RESUMO
Background and objective: This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. Methods: Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student's t-test, and Cox's regression model. Results: A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HR = 8.04; 95% CI 7.03-9.19), diabetes (HR = 1.63; 95% CI 1.40-1.89), high blood pressure (HR = 1.48; 95% CI 1.28-1.72), obesity (HR = 1.37; 95% CI 1.18-1.60) and chronic kidney disease (HR = 2.06; 95% CI 1.64-2.59) were significantly associated with mortality. Conclusions: Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years.
RESUMO
On-farm assessment of caprine colostrum quality is important for goat farmers; the ability to quickly recognize whether colostrum is suitable to feed to kids helps achieve successful passive transfer of immunity. The study compared the use of optical and digital Brix refractometers and a hydrometer against the international gold standard radial immunodiffusion (RID), using both fresh and frozen samples. A locally available ELISA methodology was included for comparison. A total of 300 samples were collected from 2 farms (farm 1: n = 157, collected by research staff within 24 h of parturition; farm 2: n = 143, collected by the farmer within 12 h of parturition). Farm 1 provided doe age for a subset of samples (n = 86). Samples were tested fresh and then frozen for shipment and repeated testing. Specific gravity was measured using a hydrometer in a subset of samples (n = 22) from farm 2. Because no gold standard thresholds are currently available for caprine colostrum, RID-derived values of 30, 40, and 50 g/L IgG were used as potential "good quality" thresholds. Pearson (ρ) and Lin's concordance correlation coefficients (CCC) were calculated for comparison of methods. Optimum thresholds were established maximizing the Youden index and minimizing the "distance closest to the top left corner" of the receiver operator characteristic curves. Brix values were correlated with RID (optical Brix, fresh: ρ = 0.73; digital Brix, fresh: ρ = 0.71; digital Brix, frozen: ρ = 0.76) and with each other (range: ρ = 0.93 to 0.99; CCC = 0.91 to 0.99). Specific gravity measured by the hydrometer yielded a strong relationship with RID (ρ = 0.83) and with Brix values (range: ρ = 0.88 to 0.90). The ELISA method was not correlated with Brix methods (range: ρ = 0.02 to 0.09) or RID (ρ = 0.20). Depending on the colostrum IgG threshold, the hydrometer yielded high Youden indices (range: 0.78 to 0.93) and low distance closest to the top left corner criteria (0 to 0.05) at a threshold of 1.047 specific gravity. For all RID IgG thresholds, the best Brix threshold (regardless of type or whether the sample was fresh or frozen) was 18 or 19%, with the highest Youden indices (range: 0.47 to 0.61) and lowest distance to the top left corner criteria (range: 0.09 to 0.16); however, we recommend 19%, because this reduces the potential of feeding poor-quality colostrum. The ELISA method was the poorest predictor of colostrum concentration. Age was not found to affect colostrum quality; however, the sample size of this subset was small. Hydrometers are inexpensive and easy to use, whereas Brix methods use only a small amount of colostrum; we suggest that either method could be used on-farm.
Assuntos
Colostro , Cabras , Imunodifusão/veterinária , Refratometria/veterinária , Animais , Colostro/química , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Congelamento , Cabras/imunologia , Imunodifusão/instrumentação , Parto , Gravidez , Curva ROC , Refratometria/instrumentaçãoRESUMO
BACKGROUND AND OBJECTIVE: This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. METHODS: Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student's t-test, and Cox's regression model. RESULTS: A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HRâ¯=â¯8.04; 95%CI 7.03-9.19), diabetes (HRâ¯=â¯1.63; 95%CI 1.40-1.89), high blood pressure (HRâ¯=â¯1.48; 95%CI 1.28-1.72), obesity (HRâ¯=â¯1.37; 95%CI 1.18-1.60) and chronic kidney disease (HRâ¯=â¯2.06; 95%CI 1.64-2.59) were significantly associated with mortality. CONCLUSIONS: Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years.
