisms have been significantly associated with the disease per se. OBJECTIVE: The aim of this study was to evaluate whether HSD11B1 gene variants, which have never been studied before, are associated with obesity and its related traits, as well as its relation to biomarkers of inflammation, liver damage and cardiovascular disease in a cohort of Spanish children. DESIGN: We performed a prospective case-control study. SUBJECTS: A total of 534 children were examined and classified as being obese (n=292) or normal weight (n=242). Anthropometric and biochemical measurements related to obesity, including inflammation, liver damage and cardiovascular disease, were determined. Genomic DNA was extracted and 10 HSD11B1 gene single-nucleotide polymorphisms (SNPs) were genotyped. RESULTS: A novel SNP, rs3753519, was strongly associated with obesity and this SNP was the only statistically significant HSD11B1 gene SNP remaining after a Bonferroni correction (odds ratio=1.97 for allelic effect, 95% confidence interval 1.23-3.16; P=0.004 and Bonferroni corrected P=0.046). In addition, this SNP was significantly and positively associated with increased body mass index (BMI), BMI z-score, weight, waist circumference, plasma γ-glutamyl transpeptidase and plasma active plasminogen activator inhibitor 1. The SNP was negatively associated with plasma adiponectin and cortisol after adjusting for sex and age. None of the inflammation biomarkers tested were associated with the risk allele. CONCLUSION: These data, which link an HSD11B1 genotype with both disease prevalence and its related phenotypes, strongly support a role for the rs3753519 polymorphism in the pathogenesis of pediatric-onset obesity.


Assuntos
11-beta-Hidroxiesteroide Desidrogenase Tipo 1/genética , Obesidade/genética , Polimorfismo de Nucleotídeo Único , 11-beta-Hidroxiesteroide Desidrogenase Tipo 1/metabolismo , Adolescente , Idade de Início , Biomarcadores/sangue , Composição Corporal/genética , Índice de Massa Corporal , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Estudos de Casos e Controles , Criança , Feminino , Perfilação da Expressão Gênica , Predisposição Genética para Doença , Genótipo , Humanos , Inflamação/sangue , Inflamação/genética , Resistência à Insulina , Fígado/metabolismo , Masculino , Obesidade/epidemiologia , Obesidade/metabolismo , Estudos Prospectivos , Espanha/epidemiologia
4.
Ann Nutr Metab ; 58(4): 343-50, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21996789

RESUMO

BACKGROUND/AIMS: There is a strong debate on the diagnosis and early phenotypic expression of the metabolic syndrome in children. The aim of the present study was to examine the frequency of the metabolic syndrome using various definitions in obese prepubertal and pubertal children. METHODS: 478 (213 females and 265 males) obese children were recruited in three provinces of Spain. Blood pressure (BP), waist circumference, and weight and height were measured, and body mass index was calculated. Glucose, insulin, high-density lipoprotein cholesterol and triacylglycerols were determined. We classified the children according to seven different proposed definitions of the metabolic syndrome. RESULTS: Regardless of the definition used, the prevalence of the metabolic syndrome (8.3-34.2%) was relatively high in obese children in the prepubertal period as well as in pubertal children (9.7-41.2%). We performed a principal-factor analysis to explain correlations among features of the metabolic syndrome and found that glucose metabolism (factor 1), dyslipidemia (factor 2) and obesity/BP (factor 3) explained 72% of the total variance. CONCLUSION: Irrespective of the classification used, the metabolic syndrome is not only present in pubertal but also in prepubertal children. International definitions of the metabolic syndrome should also consider criteria specific for children in the prepubertal period, i.e. children aged <10 years.


Assuntos
Idade de Início , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Obesidade/fisiopatologia , Adolescente , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Guias de Prática Clínica como Assunto , Prevalência , Análise de Componente Principal , Estudos Prospectivos , Puberdade , Caracteres Sexuais , Espanha/epidemiologia
5.
J Med Entomol ; 58(4): 1701-1716, 2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-33822101

RESUMO

Madagascar has an important diversity of fleas (Siphonaptera), which almost species do not exist elsewhere. Scientists have provided huge efforts to improve knowledge on Malagasy fleas since the middle of 1900s particularly by investigating topics such as taxonomy, systematics, biogeography, and flea vector role. Since then, new species discovery has increased and currently, 48 species are recorded which the majority is endemic. Therefore, it becomes necessary to have updated keys to identify species membership. This paper presents morphological-based keys to identify at genus and species levels adult fleas reported as occurring in Madagascar. Illustrations are proposed to make easier the observation of morphological criteria, which may be tricky for sibling species.