Assuntos
COVID-19 , Diabetes Mellitus , Hipertensão , Insuficiência Renal Crônica , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Fatores de RiscoRESUMO
The aim of the present study is to assess the effect of the free-fatty-acid (FFA) content and saturation degree of dietary fat (added at 6%) on the fatty-acid (FA) digestibility and lipid-class content along the gastrointestinal tract and excreta in broilers from 22 to 37 d of age. This is essential to determine the potential use of acid oils (refining by-products rich in FFA) in broiler diets as an alternative to crude oils. The study consisted of a 2 × 4 factorial arrangement, which included 2 fat sources (soybean oils - unsaturated, or palm oils - saturated) and 4 levels of FFA (5, 15, 35, and 50%). Samples of digestive content of the gizzard, duodenum, jejunum, ileum and of the excreta were obtained at 37 d of age. Irrespective of the dietary fat source, more than 80% of total FA (TFA) was absorbed in the jejunum. Broilers fed with unsaturated diets had a higher absorption efficiency of FA than did those fed with saturated diets. This conclusion is supported by the lower FFA content and the higher TFA and polyunsaturated FA (PUFA) digestibility coefficients in the ileum (P < 0.001) observed in the former group. The dietary FFA level did not affect the FA absorption process as much as the dietary fat source did. This was supported by the lack of statistical differences among the diets with a similar saturation degree but rather different levels of FFA, for TFA, saturated FA, and PUFA digestibility coefficients both in the jejunum and ileum. However, the interactions reported in the ileum for triacylglycerol and diacylglycerol contents (P < 0.001), as well as for monounsaturated FA digestibility coefficients (P < 0.05) show that the dietary FFA content affects the FA absorption process. The present results show that the inclusion of acid oils in grower-finisher broiler diets with FFA levels up to 35% does not have a negative impact on the FA absorption process.
Assuntos
Gorduras Insaturadas na Dieta , Ácidos Graxos , Ração Animal/análise , Animais , Galinhas , Dieta/veterinária , Suplementos Nutricionais , Digestão , Ácidos Graxos não Esterificados , Trato Gastrointestinal , Óleo de SojaRESUMO
Two experiments were conducted to evaluate the use of crude soybean lecithin (L) as an alternative energy source in broiler feeding and to study its influence on performance, fatty acid (FA) digestibility between 9 to 11 D and 36 to 37 D, feed AME content, and the FA profile of the abdominal fat pad (AFP). A basal diet was supplemented at 3% with soybean oil (S; experiment 1) or a monounsaturated vegetable acid oil (A; experiment 2) and increasing amounts of L (1, 2, and 3%) were included in replacement. The inclusion of L did not modify performance results (P > 0.05). In starter diets, the replacement of S by L reduced feed AME content (P < 0.001) and lowered PUFA digestibility (P = 0.028), whereas in the grower-finisher phase, a blend of 2% of S and 1% of L did not modify feed AME content or FA digestibility. When L was included instead of A, no effects on feed AME value and total FA digestibility (P > 0.05) were shown in the starter phase, whereas in grower-finisher diets, a blending of 2% of A and 1% of L enhanced feed AME content (P < 0.001) and total FA digestibility (P = 0.001). The FA profile of the AFP reflected the FA composition of the diets. Crude soybean lecithin represents an alternative energy source for broiler chickens, and it can be used in growing-finishing diets in replacement of 1% S. The best option to include both alternative fats (L and A) was 2% of L with 1% of A in starter diets and 1% of L with 2% of A in grower-finisher diets because they showed positive synergic effects. The results suggest that dietary FA profile have a bigger impact on the AFP saturation degree than the different dietary lipid molecular structures.