Assuntos
Sifonápteros/classificação , Animais , Feminino , Madagáscar , Masculino , Sifonápteros/anatomia & histologia
6.
Fertil Steril ; 35(2): 142-8, 1981 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7202739

RESUMO

Of follicular oocytes with germinal vesicles, 79% resumed meiosis within 48 hours in modified Ham's F-10 medium for oocyte culture, and 59% of them reached the second-metaphase stage of meiosis. An increase in cortical granules and tubular aggregates and a decrease in the Golgi apparatus were observed during the maturation process. Scanning electron microscopy of the oocyte surface revealed a decrease in number and length of microvilli. Nuclear DNA contents diminished to approximately one-half, but cytoplasmic protein contents measured by cytofluorometry were unchanged after culture in spite of these structural changes. Insemination with washed spermatozoa resulted in fertilization of 5 of 43 zona-intact cultured oocytes. After removal of the zona, 6 of 17 cultured oocytes showed polyspermic penetration, although immature oocytes were not fertilized even after removal of the zona. Cultured granulosa cells secreted progesterone spontaneously, and its amount was correlated with follicular size. Ultrastructurally, mitochondria with laminar cristae, enlarged nuclei, dispersed Golgi apparatus, smooth endoplasmic reticulum, lipid droplets in the ooplasm, and granular cytoplasmic protrusions were observed on the oocyte surface.


Assuntos
Células da Granulosa/ultraestrutura , Oócitos/ultraestrutura , Óvulo/ultraestrutura , Membrana Celular/ultraestrutura , Núcleo Celular/ultraestrutura , Células Cultivadas , Citoplasma/ultraestrutura , DNA/biossíntese , Feminino , Fertilização in vitro , Células da Granulosa/fisiologia , Humanos , Microvilosidades/ultraestrutura , Mitocôndrias/ultraestrutura , Oócitos/fisiologia , Progesterona/metabolismo , Fatores de Tempo
7.
Clin Chim Acta ; 221(1-2): 23-31, 1993 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-8149640

RESUMO

The purpose of this study was to develop a new method for determination of the mineral element in teeth and bone using a microwave digestion procedure coupled to atomic absorption spectrometry. Samples were ashed at 450 degrees C for 4.5 h and subsequently digested in a microwave oven at maximum power (600 W) for 10 s using a Teflon closed Parr bomb. This method permits the rapid dissolution of the biological samples, avoiding operations such as slicing and cutting which often introduce alterations in sample homogeneity and may contribute to their contamination. The analysis of Na, K, Ca, Mg, Fe, Zn, Ba, Cd and Pb showed good reproducibility, precision and accuracy as compared with the certified values for the IAEA H-5 animal bone. Average concentration for those elements in permanent teeth obtained from children aged 11-18 years by orthodontics are given.


Assuntos
Osso e Ossos/química , Micro-Ondas , Dente/química , Adolescente , Animais , Técnicas de Química Analítica/métodos , Criança , Humanos , Metais/análise , Minerais/análise , Ácido Nítrico , Espectrofotometria Atômica
8.
Sci Total Environ ; 156(2): 145-50, 1994 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-7992034

RESUMO

The aim of this study was to investigate tooth lead concentrations in a Spanish population living in Coruña, Spain. A total of 220 teeth were analysed using a microwave oven digestion procedure and lead content was measured by atomic absorption spectrometry. Samples were classified according to age, sex, type of tooth, cause of extraction and place of residence. Tooth lead levels followed a logarithmic-normal distribution. The general geometric mean was 10.36 micrograms/g of tooth. There was a significant increase in teeth lead levels with advancing age. Permanent teeth showed higher values (13.09 +/- 1.07 micrograms/g, mean +/- S.E.M.) than deciduous teeth (3.96 +/- 1.07 micrograms/g). However, no differences were found between sexes. High lead concentrations were detected in pathological teeth, particularly in those with periodontal pathology, suggesting a relation between lead levels and dental disease. Nevertheless, teeth with caries did not show any significant lead increase. People living in urban areas of the coast had the highest lead teeth contamination. This is the first study in Spain which describes the tooth lead levels as a marker of lead exposure.


Assuntos
Exposição Ambiental/análise , Chumbo/análise , Dente/química , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Cárie Dentária/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha
9.
Sci Total Environ ; 192(2): 183-91, 1996 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-8956526

RESUMO

The purpose of this study was to determine the relationships of lead content in the human tooth with the prevalence of caries, dental plaque, pH of saliva, levels of Salivalis lactobacilli (SL) and Mutans streptococci (MS), degree of dental abrasion, tooth colour and toothbrushing frequency. A total of 220 teeth (one per person) were analysed using a microwave oven digestion procedure and lead content was measured by atomic absorption spectrometry. Tooth lead content followed a logarithmic-normal distribution and it increased with the prevalence of caries. Tooth lead concentrations were positively correlated with all the considered dental health factors except the pH of saliva, for which there was a significant negative correlation. Coloured teeth and teeth subject to abrasion showed the highest lead content. The highest number of colonies of SL and MS in saliva paralleled the highest lead tooth levels. Teeth obtained from irregular brushers presented higher tooth lead contents than subjects with a regular toothbrushing frequency. Multiple logistic regression analysis showed a significant association between tooth lead levels and dental plaque surface, Salivalis lactobacilli number, dental abrasion and dental colour. We conclude that accumulation of lead in teeth is associated with those dental health factors.


Assuntos
Chumbo/análise , Doenças Dentárias/etiologia , Dente/química , Adolescente , Adulto , Idoso , Criança , Cor , Cárie Dentária/epidemiologia , Placa Dentária/epidemiologia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Lactobacillus/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Saliva/fisiologia , Streptococcus mutans/isolamento & purificação , Abrasão Dentária , Doenças Dentárias/epidemiologia , Escovação Dentária
10.
Int J Vitam Nutr Res ; 71(6): 325-31, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11840835

RESUMO

A meta-analysis of the most representative Spanish nutrition studies was carried out to identify inadequate intakes of vitamins, A, B1, B6, C, E, folate, iron, and calcium in children aged 4 to 18. Information on vegetable, fruit and fruit juice/beverage intake was also solicited. Data drawn from the selected studies yielded a total of 6540 children and adolescents in eight geographical areas. The sample was stratified by age (children: 4 to 14 years old and adolescents: 13-18 years old) and sex. Inadequate intakes (below two-thirds of the recommended values) were notable in children for vitamin E, vitamin C, and vitamin A and in girls, iron. In adolescents, low intakes were especially marked for vitamin E and vitamin A, and in girls, calcium, folate, and iron. Adolescents consumed more vegetables, fruit juice, and fruit drinks whereas children had higher fruit intakes. Regional differences in consumption were also detected. Strategies for improving nutrient intake in these vulnerable populations are discussed.


Assuntos
Deficiência de Ácido Ascórbico/epidemiologia , Deficiência de Ácido Ascórbico/prevenção & controle , Cálcio/deficiência , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/prevenção & controle , Deficiências de Ferro , Deficiência de Tiamina/epidemiologia , Deficiência de Tiamina/prevenção & controle , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/prevenção & controle , Deficiência de Vitamina B 6/epidemiologia , Deficiência de Vitamina B 6/prevenção & controle , Deficiência de Vitamina E/epidemiologia , Deficiência de Vitamina E/prevenção & controle , Adolescente , Bebidas , Criança , Pré-Escolar , Registros de Dieta , Feminino , Frutas , Humanos , Masculino , Fatores de Risco , Distribuição por Sexo , Espanha , Verduras
11.
Eur J Pediatr Surg ; 6(4): 198-203, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8877349

RESUMO

We compared the efficacies of prednisolone and dexamethasone for treatment of children with oesophageal burns due to ingestion of caustic substances. The criteria of efficacy used were a) stricture severity by 3 weeks post-ingestion, b) reduction in burn severity by 3 weeks post-ingestion and c) number of dilatations required over the first year post-ingestion. Thirty-six children (24 boys and 12 girls; mean age 23.6 +/- 7.4 months) were selected from a total of 63 patients admitted over a ten-year period to the General Hospital of Galicia with second- or third-degree oesophageal burns due to accidental ingestion of liquid alkali preparations. The patients were divided into two groups of 18, one group for treatment with prednisolone (2 mg/kg/day) and the other for treatment with dexamethasone (1 mg/kg/day). Strictures developed in 12 (66.7%) of the children in the prednisolone-treated group and only 7 (38.9%) of the children in the dexamethasone-treated group. Severe strictures developed in 10 (55.6%) of the children in the prednisolone-treated group and only 5 (27.8%) of the children in the dexamethasone treated group. However, there was no significant difference between the groups in the posttreatment distribution of stricture-severity ratings. Burn healing was significantly better in the dexamethasone-treated group. Similarly, the number of dilatations necessary during the first year of treatment was significantly lower in the dexamethasone-treated group. Our results thus indicate that, by comparison with prednisolone, dexamethasone leads to improved burn healing and reduced need for dialatations during the first year post-injury.