Assuntos
Galinhas/fisiologia , Digestão/efeitos dos fármacos , Ácidos Graxos Monoinsaturados/metabolismo , Glycine max/química , Lecitinas/metabolismo , Óleo de Soja/metabolismo , Tecido Adiposo/química , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Relação Dose-Resposta a Droga , Metabolismo Energético/efeitos dos fármacos , Feminino , Lecitinas/administração & dosagem , Óleos de Plantas/metabolismo , Distribuição Aleatória , Óleo de Soja/administração & dosagemRESUMO
The aim of the present study is to evaluate the effect of the dietary fat saturation degree and age on the lipid class (TAG, DAG, MAG, and FFA) composition and fatty acid digestibility along the gastrointestinal tract (GIT) and excreta in broiler chickens. A total of 120 one-day-old female broiler chickens were randomly distributed in 2 dietary treatments (6 cages/treatment), which resulted from the supplementation of a basal diet with 6% of soybean oil or palm oil. Two digestibility balances were carried out at 14 and 35 d and fatty acid digestibility and lipid class composition were determined in the gizzard, duodenum, jejunum, ileum, and excreta. Along de GIT, both fatty acid digestibility and lipid class composition were influenced by the dietary fat source and the age of the chickens. The absorption of the unsaturated fat was more efficient and faster than it was for the saturated fat. The ability of adult chickens to absorb fat was higher than for young chickens. The results show that the duodenum is the main place of fat digestion (hydrolysis), and the jejunum the main place of fat absorption. The role of the ileum on fat absorption is very important, as it is the last segment of the GIT where the absorption of fatty acids has been described. Thus, it was the contribution of the ileum that was responsible for the higher fat utilization observed for animals fed the unsaturated diet than for those fed the saturated diet at 14 d, and it was also responsible for the improvement on the utilization of the saturated diet between 14 and 35 d. All the results suggest that the absorption of fatty acids is more limiting than is hydrolysis, because the main differences were observed in the jejunum and ileum, where the absorption of fatty acids takes place.
Assuntos
Galinhas , Dieta/veterinária , Gorduras na Dieta/administração & dosagem , Digestão/fisiologia , Ácidos Graxos/metabolismo , Fatores Etários , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Feminino , Conteúdo Gastrointestinal/química , Metabolismo dos Lipídeos , Óleo de Palmeira , Óleo de SojaRESUMO
The aim of the present study is to assess the effect of the dietary free fatty acid (FFA) content and dietary fat saturation degree on the fatty-acid (FA) digestibility and lipid-class content along the gastrointestinal tract and excreta in broiler chickens. The 8 experimental diets resulted from replacing crude soybean oil with soybean acid oil from chemical refining, or crude palm oil with palm FA distillate from physical refining. Thus, there were 4 soybean and 4 palm diets with 6% added fat varying in their FFA% (5, 15, 35, and 50%). Samples of digestive content (gizzard, duodenum, jejunum, and ileum) and excreta were collected at 14 D for the determination of the FA digestibility and lipid-class content. The total FA digestibility coefficients reported for the chickens fed S diets in the jejunum, ileum, and excreta were higher than for those fed P diets (P ≤ 0.02). The general greater digestibility of the unsaturated diets was mainly explained by a higher contribution of the ileum to the absorption of saturated FA. The dietary FFA content mainly affected the FA absorption process. The diets with 50% FFA presented lower saturated FA digestibility coefficients in the jejunum and ileum (P ≤ 0.03), and higher content of FFA in the ileum and excreta (P ≤ 0.014), in comparison to the diets with 5% FFA. The 15% FFA diets were not different from the 5% FFA diets, regarding the saturated FA digestibility in the jejunum and excreta, and the FFA content in the ileum and excreta. It was concluded that unsaturated diets with moderate content of dietary FFA (up to 15%) could be used in broiler-chicken starter diets, as they led to similar FA absorption and performance results to the diets with the lowest dietary FFA content. From the present study, it has also been concluded that dietary saturated FA content has a greater impact on FA absorption than the dietary FFA content has.