Assuntos
Anti-Inflamatórios/uso terapêutico , Queimaduras Químicas/tratamento farmacológico , Dexametasona/uso terapêutico , Esôfago/lesões , Prednisolona/uso terapêutico , Queimaduras Químicas/classificação , Pré-Escolar , Dilatação , Estenose Esofágica/prevenção & controle , Estenose Esofágica/terapia , Esôfago/diagnóstico por imagem , Feminino , Humanos , Lactente , Masculino , Radiografia
12.
Eur J Pediatr Surg ; 6(4): 204-7, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8877350

RESUMO

During the subacute and chronic phases of esophagitis due to ingestion of a caustic substance, the patient commonly displays stricture, esophageal rigidity and dysphagia. We used esophageal manometry, radiology, pH monitoring and 99mTc scintigraphy to investigate esophageal motor function in 25 children (mean age 24 +/- 7 months) with chronic esophagitis after second- and/or third-degree caustic burns. The results were compared with those for a control group of 12 children (mean age 32 +/- 19 months) under surveillance for suspected gastroesophageal reflux (GER) but for whom this pathology was later ruled out. Seventeen (68%) of the lesioned-group children showed esophageal dysfunction as revealed by monitoring of pH over a 24-hour period. Over this period, the mean percentage of time with pH below 4 was 19 +/- 10%, the mean number of reflux episodes was 48 +/- 52, the mean number of reflux episodes lasting longer than 5 min was 10 +/- 5, and the mean duration of the longest reflux episode was 51 +/- 21 min. Manometry indicated that, in the lesioned group, an average of 77 +/- 18% of peristaltic waves were nonpropulsive, while the mean Esophageal Work Index (number of propulsive waves per hour x mean maximum pressure developed during propulsive waves) was 227 +/- 192 units. All of the above means were significantly different (p < 0.01) from the corresponding control-group means. Esophageal strictures were observed in 60% (15) of the children. In 2 cases it was minimal, 2 cases moderate and 11 cases had severe strictures. 99mTc scintigraphy indicated that esophageal transit was slightly delayed in four, moderately delayed in five and severely delayed in 16 of the lesioned-group subjects. There was close correspondence between the results of manometry and scintigraphy as regards severity of esophageal dysfunction. These results indicate that motility disturbances and GER are very frequent sequelae of caustic burns of the esophagus, and should be taken into account when evaluating symptoms and deciding on the therapeutic strategy (including diet) to be followed.


Assuntos
Queimaduras Químicas/fisiopatologia , Esofagite/fisiopatologia , Junção Esofagogástrica/fisiopatologia , Esôfago/lesões , Pré-Escolar , Esofagite/etiologia , Esofagite Péptica/fisiopatologia , Humanos , Concentração de Íons de Hidrogênio , Lactente , Manometria , Peristaltismo , Pressão , Tecnécio
13.
Rev Esp Enferm Dig ; 96(5): 296-305, 2004 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-15180441

RESUMO

OBJECTIVE: to assess the incidence of inflammatory bowel disease in Oviedo (Northern Spain), and to describe the clinical features of new patients. PATIENTS AND METHODS: a prospective population-based study was made at the Health Area IV, Principality of Asturias (Oviedo, 312,324 inhabitants). All new diagnosed patients with inflammatory bowel disease were registered over a 2-year period. RESULTS: a total of 85 patients were included, 47 of these with ulcerative colitis (UC), 37 with Crohns disease (CD), and 1 with undetermined colitis. The overall adjusted incidence rate of UC and CD per 105 inhabitants between 15-64 years was 9.1 (95% CI: 5-13.1) and 7.5 (95% CI: 3.8-11.2), respectively. The global male/female ratio was 0.9, without significant differences between both diseases. CD patients were younger than those with UC (33 +/- 15 years vs 45 +/- 20 years; p < 0.05). Mostly, CD patients were diagnosed at an age younger than 35 years (65%), while UC patients were diagnosed at an age between 25 and 64 years (81%). Disease extension in UC was proctitis in 11%, left-side colitis in 53% and extensive colitis in 36%. With respect to CD, the ileo-colonic form predominated (49%), followed by the ileal (40%) and colonic (11%) forms; an inflammatory, stenotic and fistulous pattern was seen in 54, 22 and 24% of patients, respectively. CONCLUSIONS: in our area, the incidence of CD is similar to that in other Northern European countries, while UC has a lower incidence. CD mainly affects young people, while UC predominates in middle-aged patients. At diagnosis, UC is predominantly localized, the ileo-colonic form and an inflammatory pattern being most frequent in CD patients.


Assuntos
Doenças Inflamatórias Intestinais/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Doenças Inflamatórias Intestinais/diagnóstico , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia
14.
Rev Esp Enferm Dig ; 96(8): 548-54; 554-8, 2004 Aug.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-15449986

RESUMO

OBJECTIVES: Infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn's disease. We present here the results of retreatment and long-term maintenance therapy. PATIENTS AND METHODS: Eighty one consecutive patients with active fistulizing Crohn's disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6). Those patients who failed to respond after the initial cycle (group 1, n = 25), or those who relapsed after having responded (group 2, n = 13), received retreatment with three similar doses (weeks 0,2, and 6). Those who responded to retreatment were included in a long-term maintenance programme (n = 44), with repeated doses (5 mg/kg i.v. infusions) every eight weeks for 1-2 years. RESULTS: In the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders) presented a complete response, compared to 77% in group 2 (relapsers) (p < 0.0001). In the maintenance treatment, the global response was 88% (39/44). The mean number of doses per patient was 4.4 +/- 2 (range 1-9) with a duration of 36 +/- 12 weeks (range 8-72). Adverse effects were not significantly increased in either treatment. CONCLUSIONS: Both retreatment and long-term maintenance therapy with infliximab, are highly effective and well tolerated in fistulizing Crohn's disease patients.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Doença de Crohn/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Fístula Intestinal/tratamento farmacológico , Adolescente , Adulto , Idoso , Algoritmos , Doença de Crohn/complicações , Feminino , Humanos , Infliximab , Fístula Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Retratamento , Fatores de Tempo
15.
Rev. cir. (Impr.) ; 71(6): 523-529, dic. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1058313

RESUMO

Resumen Introducción: La duodeno pancreatectomía cefálica es una operación compleja cuyos resultados a corto plazo son multifactoriales. Objetivo: Evaluar el impacto de la curva de aprendizaje en los resultados a corto plazo de la duodenopancreatectomía cefálica en un hospital de nivel II. Materiales y Método: Se analizaron los datos obtenidos a partir de una base de datos mantenida prospectivamente desde 2005. Se definieron dos periodos de tiempo: de 2005 a 2011 y de 2012 a 2017. Se compararon la morbilidad, mortalidad y estancia postoperatoria de ambos períodos. Resultados: Durante el período de tiempo estudiado se hicieron 126 duodenopancreatectomías cefálicas, 61 durante la primera etapa y 65 durante la segunda. La tasa de transfusión intraoperatoria se redujo de 33% a 15% (p = 0,011). La tasa de transfusión postoperatoria se redujo de 39 a 23% (p = 0,021). No hubo diferencias significativas con respecto a la incidencia global de complicaciones postoperatorias (59% y 52,3%). La incidencia de abscesos intraabdominales fue significativamente menor en el segundo período (18% y 4,6%, respectivamente; p = 0,038). La tasa de reintervenciones se redujo significativamente, de 22% a 9% (p = 0,049). También se redujo significativamente la tasa de mortalidad, de 6,56% a 0% (p = 0,032). La estancia media postoperatoria disminuyó significativamente en el segundo período, pasando de 19,6 a 15,8 días (p = 0,001), con una mayor proporción de pacientes dados de alta en los 8 primeros días de postoperatorio (11,5% y 38,5%, respectivamente; p = 0,001). Conclusión: La curva de aprendizaje es un factor que permite mejorar los resultados de la duodenopancreatectomía cefálica, en un hospital de nivel II, hasta alcanzar valores similares a los de un hospital de nivel III.