Assuntos
Galinhas/fisiologia , Digestão/efeitos dos fármacos , Ácidos Graxos não Esterificados/metabolismo , Metabolismo dos Lipídeos , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Dieta/veterinária , Digestão/fisiologia , Ácidos Graxos não Esterificados/administração & dosagem , Feminino , Trato Gastrointestinal/fisiologia , Lipídeos/classificação , Distribuição AleatóriaRESUMO
Antecedentes y objetivo: El objetivo de este estudio es describir las características de los pacientes con COVID-19 en un estado del norte de México y determinar las comorbilidades asociadas con la mortalidad. Métodos: Se examinaron pacientes con COVID-19, divididos en supervivientes y no supervivientes. Los datos fueron analizados mediante las pruebas de X2, t de Student y el modelo de regresión de Cox. Resultados: Se incluyeron 17.479 pacientes, reportando un 6,3% de mortalidad. Los factores que se asociaron con esta fueron: edad mayor a 60 años (HR = 8,04; IC 95% 7,03 a 9,19), diabetes (HR = 1,63; IC 95% 1,40 a 1,89), hipertensión arterial sistémica (HR = 1,48; IC 95% 1,28 a 1,72), obesidad (HR = 1,37; IC 95% 1,18 a 1,60) y daño renal crónico (HR = 2,06; IC 95% 1,64 a 2,59). Conclusiones: La diabetes, la hipertensión arterial, la obesidad y el daño renal crónico incrementan la mortalidad en pacientes con COVID-19 en la población de Coahuila, México; el factor que más contribuye para el riesgo de muerte es la edad mayor a 60 años (AU)
Background and objective: This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. Methods: Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student's t-test, and Cox's regression model. Results: A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HR = 8.04; 95% CI 7.03-9.19), diabetes (HR = 1.63; 95% CI 1.40-1.89), high blood pressure (HR = 1.48; 95% CI 1.28-1.72), obesity (HR = 1.37; 95% CI 1.18-1.60) and chronic kidney disease (HR = 2.06; 95% CI 1.64-2.59) were significantly associated with mortality. Conclusions: Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Pandemias , Estudos Retrospectivos , Fatores de Risco , México/epidemiologiaRESUMO
BACKGROUND: Some patients with chronic benign neutropenia present granulocytes distribution disorders within their different physiologic pools, and this situation can be exposed by granulocyte mobilization tests. Stimulation with hydrocortisone is the best known test, but its performance and interpretation are not well standardized. Granulocyte mobilization test with hydrocortisone was performed in 19 patients with chronic peripheral idiopathic granulocytopenia, by applying homogeneous criteria. PATIENTS AND METHOD: The test included an injection of intravenous hydrocortisone 200 mg after a first basal blood neutrophil determination, and a second neutrophil count four hours after steroid administration. Following data were registered: basal blood neutrophil count (BNC), final blood neutrophil count (FNC), difference between both counts or increment (INCR), and the ratio = 60% of INCR/2.0 (109/1) BNC, which we name demargination index (DI). RESULTS: Three response patterns (three patient groups) were observed: pattern I, with FNC > 2.0 109/1 and DI >/= 1 (false neutropenia with hypermargination component); pattern II, with FNC > 2.0 (109/1) and DI < 1 (false neutropenia with pathogenic mechanisms others than hypermargination), and pattern III, with FNC < 2.0 (109/1) and DI < 1 (true neutropenia). There were no significant differences in BNC or INCR when groups I and II were compared, but we found differences in FNC (p = 0.026) and DI (p = 0.026). Comparison between groups I and III showed differences in all four parameters (BNC P = 0.07, FNC p < 0.001, INCR p = 0.02, and DI p < 0.001). No differences were found between groups II and III. CONCLUSIONS: Granulocyte mobilization test with intravenous hydrocortisone 200 mg and a four-hours interval between basal and final neutrophil counts, allows differentiation between false neutropenia with hypermargination component and true neutropenia.