Introduction: The duodenum pancreatectomy cephalic is a complex operation whose short-term results are multifactorial. Aim: To assess the impact of the learning curve on the short-term outcomes of cephalic duodenopancreatectomy at a level II hospital. Materials Method: We analyze the data obtained from a database maintained prospectively since 2005. Two time periods were defined: from 2005 to 2011 and from 2012 to 2017. The morbidity, mortality and postoperative stay of both periods were compared. Results: 126 cephalic duodenopancreatectomies were performed, 61 during the first period and 65 during the second. The intraoperative transfusion rate was reduced from 33% to 15% (p = 0.011). The postoperative transfusion rate was reduced from 39 to 23% (p = 0.021). There were no significant differences with respect to the overall incidence of postoperative complications (59% and 52.3%, respectively). However, the incidence of intra-abdominal abscesses was significantly lower in the second period (18% and 4.6%, respectively, p = 0.038). The rate of reoperations was significantly reduced, from 22% to 9% (p = 0.049). The mortality rate was also significantly reduced, from 6.56% to 0% (p = 0.032). The mean postoperative stay decreased significantly in the second period, from 19.6 to 15.8 days (p = 0.001), with a higher proportion of patients discharged in the first 8 postoperative days (11.5% and 38.5%, respectively, p = 0.001). Conclusion: The learning curve is a factor allows improving the results of cephalic pancreaticoduodenectomy, in a level II hospital, until reaching values similar to those of a level III hospital.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/complicações , Pancreaticoduodenectomia/efeitos adversos , Curva de Aprendizado , Período Pós-Operatório , Pancreaticoduodenectomia/educação , Pancreaticoduodenectomia/métodos , Pancreaticoduodenectomia/mortalidade
16.
Allergol Immunopathol (Madr) ; 36(2): 66-71, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18479657

RESUMO

BACKGROUND: The factors relevant to the prognosis of childhood asthma differ from one population to another. OBJECTIVES: To characterize the course of childhood asthma in the catchment area of our hospital, and to identify prognostic factors for this population. METHODS: All children given a diagnosis of asthma in the paediatric pulmonology service of a tertiary hospital were followed up for 5 years. RESULTS: Satisfactory control of asthma was achieved in 69 % of cases. The factors identified as associated with poor control were allergy to cats and pollen, a large number of crises in the year prior to diagnosis, and younger age at onset. CONCLUSIONS: In our region, childhood asthma has a relatively favourable prognosis. The subsequent course of the disease appears to be determined in childhood. The persistence of symptoms appears to depend to a significant extent on the degree of atopy.


Assuntos
Asma/etiologia , Adolescente , Idade de Início , Asma/diagnóstico , Asma/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pico do Fluxo Expiratório/imunologia , Valor Preditivo dos Testes , Prognóstico , Rinite Alérgica Sazonal/complicações , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Fatores de Risco , População Rural , Índice de Gravidade de Doença , Testes Cutâneos , Espanha , População Urbana
17.
Am J Anat ; 156(3): 401-27, 1979 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-532792

RESUMO

Small (60-90 micrometer) and large (100-130 micrometer) preantral follicles were isolated from adult mouse ovaries by a collagenase-dissection technique. These follicles were composed of resting oocytes surrounded either by granulosa cells, only, or by granulosa and undifferentiated theca cells. Further enzymatic dissociation of primary follicles yielded monodisperse cells characterized by abundant rough endoplasmic reticulum, microfilament-rich pseudopodia and only scant lipid droplets. These cells reaggregated, when explanted in stationary culture, forming epithelial cords and structures macroscopically reminiscent of native ovarian follicles. Anticipated association of follicular cells in epithelial-like monolayers was rare (less than or equal to 10% of all cultured cells). Formation and growth of both follicle-like (FLS) and cord-like (CLS) structures occurred within 24 hours of culture, continued for 14 days, and was inhibited by cytochalasin B, but not by neuraminidase. FLS and CLS, as well as cell monolayers, underwent luteinization, as indicated by the presence in the culture medium of radioimmunoassayable progesterone and by frequent cytological features suggestive of active steroidogenesis. The present report indicates that (a) specific cell affinities exist among immature follicular cells which may play a role in folliculogenesis; and (b) follicular cells are endowed, from their early developmental stages with intrinsic steroidogenic capabilities which become phenotypically expressed after escape from the intraovarian environment.