Assuntos
Hidrocortisona , Neutropenia/imunologia , Neutrófilos/fisiologia , Adolescente , Adulto , Criança , Doença Crônica , Feminino , Humanos , Hidrocortisona/administração & dosagem , Injeções Intravenosas , Masculino , Pessoa de Meia-IdadeRESUMO
Primary effusion lymphoma (PEL) is a recently individualized form of non-Hodgkin lymphoma (WHO classification) that mainly develops in HIV infected males, more frequently in homosexuals and advanced stages of the disease (total CD4+ lymphocyte count below 100-200/mL). Occasionally, it appears in others immunodepressive states (such as solid organs postransplant period) and even, although very rarelly, in immunocompetents patients. From a pathogenetic point of view, PEL has been related to Kaposi's sarcoma-associated herpes virus (also named human herpesvirus 8) and to the clinical antecedent of Kaposís sarcoma. Relative unfrequency of this disease, the absence of wide casuistics allowing a better characterization, and its unfavorable outcome, support the need of a deeper knowledge. We present here the clinical-biological findings of three patients that were diagnosed of pleural PEL in our institution in the last two years.
Assuntos
Infecções por HIV/complicações , HIV-1/isolamento & purificação , Herpesvirus Humano 8/isolamento & purificação , Linfoma não Hodgkin/complicações , Cavidade Pleural/patologia , Adulto , Biópsia , Contagem de Linfócito CD4 , Infecções por HIV/patologia , Infecções por HIV/virologia , Humanos , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/virologia , Masculino , Pleura/patologia , Pleura/virologia , Cavidade Pleural/virologiaRESUMO
Our objective was to determine if the phycobiliproteins of Arthrospira (Spirulina) maxima protect renal cells against mercury-caused oxidative stress and cellular damage in the kidney. We used 40 male mice that were assigned into eight groups: (1) a control group that received 100mM phosphate buffer (PB) ig and 0.9% saline ip, (2) PB+HgCl(2) (5mg/kg ip), (3) PB plus phycobiliproteins (100mg/kg ig), (4) PB plus C-phycocyanin (100mg/kg ig), and four groups receiving HgCl(2)+phycobiliproteins or C-phycocyanin (50, and 100mg/kg ig). The left kidneys were used to determine lipid peroxidation, quantification of reactive oxygen species, and reduced glutathione and oxidised content. The right kidneys were processed for histology. The HgCl(2) caused oxidative stress and cellular damage. All doses of phycobiliproteins or C-phycocyanin prevented enhancement of oxidative markers and they protected against HgCl(2)-caused cellular damage.
Assuntos
Proteínas de Bactérias/administração & dosagem , Cianobactérias/química , Nefropatias/tratamento farmacológico , Rim/efeitos dos fármacos , Cloreto de Mercúrio/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Ficobiliproteínas/administração & dosagem , Ficocianina/administração & dosagem , Substâncias Protetoras/administração & dosagem , Animais , Humanos , Rim/metabolismo , Nefropatias/induzido quimicamente , Nefropatias/metabolismo , Masculino , CamundongosAssuntos
Vasos Sanguíneos/efeitos dos fármacos , Cafeína/efeitos adversos , Cafeína/farmacologia , Ergotamina/efeitos adversos , Ergotamina/farmacologia , Ergotismo/complicações , Ergotismo/etiologia , Isquemia/etiologia , Cafeína/uso terapêutico , Doença Crônica , Combinação de Medicamentos , Ergotamina/uso terapêutico , Feminino , Humanos , Perna (Membro)/irrigação sanguínea , Transtornos de Enxaqueca/tratamento farmacológico , Adulto JovemRESUMO
In the upwelling zone of the northeastern Pacific, cold nutrient-rich conditions alternate with warm nutrient-poor intervals on timescales ranging from months to millennia. In this setting, the abundances of Pacific sardine (Sardinops sagax) and northern anchovy (Engraulis mordax) fluctuate by several orders of magnitude, with sardine dominating during warm conditions and anchovy dominating during cool conditions. Two population models can explain the response of these fishes to adverse conditions. Under the basin model, species distributions contract to a central (optimal) range during population crashes. Expectations of this model may include a single range-wide population with a decline in genetic diversity on both sides of a central refuge. In contrast, the self-recruitment model invokes a series of local oceanographic domains that maintain semi-isolated subpopulations. During adverse conditions, some subpopulations cannot complete the life cycle within the local environment and are extirpated. Expectations of this model include some degree of population genetic structure and no clear gradient in genetic diversity. We examined mitochondrial DNA cytochrome b sequences to assess these competing models for anchovy (N = 196; 539 bp) and sardine (N = 107; 425 bp). The mitochondrial DNA gene genealogies are shallow but diverse for both species. Haplotype frequencies are homogeneous among subpopulations, but genetic diversities peak for both species along Baja California and adjacent southern California. Mismatch distributions and Tajima's D-values reveal distinctive signatures of population bottlenecks and expansions. Sardine haplotypes coalesce at approximately 241,000 years bp, with an initial female effective population size Nf0 = 0 followed by exponential growth to Nf1 = 115 million. Anchovy haplotypes coalesce at approximately 282,000 years bp, with an initial population size of Nf0 = 14,000, followed by exponential growth to Nf1 = 2.3 million. These results indicate a founder event for sardine and a severe population decline for anchovy in the California Current during the late Pleistocene. Overall, these data support the basin model on decadal timescales, although local recruitment may dominate on shorter timescales.
Assuntos
Clima , Peixes/genética , Variação Genética , Genética Populacional , Modelos Biológicos , Animais , Sequência de Bases , Citocromos b/genética , Geografia , Haplótipos/genética , Modelos Genéticos , Dados de Sequência Molecular , Oceano Pacífico , Dinâmica Populacional , Análise de Sequência de DNA , Especificidade da Espécie , Temperatura , Movimentos da ÁguaRESUMO
La anamnesis y la exploración física son las herramientas básicas con las que cuenta el médico de familia en la consulta diaria. Se definen las pruebas diagnósticas en atención primaria (AP) como aquellas pruebas que son solicitadas directamente por el médico de AP y, aun siendo realizadas fuera de la consulta, no suponen una transferencia en la responsabilidad clínica sobre el paciente. El objetivo de esta segunda parte es revisar los aspectos más importantes de las pruebas bioquímicas de laboratorio que solicitamos diariamente en nuestras consultas de AP (AU)
Anamnesis and physical examination are the basic tools of the Family Doctor in daily routine practice. Diagnostic tests in Primary Care are defined as these tests that are directly requested by the Primary Care doctor, and although being performed outside the clinic, there is no transfer of clinical responsibility of the patient. The purpose of this second part is to review the most important aspects of the biochemistry tests that are requested daily in Primary Care clinics (AU)
Assuntos
Humanos , Masculino , Feminino , Testes Laboratoriais/métodos , Testes Laboratoriais/estatística & dados numéricos , Técnicas de Laboratório Clínico , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Glicemia/análise , Testes de Química Clínica/métodos , Sensibilidade e Especificidade , Transaminases/análise , Creatinina/análise , Atenção Primária à Saúde/tendências , Atenção Primária à Saúde , Testes de Química Clínica/instrumentação , Medicina de Família e Comunidade/tendências , Testes de Química Clínica/tendências , Testes de Química ClínicaRESUMO