Assuntos
Folículo Ovariano/citologia , Animais , Agregação Celular/efeitos dos fármacos , Divisão Celular , Separação Celular/métodos , Técnicas de Cultura , Citocalasina B/farmacologia , Feminino , Camundongos , Folículo Ovariano/metabolismo , Progesterona/metabolismo
18.
J Pediatr Gastroenterol Nutr ; 25(3): 296-300, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9285380

RESUMO

BACKGROUND: The aim of the current study was to evaluate the prevalence of lactose malabsorption (LM) in Galicia (NW Spain) in order to design nutritional intervention and/or public education strategies for high risk groups. METHODS: We conducted a study of LM by breath-hydrogen carbohydrate absorption test (BH2 test) in 850 healthy subjects. All subjects underwent BH2 tests following ingestion of a aqueous solution of 2 g lactose/kg body weight up to a maximum of 50 g. Subjects with LM were retested after ingesting 250 ml of milk and/or 250 ml of yogurt. RESULTS: The frequency of LM in the subjects who ingested 2 g lactose/kg body weight was 32.5%. This percentage decreased significantly with a decrease in the quantity of administered lactose and the vehicle was milk or yogurt-only 13.7% was LM after 250 ml of milk and 3.8% after 250 ml of yogurt. Gastrointestinal symptoms also depend on dosage of lactose and vehicle, decreasing from 54.3% after 2 g lactose/kg to 18.5% after milk and to 0% after yogurt. The frequency and number of gastrointestinal symptoms were significantly higher (p < 0.001) in LM than in lactose absorption (LA). CONCLUSIONS: Lactose malabsorption is prevalent in the population of Galicia. An important number of subjects identified as LM with usual clinical testing become LA when the ingestion of dairy products is limited so that the amount of lactose consumed is similar to that contained in a usual serving. Our results suggest the importance of BH2 testing following ingestion of usual consumed amounts of lactose per serving.


Assuntos
Intolerância à Lactose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Intolerância à Lactose/fisiopatologia , Masculino , Pessoa de Meia-Idade , Leite , Espanha , Iogurte
19.
Acta Vitaminol Enzymol ; 4(1-2): 1-11, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-6289643

RESUMO

Diagnostic and therapeutical uses of vitamin D3 and its metabolites are reviewed. Special emphasis is dedicated to the fetomaternal relationships of 1,25 (OH)2 D3 and 25-OH-D3 at term. The serum levels of 1,25 (OH)2 D3 have been found to be higher in the maternal serum then in the corresponding fetus (85.3 pg/ml and 50.9 pg/ml, respectively). The highest serum levels of 1,25 (OH)2 D3 were found in October and the lowest ones in January showing that there is a dependence on the ultraviolet light. It has been found that there is a correlation between the fetomaternal serum levels of 1,25 (OH)2 D3 and 25-OHD. However, there is no correlation between the serum levels of 1,25 (OH)2 D3 and 25-OHD3, neither in the fetus nor in the mother.


Assuntos
Colecalciferol/uso terapêutico , Raquitismo/terapia , Deficiência de Vitamina D/terapia , Adulto , Calcifediol/sangue , Calcifediol/uso terapêutico , Calcitriol/sangue , Calcitriol/uso terapêutico , Criança , Colecalciferol/metabolismo , Feminino , Sangue Fetal/metabolismo , Feto/metabolismo , Humanos , Hipofosfatemia Familiar/tratamento farmacológico , Lactente , Recém-Nascido , Necessidades Nutricionais , Gravidez , Raquitismo/diagnóstico , Raquitismo/tratamento farmacológico , Estações do Ano , Raios Ultravioleta
20.
An Esp Pediatr ; 23(3): 170-4, 1985 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-4073685

RESUMO

Results of a comparative study of serum activity levels of creatine kinase, lactodehydrogenase and their isoenzyme in mothers of 13 children with Duchenne progressive muscular distrophy are presented. CPK sensibility was 100%, while that of LDH1/LDH2 and LDH5 were 23% and 38,4% respectively. It is concluded that CPK has a great liability index, and that it is superior to LDT and their isoenzyme for detection of carriers of Duchenne progressive muscular distrophy.


Assuntos
Creatina Quinase/sangue , Triagem de Portadores Genéticos , L-Lactato Desidrogenase/sangue , Distrofias Musculares/enzimologia , Adulto , Feminino , Humanos , Isoenzimas
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