La anamnesis y la exploración física son las herramientas básicas con las que cuenta el médico de familia en la consulta diaria. Se definen las pruebas diagnósticas en Atención Primaria como aquellas pruebas que son solicitadas directamente por el médico de Atención Primaria y, aún siendo realizadas fuera de la consulta, no suponen una transferencia en la responsabilidad clínica sobre el paciente. Debemos tener claras cuáles son sus indicaciones y una serie de cuestiones básicas para poder realizar un uso racional de las mismas (AU)
The anamnesis and the physical examination are the basic tools of the Family Doctors in their daily clinics. Diagnostic tests in Primary Care are defined as those tests that are requested directly by the Primary Care doctor and, although they are performed outside the clinic, this does not assume a transfer of clinical responsibility of the patient. We must be clear what their indications are and a have series of basic questions to be able to make rational use of them (AU)
Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Testes Laboratoriais/métodos , Testes Laboratoriais/políticas , Testes de Coagulação Sanguínea/métodos , Tempo de Tromboplastina Parcial , Atenção Primária à Saúde , Testes Laboratoriais/classificação , Testes Laboratoriais/estatística & dados numéricos , Medicina de Família e Comunidade/educação , Medicina de Família e Comunidade/normas , Medicina de Família e Comunidade/tendências , Medicina Nuclear/estatística & dados numéricos , Medicina Nuclear/tendênciasRESUMO
El síndrome de Klinefelter (SK) es la forma más frecuente de hipogonadismo hipergonadotrófico del varón. Su asociación con la enfermedad tromboembólica venosa es bien conocida. La enfermedad tromboembólica venosa engloba la trombosis venosa profunda y el tromboembolismo pulmonar). Esta última patología es una entidad de difícil diagnóstico y potencialmente mortal que requiere una adecuada anamnesis y exploración física. Presentamos el caso de un paciente de 36 años con síndrome de Klinefelter que solicitó la asistencia de su médico de Atención Primaria por disnea (AU)
Klinefelter Syndrome is the most common form of hypergonadotrophic hypogonadism in the male. Its association with venous thromboembolic disease is well known. Venous thromboembolic disease includes deep vein thrombosis and pulmonary thromboembolism). This last condition is difficult to diagnose and is potentially fatal and requires na adequate anamnesis and physical examination. We present a case of a 36 year-old patient with Klinefelter syndrome who visited his Primary Care doctor for dyspnoea (AU)
Assuntos
Humanos , Masculino , Adulto , Síndrome de Klinefelter/complicações , Síndrome de Klinefelter/diagnóstico , Insuficiência Venosa/complicações , Insuficiência Venosa/diagnóstico , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Atenção Primária à Saúde , Cardiomegalia/complicações , Cardiomegalia , Radiografia Torácica , Síndrome de Klinefelter/economia , Síndrome de Klinefelter/terapia , Síndrome de Klinefelter , Embolia Pulmonar , Imageamento por Ressonância Magnética/métodosRESUMO
No disponible
No disponible
Assuntos
Humanos , Feminino , Adulto Jovem , Isquemia/induzido quimicamente , Ergotismo/complicações , Ergotaminas/efeitos adversos , Doenças Vasculares Periféricas/induzido quimicamenteRESUMO
El linfoma primario de cavidades (LPC) constituye un variedad de linfoma no Hodgkin individualizada por la clasificación OMS, que se desarrolla principalmente en pacientes varones con infección por HIV, más frecuentemente homosexuales y en estadios avanzados de la enfermedad (recuento total de linfocitos CD4+ inferior a 100-200/µL), aunque en ocasiones pueden aparecer en otras circunstancias asociadas a estados de inmunodepresión (como puede ser en el postrasplante de órganos sólidos) e incluso, de forma muy ocasional, en pacientes inmunocompetentes. Desde un punto de vista patogenético se ha relacionado con el virus herpes asociado a sarcoma de Kaposi (también denominado virus herpes tipo 8) y al propio antecedente clínico de sarcoma de Kaposi. La relativa rareza de esta enfermedad, la falta de casuísticas amplias que logren caracterizarla mejor y su pronóstico tan desfavorable, obligan a profundizar en un mejor conocimiento de la misma. Presentamos los hallazgos clínico-biológicos de tres pacientes diagnosticados de LPC pleural en nuestro centro en los últimos dos años (AU)
Assuntos
Humanos , Masculino , Adulto , Herpesvirus Humano 8 , Cavidade Pleural , Pleura , HIV-1 , Infecções por HIV , Contagem de Linfócito CD4 , Biópsia , Linfoma não HodgkinRESUMO
INTRODUCCIÓN. El objetivo del estudio fue conocer la opinión del médico de Atención Primaria (AP) ante la obesidad y su motivación para atender a estos pacientes. MATERIAL Y MÉTODOS. Estudio descriptivo transversal.Mil doscientos médicos españoles de AP, muestreo aleatorio estratificado por comunidades autónomas. Encuesta de63 ítems autocumplimentable, datos sociodemográficos, salud del encuestado, opinión sobre la obesidad, motivación para atender a estos pacientes y tratamiento. RESULTADOS. Se repartieron 897 encuestas, respondieron519 (57,9%). Entre estos, el 63,5% eran hombres, grupo de edad entre 45-54 años (61,0%). Un 18,5% fumaban, un91,7% consumió alcohol y un 45,5% practicaban ejercicio. El35,5% tenía sobrepeso y el 4,9%, obesidad. De estos, el15,4% nunca realizó dieta. El 91,9% tenía una percepción buena, muy buena o excelente de su propia salud. El 90,7% (IC 95%; 88,2-93,2) considera la obesidad una enfermedad y el 71,9% causa de muerte prevenible (64,4%zona norte de España p < 0,05). El 58,7% diagnosticó hipertensión o diabetes antes que obesidad. Un 88,3% observó un incremento de la tasa de obesidad entre sus pacientes. El54,1% (IC 95%; 49,8-58,4) consideraban tener habilidad para motivar al paciente. El 50,1% (IC 95%; 45,8-54,4) prefería trabajar con pacientes con normo peso. Un 61,9% veía al obeso como gran comedor, inactivo y que no hacía caso al consejo médico, el 81,3% creían que el obeso se resiste a cambios del estilo de vida a largo plazo. Un 31,8% cree que los profesionales presentan actitudes negativas hacia estos pacientes (20% en la zona sur-este, p < 0,05). Un 52,3% había leído el último año 1-5 artículos sobre obesidad, 34,7% más de seis (44,2% en la zona centro, p < 0,05)...(AU)
INTRODUCTION. The main objective of this study was to know the opinion of primary care physicians (AP) toward obesity and their motivation to attend to these patients. MATERIAL AND METHODS. This was a cross-sectional study that included 1200 Spanish primary care physicians, obtained by stratified random sampling by the Autonomous Communities. Data were obtained regarding a 63 self-administered item survey, socio demographic aspects, health survey, opinion on obesity, motivation to care for these patients and treatment. RESULTS. A total of 897 surveys were distributed, obtaining519 responses (57.9%). Among these, 63.5% were men, with an age group 45-54 years (61.0%), 18.5% smoked,91.7% consumed alcohol, 45.5% practiced exercise, 35.5%were overweight and 4.9% obese. A total of 15.4% had never gone on a diet and 91.9% had a good, very good or excellent perception of their own health. It was found that 90.7% (95% CI; 88.2-93.2) consider obesity as a disease and 71.9% consider that it is a preventable case if death (64.4% north zone of Spain p < 0.05). Hypertension or diabetes, had been diagnosed in 58.7% rather than obesity and 88.3% observed an increase in the rate of obesity among their patients. A total of 54.1% (95% CI; 49.8-58.4) believed that they have ability to motivate the patient, but 50.1% (95% CI; 45.8-54.4) would rather work with normal weight patients. The obese patients are considered to be overeaters, inactive and those who do not follow medical advice by 61.9% and 81.3% believe that obese patients are resistant to long-term lifestyle change. A total of 31.8% believe that the professionals have negative attitudes towards these patients (20% south-east, p < 0.05); 52.3% have read 5articles on obesity, 34.7% more than six (44.2% in the center zone, p < 0.05) in the last year...(AU)